滑膜关节内营养转运的研究

Synovial fluid is made of hyaluronic acid and lubricin, proteinases, and collagenases. The normal synovial fluid contains 3-4 mg/ml hyaluronan (hyaluronic acid), a polymer of disaccharides composed of D-glucuronic acid and D-N-acetylglucosamine joined by alternating beta-1,4 and beta-1,3 glycosidic bonds.
Synovial Fluid Composition and Functions | Bone and Spine
boneandspine.com/synovial-fluid/

老化的关节软骨除了在软骨和滑膜液之间建立的间质液交换机制外,没有其他的营养运输方式进入软骨细胞。血液中分泌的营养在滑液中充分混合,在关节形成过程中进入软骨,与软骨细胞相遇。因此,软骨通透性的局部变化在整个机制中起着非常重要的作用。在分析上,该问题被表述为一个双区域扩散和流动模型:两个接近的软骨表面之间和多孔软骨内部的流动和扩散。耦合混合边值问题的解只能在少数特殊情况下得到。据观察,表层渗透的增加不允许营养进入深层区域的细胞,使它们死亡。在患病的关节,营养运输是非常困难的,因为增加刚性或局部变化的渗透软骨。本文进一步得出结论:对于低分子量溶质,营养输送现象以扩散为主,而对于大分子量溶质,营养输送则以机械泵送为主。

 

 

Knee Surg Sports Traumatol Arthrosc. 2013 Aug; 21(8): 1751–1762.
Nutrition and degeneration of articular cartilage

2013年8月;21日(8):1751 - 1762。

营养和关节软骨的退化

 

介绍

关节软骨是一种无血管组织,由两种潜在的途径滋养:软骨下骨血管的扩散和滑膜液的扩散。这些途径的相对重要性是有争议的[12]。收集到的证据表明,软骨营养缺乏可能是该组织变性的主要原因之一[10,14,15,25]。动物的自显影和示踪研究表明,虽然未成熟的关节软骨可以通过滑膜和软骨下途径获得营养,但成熟动物的关节软骨仅从滑膜液中获得营养,因为软骨下区存在钙化屏障[21-23]。除此之外,Maroudas和Bullough[20]对人体的研究也提供了证据,表明可溶性分子物质只有在未成熟的人体标本中才能从骨髓腔进入软骨。然而,Greenwald和Haynes[9]采用无毒荧光和示踪技术观察了人类股骨头内的血液运动,发现骨髓内的荧光物质可以穿透成人软骨组织[1,2,9]。



虽然这些研究表明关节软骨可以通过软骨下骨髓和滑膜途径获得营养,但这两条途径的相对重要性仍不确定。我们的假设是,来自软骨下骨髓和滑膜液的营养途径在维持成人正常软骨内环境平衡和功能方面起着关键作用。本研究的目的是确定营养途径与关节软骨退变之间的关系。确定哪些航线的营养(软骨下骨髓或滑液)在维持成人正常软骨内稳态中起着至关重要的作用和功能,我们通过SF-only剥夺了关节软骨的营养,BM-only,或both-SFBM使用PVC帽。营养不足的影响被总值断层扫描评估在不同的时间点,组织学分析,免疫组织化学,和实时PCR。

目的

确定滑膜液(SF)或软骨下骨髓(BM)作为软骨变性的营养来源的重要性。



方法

将95个月大的公兔按营养来源随机分为5组:SFBM-both;BM-only;SF-only;None-SFBM;和免费插头(无限制)。用聚氯乙烯(PVC)帽阻塞股骨远端滑车上形成的直径4毫米的圆柱形骨软骨栓的营养。4、8和12周后,通过组织学、免疫组织化学和实时PCR检测软骨的变化。



结果

仅bm组软骨损伤最大,其次为None-SFBM组和sf组。与其他组相比,BM-only组和None-SFBM组的细胞凋亡增加。仅限bm组和非sfbm组的软骨在所有时间点都明显比均为sfbm组和均为自由栓塞组的软骨更薄,而仅限sf组的软骨在8周后出现了这种差异。与sfbm和Free plug相比,各组中collagen和aggrecan mrna的表达均下降,而MMP-3的表达均上升。



结论

我们的数据表明,sf -源性营养是成人软骨结构和功能的主要营养来源。当唯一的营养来源是骨髓时,观察到软骨损伤。

Nutrition and degeneration of articular cartilage
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717153/

 

 

A study of nutritional transport in a synovial joint - ScienceDirect
https://www.sciencedirect.com/science/article/pii/0898122189900436

 

Knee Surg Sports Traumatol Arthrosc. 2013 Aug; 21(8): 1751–1762.

