低剂量暴露于氨甲环酸对人体软骨没有明显的毒性作用

IF 2 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-07-15 DOI:10.1016/j.knee.2025.06.019

Arash Sherafatvaziri , Mohammad Hossein Nabian , Fardis Vosoughi , Elham Madreseh , Alireza Mirzamohamadi , Ramin Shayan-moghadam

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引用次数: 0

摘要

最近的研究引起了人们对氨甲环酸（TXA）对软骨的潜在细胞毒性作用的关注。本研究旨在评估低剂量TXA暴露对人体软骨的安全性。方法在这项离体研究中，入选了30例接受全膝关节置换术（TKA）的内翻性骨关节炎膝关节患者。在手术中，从每位患者的股骨外侧髁上取下一组6个骨软骨塞，共180个塞。随后，每组的所有三个插头随机暴露于TXA处理组之一：1mg /ml （TI组），5mg /ml （TV组）或10mg /ml （TX组）的TXA。每组的其余三个塞被分配给对照组，并暴露于0.9%的生理盐水中作为比较的匹配。使用吖啶橙/碘化丙啶染色法在基线、暴露后3和6小时评估TXA剂量和暴露时间对细胞活力的影响。结果TI组、TV组、TX组和对照组的细胞活力随着时间的推移而下降(P = 0.006, P <；0.001, P = 0.001, P <；分别为0.001)。但各组间下降趋势差异无统计学意义（P = 0.3），暴露后基线、3、6 h TXA浓度与生理盐水对照直接比较，细胞死亡差异无统计学意义（P = 0.538、P = 0.256、P = 0.287）。结论低剂量TXA（≤10 mg/ml）暴露6h对人体软骨没有明显的毒性作用。

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Low-dose exposure to tranexamic acid has no significant toxic effect on human cartilage

Background

Recent studies have raised concerns about the potential cytotoxic effects of tranexamic acid (TXA) on cartilage. This study aimed to evaluate the safety of low-dose TXA exposure on human cartilage.

Method

In this ex-vivo study, 30 patients with a varus osteoarthritic knee undergoing total knee arthroplasty (TKA) were enrolled. During the surgery, a set of six osteochondral plugs was harvested from the apparently intact lateral condyle of each patient’s femur, resulting in a total of 180 plugs. Subsequently, all three plugs of each set were randomly exposed to one of the TXA treatment groups: 1 mg/ml (TI group), 5 mg/ml (TV group), or 10 mg/ml (TX group) of TXA. The remaining three plugs of each set were assigned to the control group and exposed to 0.9 % saline as a match for comparison. The effects of TXA dose and exposure time on cell viability were assessed using acridine orange/propidium iodide staining at baseline, 3, and 6 h post-exposure.

Results

Cell viability decreased over time in the TI, TV, TX, and control groups compared with their baselines (P = 0.006, P < 0.001, P = 0.001, P < 0.001, respectively). However, the differences in the trend of decline were not statistically significant between groups (P = 0.3), and direct comparisons among TXA concentrations and saline control at baseline, 3, and 6 h after exposure showed no statistically significant difference in cell death (P = 0.538, P = 0.256, P = 0.287, respectively).

Conclusions

Exposure to low-dose TXA (≤10 mg/ml) for up to 6 h did not cause significant toxic effects on human cartilage.

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.