Characterization of Knee Meniscal Pathology: Correlation of Gross, Histologic, Biochemical, Molecular, and Radiographic Measures of Disease
Characterization of Knee Meniscal Pathology: Correlation of Gross, Histologic, Biochemical, Molecular, and Radiographic Measures of Disease
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DOI：
10.1055/s-0034-1376333
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发表时间：
2015-04-01
影响因子：
1.7
通讯作者：
Cook, James L.
中科院分区：
文献类型：
--
作者：
Roller, Brandon L.;Monibi, Farrah A.;Cook, James L.
半月板病理是一种非常普遍的问题，它不可避免地导致骨关节炎以及相关的疼痛、肿胀和残疾。关于半月板疾病的分子、生化和组织学方面的资料相对较少。这项研究描述了半月板病理在出现症状性骨关节炎时的特征，并将临床和基础科学数据联系起来，试图描绘出临床上相关的疾病机制。接受全膝关节置换术的23例患者的27个膝关节为影响组，6个无症状的老年膝关节为对照组。所有半月板组织均被采集，并对大体和组织病理学进行主观评分。生化分析测定糖胺多聚糖(GAG)含量、胶原(羟脯氨酸)含量和水分含量。实时定量聚合酶链式反应分析参与合成(胶原蛋白1、2、3和6)、降解(基质金属蛋白酶[MMP1、-2、-3、-13])和血管生成(血管内皮生长因子)的基因。采用负重的前后位X线片来确定外侧和内侧椎间的关节间隙测量，并对骨关节炎的变化进行主观评分。对数据进行统计学上的显著差异比较，并确定评估变量之间相关性的存在和强度。病变半月板的大体和组织病理学评分明显高于对照半月板。与对照半月板相比，患侧半月板的水分、蛋白多糖和胶原含量显著增加。与对照组相比，受影响组的COL1、COL3和COL6基因表达水平显著升高。在感染组中，基质金属蛋白酶-13的表达显著增加。MMP2和MMP3在感染组的表达水平明显低于对照组。与外侧椎间相比，受影响组关节间隙明显变窄，内侧椎间隙的X线片评分更高。变量之间存在几个强相关和中等强相关。这些数据表明，半月板病理的体外测量对了解疾病机制和预测临床疾病具有潜在的价值。
Meniscal pathology is an extremely prevalent problem, which inevitably leads to osteoarthritis and associated pain, swelling, and disability. Relatively little data are available regarding the molecular, biochemical, and histologic aspects of meniscal disease. This study characterizes meniscal pathology in the presence of symptomatic osteoarthritis and correlates clinical and basic science data in an attempt to delineate clinically relevant mechanisms of disease. Twenty-seven knees from 23 patients who underwent total knee arthroplasty comprised the affected group and 6 aged non-symptomatic knees were used as controls. All meniscal tissues were harvested and subjectively scored for gross and histologic pathology. Biochemical analyses were performed to determine glycosaminoglycan (GAG) content, collagen (hydroxyproline) content, and water content. Real-time polymerase chain reaction analysis was conducted for genes involved in synthesis (collagens [col] 1, 2, 3, and 6), degradation (matrix metalloproteinases [MMP-1, -2, -3, -13]), and angiogenesis (vascular endothelial growth factor). Weight-bearing, anterior-posterior radiographic views were used to determine joint space measurements for lateral and medial compartments, and were subjectively scored for osteoarthritic changes. Data were compared for statistically significant differences and to determine the presence and strength of correlations among variables assessed. Affected menisci had significantly higher gross and histologic pathology scores compared with control menisci. Affected menisci had significantly higher water, proteoglycan, and collagen content compared with controlmenisci. Col 1, 3, and 6 gene expression levels for the affected group were significantly increased compared with controls. MMP-13 expression was significantly increased for the affected group. MMP-2 and -3 expression levels were significantly lower in the affected group compared with controls. The affected group had significantly more joint space narrowing and higher radiographic scores for medial compared with lateral compartments. Several strong and moderately strong correlations were present between variables. These data suggest that in vitro measures of meniscal pathology have potential value for understanding disease mechanisms and predicting clinical disease.