体外冲击波治疗兔膝骨关节炎白细胞介素1β及基质金属蛋白酶13的表达.doc

体外冲击波治疗兔膝骨关节炎：白细胞介素1及基质金属蛋白酶13的表达侯晓东1，刘洪柏1，刘克敏21广东省人民医院，广东省医学科学院，广东省广州市 510080；2中国康复研究中心，北京博爱医院，北京市 100068Effects of extracorporeal shock wave therapy on interleukin-1beta and matrix metalloproteinase-13 expression in rabbits with knee osteoarthritisHou Xiao-dong1, Liu Hong-bo1, Liu Ke-min21Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China;2China Rehabilitation Research Center, Beijing Boai Hospital, Beijing 100068, China摘要背景：白细胞介素1和基质金属蛋白13能促进软骨细胞的分解代谢，抑制软骨细胞的合成修复能力，引起细胞外基质的降解，在骨关节炎的发生中有十分重要的作用。目的：观察体外冲击波对兔膝骨关节炎软骨细胞中白细胞介素1和基质金属蛋白酶13表达的影响。方法：将30只新西兰兔随机分为治疗组、模型组、对照组，每组10只。治疗组和模型组均采用改良伸直位固定6周，制备兔膝骨关节炎模型。治疗组造模后给予体外冲击波治疗1次，能流密度0.1 mJ/mm2，冲击次数1 000次。对照组不作任何处理。各组兔于治疗后4周处死，取膝关节液和关节软骨。苏木精-伊红染色和甲苯胺蓝染色法检测各组膝关节病理学形态改变，采用酶联免疫吸附法测定关节液白细胞介素1水平，免疫组化法检测白细胞介素1和基质金属蛋白酶13的表达。结果与结论：治疗组和模型组关节液白细胞介素1水平较对照组明显增高(P 0.01)，治疗结束后治疗组关节液白细胞介素1水平较模型组下降(P 0.05)。治疗组和模型组软骨组织Mankin评分较对照组明显增高 (P 0.01)，治疗结束后治疗组软骨组织Mankin评分较模型组下降(P 0.05)。治疗组和模型组软骨细胞白细胞介素1和基质金属蛋白酶13阳性表达率较对照组明显增高(P 0.01)，治疗结束后治疗组软骨细胞白细胞介素1和基质金属蛋白酶13阳性表达率较模型组下降(P 0.05)。结果可见体外冲击波能下调膝骨关节炎软骨细胞白细胞介素1和基质金属蛋白酶13的表达，促进型胶原和蛋白聚糖的合成，从而对膝骨关节炎起防治作用。中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程全文链接：关键词：组织构建；骨组织工程；体外冲击波；骨关节炎；白细胞介素1；基质金属蛋白酶子13； Abstract：BACKGROUND:Interleukin-1 and matrix metalloproteinase-13 can promote the metabolism of chondrocytes, inhibit the capacity of synthesizing and repairing, induce the degradation of extracellular matrix, and play a crucial role in the occurrence of osteoarthritis.OBJECTIVE:To observe the effects of extracorporeal shock wave therapy on the interleukin-1 and matrix metalloproteinase-13 expression in rabbits with experimental knee osteoarthritis.METHODS:Thirty New Zealand rabbits were randomly and equally divided into treatment group, model group and control group, with 10 rabbits in each group. Model of knee osteoarthritis was established in both the treatment group and model group, using modified plaster cast in extension position for 6 weeks. Then the rabbits of treatment group were treated with extracorporeal shock wave therapy, each 1 000 impulse, at the energy flux density of 0.1 mJ/mm2. There were no treatments in the control group. The rabbits in each group were sacrificed at 4 weeks after treatment, the knee synovial fluid and articular cartilage were collected from the rabbits. The pathological changes of knee joint were detected using hematoxylin-eosin staining and toluidine blue staining. The interleukin-1 and matrix metalloproteinase-13 expression in the synovia was detected using ELISA and immunohistochemical staining respectively.RESULTS AND CONCLUSION:The interleukin-1 concentration in the synovial fluid was significantly higher in the treatment group and model group than the control group (P 0.01), and the treatment group after treatment showed a lower concentration than the model group (P 0.05). Mankin scores in treatment group and model group were significantly increased compared with the control group (P 0.01), and the treatment group after treatment showed a lower score than the model group (P 0.05). The interleukin-1 and matrix metalloproteinase-13 positive expression rates in the treatment group and model group were significantly increased compared with the control group (P 0.01), and the treatment group after treatment showed a lower rate than the model group (P 0.05). The extracorporeal shock wave therapy can downregulate the expression of interleukin-1 and matrix metalloproteinase-13, promote the synthesis of new collagen and proteoglycan, therefore effectively improve the osteoarthritis.中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程全文链接：Key words：low-energy shock waves;osteoarthritis, knee;interleukin-1beta;matrix metalloproteinase-13;中图分类号:R318基金资助:2012年度广东省医学科研基金立项课题(A2012023)，课题名称：低能量ESW对兔实验性骨关节炎关节软骨代谢影响的研究通讯作者:刘克敏，中国康复研究中心，北京博爱医院，北京市 100068作者简介: 侯晓东，男，1972年生，湖南省衡阳市人，汉族，1999年衡阳医学院毕业，主治医师，主要从事骨与关节损伤方面的研究。引用本文:侯晓东,刘洪柏,刘克敏. 体外冲击波治疗兔膝骨关节炎：白细胞介素1及基质金属蛋白酶13的表达J.中国组织工程研究, 2014, 18(15): 2397-2402.Hou Xiao-dong,Liu Hong-bo,Liu Ke-min. Effec