Relationship between trace elements in synovial fluid and cartilage and severity of knee osteoarthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Yongshi , CHEN Hong , MOU Ping , SUN Bangjie , ZENG Yi ,  YANG Jing

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;

Corresponding author：

YANG Jing, Email: cd_yangjing@163.com

Keywords：

Knee; osteoarthritis; trace element; copper; zinc; manganese

DOI：

10.7507/1002-1892.202302008

Video：

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Objective To investigate the relationship between trace elements in synovial fluid and cartilage and severity of knee osteoarthritis (KOA). Methods Patients with KOA who underwent knee arthrocentesis or total knee arthroplasty (TKA) were recruited based on inclusion criteria between June 2021 and December 2021. Synovial fluid samples were obtained during knee arthrocentesis and TKA, and participants were divided into the mild group (grading Ⅰ/Ⅱ) and the severe group (grading Ⅲ/Ⅳ) according to the Kellgren-Lawrence grading (K-L grading). Cartilage samples with different degrees of wear were collected during the TKA from the same patient and were divided into mild wear (0-1 point) and severe wear (2-4 points) groups based on the Pelletier score. The contents of copper (Cu), zinc (Zn), and manganese (Mn) in synovial fluid and cartilage were evaluated by inductively coupled plasma mass spectrometry, and the differences between groups were compared. Results A total of 33 synovial fluid samples were collected, including 19 specimens from 14 patients who underwent knee arthrocentesis of mild group, with 5 bilateral sides knee arthrocentesis in them, and 14 specimens from 14 TKA patients of severe group. The patients were significantly younger in the mild group than in the severe group (P<0.05), but there was no significant difference in gender or body mass index between the two groups (P>0.05). Nineteen pairs of cartilage samples with mild and severe wear were collected from severe KOA patients (K-L grading Ⅲ and Ⅳ), including 9 males and 10 females, with an average age of 70.4 years (range, 58-80 years). The body mass index ranged from 21.2 to 30.7 kg/m², with an average of 25.6 kg/m². The content of Zn in synovial fluid and cartilage from KOA patients was the highest, followed by Cu, and Mn was the lowest. The Cu content in synovial fluid was significantly higher in the severe group than in the mild group (P<0.05), and in the severe wear group than in the mild wear group (P<0.05). There was no significant difference in Zn and Mn content between the two groups (P>0.05). Conclusion The Cu content increases with the severity of cartilage wear in patients with KOA.

Citation： LI Yongshi, CHEN Hong, MOU Ping, SUN Bangjie, ZENG Yi, YANG Jing. Relationship between trace elements in synovial fluid and cartilage and severity of knee osteoarthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(5): 584-588. doi: 10.7507/1002-1892.202302008 Copy

