Javier Fernández-Torres, Karina Martínez-Flores, Indira Xiomara Puerta-Escalante, Nathalie Montaño-Armendariz, Carlos Suárez-Ahedo, Víctor Ilizaliturri-Sánchez, Rolando Espinosa-Morales, Carlos Alberto Lozada-Pérez, Yessica Zamudio-Cuevas
{"title":"焦磷酸钙晶体、氧化应激和临床特征对膝关节骨性关节炎严重程度的相互影响。","authors":"Javier Fernández-Torres, Karina Martínez-Flores, Indira Xiomara Puerta-Escalante, Nathalie Montaño-Armendariz, Carlos Suárez-Ahedo, Víctor Ilizaliturri-Sánchez, Rolando Espinosa-Morales, Carlos Alberto Lozada-Pérez, Yessica Zamudio-Cuevas","doi":"10.1007/s10067-024-07220-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Deposition of calcium pyrophosphate (CPP) crystals is observed in most joints affected by severe osteoarthritis (OA). CPP may cause local damage by inducing an inflammatory process and oxidative stress (OS).</p><p><strong>Objectives: </strong>To evaluate inflammation and OS induced by CPP deposition and their association with the degree of knee OA.</p><p><strong>Methods: </strong>Synovial fluid (SF) from patients with OA classified as grade 3 and 4 (ACR criteria) was analyzed. Reactive oxygen species (ROS) and H<sub>2</sub>O<sub>2</sub> levels were quantified, and inflammation by white blood cell (WBC) count. CPPs were detected by polarized light microscopy. Multifactorial dimensionality reduction (MDR) was used to visualize possible interactive effects between variables.</p><p><strong>Results: </strong>Fifty-six SF were analyzed, 22 (39.28%) were in moderate OA and 34 (60.71%) in severe OA. CPPs were identified in 17 moderate OA and 18 severe OA samples. In the moderate OA, ROS levels were significantly higher in the CPP + group (5.0% vs 2.0%, P = 0.03). Body mass index and CPP were significantly correlated (r = - 0.439, P = 0.041). In the severe OA group, there were significant correlations of age with WBC (r = - 0.431, P = 0.011), WBC with H<sub>2</sub>O<sub>2</sub> (r = 0.454, P = 0.007), and ROS with H<sub>2</sub>O<sub>2</sub> (r = 0.387, P = 0.024). MDR analysis revealed strong synergistic interactions between H<sub>2</sub>O<sub>2</sub> and sex (6.68%) for moderate OA, while for severe OA, there were interactions between sex and ROS (6.99%) and between sex and inflammation (4.39%).</p><p><strong>Conclusion: </strong>ROS and inflammation may be factors that potentiate damage in knee OA, and this may help in the development of antioxidant interventions for CPP-associated OA. Key Points • This study evaluated CPP crystal-induced oxidative stress and inflammation and their effect on OA severity. • In the moderate OA phenotype, CPP crystals modify ROS levels. • ROS and inflammation are factors that increase damage in knee OA, especially when CPP crystals are present.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"433-441"},"PeriodicalIF":2.9000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Interplay of calcium pyrophosphate crystals, oxidative stress, and clinical features on knee osteoarthritis severity.\",\"authors\":\"Javier Fernández-Torres, Karina Martínez-Flores, Indira Xiomara Puerta-Escalante, Nathalie Montaño-Armendariz, Carlos Suárez-Ahedo, Víctor Ilizaliturri-Sánchez, Rolando Espinosa-Morales, Carlos Alberto Lozada-Pérez, Yessica Zamudio-Cuevas\",\"doi\":\"10.1007/s10067-024-07220-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Deposition of calcium pyrophosphate (CPP) crystals is observed in most joints affected by severe osteoarthritis (OA). CPP may cause local damage by inducing an inflammatory process and oxidative stress (OS).</p><p><strong>Objectives: </strong>To evaluate inflammation and OS induced by CPP deposition and their association with the degree of knee OA.</p><p><strong>Methods: </strong>Synovial fluid (SF) from patients with OA classified as grade 3 and 4 (ACR criteria) was analyzed. Reactive oxygen species (ROS) and H<sub>2</sub>O<sub>2</sub> levels were quantified, and inflammation by white blood cell (WBC) count. CPPs were detected by polarized light microscopy. Multifactorial dimensionality reduction (MDR) was used to visualize possible interactive effects between variables.</p><p><strong>Results: </strong>Fifty-six SF were analyzed, 22 (39.28%) were in moderate OA and 34 (60.71%) in severe OA. CPPs were identified in 17 moderate OA and 18 severe OA samples. In the moderate OA, ROS levels were significantly higher in the CPP + group (5.0% vs 2.0%, P = 0.03). Body mass index and CPP were significantly correlated (r = - 0.439, P = 0.041). In the severe OA group, there were significant correlations of age with WBC (r = - 0.431, P = 0.011), WBC with H<sub>2</sub>O<sub>2</sub> (r = 0.454, P = 0.007), and ROS with H<sub>2</sub>O<sub>2</sub> (r = 0.387, P = 0.024). MDR analysis revealed strong synergistic interactions between H<sub>2</sub>O<sub>2</sub> and sex (6.68%) for moderate OA, while for severe OA, there were interactions between sex and ROS (6.99%) and between sex and inflammation (4.39%).