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目的检测护骨素(OPG)在强直性脊柱炎(AS)外周关节滑膜组织中的表达,并以类风湿关节炎(RA)、骨关节炎(OA)患者和健康志愿者外周关节滑膜组织为对照,了解OPG表达与AS患者外周关节骨质破坏病理改变的相关性。方法应用单克隆抗体,通过免疫组织化学方法检测13例AS、16例RA、17例OA及6名健康对照关节滑膜组织中OPG的表达及分布状况,并通过计算机辅助图像分析系统和半定量分析方法确定OPG在各滑膜组织中表达水平之间的差异,分析OPG表达与炎性指标及关节X线分期之间的相关性。结果OPG蛋白在所有13例AS滑膜组织中均有阳性表达,阳性细胞主要分布于滑膜衬里层、衬里下层区域,滑膜软骨交界区OPG表达明显低于滑膜衬里层和衬里下层;2名健康对照滑膜组织中有阳性表达,但明显低于AS患者组。RA及OA患者组未见OPG阳性表达。结论譹AS组滑膜组织中OPG表达水平明显高于健康对照组(P<0.01),而RA、OA滑膜组织中未见OPG表达,说明OPG的高水平表达是滑膜组织对炎症反应/关节破坏所特有的表现,OPG的局部表达是维持AS关节骨代谢稳定的重要因素,这可能是大多数AS患者外周关节受累预后好于RA的原因之一。譺AS患者组滑膜软骨交界区中OPG表达量显著减少可能是导致关节骨质破坏的重要原因,提示关节局部应用OPG治疗有可能改善受累关节的骨?
Objective To detect the expression of osteoprotegerin (OPG) in peripheral synovial tissue of ankylosing spondylitis (AS) and to evaluate the relationship between osteoporosis (OA) and peripheral synovial membrane in rheumatoid arthritis (RA), osteoarthritis Tissue as a control to understand the correlation between OPG expression and pathological changes of peripheral joint osteoarthritis in AS patients. Methods The expression and distribution of OPG in 13 AS, 16 RA, 17 OA and 6 healthy controls synovial tissue were detected by immunohistochemistry with monoclonal antibody. The expression of OPG in synovial tissue was detected by computer-aided image analysis system and semi-quantitative Analytical methods to determine the expression of OPG in each synovial tissue differences between the analysis of OPG expression and inflammatory markers and the correlation between the X-ray staging. Results The expression of OPG protein in all 13 AS synovial tissues was positive. The positive cells mainly distributed in the synovial lining. The expression of OPG in the lower lining and synovial cartilage junction was significantly lower than that in the synovial lining and lining. 2 There was a positive expression in the healthy control synovial tissue, but significantly lower than the AS patients. There was no OPG positive expression in RA and OA patients. CONCLUSION: The expression of OPG in synovial tissue of AS group was significantly higher than that in healthy control group (P <0.01), while there was no expression of OPG in synovial tissue of RA and OA. The specific expression of joint destruction, the local expression of OPG is to maintain the stability of AS bone metabolism an important factor, which may be the majority of AS patients with peripheral joint involvement prognosis better than RA one of the reasons. The significant decrease of OPG expression in synovial cartilage junction of AS patients may be an important reason leading to the destruction of joint bone. It suggests that the local application of OPG may improve the bone of affected joint.