髋关节骨性关节炎组织学计量与炎性因子表达  

Correlation of histomorphometry and inflammatory factor expression in hip osteoarthritis

作　　者：于腾波[1] 程永帅[1] 孙康[1] 江莉[1] 褚言琛[2] 李富江[1] 寇德伟[2] 张德刚[1] 王爱民[3] 

机构地区：[1]青岛大学医学院附属医院关节外科,266003 [2]青岛大学医学院附属医院创伤外科,266003 [3]第三军医大学大坪医院骨科

出　　处：《中华实验外科杂志》2009年第5期641-643,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨骨性关节炎各组织成分中细胞因子、金属基质蛋白酶等炎性物质表达水平与疾病的关系。方法获取行OA组关节置换及创伤性股骨颈骨折组患者手术时的软骨、滑膜组织和软骨下骨，苏木素-伊红（HE）染色行软骨下骨组织形态计量分析，应用放射免疫测定肿瘤坏死因子（TNF）-α与白细胞介素（IL）-1β，以酶联免疫吸附试验（ELISA）测金属基质蛋白酶（MMP）-9蛋白表达水平，并将两组结果进行t检验，软骨下骨组织计量值与细胞因子水平进行相关分析。结果OA组较非OA对照组软骨下骨骨形成增加，骨质硬化骨小梁数目增加并错乱；滑膜组织中MMP-9表达上调；软骨组织中MMP-9及IL-1β较对照组提高；而在软骨下骨，MMP-9、TNF—α及IL-1β均有增高，并且与软骨下骨组织学改变相关联。结论证实了OA促炎症条件的病理学基础，并且炎性改变与软骨硬化及关节软骨退变相关。Objective： Tolnvestigate the expression of several cytokines,matrix metalloproteinases （MMPs） in osteoarthritis （OA） and control joint tissues, and explore the possible pathological mechanism of inflammation from subehondral bone to test the hypothesis that the severity of hip OA is related to local levels of inflammatory metabolites and their corresponding enzymes. Methods The cartilage, synovial and subchondral bone tissues were collected from patients undergoing operations for OA and femoral head trauma, and the latter worked as control subjects. HE stain was adopted for subchondral bone histomorphometric analysis with 4 parameters including bone volume fraction, trabecular thinness, trabecular number, and trabecular separation. The inflammatory mediators in cartilage, synovial and subchondral bone tissues,such as tumor necrosis factor （TNF）-α and interleukin （IL）-1β were measured by radioimmunoassay, and MMP-9 by ELISA. Correlation of bone tissue histomorphometry and inflammatory factor expression in hip OA was analyzed. Results Increased subchondral bone formation and subchondral bone sclerosis were observed in OA group. For bone tissue histomorphometry, there was significant difference in bone volume fraction,trabeeular number and trabecular separation except trabecular thinness. OA cartilage and synovium tissue revealed significantly higher level of MMP-9 expression ,while IL-1β expression was significantly higher in OA cartilage. Interestingly, MMP-9, TNF-α and IL-1β were all up-regulated in OA subchondral bone, and had good correlation with joint tissue histomorphometrie changes. Conclusion Inflammatory factors were up-regulated in OA joint tissues especially in the subchondral bone, and had good correlation with tissue histomorphometric changes. It also supports the hypothesis that vascularized subehondral region may increase the synthesis of cytokines and MMPs,leading to degradation of adjacent cartilage.

关 键 词：骨性关节炎 细胞因子 金属蛋白酶 髋关节 组织学 

分 类 号：R684.3[医药卫生—骨科学] R135.2[医药卫生—外科学]