</p><p><strong>Conclusion: </strong>ROS and inflammation may be factors that potentiate damage in knee OA, and this may help in the development of antioxidant interventions for CPP-associated OA. Key Points • This study evaluated CPP crystal-induced oxidative stress and inflammation and their effect on OA severity. • In the moderate OA phenotype, CPP crystals modify ROS levels. • ROS and inflammation are factors that increase damage in knee OA, especially when CPP crystals are present.</p>\",\"PeriodicalId\":10482,\"journal\":{\"name\":\"Clinical Rheumatology\",\"volume\":\" \",\"pages\":\"433-441\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Rheumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10067-024-07220-y\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10067-024-07220-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/6 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：大多数受严重骨关节炎（OA）影响的关节都有焦磷酸钙（CPP）晶体沉积。CPP可能通过诱发炎症过程和氧化应激（OS）造成局部损伤：评估 CPP 沉积引起的炎症和氧化应激，以及它们与膝关节 OA 程度的关系：方法：分析被分为 3 级和 4 级（ACR 标准）的 OA 患者的滑膜液（SF）。对活性氧（ROS）和 H2O2 水平进行量化，并通过白细胞（WBC）计数对炎症进行量化。偏振光显微镜检测 CPPs。多因素降维法（MDR）用于观察变量之间可能存在的交互效应：对 56 例 SF 进行了分析，其中 22 例（39.28%）为中度 OA，34 例（60.71%）为重度 OA。在 17 个中度 OA 和 18 个重度 OA 样本中发现了 CPPs。在中度 OA 中，CPP + 组的 ROS 水平明显更高（5.0% 对 2.0%，P = 0.03）。体重指数与 CPP 呈显著相关（r = - 0.439，P = 0.041）。在重度 OA 组中，年龄与白细胞（r = - 0.431，P = 0.011）、白细胞与 H2O2（r = 0.454，P = 0.007）、ROS 与 H2O2（r = 0.387，P = 0.024）存在明显相关性。MDR分析显示，对于中度OA，H2O2与性别（6.68%）之间存在很强的协同作用，而对于重度OA，性别与ROS（6.99%）之间以及性别与炎症（4.39%）之间存在相互作用：结论：ROS和炎症可能是加剧膝关节OA损伤的因素，这可能有助于开发针对CPP相关OA的抗氧化干预措施。要点 - 本研究评估了 CPP 晶体诱导的氧化应激和炎症及其对 OA 严重程度的影响。- 在中度 OA 表型中，CPP 晶体改变了 ROS 水平。- ROS 和炎症是增加膝关节 OA 损伤的因素，尤其是当 CPP 晶体存在时。
Interplay of calcium pyrophosphate crystals, oxidative stress, and clinical features on knee osteoarthritis severity.
Background: Deposition of calcium pyrophosphate (CPP) crystals is observed in most joints affected by severe osteoarthritis (OA). CPP may cause local damage by inducing an inflammatory process and oxidative stress (OS).
Objectives: To evaluate inflammation and OS induced by CPP deposition and their association with the degree of knee OA.
Methods: Synovial fluid (SF) from patients with OA classified as grade 3 and 4 (ACR criteria) was analyzed. Reactive oxygen species (ROS) and H2O2 levels were quantified, and inflammation by white blood cell (WBC) count. CPPs were detected by polarized light microscopy. Multifactorial dimensionality reduction (MDR) was used to visualize possible interactive effects between variables.
Results: Fifty-six SF were analyzed, 22 (39.28%) were in moderate OA and 34 (60.71%) in severe OA. CPPs were identified in 17 moderate OA and 18 severe OA samples. In the moderate OA, ROS levels were significantly higher in the CPP + group (5.0% vs 2.0%, P = 0.03). Body mass index and CPP were significantly correlated (r = - 0.439, P = 0.041). In the severe OA group, there were significant correlations of age with WBC (r = - 0.431, P = 0.011), WBC with H2O2 (r = 0.454, P = 0.007), and ROS with H2O2 (r = 0.387, P = 0.024). MDR analysis revealed strong synergistic interactions between H2O2 and sex (6.68%) for moderate OA, while for severe OA, there were interactions between sex and ROS (6.99%) and between sex and inflammation (4.39%).
Conclusion: ROS and inflammation may be factors that potentiate damage in knee OA, and this may help in the development of antioxidant interventions for CPP-associated OA. Key Points • This study evaluated CPP crystal-induced oxidative stress and inflammation and their effect on OA severity. • In the moderate OA phenotype, CPP crystals modify ROS levels. • ROS and inflammation are factors that increase damage in knee OA, especially when CPP crystals are present.
期刊介绍：
Clinical Rheumatology is an international English-language journal devoted to publishing original clinical investigation and research in the general field of rheumatology with accent on clinical aspects at postgraduate level.
The journal succeeds Acta Rheumatologica Belgica, originally founded in 1945 as the official journal of the Belgian Rheumatology Society. Clinical Rheumatology aims to cover all modern trends in clinical and experimental research as well as the management and evaluation of diagnostic and treatment procedures connected with the inflammatory, immunologic, metabolic, genetic and degenerative soft and hard connective tissue diseases.
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