Clinical application of Cartilage-derived Retinoic Acid-sensitive Protein in Orthopaedic Surgery

测定骨关节炎（CA）和类风湿关节炎（RA）关节液中的浓度。CA中CD-RAP的平均SF浓度显着高于RA。轻度CA组CD-RAP明显高于中、重度CA组。轻度RA组的CD-RAP也显著高于其他RA组，并随疾病进展而下降。免疫组化结果显示，在新生纤维软骨中，CD-RAP表达于软骨细胞的胞浆中。由于CD-RAP主要在年轻和增殖的软骨细胞中产生，这些结果表明SF中的CD-RAP水平反映了关节软骨的重塑，并有可能成为客观评估软骨细胞恢复反应的标志物。此外，髋关节置换术翻修术后滑液中CD-RAP的浓度非常低。该结果支持CD-RAP对软骨细胞的特异性。因为在先前的手术中软骨组织被切除。在脊柱疾病患者的脑脊液中检测了CD-RAP的表达。脊髓型颈椎病、腰椎管狭窄症和腰椎间盘突出症患者的CD-RAP浓度明显高于对照组。对照组的CD-RAP浓度较低，而导致椎管狭窄的脊柱疾病患者的CD-RAP浓度明显较高。CD-RAP因神经结构受损或受压而在脑脊液中表达，可能是脊柱疾病的标志物。使用Sworm大鼠软骨肉瘤分析了CD-RAP的浓度。随着肿瘤的进展，浓度增加。肿瘤切除后血药浓度降至正常范围。结果表明，CD-RAP可能成为软骨肉瘤的潜在标志物。

The concentrations in synovial fluid from osteoarthritis (CA) and rheumatoid arthritis (RA) were measured. The mean SF concentration of CD-RAP was significantly higher in CA than in RA. The CD-RAP in the mild CA group was significantly higher than in the moderate or severe CA groups. CD-RAP in the mild RA group was also significantly higher than in the other RA groups and decreased with disease progression. Immunohistochemical study showed that CD-RAP expression was observed in the cytoplasm of chondrocytes in newly formed fibrocartilage. As CD-RAP is mainly produced in young and proliferating chondrocytes, these results suggest that the level of CD-RAP in SF reflects remodeling of articular cartilage and has a possibility of a marker to objectively estimate the restorative reaction of chondrocytes. In addition, the concentration of CD-RAP in synovial fluid from revision surgery of hip arthroplasty was very low. This result supports specificity of CD-RAP to chondrocytes. because the cartilaginous tissue was excised at the previous surgery.Expression of CD-RAP was measured in cerebrospinal fluid from patients with spinal diseases. The concentrations of CD-RAP in cervical myelopathy, lumbar canal stenosis, and lumbar disc herniation were significantly higher than in the control group. The CD-RAP concentration was low in the control group, whereas it was significantly higher in spinal diseases that cause spinal stenosis. CD-RAP is expressed in cerebrospinal fluid as a result of damage to or stressing of neural structures and could be a marker for spinal diseases.The concentration of CD-RAP was analyzed using Sworm rat chondrosarcoma. The concentration increased with the progression of the tumor. When the tumor was removed, the consentration went tdown to normal range. The results show that CD-RAP could become a potential marker of chondrosarcoma.