透明质酸钠预防骨关节炎时Ⅱ型胶原抗体水平的动态变化(英文)

Dynamic changes in level of antibody to type Ⅱ collagen in prevention of osteoarthritis with sodium hyaluronate

背景:研究表明透明质酸钠可作用于机体免疫系统,调节免疫细胞分泌细胞因子变化,从而抑制炎症,对治疗早期骨关节炎具有一定疗效。目的:观察关节腔内注射透明质酸钠预防膝骨关节炎过程中对Ⅱ型胶原抗体水平的影响及其动态变化。设计:随机对照观察。单位:广州市红十字会医院创伤外科研究所。材料:实验于2002-03/08在广州市创伤外科研究所动物及免疫室完成。选用成年新西兰大白兔12只。方法:取12只成年新西兰兔制备Hulth膝骨关节炎动物模型,随机等分为两组,透明质酸钠组和生理盐水对照组。透明质酸钠组术后当时及每2周关节内注射10g/L透明质酸钠1mL至12周;对照组注射生理盐水1mL为对照。各组术前及术后每隔2周收集血清,建立间接夹心酶联免疫吸附法,检测Ⅱ型胶原抗体水平。主要观察指标:对比分析不同时期实验组与生理盐水对照组预防兔膝骨关节炎血清Ⅱ型胶原抗体水平的动态变化及两组组内各时期Ⅱ型胶原水平与术前的比较。结果:所有实验数据均来自12只新西兰大白兔实验结果统计数据。透明质酸钠组术后第6,10,12周Ⅱ型胶原抗体水平与术前比较均显著提高(P<0.05);生理盐水对照组Ⅱ型胶原抗体水平第10周显著高于术前(P<0.05);透明质酸钠组与生理盐水对照组同期比较Ⅱ型胶原抗体水平均无显著差异。结论:骨关节炎使机体产生自身免疫,引起自身Ⅱ型胶原抗体水平增加。透明质酸钠能促进体液免疫应答,导致抗体水平进一步升高。提示注射透明质酸钠治疗膝骨关节炎时,应考虑其免疫调节作用。但值得一提的是,透明质酸钠为糖胺多糖本身不具备产生特异性Ⅱ型胶原抗体的免疫原性,它究竟通过何种途径调节体液免疫应答有待于进一步深入观察。

BACKGROUND： It is indicated in study that sodium hyaluronate （SH） works in body immune system and regulates the changes in immune cell to secrete cellular factors so as to inhibit inflammation, which provides a certain therapeutic effects on treatment of osteoarthritis at early stage. OBJECTIVE： To observe the effects of intraarticular injection of SH on the level of antibody to type Ⅱ collagen during prevention of osteoarthritis in knee and its dynamic changes. DESIGN： Randomized control observation was designed. SETTING： Institute of Traumatic Surgery in Guangzhou Red Crossing Hospital. MATERIALS： The experiment was performed in Animal-Immunity Room of Guangzhou Institute of Traumatology and Surgery from March to August 2002, in which, 12 New Zealand adult white rabbits were employed. METHODS： Twelve New Zealand adult rabhits were employed to prepare Huhh model of osteoarthritis in knee and were randomized equally into two groups, named SH group and the control with physiological saline （PS control）. In SH group, 10 g/L SH （hyalgan） 1mL was injected intraartieularly beginning right after surgery, once every 2 weeks, lasting 12 weeks. In the control group, PS was injected lmL. Serum was collected once every 2 weeks before and after surgery in each group. Indirect enzyme linked immunosorbent assay （ELISA） was established to assay the level of antibody to type Ⅱ collagen. MAIN OUTCOME MEASURES： Control analysis was applied to observe the dynamic changes in level of antibody to type Ⅱ collagen in serum in prevention of osteoarthritis of knee in rabhit between experimental group and PS control at different stages and to compare the level of type Ⅱ collagen at various stages with that before surgery within two groups. RESULTS： All of experimental data were from the experimental results in 12 New Zealand white rabbits. In SH group, on the 6^th, 10^th and 12^th weeks after surgery, the level of type Ⅱ collagen was increased significantly compared with that before surgery （P 〈 0.05） and that on the 10^th week in PS control was higher significantly than that before surgery （P 〈 0.05）. There was no significant difference in the level of type Ⅱ collagen at same stage between SH group and PS control. CONCLUSION： Osteoarthritis produces auto-immunity in body and induces increased level of antibody to type Ⅱ collagen naturally. SH promotes immune response in body fluids and results in further increased level of antibody. It is to suggest that in treatment of osteoarthritis with SH injection in knee, its immune regulation should be considered. It is worth to mention that SH is glycosaminoglycan （GAG） and it is not qualified to produce specific immunogenicity to the antibody of type Ⅱ collagen itself. A further and deep observation is expected on how it regulates immune response in body fluids actually.