OBJECTIVE: To analyze the differences in the effects of different mechanical stimuli on cells, cytokines, and proteins in synovial fluid of osteoarthritis joints, and to elucidate the indirect mechanism by which mechanical signals remodel the synovial fluid microenvironment through tissue cells. METHODS: Systematically integrate recent literature, focusing on the regulatory effects of different mechanical stimuli on the physicochemical properties of synovial fluid. Analyze the dynamic process by which mechanical stimuli regulate secretory and metabolic activities through tissue cells, thereby altering the physicochemical properties of cytokines and proteins. RESULTS: Appropriate mechanical stimuli activate mechanical signals in chondrocytes, macrophages, and synovial cells, thereby influencing cellular metabolic activities, including inhibiting the release of pro-inflammatory factors and promoting the secretion of anti-inflammatory factors, and regulating the expression of matrix and inflammation-related proteins such as cartilage oligomeric matrix protein, peptidoglycan recognition protein 4, and matrix metalloproteinases. CONCLUSION Mechanical stimuli act on tissue cells, indirectly reshaping the synovial fluid microenvironment through metabolic activities, thereby regulating the pathological process of osteoarthritis.
Humans ; Osteoarthritis/physiopathology* ; Synovial Fluid/chemistry* ; Chondrocytes/metabolism* ; Cytokines/metabolism* ; Macrophages/metabolism* ; Stress, Mechanical ; Cartilage Oligomeric Matrix Protein/metabolism* ; Matrix Metalloproteinases/metabolism* ; Synovial Membrane/cytology*

OBJECTIVE: To observe the therapeutic effects of different waves of electroacupuncture (EA) on knee osteoarthritis (KOA), and to explore the mechanism of different waves of EA on promoting cartilage repair. METHODS: Ninety- seven patients with KOA were randomly divided into a dilatational wave group (32 cases, 2 cases dropped off), a continuous wave group (32 cases, 2 cases dropped off) and a discontinuous wave group (33 cases, 3 cases dropped off). The same acupoints of Xuehai (SP 10), Liangqiu (ST 34), Dubi (ST 35) and Neixiyan (EX-LE 4) were selected in the three groups. The dilatational wave (frequency of 2 Hz/10 Hz) was used in the dilatational wave group, the continuous wave (frequency of 10 Hz) was used in the continuous wave group, and the discontinuous wave (frequency of 10 Hz) was used in the discontinuous wave group. All the needles were retained for 30 min. All the treatment was given 3 times a week (on Monday, Wednesday and Friday) for 4 weeks. Lysholm knees scoring scale (LKSS) was used to evaluate the knee joint function before and after treatment, and the content of transforming growth factor-β1 (TGF-β1) in the joint effusion before and after treatment was determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: Compared before treatment, the total score and each score of LKSS were increased after treatment in the three groups (all <0.05). The improvements of total score, pain score, instability score, swelling score of LKSS in the continuous wave group and the dilatational wave group were superior to those in the discontinuous wave group (all <0.05). The content of TGF-β1 in the joint effusion in each group was increased after treatment (<0.05), and the improvement in dilatational wave group was superior to thoes in the continuous wave group and the discontinuous wave group (all <0.05). CONCLUSION The three different waves of EA could all improve the clinical symptoms of KOA, which may promote cartilage repair by increasing TGF-β1 content. The dilatational wave had the best overall effect, which can be used as a clinical optimal treatment.
Acupuncture Points ; Electroacupuncture ; Humans ; Knee Joint ; Osteoarthritis, Knee ; therapy ; Synovial Fluid ; chemistry ; Transforming Growth Factor beta1 ; analysis ; Treatment Outcome

