Clinical Trial and In Vitro Study for the Role of Cartilage and Synovia in Acute Articular Infection.
Clinical Trial and In Vitro Study for the Role of Cartilage and Synovia in Acute Articular Infection.
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DOI：
10.1155/2015/430324
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发表时间：
2015
影响因子：
4.6
通讯作者：
Schmal H
中科院分区：
文献类型：
--
作者：
Langenmair ER;Kubosch EJ;Salzmann GM;Beck S;Schmal H
Objective.骨关节炎是急性关节感染的长期并发症。然而，软骨和滑膜在这一过程中的作用尚未完全了解。方法.急性关节感染患者入选前瞻性临床试验，并与关节成形术（n = 8）或完整关节（n = 67）患者的渗出液细胞因子组成进行比较。还使用关节感染的人体外模型分析细胞因子和细胞功能。结果关节成形术患者的滑膜IL-1β水平显著较高（p = 0.004）。在无软骨细胞的体外模型中也发现较高的IL-1β浓度（p < 0.05）。抗炎细胞因子IL-4和IL-10在体内和体外一致表达，显示与软骨或软骨细胞的存在无关。相反，FasL水平在体外稳定增加，在没有软骨细胞的情况下达到更高的水平（p < 0.05）。同样，在软骨细胞存在下，感染期间滑膜成纤维细胞（SFB）的活力更高。软骨代谢标志物聚集蛋白聚糖和碱性成纤维细胞生长因子在完整关节中浓度较高，但也由SFB合成。结论.我们的数据表明，软骨的抗炎作用与SFB对感染的抵抗力增强有关，这显示了有效合成软骨代谢物的能力。该试验已在DRKS 00003536，MISSinG注册。
Objective. Osteoarthritis is a long-term complication of acute articular infections. However, the roles of cartilage and synovia in this process are not yet fully understood. Methods. Patients with acute joint infections were enrolled in a prospective clinical trial and the cytokine composition of effusions compared in patients with arthroplasty (n = 8) or with intact joints (n = 67). Cytokines and cell function were also analyzed using a human in vitro model of joint infection. Results. Synovial IL-1β levels were significantly higher in patients with arthroplasty (p = 0.004). Higher IL-1β concentrations were also found in the in vitro model without chondrocytes (p < 0.05). The anti-inflammatory cytokines IL-4 and IL-10 were consistently expressed in vivo and in vitro, showing no association with the presence of cartilage or chondrocytes. In contrast, FasL levels increased steadily in vitro, reaching higher levels without chondrocytes (p < 0.05). Likewise, the viability of synovial fibroblasts (SFB) during infection was higher in the presence of chondrocytes. The cartilage-metabolism markers aggrecan and bFGF were at higher concentrations in intact joints, but also synthesized by SFB. Conclusions. Our data suggest an anti-inflammatory effect of cartilage associated with the SFBs' increased resistance to infections, which displayed the ability to effectively synthesize cartilage metabolites.The trial is registered with DRKS 00003536, MISSinG.