Subchondral cyst development and MMP-1 expression during progression of osteoarthritis: An immunohistochemical study
Subchondral cyst development and MMP-1 expression during progression of osteoarthritis: An immunohistochemical study
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DOI：
10.1016/j.otsr.2013.03.019
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发表时间：
2013-09-01
影响因子：
2.3
通讯作者：
Papadimitriou, E.
中科院分区：
文献类型：
--
作者：
Kaspiris, A.;Khaldi, L.;Papadimitriou, E.
背景：软骨下骨囊肿(SBC)的形成常见于骨关节炎患者。此外，已有多项研究表明基质金属蛋白酶(MMPs)在骨性关节炎患者中的表达升高。目的：本研究的目的是探讨Sbcs和MMP1的表达与骨性关节炎进展过程中的骨软骨改变之间的关系。作为对照，我们使用了三名患者的股骨头作为对照，这些患者的股骨头没有明显的骨性关节炎变化。结果：根据Mankin组织学严重程度评分，标本被分为四组。利用免疫组织化学方法，我们发现了疾病最严重部位的SBCs。具体地说，与I组(Mankin：1-3)和II组(Mankin：4-5)相比，III组(Mankin评分：6-7)和IV组(Mankin：>；=8)出现这些症状的频率更高。轻度OA期(Mankin：1-6)的特征是软骨变性和变薄，随后下层骨的成骨细胞和破骨细胞活性增加，随后出现SBCs。同时观察I、II组在软骨中的表达，III、IV组在软骨和软骨下骨中的表达。结论：本研究提供了免疫组织学证据表明，在进展期的骨性关节炎中，成骨细胞中含有表达基质金属蛋白酶-1的活化细胞，提示其可能参与了骨软骨的改变。证据水平：三级；前瞻性比较研究。(C)2013年爱思唯尔·马森公司。版权所有。
Background: Subchondral bone cyst (SBC) formation is often identified in patients with osteoarthritis. Furthermore, several studies have shown that expression of matrix metalloproteinases (MMPs) is elevated in patients with OA.Objectives: The aim of our study is to correlate the presence of SBCs and MMP-1 expression with the osteochondral alterations during OA progression.Methods: We studied the cartilage and subchondral bone of 15 patients who had undergone total knee or hip replacement due to primary OA. As controls, we used the femoral heads of three patients without macroscopic OA changes. We evaluated three specimens per patient.Results: Specimens were divided in four groups based on the Mankin histological severity score. Using immunohistochemistry, we noted SBCs at the site of greatest disease severity. Specifically, these were present more frequently in group III (Mankin score: 6-7) and IV (Mankin: >= 8), compared with group I (Mankin: 1-3) and II (Mankin: 4-5). Mild OA stages (Mankin: 1-6) were characterized by degeneration and thinning of the cartilage, followed by increased osteoblast and osteoclast activity of the subjacent bone and the subsequent appearance of SBCs. Simultaneously, we observed expression of MMP-1 in groups I and II in the cartilage and III and IV in both the cartilage and the subchondral bone. Moreover, osteoblast-like cells in the lining of the SBCs showed an increased expression of MMP-1 in stages III and IV.Conclusion: Our study provides immunohistological evidence that SBCs accumulate in advanced OA and contain activated cells, which express MMP-1, suggesting that they may thus participate in the osteochondral changes of OA. Level of evidence: Level III; prospective comparative study. (C) 2013 Elsevier Masson SAS. All rights reserved.