Inflammatory Cells in Patients with Endstage Knee Osteoarthritis: A Comparison between the Synovium and the Infrapatellar Fat Pad
Inflammatory Cells in Patients with Endstage Knee Osteoarthritis: A Comparison between the Synovium and the Infrapatellar Fat Pad
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DOI：
10.3899/jrheum.151068
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发表时间：
2016-04-01
影响因子：
3.9
通讯作者：
Ioan-Facsinay, Andreea
中科院分区：
文献类型：
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作者：
Klein-Wieringa, Inge R.;de lange-Brokaar, Badelog J. E.;Ioan-Facsinay, Andreea
目标。为了更好地了解骨关节炎(OA)关节中活跃的炎症途径，我们对膝关节炎患者滑膜和髌下脂肪垫(IFP)中的炎症细胞进行了表征和比较。采用流式细胞术对76例膝关节骨性关节炎患者(平均年龄63.3岁，女性52%，中位体重指数28.9)的免疫细胞浸润性进行了研究。疼痛评分采用视觉模拟评分(VAS，0~100 mm)。进行Spearman等级相关分析和调整了性别和年龄的线性回归分析。巨噬细胞和T细胞，其次是肥大细胞，是滑膜和IFP中最主要的免疫细胞，在这些组织中同样丰富。巨噬细胞和T细胞即使在没有额外刺激的情况下也会分泌大部分促炎细胞因子，这表明它们处于激活状态。因此，大多数CD4+T细胞具有记忆表型，并含有大量表达激活标记(CD25+，CD69+)的细胞。有趣的是，CD69+T细胞在滑膜中的百分比高于IFP中的CD4+T细胞。初步分析表明，滑膜中CD4+T细胞的数量与VAS疼痛有关(β0.51，95%可信区间0.09~1.02，P=0.02)。我们的数据表明，滑膜和IFP的免疫细胞成分相似，包括可能通过分泌促炎细胞因子而导致炎症的激活细胞。此外，初步分析表明，滑膜中的CD4+T细胞可能与膝关节终末期骨性关节炎患者的疼痛有关。
Objective. To get a better understanding of inflammatory pathways active in the osteoarthritic (OA) joint, we characterized and compared inflammatory cells in the synovium and the infrapatellar fat pad (IFP) of patients with knee OA.Methods. Infiltrating immune cells were characterized by flow cytometry in 76 patients with knee OA (mean age 63.3, 52% women, median body mass index 28.9) from whom synovial tissue (n = 40) and IFP (n = 68) samples were obtained. Pain was assessed by the visual analog scale (VAS; 0-100 mm). Spearman rank correlations and linear regression analyses adjusted for sex and age were performed.Results. Macrophages and T cells, followed by mast cells, were the most predominant immune cells in the synovium and IFP, and were equally abundant in these tissues. Macrophages and T cells secreted mostly proinflammatory cytokines even without additional stimulation, indicating their activated state. Accordingly, most CD4+ T cells had a memory phenotype and contained a significant population of cells expressing activation markers (CD25+, CD69+). Interestingly, the percent of CD69+ T cells was higher in synovial than IFP CD4+ T cells. Preliminary analyses indicated that the number of synovial CD4+ T cells were associated with VAS pain (beta 0.51, 95% CI 0.09-1.02, p = 0.02).Conclusion. Our data suggest that the immune cell composition of the synovium and the IFP is similar, and includes activated cells that could contribute to inflammation through secretion of proinflammatory cytokines. Moreover, preliminary analyses indicate that synovial CD4+ T cells might associate with pain in patients with endstage OA of the knee.