透過您的圖書館登入
IP:34.230.35.103
  • 期刊

骨性關節炎基礎醫學之探討(Ⅱ)-生化學,免疫學,細胞學之觀點

Osteoarthritis: Basic Considerations (Ⅱ)

摘要


骨性關節主要侵犯關節軟骨,是人類最常見的關節病變。瞭解正常關節軟骨的生化學,免疫學及細胞學是獲知病因,治療及預防方法的不二法門。 過去認爲骨性關節炎是一種單純的機械性磨損的現象,而且認爲骨性關節炎是年老過程中必然的現象。然而現在我們知道老化與骨性關節炎之間仍存有相當大的差異;對於骨性關節炎也將它視爲一個關節面損害與修補的平衡。過去因爲關節面軟骨特殊地處於與外界隔絕的環境而認爲免疫系統與骨性關節炎的致病機轉無關;但現在則認爲免疫系統中,體液免疫與細胞免疫的合作在骨性關節炎的病理發生上扮演了一個重要的角色。 近來細胞學的研究顯示骨性關節炎中的軟骨細胞已起了基因上的變化,變得比較趨向於軟骨母細胞的性質。多醣蛋白更迭率的增加及流失量的增加均是骨性關節炎中軟骨基質常見的現象,而此現象據信乃由軟骨細胞所控制。第一類白血球間質素(Interleukin-I)及其它細胞激素(Cytokine)可以控制包括軟骨細胞在內的許多細胞的生長分化,因而被認爲和軟骨細胞新陳代謝的加速有關。多醣蛋白的流失量,更迭率的增加及軟骨細胞受傷後發生的惡性循環都與細胞激素有關。 軟骨細胞的培養技術,骨性關節炎的標誌(marker)的發現,單株抗體的應用使得我們深信在幾年內對於骨性關節炎的細胞生物學及其致病機轉必有更透澈的瞭解。

並列摘要


Osteoarthritis involves mainly the articular cartilage and is the most common of various articular disorder affecting man. Understanding the biochemistry, immunology and cytology of normal articular cartilage is the key to discover the etiology, to develop methods of treatment and to pave ways for prevention of osteoarthritis. It was once held that osteoarthritis is a phenomenon of passive wear and tear and is almost an inevitable consequence of aging. However, we now come into that there are some differences between cartilages of osteoarthritis and aging and that osteoarthritis should be considered as a balance between 'destructions' and 'repairs' of the cartilage. For many years, immune mechanism was believed to be unrelated to the etiology of osteoarthritis for the isolated environment of cartilage. However, reports have revealed that cartilage is immunogenic and that synergism between cellular and humoral immunity plays significant roles in the pathogenesis of osteoarthritis. It has been shown in advanced cytological studies that chondrocytes, in osteoarthritic cartilages, have undergone genetic changes and been changed into a more osteoblastic state. Increased turn-over rate of proteoglycans and increased loss of proteoglycans from matrix can be demonstrated in osteoarthritic cartilages and is proved to be controlled by chondrocytes. Interleukin-I, tumor necrotic factor and other cytokines constitude ”a polypeptide mediator network” and appear to ”regulate growth, differentiation, and function of mesenchymal cells as well as cells involved in immunity, imflammation, and hematopoiesis”. These cytokines, released from cells of synovial lining as a consequence of cartilage damage, promote the metabolic function of chondrocyte that are deleterious to the matrix and perpetuate a vicious cycle for further articular cartilage damage. The technique of chondrocytes culture, identification of possible markers for osteoarthritis and the application of monclonal antibodies as probes make greater understanding of the cell biology of osteoarthritis and its mechanism possbile in the next few years.

並列關鍵字

Osteoarthritis Biochemistry Immunology Cytology

延伸閱讀