OBJECTIVE: To evaluate soluble interleukin-2 receptor alpha chain (sIL-2Rα, sCD25) in serum for the determination of rheumatoid arthritis (RA) activity. METHODS: Peripheral blood was collected from 108 patients with RA, 39 patients with osteoarthritis (OA) and 50 healthy control subjects, and synovial fluids were from 40 patients with RA. The sera from the patients with RA, the disease control group (osteoarthritis), the healthy control group, and the synovial fluids of the RA patients were detected by enzyme-linked immunosorbent assay (ELISA).The clinical manifestations and laboratory parameters of the patients with RA were recorded and the correlation with the serum sCD25 level was analyzed. RESULTS: The serum sCD25 concentration in RA group was (2 886±1 333) ng/L, the serum sCD25 concentration in OA group was (2 090±718) ng/L, and the serum sCD25 concentration in healthy group was (1 768±753) ng/L. The serum sCD25 level in the patients with RA was significantly higher than that in the disease controls and healthy controls (P<0.001). Sensitivity of serum sCD25 in the diagnosis of RA was 66.1% and specificity was 83.0%;serum sCD25 levels and erythrocyte sedimentation rate (r=0.321, P=0.001), C-reactive protein (r=0.446, P<0.001), DAS28 score (r=0.324, P<0.001), joint tenderness count (r=0.203, P=0.024), D-dimer levels (r=0.383, P<0.001), age (r=0.24, P=0.007), IgG (r=0.207, P=0.028), HRF-IgG (r=0.345, P=0.034) showed a significant positive correlation, and disease duration (r=-0.206, P=0.021) showed a negative correlation with sCD25;In patients with rheumatoid arthritis, the positive rates of serum ESR, CRP, and sCD25 were 14.3% (2 cases), 14.3% (2 cases), and 71.4% (10 cases) in the low disease activity group. The positive rates of serum ESR, CRP and sCD25 in the moderate disease activity group were 94.2% (49 cases), 82.7% (43 cases), and 86.5% (45 cases). The positive rates of serum ESR, CRP, and sCD25 in the high disease activity group were 100% (42 cases), 95.2% (40 cases), and 90.5% (38 cases);36 cases of ESR and/or CRP were negative (about 33.3%) in 108 patients, serum sCD5 levels of 17 cases in these 36 cases (about 47.2%)increased, of which 14 cases (about 82.4%) had a DAS28 score higher than 3.2. CONCLUSION The serum sCD25 has a high specificity for diagnosis of RA and a poor sensitivity. The serum level is closely related to the activity of RA, indicating that sCD25 may be involved in the inflammatory process of RA and may become a new inflammatory marker of RA. It is more meaningful for detection of serum sCD25 when RA is active, but ESR and/or CRP is negative.
Arthritis, Rheumatoid/pathology* ; Biomarkers/analysis* ; Blood Sedimentation ; C-Reactive Protein ; Case-Control Studies ; Humans ; Interleukin-2 Receptor alpha Subunit/analysis* ; Osteoarthritis ; Synovial Fluid/chemistry*

BACKGROUNDTuberculosis (TB) remains a major global public health challenge. Articular TB is an important form of extrapulmonary tuberculosis, and its diagnosis is difficult because of the low sensitivity of traditional methods. The aim of this study was to analyze the diagnostic value of T-SPOT.TB on synovial fluid for the diagnosis of articular TB.

METHODSPatients with suspected articular TB were enrolled consecutively between August 2011 and December 2015. T-SPOT.TB was performed on both synovial fluid mononuclear cells (SFMCs) and peripheral blood mononuclear cells (PBMCs). The final diagnosis of articular TB was independent of the T-SPOT.TB result. The diagnostic sensitivity, specificity, predictive value, and likelihood ratio of T-SPOT.TB on SFMCs and PBMCs were analyzed.

RESULTSTwenty patients with suspected articular TB were enrolled. Six were diagnosed with articular TB, and 14 patients were diagnosed with other diseases. Sensitivity and specificity were 83% and 86% for T-SPOT.TB on SFMCs, and 67% and 69% for T-SPOT.TB on PBMCs, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of T-SPOT.TB on SFMCs were 71% and 92%, respectively. The PPV and NPV were 50% and 82% for T-SPOT.TB on PBMCs.

