Effect of sodium hyaluronate on nitric oxide and synovial thickness in patients with knee osteoarthritis

doi:10.3969/j.issn.2095-4344.2014.52.028

Abstract

Abstract:

BACKGROUND: Intra-articular injection of sodium hyaluronate has become a preventive and complementary therapy for knee osteoarthritis that can effectively relieve pain, protect the articular cartilage, and restore the joint function.

OBJECTIVE: To observe the effects of sodium hyaluronate on nitric oxide and synovial thickness in patients with knee osteoarthritis.

METHODS: Eighty patients with knee osteoarthritis (86 knees) were randomly selected and divided into mild, moderate, severe groups. Intra-articular injection of 25 mg sodium hyaluronate was done once a week for 5 consecutive weeks. At 4 and 12 weeks after treatment, all the patients were subjected to clinical scoring according to the Japanese Knee Osteoarthritis Measure. Thirty-seven patients (40 knees) who could make joint fluid and complete ultrasonic measurement was taken as a complete monitoring group that was also divided into three groups of mild, moderate, and severe. Levels of nitric oxide and synovial thickness were measured before and at 4 weeks after treatment.

RESULTS AND CONCLUSION: At 4 weeks after treatment, the effective rates of mild, moderate and severe groups were 93%, 77% and 47 %, respectively, and the total effective rate was 79%. At 12 weeks after treatment, the effective rates of mild, moderate and severe groups were 95%, 84% and 33 %, respectively, and the total effective rate was 80%. In the complete monitoring group, the level of nitric oxide was reduced significantly in mild, moderate and severe patients at 4 weeks after treatment compared with before treatment (P < 0.05), but the synovial thickness had no difference in the mild and severe patients, and only moderate patients appeared to have thinner synovial thickness compared with before treatment (P < 0.05). Experimental findings suggest that sodium hyaluronate can reduce the level of nitric oxide and improve clinical efficacy in patients with knee osteoporosis, especially for mild and moderate knee osteoporosis patients.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: osteoarthritis, synovial membrane, nitric oxide

CLC Number:

R318

Deng Jian-feng, Gao Da-xin, Liu Zhi-xin, Wu Di, Song Hong, Yan Jia-liang, Qi Xi-ming, Sun Feng-li,. Effect of sodium hyaluronate on nitric oxide and synovial thickness in patients with knee osteoarthritis [J]. Chinese Journal of Tissue Engineering Research, 2014, 18(52): 8520-8524.

Figures/Tables 2

References

[1] Pereira D,Peleteiro B,Araujo J,et al.The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage. 2011;19: 1270-1285.

[2] 杨林,郭艾.一氧化氮在骨关节炎发病中的作用[J].中国矫形外科杂志,2009,17(7):518-519．

[3] 肖睿,唐强,蔡程,等.玻璃酸钠治疗膝骨关节炎的临床观察[J].中国矫形外科杂志,2005,13(3):198-200．

[4] Kim SB,Kwon DR,Hyun Kwak H.Additive effects of intra-articular injection of growth hormone and hyaluronic acid in rabbit model of collagenase-induced osteoarthritis. J Korean Med Sci.2010;25(5):776-780.

[5] Shimizu M,Higuchi H,Takagishi K,et al.Clinical and biochemical characteristics after intra-artilcular injetion of the treatment of osteoarthritis of the knee: porspective randomized study of sodium hylauronate and corticosteroid .J Orthop Sci. 20l0;15(1):51-56.

[6] 郭盛君,马玉峰,杜春林,等.自拟健步汤外洗治疗寒湿痹阻型膝关节骨性关节炎的疗效观察[J].中国医药导报,2012,9(4):111-113.

[7] Minami S,Okazaki T,Tanaki T,et al.A study of the effect of intra-articular injection of SLM10(sodium hyaluronate) on osteoarthritis of the knee.Jpn Pharmacol Ther.1993; 21 (suppl.):565-579．

[8] Hochberg MD,Altman RD,Brandt KD,et al.Guidelines for the medicalman agement of osteoarthritis: pact II, Osteoarthritis of knee.Arthritis Rheum.1995;38(13): 1541-1546.

[9] Lawrence JS.Rheumatism in population.London: Wiliam Heinemann Med.Books LTD.1997;76(56):53-67.

[10] Pereira D,Peleteiro B,Araujo J,et al.The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage. 2011;19(3): 1270-1285.

[11] Farrell AJ,Blake DR,Palmer BM,et al.Increased concentrations of nitrite in synovial fluid and Serum samples suggest increased nitric oxide synthesis in rheumatic diseases.Ann Rheum Dis.1992;51(11):1219-1222.

[12] Fernandes JC,Martel-Pelletier J,Pelletier JP.The role of cytokines in osteoarthritis pathophysiology. Biorheology. 2002;39(2):237-246.

[13] 金大地,孙炜,王吉兴,等.一氧化氮合酶抑制剂对骨性关节炎的潜在治疗意义[J].中华骨科杂志,2002,22(6):367-371.

[14] 郝亚荣,邱波,刘世清,等.透明质酸钠对兔骨关节炎软骨诱导型NO合酶基因表达的影响[J].中华风湿病学杂志,2005,9(1): 405-408.

[15] 姚永.透明质酸联合糖皮质激素关节腔注射治疗膝关节炎疗效分析[J].中国医药科学,2011,1(22):82-84.

[16] Mototani H,Iida A,Nakajima M,et al.A functional SNP in EDG2 increases susceptibility to knee osteoarthritis in Japanese. Hum Mol Genet.2008;17(12): 1790-1797.