Etiology of Kaschin-Beck Disease

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Kaschin-Beck disease (KBD) is the most frequent rheumatologic problem of children in norheastern China. Although it is acquired environmentally and frequently leads to life-long crippling, the etiology is still unknown. Professor Iwata visited changchun, Beijing, and Tianjin to examine KBD and other related arthritis patients. Then Professor Suzuki visited Changchun and Chengdu to give lectures on the current status of cartilage research. Finally, Professor Yang came to Osaka and Tokyo to conclude this joint project.Four young macaque monkeys each were fed with grain and water from areas actively endemic or non-endemic for KBD in Henan for 18 months. Both dietary grain and water from geographical areas endemic for KBD induced a sequence of pathological changes in the growth plates and articular cartilage and biochemical changes in the serum and urine of monkeys. These changes are similar to those in human KBD.Cartilage was removed from head of femurs, condyle of femurs, tibia plateaus, and ribs. The content and the rate of synthesis of glycosaminoglycans in various cartilages of monkeys fed grain and water endemic area were lower than those of the coontrol monkeys. The results suggest that the pathological factors of KBD relate both to grain and water in the diet in endemic areas. Another group of monkeys were fed diets of endemic grain and water from that were supplemented with selenium. Cartilages of the selenium-generous group showed significantly higher levels than those in the other groups. However, Selenium supplementation failed to stimulate growth of human infant chondrocytes. Therefore, the data provided little evidence to support the hypothesis that Selenium deficiency is a major etiologic factor in human KBD.Thus, the etiology remains unclear and we need continuing studies of the metabolism and molecular biology of cartilage in KBD in further joint research program.