Nutrition and degeneration of articular cartilage

Purpose To determine the importance of synovial fluid (SF) or subchondral bone marrow (BM) as nutrition sources in cartilage degeneration.

Methods Ninety-five-month-old male rabbits were randomly divided into 5 groups according to sources of nutrition: SFBM-both; BM-only; SF-only; None-SFBM; and Free plug (unrestricted). Nutrition to 4-mm-diameter cylindrical osteochondral plugs created on the trochlea of the distal femurs was obstructed by Polyvinyl Chloride (PVC) cap. Cartilage changes were assessed after 4, 8, and 12 weeks by histology, immunohistochemistry, and real-time PCR.

Results Cartilage in the BM-only group suffered the greatest damage, followed by the None-SFBM and SF-only groups. Apoptosis was increased in the BM-only and None-SFBM groups compared with others. Cartilage was significantly thinner at all time points in the BM-only and None-SFBM groups when compared with SFBM-both and Free plug, whereas in the SF-only group, this difference occurred after 8 weeks. Compared with SFBM-both and Free plug, expression of collagen II and aggrecan mRNAs in all groups was decreased but MMP-3 increased, respectively.

Conclusion Our data indicate that SF-derived nutrition is the dominant source of sustenance for adult cartilage structure and function. Cartilage damage is observed when the only nutrition source is the BM.

 

Nutrition and degeneration of articular cartilage
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717153/


 

Synovial fluid sources
Synovial fluid is a plasma dialysate modified by constituents secreted by the joint tissues. The major difference between synovial fluid and other body fluids derived from plasma is the high content of hyaluronic acid (mucin) in synovial fluid. The exact source of the hyaluronic acid has been the subject of debate.
Chapter 86: Synovial Fluid - CAL > Home
cal.vet.upenn.edu/projects/saortho/chapter_86/86mast.htm

 

滑液膜分为两层:外层(内膜下)和内层(内膜)。内层主要由特化巨噬细胞(巨噬细胞样滑膜细胞)和成纤维细胞样滑膜细胞两种类型的细胞组成,在维持关节内稳态中起重要作用。

纤维母细胞样滑膜细胞-维基百科

en.wikipedia.org/wiki/Fibroblast-like_synoviocyte

Synovial membrane is divided into two compartments – the outer layer (subintima) and the inner layer (intima). The inner layer is mainly composed of two cell types, specialized macrophages (macrophage-like synovial cells) and fibroblast-like synoviocytes, which are important in maintaining the internal joint homeostasis.
Fibroblast-like synoviocyte - Wikipedia
en.wikipedia.org/wiki/Fibroblast-like_synoviocyte

 

纤维母细胞样滑膜细胞-概述| ScienceDirect…

https://www.sciencedirect.com/.../immunology-and-microbiology/fibroblast-like-synoviocyte

纤维母细胞样滑膜细胞是间充质来源的合成细胞,是透明质酸和其他在正常滑膜液中发现的前teoglycans的主要来源。摘自:Kelley和Firestein的风湿病学教科书(第十版),2017年。相关术语:肿瘤坏死因子;类风湿性关节炎;关节炎;细胞凋亡;组织;滑膜

Fibroblast-Like Synoviocyte - an overview | ScienceDirect ...
https://www.sciencedirect.com/.../immunology-and-microbiology/fibroblast-like-synoviocyte
Fibroblast-like synoviocytes are synthetic cells of mesenchymal origin that are the primary source of hyaluronan and other pro­teoglycans found in normal synovial fluid. From: Kelley and Firestein's Textbook of Rheumatology (Tenth Edition), 2017. Related terms: Tumor Necrosis Factor Alpha; Inflammatory Arthritis; Arthritis; Apoptosis; Tissues; Synovium

 

Facts About Synovial Fluid Replacement Therapy
https://www.primev.com/hyaluronic-acid-ha/facts-about-synovial-fluid-replacement...
Hyaluronic Acid, the chief constituent of synovial fluid, endows properties like viscosity and elasticity to the fluid. These properties facilitate smooth functioning of bones and cartilage, assisting with joint movement. With advancing years, the Hyaluronic Acid content in synovial fluid drops, and the fluid loses its viscoelasticity.

关于滑液替代治疗的事实

https://www.primev.com/hyaluronic-acid-ha/facts-about-synovial-fluid-replacement..。

透明质酸是滑液的主要成分,赋予滑液粘度和弹性等特性。这些特性有助于骨骼和软骨的平稳运作,协助关节运动。随着年龄的增长,滑液中透明质酸含量下降,滑液失去粘弹性。