膝关节骨关节炎患者软骨炎症因子表达与病变程度的相关性  

Correlation of the expression of the inflammatory cytokines and the pathological degree in patients with knee osteoarthritis

作　　者：邬波[1,2] 马旭 柳椰[1,2] 王译晗 王佳媛[2] 李重阳 焦递进 Wu Bo;Ma Xu;Liu Ye;Wang Yihan;Wang Jiayuan;Li Chongyang;Jiao Dijin(Department of Joint Surgery,Shenyang Orthopedic Hospital,Shenyang 110044,Liaoning Province,China;Key Laboratory of Osteoarthropathy of Liaoning Province,Shenyang 110044,Liaoning Province,China)

机构地区：[1]沈阳市骨科医院关节外科,辽宁省沈阳市110044 [2]辽宁省骨关节病重点实验室,辽宁省沈阳市110044

出　　处：《中国组织工程研究》2020年第2期236-241,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:在骨性关节炎的发展过程中,导致软骨最终破坏的机制尚不清楚。研究表明,基质金属蛋白酶家族在软骨基质降解中起着重要作用。目的:观察膝关节骨关节炎患者的基质金属蛋白酶3、金属蛋白酶组织抑制因子1表达与病变程度的相关性。方法:研究经沈阳市骨科医院伦理委员会批准。收集行人工全膝关节置换的40例骨关节炎患者的胫骨平台,所有患者均自愿捐赠标本并签署知情同意书。根据Kellgren-Lawrence分级标准评价影像学骨关节炎的分级及分组:对照组6例;KL2级组11例;KL3级组15例;KL4级组14例。将标本行苏木精-伊红染色,采用Mankin病理评分对骨关节炎软骨病理学改变进行组织形态学评估,利用免疫组织化学方法检测各组软骨中的基质金属蛋白酶3和金属蛋白酶组织抑制因子1的水平。结果与结论:①苏木精-伊红染色观察发现,对照组软骨层厚,软骨细胞数量多且排列整齐;KL2组软骨浅表层不平整,偶见裂隙形成;KL3组软骨层纤维化,软骨细胞排列紊乱;KL4组软骨层结构丧失,软骨细胞数量少且排列紊乱;②免疫组织化学方法检测发现,骨关节炎组基质金属蛋白酶3表达均显著高于对照组,并且骨关节炎组中KL2组、KL3组、KL4组的基质金属蛋白酶3表达呈上升趋势(均P<0.05);骨关节炎组金属蛋白酶组织抑制因子1的表达均显著低于对照组,并且骨关节炎组中KL2组、KL3组、KL4组的金属蛋白酶组织抑制因子1表达呈下降趋势(均P<0.05);③基质金属蛋白酶3表达水平与Mankin评分存在显著的正相关(r=0.899,P<0.001);金属蛋白酶组织抑制因子1表达水平与Mankin评分存在显著的负相关(r=-0.903,P<0.001);金属蛋白酶组织抑制因子1表达水平与基质金属蛋白酶3表达水平存在显著的负相关(r=-0.881,P<0.001);④结果说明,骨关节炎患者关节软骨基质金属蛋白酶3和金属蛋白酶组织抑制因子1水平与病变严重程�BACKGROUND:In the development of osteoarthritis,the mechanism underlying cartilage damage is still unclear.Matrix metalloproteinases have been shown to play important roles in cartilage matric degradation.OBJECTIVE:To observe the correlation between the expression of matrix metalloproteinase 3,tissue inhibitor of metalloproteinase-1 and the pathological degree in knee osteoarthritis.METHODS:The study was approved by the Ethics Committee of Shenyang Orthopedic Hospital.The tibial plateaus of 40 patients with knee osteoarthritis who underwent total knee arthroplasty were collected,and all patients signed the informed consents.The classification of osteoarthritis was evaluated according to Kellgren-Lawrence(KL)scale system:11 cases of KL grade 2,15 cases of KL grade 3,and 14 cases of KL grade 4.Control group contained six cases.Samples received hematoxylin-eosin staining.The pathological changes of knee osteoarthritis cartilage were evaluated by Mankin score.Immunohistochemical staining was used to detect the contents of matrix metalloproteinase 3 and tissue inhibitor of metalloproteinase-1 in cartilage.RESULTS AND CONCLUSION:(1)Hematoxylin-eosin staining results showed that in the control group,the layer of cartilage was thick,and there were abundant chondrocytes that arranged regularly.The subcutaneous layer of cartilage in the KL grade 2 group was rugged,and fissure was observed occasionally.Fibrosis of cartilage layer was visible in the KL grade 3 group,and the chondrocytes arranged in disorder.In the KL grade 4 group,the structure of cartilage layer was lost,and there were few chondrocytes that arranged irregularly.(2)Immunohistochemical staining results showed that the expression level of matrix metalloproteinase 3 in the osteoarthritis group was significantly higher than that in the control group.The expression level of matrix metalloproteinase 3 was on a rise in the KL grade 2,3 and 4 groups(all P<0.05).The expression level of tissue inhibitor of metalloproteinase-1 in the osteoarthritis group was significan

关 键 词：骨性关节炎 基质金属蛋白酶3 金属蛋白酶组织抑制因子1 Mankin评分 相关性分析 

分 类 号：R496[医药卫生—康复医学] R684[医药卫生—临床医学]