应用磁热疗法治疗膝骨关节炎的疗效观察及机制

The curative effect and mechanism of magnetic hyperthermia in the treatment of knee osteoarthritis

目的结合传统热疗理念与磁感应技术,原创性用磁热疗法治疗膝骨关节炎(knee osteoarthritis,KOA)并探索其机制,以建立具有现代医学特色的KOA治疗新方法。方法建立大鼠原发性KOA模型,并构建以涡旋磁氧化铁纳米环为平台的高效磁热疗介质,在低强度磁场条件下对KOA病灶部位进行精准控温加热,通过痛觉、膝关节组织病理学、膝关节形态和MicroCT显微骨结构变化等临床指标检测及血清炎症因子含量测定等,观察磁热治疗KOA的疗效及机制。结果经磁热治疗后大鼠的机械痛阈值相比模型组提高了约48.9%,关节囊和滑膜组织充血、水肿及软骨表面磨损程度较模型组均明显减轻,Mankin及OARSI评分分别降低了约33%和20%,MicroCT结果显示软骨下骨的硬化程度有所改善,血清中炎症因子含量降低。结论利用涡旋磁氧化铁纳米环设计并构建高效磁热疗纳米制剂,应用于KOA的治疗有确切疗效,其机制与抑制炎症因子有关。

Objective We combined the concept of traditional medicine with magnetic induction technology,originally brought up the research concept of magnetic hyperthermia to cure KOA,explored the mechanism and constructed a new treatment of KOA with modern medical features.Methods Through establishing a primary KOA model in rats and constructing ferrimagnetic vortex domain iron oxide nanorings(FVIOs)as a platform for highly efficient magnetic hyperthermia agent,the lesions of KOA were heated accurately under the low-intensity magnetic field.We confirmed the curative effect through the results of pain perception,histopathology,knee joint morphology and microscopic bone structure and the content of serum inflammatory factor,to study the therapeutic mechanism of magnetic hyperthermia for KOA.Results Compared with the model group,the recovery of mechanical pain threshold after magnetic hyperthermia improved by approximately 48.9%;the degree of hyperemia and edema of joint capsule and synovial tissue and the wear degree of joint cartilage surface,were significantly reduced;the Mankin and OARSI scores decreased by about 33%and 20%,respectively;the MicroCT results indicated that the degree of hardening of the subchondral bone also improved;the expression of inflammatory factors in the serum was reduced.Conclusion In this study,we utilized the FVIOs as a high-efficiency magnetic hyperthermia platform for the treatment of KOA.The efficacy of magnetic hyperthermia on KOA is clarified,and the mechanism is related to the inhibition of inflammatory factors.