The natural history of the anterior cruciate ligament-deficient knee - Changes in synovial fluid cytokine and keratan sulfate concentrations
The natural history of the anterior cruciate ligament-deficient knee - Changes in synovial fluid cytokine and keratan sulfate concentrations
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DOI：
10.1177/036354659702500605
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发表时间：
1997-11-01
影响因子：
4.8
通讯作者：
Evans, CH
中科院分区：
文献类型：
--
作者：
Cameron, M;Buchgraber, A;Evans, CH
通过重建恢复膝关节稳定性，虽然提供了症状缓解，但并未显示出减少前十字韧带断裂后退行性改变的发生率。这表明创伤后骨关节炎可能不仅仅是生物力学的原因，也可能是生物化学的原因。为了验证这一点，我们测量了前十字韧带断裂后膝关节滑液中软骨代谢的七种细胞因子调节因子的水平。我们还检测了关节软骨分解代谢产物硫酸角蛋白，样本人群包括未损伤膝关节(N=10)、急性(N=60)、亚急性(N=18)和慢性(N=8)前交叉韧带缺陷症患者，滑液样本用酶联免疫吸附分析法分析。正常的滑液中含有高水平的白介素L受体拮抗剂，但低浓度的其他细胞因子。韧带断裂后即刻，IL-6、IL-8、肿瘤坏死因子-α、硫酸角蛋白、IL-L水平在整个过程中保持较低水平。随着损伤变为亚急性和慢性，IL-6、肿瘤坏死因子-α和硫酸角蛋白水平下降，但在损伤后3个月仍显著升高，IL-1ra浓度显著下降。粒细胞-巨噬细胞集落刺激因子浓度在急性和亚急性时正常，但在损伤后3个月升高IO倍，我们的数据显示前十字韧带缺失的膝关节内细胞因子和硫酸角蛋白谱持续和演变的紊乱，提示在那里的骨关节炎的发展中有重要的生化因素。
Restoring knee stability through reconstruction, while providing symptomatic relief, has not been shown to decrease the incidence of degenerative changes after rupture of the anterior cruciate ligament. This suggests that posttraumatic osteoarthritis may not be purely biomechanical in origin, but also biochemical. To test this, we measured the levels of seven cytokine modulators of cartilage metabolism in knee joint synovial fluid after anterior cruciate ligament rupture. We also measured keratan sulfate, a product of articular cartilage catabolism, The sample population consisted of patients with uninjured knee joints (N 10), and patients with acute (N = 60), subacute (N = 18), and chronic (N = 8) anterior cruciate ligament-deficient knees, Synovial fluid samples were analyzed by enzyme-linked immunosorbent assays. Normal synovial fluids contained high levels of the interleukin-l receptor antagonist but low concentrations of other cytokines. Immediately after ligament rupture there were large increases in interleukins 6 and 8, tumor necrosis factor alpha, and keratan sulfate, Interleukin-l levels remained low throughout the course. As the injury became subacute and then chronic, interleukin-6, tumor necrosis factor-alpha, and keratan sulfate levels fell but remained considerably elevated 3 months after injury, Concentrations of interleukin-1Ra fell dramatically. Granulocyte-macrophage colony-stimulating factor concentrations were normal acutely and subacutely but by 3 months after injury were elevated IO-fold, Our data reveal a persistent and evolving disturbance in cytokine and keratan sulfate profiles within the anterior cruciate ligament-deficient knee, suggesting an important biochemical dimension to the development of osteoarthritis there.