骨关节病与大骨节病关节软骨细胞凋亡的比较

Comparison of Apoptosis of Articular Chondrocytes in the Pathogenesis of Kashin-beck Disease and Primary Osteoarthritis

目的比较成年人大骨节病与骨关节病关节软骨细胞凋亡及凋亡相关调控因子Fas和诱导型一氧化氮合酶(iNOS)的表达分布特点,探讨两种疾病发病机制的异同。方法收集15例大骨节病、15例正常对照以及15例骨关节病的关节软骨,分别采用脱氧核糖核酸末端转移酶介导的脱氧核糖核酸缺口标记(TUNEL)技术和免疫组化法,观察大骨节病、骨关节病和正常对照关节软骨的细胞凋亡率、Fas及iNOS蛋白表达及其分布特点。结果大骨节病及骨关节病关节软骨细胞凋亡率较正常对照高(P<0·01),且关节软骨剥蚀区的细胞凋亡率较未剥蚀区高(P<0·05),但大骨节病与骨关节病之间软骨细胞凋亡率差异无显著性。大骨节病与骨关节病关节软骨Fas及iNOS表达阳性细胞数较正常关节软骨增多(P<0·01),且关节软骨剥蚀区Fas及iNOS表达阳性细胞数较未剥蚀区增多(P<0·05),但大骨节病与骨关节病之间Fas及iNOS表达阳性细胞数差异无显著性。结论骨关节病和大骨节病均存在软骨细胞异常凋亡,Fas和iNOS可能参与了细胞凋亡过程。

Objective To investigate chondrocyte apoptosis and expression of Fas and inducible nitric oxide synthase （iNOS） in articular cartilage in the pathogenesis of Kashin-beck disease （KBD） and primary osteoarthritis （OA）. Methods The collected samples of articular cartilage were divided into three groups： normal control （ 15 cases） , KBD adults （ 15 cases） and OA （ 15 cases）. Chondrocyte apoptosis was detected by terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling method, and Fas and iNOS in articular cartilage were stained by immunohistochemistry. Results The positive percentages of chondrocyte apoptosis stained in articular cartilage of KBD and OA were significantly higher than that of the control （ P 〈 0.01 ） , and the positive percentage of chondrocytes apoptosis in the erosed areas of articular cartilage were significantly higher than in the non-erosed areas in articular cartilage of the same patient with KBD and OA （ P 〈 0.05 ）. There was no significant difference in positive percentage of chondrocytes apoptosis between KBD and OA. The positive percentages of Fas and iNOS in chondrocytes were significantly higher in KBD and OA than in control （ P 〈 0. 01 ）. Significant differences in Fas and iNOS expression between the erosed areas and non-erosed areaswere seen in articular cartilage of patients with KBD and OA （ P 〈 0.05 ）, but such difference did not exist between KBD and OA. Conclusion Cell apoptosis seems to be associated with the pathogenesis of both KBD and OA. Fas and iNOS might mediate chondrocyte apoptosis.