CONCLUSIONSensitivity, specificity, and NPV of T-SPOT.TB on SFMCs appeared higher than that on PBMCs, indicating that T-SPOT.TB on SFMCs might be a rapid and accurate diagnostic test for articular TB.

Adult ; Female ; Humans ; Interferon-gamma Release Tests ; methods ; Male ; Middle Aged ; Pilot Projects ; Synovial Fluid ; chemistry ; Tuberculosis ; diagnosis ; Young Adult

INTRODUCTIONOsteoarthritis (OA) is a progressive degenerative disorder of the articular cartilage. Available diagnostic radiography has been poorly associated with the progress and severity of this clinical disease. As osteogenic protein-1 (OP-1) has been identified as a bone morphogenetic protein with a major role in cartilage repair, we aimed to evaluate its potential role in the diagnosis of OA.

METHODSThis was an experimental study conducted at the Department of Biochemistry, Sikkim Manipal Institute of Medical Sciences, India. Polyclonal antibodies (i.e. anti-OP-1[f]) were raised against OP-1 in mice, and subsequently used in a sandwich enzyme-linked immunosorbent assay (ELISA) to detect the presence of OP-1 in the synovial fluids of 75 osteoarthritic patients. For the purpose of correlation, the radiographic assessments of the knees of the 75 patients were graded using the Kellgren-Lawrence scoring system.

RESULTThe polyclonal antibody (i.e. anti-OP-1[f]) raised against OP-1 was able to detect the presence of OP-1 in the synovial fluids of all the osteoarthritic patients via sandwich ELISA. The level of the OP-1 was found to be much higher than the reference range and correlated positively with the severity of OA (r = 0.24; p = 0.04).

CONCLUSIONOur study shows that the polyclonal antibody, anti OP-1(f), could be used for the immunodiagnosis of osteoarthritis via sandwich ELISA.

Adult ; Aged ; Aged, 80 and over ; Animals ; Antibodies ; chemistry ; Bone Morphogenetic Protein 7 ; chemistry ; immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Knee ; physiopathology ; Mice ; Middle Aged ; Osteoarthritis ; diagnosis ; immunology ; Synovial Fluid ; chemistry

BACKGROUNDProgrammed cell death 5 (PDCD5) is a novel apoptotic regulatory gene that promotes apoptosis in various tumor cells. Studies have shown that PDCD5 accelerates the apoptosis of synoviocytes in vitro, implying a potential role in rheumatoid arthritis (RA) pathogenesis. This study examined the expression of PDCD5 in serum and synovial fluid of RA patients, its effect on the expression of inflammatory cytokine, interleukin-17 (IL-17), and the assessment of disease activity in RA.

METHODSPDCD5 and IL-17 levels in serum and synovial fluid from 18 patients with RA and 22 patients with osteoarthritis (OA) were detected using enzyme-linked immunosorbent assay (ELISA). Concentrations of serum PDCD5 in 40 healthy people were also detected as controls. As disease activity indices, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and X-ray grading scale were also evaluated.

RESULTSSerum and synovial fluid PDCD5 levels in RA patients were significantly higher than those in OA and healthy controls. Serum PDCD5 level was inversely correlated to CRP and ESR, and was significantly higher in the RF negative group than in the positive group. PDCD5 level was also negatively correlated with IL-17 levels both in serum and synovial fluid of RA patients. However, differences in synovial fluid PDCD5 level from RA patients at different Larsen stages were not detectable.

CONCLUSIONSPDCD5 affects RA pathogenesis. Insufficient apoptosis of fibroblast-like synoviocytes and inflammatory cells in RA could increase the expression of PDCD5 protein. As PDCD5 levels correlated negatively with disease activity indices and IL-17 level, PDCD5 could become a target in the diagnosis and treatment of RA.

