Subchondral Trabecular Rod Loss and Plate Thickening in the Development of Osteoarthritis
Subchondral Trabecular Rod Loss and Plate Thickening in the Development of Osteoarthritis
复制标题
骨关节炎发展过程中的软骨下小梁杆丢失和骨板增厚
DOI：
10.1002/jbmr.3313
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发表时间：
2018-02-01
影响因子：
6.2
通讯作者：
Guo, X. Edward
中科院分区：
文献类型：
--
作者：
Chen, Yan;Hu, Yizhong;Guo, X. Edward
骨性关节炎(OA)是一种常见的致残性疾病，开发有效的治疗方法仍然是一个挑战，主要是因为对其发病机制的了解有限，诊断较晚。在软骨下骨中，创伤后的快速骨质丢失和晚期骨质疏松症是该疾病公认的特征。最近的研究进一步证明了软骨下骨在骨性关节炎发生发展中的重要作用。然而，这些骨骼变化的微观结构基础还没有得到彻底的研究，异常吸收最终如何导致骨硬化的悖论仍然没有答案。通过将一种新的显微结构分析技术--个体小梁分割(ITS)应用于人膝骨关节炎的μCT图像，我们发现在严重受损和仍然完整的软骨下，棒状小梁严重丧失，板状小梁增厚，持续存在于胫骨平台的所有区域。骨小梁同时减少和骨小梁板增厚，为观察到骨性关节炎患者软骨下骨的动态和矛盾变化提供了重要的见解。此外，使用已建立的自发性骨性关节炎的豚鼠模型，我们发现在软骨退化之前类似的小梁杆丢失和板层增厚。因此，我们的研究表明，软骨下松质骨中的杆板微结构变化可能在骨性关节炎的发生发展中发挥重要作用，而先进的微结构分析技术，如ITS，对于检测这些早期但微妙的变化是必要的。随着新兴的高分辨率骨骼成像技术如高分辨率外周定量计算机断层扫描(HR-pQCT)的出现，ITS确定的骨小梁丢失有可能在未来的纵向研究或临床诊断中作为评估OA进展的一个标志物。©2017美国骨与矿物研究学会。
Developing effective treatment for osteoarthritis (OA), a prevalent and disabling disease, has remained a challenge, primarily because of limited understanding of its pathogenesis and late diagnosis. In the subchondral bone, rapid bone loss after traumatic injuries and bone sclerosis at the advanced stage of OA are well‐recognized hallmarks of the disease. Recent studies have further demonstrated the crucial contribution of subchondral bone in the development of OA. However, the microstructural basis of these bone changes has not been examined thoroughly, and the paradox of how abnormal resorption can eventually lead to bone sclerosis remains unanswered. By applying a novel microstructural analysis technique, individual trabecula segmentation (ITS), to micro‐computed tomography (μCT) images of human OA knees, we have identified a drastic loss of rod‐like trabeculae and thickening of plate‐like trabeculae that persisted in all regions of the tibial plateau, underneath both severely damaged and still intact cartilage. The simultaneous reduction in trabecular rods and thickening of trabecular plates provide important insights to the dynamic and paradoxical subchondral bone changes observed in OA. Furthermore, using an established guinea pig model of spontaneous OA, we discovered similar trabecular rod loss and plate thickening that preceded cartilage degradation. Thus, our study suggests that rod‐and‐plate microstructural changes in the subchondral trabecular bone may play an important role in the development of OA and that advanced microstructural analysis techniques such as ITS are necessary in detecting these early but subtle changes. With emerging high‐resolution skeletal imaging modalities such as the high‐resolution peripheral quantitative computed tomography (HR‐pQCT), trabecular rod loss identified by ITS could potentially be used as a marker in assessing the progression of OA in future longitudinal studies or clinical diagnosis. © 2017 American Society for Bone and Mineral Research.