中国骨质疏松杂志

OA患者关节液uPA和MMP-3,9,13,14的表达水平与关节功能的相关性研究

Correlation study between the expression of uPA, and MMP-3, 9, 13, and 14 in the synovial fluid and the joint function in patients with osteoarthritis

DOI：10.3969/j.issn.1006-7108.2014.06.003

中文关键词: 骨关节炎尿激酶型纤溶酶原激活物基质金属蛋白酶关节功能

英文关键词:Osteoarthritis Urokinase-type plasminogen activator Matrix metalloproteinases Joint function

基金项目:国家自然科学基金资助课题（81160225，81260453，81360451）；兵团医学卫生基金（2013BA020）；兵团国际交流与合作专题基金（2012BC002，2011BC004）

作者	单位
王维山1,2 史晨辉1,2 李长俊1 张振东1 陈安民2 郭风劲2*	1.新疆石河子大学医学院附属医院骨科，新疆石河子 832008 2.华中科技大学同济医学院附属同济医院骨科，武汉 430030

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中文摘要:

目的检测OA患者关节液中uPA和MMP-3,9,13,14的含量，探讨其与OA关节功能、疼痛评分之间的相关性。方法收集2007年8月~2010年12月在我院住院行关节镜诊治的膝OA患者关节液标本228份，应用ELISA法检测标本中uPA和MMP-3,9,13,14水平，采用spearman相关分析探讨uPA、MMP-3、MMP-9、MMP-13、MMP-14之间的相关关系，以及它们与关节功能评分(LKSS)、疼痛评分(VAS)之间的相关性。结果膝OA患者关节液中各个降解酶的表达水平分别为uPA（289.16±185.35 ng/mL）、MMP-3(1041.65±657.51 ng/mL)、MMP-9(41.37±28.82 ng/mL）、MMP-13(176.69±90.17 ng/mL）、MMP-14(2.73±1.31 ng/mL)；患者住院时Lysholm评分为（50.56±20.28 分），VAS评分为（6.51±1.43 分）。spearman相关分析显示uPA与MMP-3、uPA与MMP-13、MMP-3与MMP-13表达水平均呈正相关（r=0.695, 0.719, 0.713，P<0.01）, uPA、MMP-9、MMP-14表达水平无相关关系(P >0.05)。uPA、MMP-3和MMP-13均与关节功能评分呈现正相关关系（r=0.574,0.616,0.691，P <0.01），MMP-9和MMP-14与关节功能评分之间无相关关系，uPA、MMP-3,9,13,14与VAS评分均呈现正相关关系（r=0.361,0.417,0.136,0.514, 0.156，P <0.05）。结论在诸多基质降解酶系中，uPA、MMP-3和MMP-13的表达与膝OA临床症状较为密切，尤其是uPA和MMP-13的作用更加显著，研究uPA和MMP-13在OA病理变化中的分子机制，可望为OA的诊治提供新的思路。

英文摘要:

Objective To detect the expression of uPA and MMP-3, 9, 13, and 14 in the synovial fluid in patients with osteoarthritis (OA), and to explore the possible correlation among the expression level, the joint function, and the joint pain level. Methods From August 2007 to December 2010, 228 joint fluid samples were collected from the OA patients, who underwent arthroscopy treatment in our hospital. The expression of uPA and MMP-3, 9, 13, and 14 was determined using the enzyme-linked immunosorbent assay (ELISA). The joint function score was assessed according to the Lysholm system. The joint pain score was assessed using the VAS. The possible correlation among them was analyzed using the Spearman correlative analysis. Results The expression level of uPA, MMP-3, MMP-9, MMP-13, and MMP-14 was 289.16±185.35 ng/mL, 1041.65±657.51 ng/mL 41.37±28.82 ng/mL, 176.69±90.17 ng/mL, and 2.73±1.31 ng/mL, respectively. The Lysholm score (LKSS) was 50.56±20.28, and the VAS score was 6.51±1.43. According to the spearman correlative analyzing results, the positive correlation among the expression of uPA, MMP-3, and MMP-13 was observed (r=0.695, 0.719, and 0.713; P<0.01), while no correlation among the expression of uPA, MMP-9, and MMP-14 was observed (P>0.05). The expression of uPA, MMP-3, and MMP-13 was positively correlated with LKSS (r=0.574, 0.616, and 0.691; P<0.01). No correlation between the expression of uPA, MMP-9, and MMP-14 and LKSS was observed. The expression of uPA, MMP-3, 9, 13, and 14 was positively correlated with VAS (r=0.361, 0.417, 0.136, 0.514, and 0.156; P<0.05). Conclusion The expression of uPA, MMP-3 and MMP-13, especially the expression of uPA and MMP-13, in the synovial fluid is significant correlated with the clinical symptoms in OA. The study of the molecular mechanism of uPA and MMP-13 in the pathological change in OA may provide a new way for the diagnosis and treatment of OA.

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