 |
|
|
 |
Blood-Induced Joint Damage: Longterm Effects
in Vitro and in Vivo
MICHEL HOOIVELD, GORIS ROOSENDAAL, MARIEKE VIANEN, MARIJKE VAN DEN BERG, JOHANNES BIJLSMA, and FLORIS LAFEBER
ABSTRACT. Methods. Human and canine articular cartilage tissue was cultured in the presence of homologous whole blood during 4 days. The in vitro cartilage matrix turnover was analyzed directly after blood exposure or following culture for additional periods of 2, 5, and 10 weeks in the absence of blood. The in vivo longterm effects were determined by injecting autologous blood into the right knee of 12 Beagle dogs. Six dogs were killed shortly after blood injections; the 6 remaining dogs were killed 10 weeks later. Cartilage matrix turnover and the cartilage destructive properties of the synovial tissue were analyzed. Results. Short term (4 days) in vitro exposure of human or canine cartilage to whole blood inhibited proteoglycan synthesis by more than 98% (day 4), an inhibition which lasted until week 10 (70 and 75% inhibition, respectively). Also the in vivo short term exposure of cartilage to blood induced the adverse changes in cartilage proteoglycan turnover seen shortly after exposure. However, in vivo 10 weeks after the last injection, normalization of cartilage matrix turnover was observed. Synovial inflammation was absent and no destructive activity was found. Conclusion. These data show a discrepancy between the in vitro and in vivo longterm effects of blood on cartilage. A possible explanation for the in vivo recovery after experimental joint bleeding in dogs could be that the observed changes in cartilage only predispose to acute damage but that additional (e.g., mechanical) factors are needed to induce permanent joint damage. (J Rheumatol 2003;30:339-44) Key Indexing Terms:
CARTILAGE From Rheumatology and Clinical Immunology and Van Creveldkliniek (National Hemophilia Center), University Medical Center Utrecht, Utrecht, The Netherlands. M.J.J. Hooiveld, MSc, Rheumatology and Clinical Immunology, and Van Creveldkliniek; G. Roosendaal MD, PhD, Van Creveldkliniek; M.E. Vianen, BA, Rheumatology and Clinical Immunology; H.M. van den Berg MD, PhD, Van Creveldkliniek; J.W.J. Bijlsma, MD, PhD; F.P.J.G. Lafeber, PhD, Rheumatology and Clinical Immunology. Address reprint requests to Dr. F.P.J.G. Lafeber, Department of Rheumatology and Clinical Immunology -F02.127-, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands. Submitted February 25, 2002; revision accepted August 13, 2002. |