Repeated intraarticular injections of triamcinolone acetonide alter cartilage matrix metabolism measured by biomarkers in synovial fluid
Repeated intraarticular injections of triamcinolone acetonide alter cartilage matrix metabolism measured by biomarkers in synovial fluid
复制标题
DOI：
10.1016/j.orthres.2004.10.003
复制
发表时间：
2005-05-01
影响因子：
2.8
通讯作者：
Laverty, S
中科院分区：
文献类型：
--
作者：
Céleste, C;Ionescu, M;Laverty, S
尽管关节内（IA）皮质类固醇常用于治疗关节疾病，但其反复使用对关节软骨的影响仍存在争议。本研究的目的是确定临床推荐剂量的曲安奈德（TA）对软骨代谢滑膜液（SF）生物标志物的影响。研究了10匹成年马的桡腕关节骨关节炎（OA）。每匹马随机选择一个桡腕关节进行治疗，对侧解剖配对关节作为对照。两关节每周进行无菌关节穿刺，连续13周。实验前3周的初步结果确定了每个关节未经治疗的基线对照标志物水平，每个关节都是自己的对照。在第3周、第5周和第7周，将含有12 mg TA的无菌悬液注射到治疗关节中，并将等量的0.9%无菌生理盐水溶液注射到对照组关节中。SF免疫检测聚集蛋白转换（CS 846 & KS）、I型和II型胶原裂解（C1, 2C）和II型胶原合成（CPH）的生物标志物。在治疗关节中，与基线水平相比，注射IA TA后CS 846、KS、C1、2C和CPH表位浓度显著增加。在治疗关节注射IA TA后，对侧对照关节中C1、2C和CPH表位浓度也显著增加。治疗组和对照组关节除。领域。这些发现表明，TA改变了治疗关节软骨和胶原蛋白代谢，有趣的是，也改变了对照关节，这表明药物具有全身作用。虽然观察到的结果直观地支持长期内酯类药物治疗改变关节代谢的假设，这可能有有害的影响；需要进一步的研究来证实这一点。(c) 2004年骨科研究学会。Elsevier Ltd.出版。版权所有。
Although intraarticular (IA) corticosteroids are frequently used to treat joint disease, the effects of their repeated use on articular cartilage remains controversial. The aim of our study was to determine the effects of a clinically recommended dose of IA triamcinolone acetonide (TA), on synovial fluid (SF) biomarkers of cartilage metabolism. Ten adult horses, free of osteoarthritis (OA) in their radiocarpal joints, were Studied. One radiocarpal joint of each horse was randomly chosen for treatment and the contralateral anatomically paired joint acted as the control. Aseptic arthrocentesis was performed weekly on both joints for 13 weeks. The initial results from the first 3 weeks of the experimental period established baseline untreated control marker levels for each joint, each being its own control. On weeks 3, 5, and 7, a sterile suspension of 12 mg of TA was injected into the treated joint and an equivalent volume of sterile saline solution (0.9%) was injected into the control joint. SF was immunoassayed for biomarkers of aggrecan turnover (CS 846 & KS), types I and II collagen cleavage (C1, 2C) and type II collagen synthesis (CPH). In treated joints, there was a significant increase in CS 846, KS, C1,2C and CPH epitope concentrations following IA TA injections when compared to baseline levels. There was also a significant increase in C1,2C and CPH epitope concentrations in the contralateral control joints following IA TA injections in the treated joint. Significant differences were observed between treated and control joints for all markers except. CPII. These findings indicate that TA alters articular cartilage and collagen metabolism in treated and, interestingly, also in control joints, suggesting a systemic effect of the drug. Though intuitively the observed findings would favor the hypothesis that long-term IA TA treatment changes joint metabolism and this may have detrimental effects; further studies would be necessary to confirm this. (c) 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.