1.	Xu X, Li N, Wu Y, et al. Zhuifeng tougu capsules inhibit the TLR4/MyD88/NF-κB signaling pathway and alleviate knee osteoarthritis: In vitro and in vivo experiments. Front Pharmacol, 2022, 13: 951860. doi: 10.3389/fphar.2022.951860.
2.	Zhou J, Liu C, Sun Y, et al. Genetically predicted circulating levels of copper and zinc are associated with osteoarthritis but not with rheumatoid arthritis. Osteoarthritis Cartilage, 2021, 29(7): 1029-1035.
3.	赵冬妮, 白玉, 梅轶芳, 等. 微量元素对骨关节炎影响的研究进展. 中国实用内科杂志, 2019, 39(11): 991-993.
4.	Zhang S, Sun L, Zhang J, et al. Adverse impact of heavy metals on bone cells and bone metabolism dependently and independently through anemia. Adv Sci (Weinh), 2020, 7(19): 2000383. doi: 10.1002/advs.202000383.
5.	中华医学会骨科学分会关节外科学组. 骨关节炎诊疗指南 (2018年版). 中华骨科杂志, 2018, 38(12): 705-715.
6.	Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
7.	曾凡, 陈柏屹, 王康, 等. 加味独活寄生合剂对膝骨关节炎模型兔膝关节软骨组织细胞自噬及凋亡相关蛋白的影响. 中医杂志, 2022, 63(8): 773-780.
8.	牟利民, 张文豪, 张思平, 等. 绝经后女性退变性膝骨关节炎疼痛与性激素水平及关节液炎性因子的相关性研究. 中国全科医学, 2022, 25(29): 3652-3657.
9.	王海英, 丁晓, 杨立, 等. 不同分期骨关节炎关节液中相关降解酶的表达差异. 中国组织工程研究, 2019, 23(23): 3609-3615.
10.	李国勇. 相关因素与膝关节骨关节炎结构中微量元素含量的关系及微量元素之间相关性研究. 南昌: 南昌大学, 2022.
11.	Mazarakioti EC, Zotos A, Thomatou AA, et al. Inductively coupled plasma-mass spectrometry (ICP-MS), a useful tool in authenticity of agricultural products’ and foods’ origin. Foods, 2022, 11(22): 3705. doi: 10.3390/foods11223705.
12.	Zhao T, Chen T, Qiu Y, et al. Trace element profiling using inductively coupled plasma mass spectrometry and its application in an osteoarthritis study. Anal Chem, 2009, 81(9): 3683-3692.
13.	李博, 胡如印, 孙立, 等. 膝关节液微量元素含量与骨性关节炎关节镜下Outerbridge分级关系的研究. 中国矫形外科杂志, 2016, 24(3): 265-269.
14.	薛志超, 常祺, 朱履刚, 等. 膝关节液微量元素浓度对骨性关节炎患者病情程度的评估价值分析. 四川解剖学杂志, 2020, 28(3): 165-166.
15.	Roczniak W, Brodziak-Dopierała B, Cipora E, et al. Factors that affect the content of cadmium, nickel, copper and zinc in tissues of the knee joint. Biol Trace Elem Res, 2017, 178(2): 201-209.
16.	Yazar M, Sarban S, Kocyigit A, et al. Synovial fluid and plasma selenium, copper, zinc, and iron concentrations in patients with rheumatoid arthritis and osteoarthritis. Biol Trace Elem Res, 2005, 106(2): 123-132.
17.	Zhang X, Wang Q, Wu J, et al. Crystal structure of human lysyl oxidase-like 2 (hLOXL2) in a precursor state. Proc Natl Acad Sci U S A, 2018, 115(15): 3828-3833.
18.	Suska F, Esposito M, Gretzer C, et al. IL-1alpha, IL-1beta and TNF-alpha secretion during in vivo/ex vivo cellular interactions with titanium and copper. Biomaterials, 2003, 24(3): 461-468.
19.	Huang CC, Chiou CH, Liu SC, et al. Melatonin attenuates TNF-α and IL-1β expression in synovial fibroblasts and diminishes cartilage degradation: Implications for the treatment of rheumatoid arthritis. J Pineal Res, 2019, 66(3): e12560. doi: 10.1111/jpi.12560.
20.	Na HS, Park JS, Cho KH, et al. Interleukin-1-interleukin-17 signaling axis induces cartilage destruction and promotes experimental osteoarthritis. Front Immunol, 2020, 11: 730. doi: 10.3389/fimmu.2020.00730.
21.	Guan T, Wu Z, Xu C, et al. The association of trace elements with arthritis in US adults: NHANES 2013-2016. J Trace Elem Med Biol, 2023, 76: 127122. doi: 10.1016/j.jtemb.2022.127122.
22.	Huang L, Li P, Guo L, et al. Zinc finger protein 521 attenuates osteoarthritis via the histone deacetylases 4 in the nucleus. Bioengineered, 2022, 13(6): 14489-14502.
23.	Zhou T, Ran J, Xu P, et al. A hyaluronic acid/platelet-rich plasma hydrogel containing MnO₂ nanozymes efficiently alleviates osteoarthritis in vivo. Carbohydr Polym, 2022, 292: 119667. doi: 10.1016/j.carbpol.2022.119667.
24.	Chen L, Tiwari SR, Zhang Y, et al. Facile synthesis of hollow MnO₂ nanoparticles for reactive oxygen species scavenging in osteoarthritis. ACS Biomater Sci Eng, 2021, 7(4): 1686-1692.
25.	Li G, Cheng T, Yu X. The impact of trace elements on osteoarthritis. Front Med (Lausanne), 2021, 8: 771297. doi: 10.3389/fmed.2021.771297.