Aged ; Apoptosis ; Apoptosis Regulatory Proteins ; analysis ; blood ; physiology ; Arthritis, Rheumatoid ; etiology ; Blood Sedimentation ; C-Reactive Protein ; analysis ; Female ; Humans ; Interleukin-17 ; analysis ; blood ; physiology ; Male ; Middle Aged ; Neoplasm Proteins ; analysis ; blood ; physiology ; Synovial Fluid ; chemistry

OBJECTIVETo observe beta-catenin expression of Wnt signaling pathway in rats with knee osteoarthritis, and influence of Bushen Huoxue decoction on beta-catenin and MMP-7 expression of synoviocytes in rats with knee osteoarthritis (OA).

METHODSRats model with knee osteoarthritis were established by Hulth method. Primary synoviocytes and OA synoviocytes were cultured with collagenase digestion method. The cultured synoviocytes were divided into normal group, OA model group and Bushen Huoxue decoction group. Western blotting method was used to detect beta-catenin, MMP-7 protein expression of synoviocytes after acting by Bushen Huoxue decoction for 48 h; ELISA method was used to detect MMP-7 expression of synovial supernatant.

RESULTSOA synoviocytes were cultured successfully. Western blotting showed that beta-catenin, MMP-7 expression in OA synoviocytes was significantly higher than normal group, Bushen Huoxue decoction could significantly reduce beta-catenin, MMP-7 expression; ELISA results showed that MMP-7 expression of OA synovial supernatant was significantly higher than normal synoviocytes supernatant, Bushen Huoxue decoction significantly regulated the level MMP-7 down.

CONCLUSION(1) High expression of beta-catenin in OA synoviocytes indicates that Wnt classical signal pathway is activated in rat with knee osteoarthritis; (2) High expression of MMP-7 expression in OA synoviocytes confirms the MMP-7 is downstream genes of Wnt/beta-catenin signal pathway; (3) Activation of Wnt signal pathway and increase of MMP-7 may cause degradation of articular cartilage, and promote the formation of osteoarthritis; (4) Bushen Huoxue decoction can reduce expression of MMP-7, and promote cartilage repair, which may be one of mechanisms of osteoarthritis.

Animals ; Blotting, Western ; Drugs, Chinese Herbal ; pharmacology ; Enzyme-Linked Immunosorbent Assay ; Male ; Matrix Metalloproteinase 7 ; analysis ; Osteoarthritis, Knee ; drug therapy ; metabolism ; Rats ; Rats, Wistar ; Synovial Fluid ; chemistry ; cytology ; beta Catenin ; analysis

OBJECTIVETo observe the difference in the therapeutic efficacy of warm needling therapy on knee osteoarthritis (KOA) patients of different Chinese medical syndrome types.

METHODSTotally 197 KOA outpatients [including wind-cold-damp retention syndrome (50 cases, 61 knees), yang deficiency cold coagulation syndrome (48 cases, 58 knees), stagnation of blood stasis syndrome (49 cases, 63 knees), and insufficiency of Shen-essence syndrome (50 cases, 66 knees)] were treated with warm needling therapy, 10 days as one therapeutic course, 3 courses in total. The symptom score and changes of clinical efficacy were assessed. The contents of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in the synovial fluid were determined before and after treatment.

RESULTSThe symptom scores and the clinical efficacy were improved in all syndrome groups after treatment (P < 0.05), with the best effects shown in the yang deficiency cold coagulation syndrome (P < 0.05) and the worst effects shown in the stagnation of blood stasis syndrome (P < 0.05). The contents of IL-1, IL-6, and TNF-alpha in the synovial fluid decreased after treatment in all syndrome groups (P < 0.05), with the best effects shown in the yang deficiency cold coagulation syndrome (P < 0.05).

CONCLUSIONWarm needling therapy had favorable therapeutic effects on KOA patients of wind-cold-damp retention syndrome, yang deficiency cold coagulation syndrome, and insufficiency of Shen-essence syndrome, with the best effects shown on KOA patients of yang deficiency cold coagulation syndrome.

Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Interleukin-1 ; analysis ; Interleukin-6 ; analysis ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Osteoarthritis, Knee ; diagnosis ; therapy ; Synovial Fluid ; chemistry ; Tumor Necrosis Factor-alpha ; analysis ; Yang Deficiency ; therapy

This study is to observe anti-inflammation mechanism of Astragalus heteropolysaccharides (AHPS) on rats with adjuvant arthritis (AA). Rats were treated with AHPS (1 000, 500, and 250 mg x kg(-10, ig) and Tripterygium wilfordii polyglycolide (TWP, 60 mg x kg(-1), ig), separately. TNF-alpha and IL-1beta contents in serum were determined with radioimmunoassay, pathomorphologic changes of synovium of knee joint were observed by histological section with HE staining, synoviocyte apoptosis of knee joint of rats was analyzed by Tunel detection, and Bax and Bcl-2 positive expression were detected by immunohistochemical method. The results were as follows: (1) both AHPS and TWP could improve significantly primary and secondary clinical symptoms of rats with AA and inflammatory response in articular synovium; (2) the contents of TNF-alpha and IL-1beta in serum of rats with AA increased significantly composed with those in groups treated with AHPS (1 000 and 500 mg x kg(-1)), and the amount of synoviocyte apoptosis decreased significantly (P < 0.01 or P < 0.05); (3) the positive expression of Bax in synovium of rats with AA was a little bit higher than that in normal control (P > 0.05), but the positive expression of Bcl-2 significantly increased (P < 0.01). AHPS (1 000 and 500 mg x kg(-1)) could up-regulate positive expression of Bax and down-regulate the positive expression of Bcl-2 significantly (P < 0.05 or P < 0.01). The results show that AHPS can evidently decrease TNF-alpha and IL-1beta level in serum of rats with AA, which is one of molecular mechanisms that AHPS has anti-inflammatory properties. AHPS can induce synoviocyte apoptosis of rats with AA, which is achieved by the regulating effect of AHPS on the positive expression of Bax and Bcl-2.
Animals ; Apoptosis ; drug effects ; Arthritis, Experimental ; drug therapy ; metabolism ; pathology ; Astragalus Plant ; chemistry ; Disease Models, Animal ; Interleukin-1beta ; blood ; Male ; Polysaccharides ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Wistar ; Synovial Fluid ; drug effects ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo observe the influence of intra-articular injection of sodium hyaluronate (SH) on the expression of inducible nitric oxide synthase (iNOS) in the synovium and nitric oxide (NO) content in synovial fluid of rabbits with traumatic osteoarthritis (OA).

METHODSSixteen white rabbits underwent unilateral anterior cruciate ligament transection and were randomly divided into 2 groups 5 weeks after the operation. Rabbits in the experimental group received intra-articular injection of 0.3 ml of 1% SH, once a week for 5 weeks. Animals in the control group were treated under the same conditions using physiological saline. All the animals were sacrificed at the 10th week after surgery. The mRNA expression of iNOS in the synovium was analyzed using reverse transcription-polymerase chain reaction. The content of NO in the synovial fluid was assayed.

RESULTSThe level of iNOS expression of the synovium in the experimental group was lower than that in control group (0.47+/-0.09 vs. 0.65+/-0.12, t equal to 3.45, P less than 0.01). Compared with control group, the content of NO decreased significantly in synovial fluid of SH injection group (134.11 micromolar/L +/- 12.47 micromolar/L vs. 152.17 micromolar/L +/- 15.69 micromolar/L, t equal to 2.55, P less than 0.05).

CONCLUSIONSSH significantly decreases the content of NO in the synovial fluid of rabbits with traumatic OA. SH may exert the effect on synovial fluid NO level as a result of the suppression of iNOS expression in the synovium. It may be one of the mechanisms of the therapeutic effect of SH on early traumatic OA.

Animals ; Anterior Cruciate Ligament Injuries ; Hyaluronic Acid ; pharmacology ; therapeutic use ; Nitric Oxide ; analysis ; Nitric Oxide Synthase Type II ; analysis ; Osteoarthritis ; drug therapy ; etiology ; metabolism ; Rabbits ; Random Allocation ; Synovial Fluid ; chemistry ; Synovial Membrane ; enzymology