Decreased lubricin concentrations and markers of joint inflammation in synovial fluids from patients with anterior cruciate ligament injury

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Elsaid, K. A.¹; Fleming, B. C.²; Oksendahl, H. L.¹; Machan, J. T.¹; Fadale, P. D.²; Hulstyn, M. J.²; Shalvoy, R.²; Jay, G. D.²

Decreased lubricin concentrations and markers of joint inflammation in synovial fluids from patients with anterior cruciate ligament injury

Arthritis Rheum. June 2008;58(6):1707-1715

©2008 American College of Rheumatology

Affiliations

¹Rhode Island Hospital, Providence

²Brown University, and Rhode Island Hospital, Providence, Rhode Island
Abstract

Objective: To study the effect of anterior cruciate ligament (ACL) injury on lubricin concentration in synovial fluid (SF) and its correlation with time post-injury, inflammatory cytokines, lubricin degrading enzymes, and SF proteoglycan content.

Methods: SF samples were obtained from both knees of 30 patients with a unilateral ACL insufficiency 32–364 days post-injury. Lubricin, inflammatory cytokines [interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6)] and catabolic enzymes [procathepsin-B and neutrophil elastase (NE)] were quantified in the SF of injured and contralateral (uninjured) joints using ELISAs. Sulfated glycosaminoglycans (sGAG) levels in SF were measured by Alcian blue binding assay.

Results: SF lubricin concentrations were significantly (p<0.001) reduced following ACL injury when compared to the contralateral joint. Within 12-months, the lubricin concentration of the injured knee (slope=0..006, SE=0.00010, p<0.001) approached that of the contralateral knee, which did not change with time (slope=−0.0002, SE=0.00050, p=0.71). TNF-α levels showed a significant negative relationship with log2 lubricin levels. IL-1β, TNF-α, IL-6, procathepsin-B and NE concentrations in injured SF were greater in samples whose injuries were recent compared to those that were chronic. There were no detectable cytokines or enzymes in SF of contralateral joints. sGAG concentrations were significantly (p<0.01) higher in injured SF compared to contralateral joints.

Conclusions: The decrease in SF lubricin concentrations following ACL injury may place the joint at an increased risk of wear-induced damage, as a consequence of lack of boundary lubrication, potentially leading to secondary osteoarthritis. The decrease in SF lubricin was associated with elevation of inflammatory cytokines.
Links

DOI: 10.1002/art.23495

PubMed: 18512776

PubMedCentral: PMC2789974

WoS: 000256724900018
History

Received: 2007-10-17

Accepted: 2008-02-29

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