Synovial fluid cytokine concentrations as possible prognostic indicators in the ACL-deficient knee.
Synovial fluid cytokine concentrations as possible prognostic indicators in the ACL-deficient knee.
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DOI：
10.1007/bf01552652
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发表时间：
1994-01-01
期刊：
影响因子：
--
通讯作者：
Evans, C H
中科院分区：
文献类型：
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作者：
Cameron, M L;Fu, F H;Evans, C H
如果损伤不修复，大约44%的患者会在前十字韧带(ACL)断裂后发生骨关节炎(OA)。通过重建恢复膝关节的稳定性，虽然提供了症状缓解，但并没有显示出减少退行性变化的发生率。事实上，最近的研究表明，50%-60%的前交叉韧带重建患者继续发展为退行性变化或明显的骨关节炎。根据这些数据，我们的小组认为创伤后骨关节炎的原因不是生物力学的，而是生化的。为了验证这一假设，我们测量了前交叉韧带断裂后膝关节滑液中9种细胞因子的水平，这些细胞因子对调节关节滑液中软骨的生理和病理生理学代谢起重要作用。我们的患者包括急性和慢性前交叉韧带断裂。共采集84份样品，采用酶联免疫吸附试验进行分析。在收集的数据的基础上，我们能够识别出根据他们的滑液细胞因子谱，可能处于更高或更低的创伤后骨性关节炎风险的患者亚组。一般来说，患者的白介素1α、碱性成纤维细胞生长因子、转化生长因子β、粒细胞/巨噬细胞集落刺激因子、白介素6和白介素8的浓度与炎症反应一致。非常有趣的是，这些细胞因子水平在损伤后4周的患者和慢性患者中非常相似，这导致我们假设急性渗出消失后，慢性阴燃炎症反应仍然存在。
Approximately 44% of patients develop osteoarthritis (OA) following rupture of the anterior cruciate ligament (ACL) if the injury is left unrepaired. Restoring knee stability through reconstruction, while providing symptomatic relief, has not been shown to reduce the incidence of degenerative changes. In fact, recent studies have shown that 50%-60% of ACL-reconstructed patients go on to develop degenerative changes or frank osteoarthritis. In light of these data, our group suggests that the cause of post-traumatic osteoarthritis is not biomechanical but biochemical. To test this hypothesis, we measured levels of nine cytokines which are important in modulating physiological and pathophysiological metabolism of cartilage in knee joint synovial fluid following ACL rupture. Our patient population contained both acute and chronic ACL ruptures. A total of 84 samples were collected and analyzed by enzyme-linked immunosorbent assay. On the basis of the data collected, we were able to identify subgroups of patients who, on the basis of their synovial fluid cytokine profile, may be at greater or lesser risk of developing post-traumatic OA. In general, patients displayed concentrations of interleukin-1 alpha (IL-1 alpha), basic fibroblastic growth factor (bFGF), transforming growth factor-beta (TGF-beta), granulocyte/macrophage-colony stimulating factor (GM-CSF), IL-6, and IL-8 that we interpreted as being consistent with an inflammatory reaction. Of great interest is the fact that the levels of these cytokines were very similar in patients 4 weeks after injury and in chronic patients, leading us to hypothesize that a chronic smoldering inflammatory reaction persists after resolution of the acute effusion.(ABSTRACT TRUNCATED AT 250 WORDS)