OA患者关节液与血清中金属蛋白酶及其抑制剂的检测及临床意义

Serum and synovial fiuid levels of matrix metalloproteinases and its tissue inhibitor in patients with os-teoarthritis

目的 本文探讨基质金属蛋白酶（MMP-3、MMP-1）及组织抑制剂（TIMP-1）对骨关节炎发病作用机理研究。方法 对46例膝关节骨性关节炎患者,20例正常人血清标本,以及8例正常人关节液标本中的MMPs,TIMP及细胞因子进行了研究。MMP-3、MMP-1、TIMP-1的检测均采用双抗体夹心ELISA法。结果OA患者血清中MMP-3、MMP-1的水平没有性别差异,患者关节液中的MMP-3含量男性显著高于女性,约为1～2.5倍。患者关节液中MMP-3、MMP-1、TIMP-1的含量均显著高于血清中的含量。患者血清中只有MMP-3的水平显著高于正常对照组,MMP-1、TIMP-1的水平与正常对照组无显著性差异;而关节液中MMP-3、MMP-1、TIMP-1的水平均显著高于正常对照组。本研究结果还显示MMP-3、MMP-1和TIMP-1与病程成正相关。结论OA患者关节液中MMP-3水平增高的幅度比TIMP-1要大,由于二者间的相对平衡被破坏而促进了关节软骨的降解,导致关节软骨进行性破坏。

Objective To measure serum and synovial fluid levels of matrix metalloproteinases(MMP-3, MMP-1),and tissue inhibitor of metalloproteinases(TIMP-1) for the investigation of the mechanism of os-teoarthritis (OA) Methods 46 patients with knee osteoarthritis were studied and 20 specimens of normal serum and 8 specimens of normal synovial fluid were used for the measurements. Serum and synovial fluid levels of MMPs(MMP-3,MMP-1) ,TIMP(TIMP-1) were measured by enzyme immunoassays.Results In the OA patients, the synovial fluid levels of MMP-3,MMP-1,TIMP-1 were both significantly higher than that in the serum,MMP-3 was approximately 200 times higher than in serum. Only the synovial fluid level of MMP-3 was higher in males than in females. The synovial fluid levels of MMP-1, MMP-3 ,TIMP-1 were elevated in OA when compared with normal, with only higher levels of MMP-3 in serum found in OA. The synovial fluid concentration of MMP-3,MMP-1 and TIMP-1 were related to the degree of OA. Conclusion These findings demonstrate that the balance between the synovial fluid level of MMP-3 and TIMP-1 is broken and might promote cartilage degradation.