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Markers of cartilage and synovial metabolism in joint fluid and serum of patients with chondromalacia of the patella

Väätäinen, Urho; Lohmander, L. Stefan LU ; Thonar, Eugene; Hongisto, Tero; Ågren, Ulla; Rönkkö, Seppo; Jaroma, Heikki; Kosma, Veli Matti; Tammi, Markku and Kiviranta, Ilkka (1998) In Osteoarthritis and Cartilage 6(2). p.115-124
Abstract

Objective: To further our understanding of the pathogenesis of chondromalacia of the patella (CM), we have studied the release into knee joint fluid and serum, obtained from patients with CM, of molecules associated with the metabolism of joint cartilage matrix and synovium. Methods: Interleukin-1 α (IL-1α), interleukin-1 β (IL-1β), interleukin-6 (IL-6), stromelysin-1 (MMP-3), interstitial collagenase (MMP-1), tissue inhibitor for metalloproteinases-1 (TIMP-1), phospholipase activity A2 (PLA2), hyaluronan (HA), aggrecan fragments (AGN) and antigenic keratan sulfate (KS) were quantified in knee joint lavage fluid from 96 patients with CM; KS and HA also was measured in serum. Chondromalacia was graded on a scale of... (More)

Objective: To further our understanding of the pathogenesis of chondromalacia of the patella (CM), we have studied the release into knee joint fluid and serum, obtained from patients with CM, of molecules associated with the metabolism of joint cartilage matrix and synovium. Methods: Interleukin-1 α (IL-1α), interleukin-1 β (IL-1β), interleukin-6 (IL-6), stromelysin-1 (MMP-3), interstitial collagenase (MMP-1), tissue inhibitor for metalloproteinases-1 (TIMP-1), phospholipase activity A2 (PLA2), hyaluronan (HA), aggrecan fragments (AGN) and antigenic keratan sulfate (KS) were quantified in knee joint lavage fluid from 96 patients with CM; KS and HA also was measured in serum. Chondromalacia was graded on a scale of I to IV according to Outerbridge (1961). The histopathology of the synovial membrane close to the patellofemoral joint was evaluated. Control samples were obtained from nine patients with knee pain presenting with arthroscopically normal knee joints. Results: The concentration of MMP-3, MMP-1 and TIMP-1 proteins in joint lavage fluid were increased in advanced (grade IV) CM, compared with controls. Levels of MMP-1 in lavage fluid correlated with the severity of CM (r = 0.38, P <0.01) and MMP-1 and MMP-3 concentrations correlated with each other (r = 0.45, P <0.001). TIMP-1 was elevated in grade IV CM compared with grades II and III CM (P <0.02, P <0.01). Interleukins (IL-1α, IL-1β and IL-6) showed no significant change in CM. The lavage fluid level of PLA2 increased with the severity of CM (r = 0.40, P <0.001). Serum KS was higher in CM IV than in controls (P = 0.05), while lavage fluid KS concentration was elevated in CM I (P = 0.04). There were no differences in the lavage fluid levels of AGN and HA between the different study groups. Synovium showed slight or moderate histological signs of inflammation in 9% of CM patients. Conclusion: The changes in the release and activity of these marker molecules from serum and synovial fluid may reflect changes in the metabolism of articular cartilage and synovium in CM, that are consistent with those observed in early-stage tibiofemoral cartilage changes in OA.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Chondromalacia, Joint fluid, Knee, Marker, Osteoarthritis
in
Osteoarthritis and Cartilage
volume
6
issue
2
pages
10 pages
publisher
Elsevier
external identifiers
  • Scopus:0032031098
ISSN
1063-4584
DOI
10.1053/joca.1997.0101
language
English
LU publication?
no
id
1a66a6f2-b966-4d2f-ae84-61d797ffe327
date added to LUP
2016-05-04 23:59:24
date last changed
2016-07-15 11:12:05
@misc{1a66a6f2-b966-4d2f-ae84-61d797ffe327,
  abstract     = {<p>Objective: To further our understanding of the pathogenesis of chondromalacia of the patella (CM), we have studied the release into knee joint fluid and serum, obtained from patients with CM, of molecules associated with the metabolism of joint cartilage matrix and synovium. Methods: Interleukin-1 α (IL-1α), interleukin-1 β (IL-1β), interleukin-6 (IL-6), stromelysin-1 (MMP-3), interstitial collagenase (MMP-1), tissue inhibitor for metalloproteinases-1 (TIMP-1), phospholipase activity A<sub>2</sub> (PLA<sub>2</sub>), hyaluronan (HA), aggrecan fragments (AGN) and antigenic keratan sulfate (KS) were quantified in knee joint lavage fluid from 96 patients with CM; KS and HA also was measured in serum. Chondromalacia was graded on a scale of I to IV according to Outerbridge (1961). The histopathology of the synovial membrane close to the patellofemoral joint was evaluated. Control samples were obtained from nine patients with knee pain presenting with arthroscopically normal knee joints. Results: The concentration of MMP-3, MMP-1 and TIMP-1 proteins in joint lavage fluid were increased in advanced (grade IV) CM, compared with controls. Levels of MMP-1 in lavage fluid correlated with the severity of CM (r = 0.38, P &lt;0.01) and MMP-1 and MMP-3 concentrations correlated with each other (r = 0.45, P &lt;0.001). TIMP-1 was elevated in grade IV CM compared with grades II and III CM (P &lt;0.02, P &lt;0.01). Interleukins (IL-1α, IL-1β and IL-6) showed no significant change in CM. The lavage fluid level of PLA<sub>2</sub> increased with the severity of CM (r = 0.40, P &lt;0.001). Serum KS was higher in CM IV than in controls (P = 0.05), while lavage fluid KS concentration was elevated in CM I (P = 0.04). There were no differences in the lavage fluid levels of AGN and HA between the different study groups. Synovium showed slight or moderate histological signs of inflammation in 9% of CM patients. Conclusion: The changes in the release and activity of these marker molecules from serum and synovial fluid may reflect changes in the metabolism of articular cartilage and synovium in CM, that are consistent with those observed in early-stage tibiofemoral cartilage changes in OA.</p>},
  author       = {Väätäinen, Urho and Lohmander, L. Stefan and Thonar, Eugene and Hongisto, Tero and Ågren, Ulla and Rönkkö, Seppo and Jaroma, Heikki and Kosma, Veli Matti and Tammi, Markku and Kiviranta, Ilkka},
  issn         = {1063-4584},
  keyword      = {Chondromalacia,Joint fluid,Knee,Marker,Osteoarthritis},
  language     = {eng},
  number       = {2},
  pages        = {115--124},
  publisher    = {ARRAY(0x76876a0)},
  series       = {Osteoarthritis and Cartilage},
  title        = {Markers of cartilage and synovial metabolism in joint fluid and serum of patients with chondromalacia of the patella},
  url          = {http://dx.doi.org/10.1053/joca.1997.0101},
  volume       = {6},
  year         = {1998},
}