髋关节骨关节炎与股骨颈骨折患者滑液对去分化软骨细胞VEGF表达的影响  

The VEGF production by dedifferentiated chondrocytes under synovial fluid stimulation from coxarthrosis and femoral neck fracture patients

作　　者：于腾波[1] 程永帅[1] 孙康[1] 刘金钊[1] 王志杰[1] 马学晓[1] 王爱民[2] 

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

出　　处：《中华骨科杂志》2010年第12期1206-1210,共5页Chinese Journal of Orthopaedics

摘　　要：目的研究髋关节骨关节炎（osteoarthritis，OA）及股骨颈骨折（remoralneck fracture，FNF）患者软骨细胞血管内皮生长因子vascularendothelial growthfactor，VEGF）表达，同时对比分析OA滑膜液及创伤后滑膜液对去分化软骨细胞分泌VEGF的影响，从而探索炎性因子致去分化软骨细胞异常的VEGF表达变化。方法取12例髋关节OA与8例FNF患者的软骨进行HE和番红O-固绿染色后行Mankin评分。将OA组及FNF组软骨组织分别粉碎后富集软骨细胞进行单层培养，取细胞换液时遗弃的上清液作为检测标本，以cathepsinB作为检测OA组软骨细胞去分化程度的指标，并且动态检测VEGF水平，并各培养基于传代培养时分别加入OA滑膜液、DMEM及创伤后滑膜液以观察其对软骨细胞VEGF分泌的影响。数据统计分析使用SPSS11．0统计软件。结果OA组软骨Mankin评分明显较骨折组升高，随着培养时间延长软骨细胞逐渐丧失其原有细胞形态并伴显著的cathepsinB上调和VEGF下调；OA滑膜液可促使软骨细胞特别是OA组软骨细胞上调分泌VEGF，但刺激所产生的VEGF较原代培养初期明显减少，而FNF滑膜液对VEGF上调影响不大。结论OA软骨损害Mankin评分与原代培养初期VEGF成正相关；软骨细胞体外原代培养后迅速表现为去分化特性；OA较FNF滑膜液可以促使软骨细胞特别是OA组细胞表达更多的VEGF，提示OA滑膜液参与病程进展，并且OA组软骨细胞病理表型更倾向于表达较多VEGF；而FNF滑膜液则相对有利于维持软骨细胞的原有表型。Objective To investigate the vascular endothelial growth factor （VEGF） expression level by chondrocytes isolated from patients with osteoarthritis （OA） in hip or femoral neck fracture （FNF） and explore the effect of synovial fluid from OA or FNF on secretion of VEGF, Methods The cartilage tissues were collected from 12 patients with OA in hip and 8 patients with FNF. Cartilage was stained with HIM and Safranin O/Fast Green （S/F） method. The damage of cartilage was evaluated using Mankin scores. Cathepsin B which was selected for cell dedifferentiation monitoring marker and VEGF level was detected in the supernatant fluid. The synovial fluid from OA, FNF and DMEM were respectively added to the culture medium to explore their effects on regulating VEGF. Results Cartilage the Mankin scores of OA group were higher than that of FNF group. Chondrocytes gradually lost their original spherical appearance, with Cathepsin B upregulated while VEGF downregulated. The OA synovial fluid can stimulate chongdroeytes to secrete more VEGF than the one from patients with FNF. However, chondroeytes gradually produced less VEGF after passaging. Conclusion Mankin scores had good correlation with chondrocytes VEGF production in the early stage of primary culture. Chondrocytes showed quick dedifferentiation characteristics in vitro. OA synovial fluid showed ahig ger capability in stimulating ehondrocytes to express more VEGF, which might indicate that OA synovial fluid participated in the pathological process of OA.

关 键 词：骨关节炎 髋 股骨颈骨折 软骨细胞 血管内皮生长因子类 

分 类 号：R686[医药卫生—骨科学]