Synovial Neuronal Changes in Knee Joint Osteoarthritis

Haq Nawaz,Aisha Siddiqah Ahmed,Bo Christer Bertilson,Jian Li,Mahmood Ahmed,Masood Umer,Shahryar Noordin

doi:10.4236/ojra.2016.62005

Haq Nawaz, Aisha Siddiqah Ahmed + Show 5 more

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https://doi.org/10.4236/ojra.2016.62005

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Abstract

Purpose: The purpose is to study whether pain and inflammation in knee joint osteoarthritis (OA) are associated with local synovial neuronal changes. Methods: Synovial biopsies were harvested from the medial and lateral knee compartments from OA patients undergoing total joint replacement surgery. All patients had predominant pain at the medial joint compartment. Pain and knee joint function were evaluated by knee society score (KSS). Synovial inflammation was analyzed by histopathological analysis and expression of growth associated protein-43 (GAP-43), sensory (SP, CGRP) and autonomic (NPY, VIP, TH) neuropeptides was studied by single and double immunohistochemistry techniques. Results: We observed reduced KSS and increased inflammatory score in synovial membrane of medial knee compartment. A significant increase in GAP-43 [P = 0.001], SP [P = 0.05], CGRP [P = 0.05] and TH [P = 0.05] expression was observed and SP, CGRP and NPY were found to be co-existed predominantly with GAP-43 in synovial membrane collected from medial compared to the lateral knee compartment. Conclusions: Regenerating nerve fibers containing sensory and autonomic neuropeptides are associated with pain and inflammation in knee joint OA.

Highlights

Osteoarthritis (OA) is the most prevalent painful joint disease leading to functional disability
knee society score (KSS) was considerably reduced with mean score observed as 15.4 for pain, 14.6 for motion and 15 points for knee stability
Our present study indicates that pain and inflammation in patients with knee joint OA are related to neuronal changes in the synovia

Summary

Introduction

Osteoarthritis (OA) is the most prevalent painful joint disease leading to functional disability. (2016) Synovial Neuronal Changes in Knee Joint Osteoarthritis. Role of synovial inflammation in development of joint pain and disease progression is implicated mainly by the release of various pro-inflammatory mediators [3] [4]. Free nerve endings are identified in the rat and human synovial membrane [5] [6] and probably play an important role in joint pain mediation. Peripheral release of SP from nerve terminals has sensitizing effect on surrounding nociceptive afferents and stimulates immune cells to release pro-inflammatory cytokines. A link between autonomic neuropeptides NPY, VIP and TH with the degree of synovial inflammation in rheumatoid arthritis (RA) and OA has been reported [11] [12]. Sprouting of sensory and autonomic nerve fibers has been suggested to occur in painful arthritic joint in experimental arthritis [13]

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