The chondrotoxicity of single-dose corticosteroids
The chondrotoxicity of single-dose corticosteroids
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DOI：
10.1007/s00167-011-1820-6
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发表时间：
2012-09-01
影响因子：
3.8
通讯作者：
Kim, Hyeon Joo
中科院分区：
文献类型：
--
作者：
Dragoo, Jason L.;Danial, Christina M.;Kim, Hyeon Joo
皮质类固醇通常被注射到关节间隙中。然而，研究尚未检查一次性注射剂量的软骨毒性。本研究的目的是评价地塞米松磷酸钠的作用（Decadron（A（R），醋酸甲泼尼龙（Depo-Medrol（A（R）、倍他米松磷酸钠和倍他米松醋酸盐（Celestone（A（R））Soluspan（A（R），和曲安奈德（Kenetamine（A（R）对体外人软骨细胞活力的影响。将注射剂量的每种皮质类固醇分别递送至人软骨细胞，持续它们各自的平均作用持续时间，新陈代谢.还进行了为期14天的时间对照试验。活/死减少生物危害活力/细胞毒性测定用于量化软骨细胞活力。在其平均作用时间内，与对照培养基相比，倍他米松磷酸钠/醋酸钠溶液和曲安奈德导致软骨细胞活力显著降低（分别为19.8 +/- A 2.9%与5.2 +/- A 2.1%，P = 0.0025和10.2 +/- A 1.3%与4.8 +/- A 0.9%，P = 0.0049）。在14天的试验中，与对照培养基相比，仅倍他米松磷酸钠/乙酸钠溶液导致软骨细胞活力显著降低（21.5%对4.6%，P < 0.001）。使用生理学相关的体外模型，单次注射倍他米松磷酸钠和倍他米松乙酸钠溶液显示出一致且显著的软骨毒性，应谨慎使用。鉴于在一项试验中观察到的曲安奈德的软骨毒性，可能有一些证据表明这种药物是软骨毒性的。然而，在第14天，磷酸倍他米松钠和醋酸倍他米松是导致显著细胞死亡的唯一条件。
Corticosteroids are commonly injected into the joint space. However, studies have not examined the chondrotoxicity of one-time injection doses. The purpose of this study is to evaluate the effect of dexamethasone sodium phosphate (Decadron(A (R))), methylprednisolone acetate (Depo-Medrol(A (R))), betamethasone sodium phosphate and betamethasone acetate (Celestone(A (R)) Soluspan(A (R))), and triamcinolone acetonide (Kenalog(A (R))) on human chondrocyte viability in vitro.Single-injection doses of each of the corticosteroids were separately delivered to human chondrocytes for their respective average duration of action and compared to controls using a bioreactor containing a continuous infusion pump constructed to mimic joint fluid metabolism. A 14-day time-controlled trial was also performed. A live/dead reduced biohazard viability/cytotoxicity assay was used to quantify chondrocyte viability.Over their average duration of action, betamethasone sodium phosphate/acetate solution and triamcinolone acetonide caused significant decreases in chondrocyte viability compared to control media (19.8 +/- A 2.9% vs. 5.2 +/- A 2.1%, P = 0.0025 and 10.2 +/- A 1.3% vs. 4.8 +/- A 0.9%, P = 0.0049, respectively). In the 14-day trial, only betamethasone sodium phosphate/acetate solution caused a significant decrease in chondrocyte viability compared to control media (21.5% vs. 4.6%, P < 0.001).A single-injection dose of betamethasone sodium phosphate and betamethasone acetate solution illustrated consistent and significant chondrotoxicity using a physiologically relevant in vitro model and should be used with caution. Given the observed chondrotoxicity of triamcinolone acetonide in a single trial, there may be some evidence that this medication is chondrotoxic. However, at 14 days, betamethasone sodium phosphate and betamethasone acetate was the only condition that caused significant cell death.