1. Xu X, Li N, Wu Y, et al. Zhuifeng tougu capsules inhibit the TLR4/MyD88/NF-κB signaling pathway and alleviate knee osteoarthritis: In vitro and in vivo experiments. Front Pharmacol, 2022, 13: 951860. doi: 10.3389/fphar.2022.951860.
2. Zhou J, Liu C, Sun Y, et al. Genetically predicted circulating levels of copper and zinc are associated with osteoarthritis but not with rheumatoid arthritis. Osteoarthritis Cartilage, 2021, 29(7): 1029-1035.
3. 赵冬妮, 白玉, 梅轶芳, 等. 微量元素对骨关节炎影响的研究进展. 中国实用内科杂志, 2019, 39(11): 991-993.
4. Zhang S, Sun L, Zhang J, et al. Adverse impact of heavy metals on bone cells and bone metabolism dependently and independently through anemia. Adv Sci (Weinh), 2020, 7(19): 2000383. doi: 10.1002/advs.202000383.
5. 中华医学会骨科学分会关节外科学组. 骨关节炎诊疗指南 (2018年版). 中华骨科杂志, 2018, 38(12): 705-715.
6. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis, 1957, 16(4): 494-502.
7. 曾凡, 陈柏屹, 王康, 等. 加味独活寄生合剂对膝骨关节炎模型兔膝关节软骨组织细胞自噬及凋亡相关蛋白的影响. 中医杂志, 2022, 63(8): 773-780.
8. 牟利民, 张文豪, 张思平, 等. 绝经后女性退变性膝骨关节炎疼痛与性激素水平及关节液炎性因子的相关性研究. 中国全科医学, 2022, 25(29): 3652-3657.
9. 王海英, 丁晓, 杨立, 等. 不同分期骨关节炎关节液中相关降解酶的表达差异. 中国组织工程研究, 2019, 23(23): 3609-3615.
10. 李国勇. 相关因素与膝关节骨关节炎结构中微量元素含量的关系及微量元素之间相关性研究. 南昌: 南昌大学, 2022.
11. Mazarakioti EC, Zotos A, Thomatou AA, et al. Inductively coupled plasma-mass spectrometry (ICP-MS), a useful tool in authenticity of agricultural products’ and foods’ origin. Foods, 2022, 11(22): 3705. doi: 10.3390/foods11223705.
12. Zhao T, Chen T, Qiu Y, et al. Trace element profiling using inductively coupled plasma mass spectrometry and its application in an osteoarthritis study. Anal Chem, 2009, 81(9): 3683-3692.
13. 李博, 胡如印, 孙立, 等. 膝关节液微量元素含量与骨性关节炎关节镜下Outerbridge分级关系的研究. 中国矫形外科杂志, 2016, 24(3): 265-269.
14. 薛志超, 常祺, 朱履刚, 等. 膝关节液微量元素浓度对骨性关节炎患者病情程度的评估价值分析. 四川解剖学杂志, 2020, 28(3): 165-166.
15. Roczniak W, Brodziak-Dopierała B, Cipora E, et al. Factors that affect the content of cadmium, nickel, copper and zinc in tissues of the knee joint. Biol Trace Elem Res, 2017, 178(2): 201-209.
16. Yazar M, Sarban S, Kocyigit A, et al. Synovial fluid and plasma selenium, copper, zinc, and iron concentrations in patients with rheumatoid arthritis and osteoarthritis. Biol Trace Elem Res, 2005, 106(2): 123-132.
17. Zhang X, Wang Q, Wu J, et al. Crystal structure of human lysyl oxidase-like 2 (hLOXL2) in a precursor state. Proc Natl Acad Sci U S A, 2018, 115(15): 3828-3833.
18. Suska F, Esposito M, Gretzer C, et al. IL-1alpha, IL-1beta and TNF-alpha secretion during in vivo/ex vivo cellular interactions with titanium and copper. Biomaterials, 2003, 24(3): 461-468.
19. Huang CC, Chiou CH, Liu SC, et al. Melatonin attenuates TNF-α and IL-1β expression in synovial fibroblasts and diminishes cartilage degradation: Implications for the treatment of rheumatoid arthritis. J Pineal Res, 2019, 66(3): e12560. doi: 10.1111/jpi.12560.
20. Na HS, Park JS, Cho KH, et al. Interleukin-1-interleukin-17 signaling axis induces cartilage destruction and promotes experimental osteoarthritis. Front Immunol, 2020, 11: 730. doi: 10.3389/fimmu.2020.00730.
21. Guan T, Wu Z, Xu C, et al. The association of trace elements with arthritis in US adults: NHANES 2013-2016. J Trace Elem Med Biol, 2023, 76: 127122. doi: 10.1016/j.jtemb.2022.127122.
22. Huang L, Li P, Guo L, et al. Zinc finger protein 521 attenuates osteoarthritis via the histone deacetylases 4 in the nucleus. Bioengineered, 2022, 13(6): 14489-14502.
23. Zhou T, Ran J, Xu P, et al. A hyaluronic acid/platelet-rich plasma hydrogel containing MnO₂ nanozymes efficiently alleviates osteoarthritis in vivo. Carbohydr Polym, 2022, 292: 119667. doi: 10.1016/j.carbpol.2022.119667.
24. Chen L, Tiwari SR, Zhang Y, et al. Facile synthesis of hollow MnO₂ nanoparticles for reactive oxygen species scavenging in osteoarthritis. ACS Biomater Sci Eng, 2021, 7(4): 1686-1692.
25. Li G, Cheng T, Yu X. The impact of trace elements on osteoarthritis. Front Med (Lausanne), 2021, 8: 771297. doi: 10.3389/fmed.2021.771297.

Chinese Journal of Reparative and Reconstructive Surgery

Relationship between trace elements in synovial fluid and cartilage and severity of knee osteoarthritis

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