Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
A Specific Chemokine Expression Pattern Is Associated with Synovial Inflammation and Symptoms in Patients with Traumatic Knee Injury Undergoing Arthroscopic Meniscectomy.
Scanzello7, Carla R., McKeon6, Brian, Swaim6, Bryan H., DiCarlo5, Edward, Umoh4, Eva, Kanda8, Veero, Nair8, Anjali
Brigham & Womens Hosp, Boston, MA
Brigham and Womens Hospital, Boston, MA
Hospital for Special Surgery, New York, NY
Hospital for Special Surgery, New York NY
Hosptial for Special Surgery, New York NY
New England Baptist Hospital, Boston MA
Rush University Medical Center, Chicago, IL
Rush University Medical Center, Chicago IL
In established OA, the presence of synovitis is associated with pain and progression, but a relationship between synovitis, symptoms and meniscal pathology in isolated meniscal disease has not been previously investigated. The present studies were undertaken to characterize synovial pathology in patients with traumatic knee injuries associated with meniscal tears, and to determine the relationship between synovial inflammation, meniscal and cartilage pathology, and symptoms. Furthermore, the synovial gene expression patterns were analyzed to gain insight into the gene products and molecular pathways that may contribute to development of meniscal pathology and synovial inflammation in these patients.
Patients without clinical or radiographic evidence of OA undergoing athroscopic menisectomy for traumatic knee injuries were recruited. Pain and function were assessed preoperatively utilizing the Lysholm score (a patient-administered questionnaire measuring knee-specific symptoms and dysfunction); meniscal and cartilage abnormalities were documented at the time of surgery. Inflammation was scored histologically on synovial biopsies and associations between inflammation and Lysholm scores determined. Microarray analysis of synovial tissue was performed and expression patterns in patients with or without inflammation compared. The microarray results were confirmed by real-time pcr.
Synovial inflammation was present in 42% of the patients and was associated with worse pre-operative Lysholm scores, independent of age, gender, or pre-existing cartilage pathology. Microarray analysis and real-time PCR revealed a chemokine signature in synovial biopsies with increased inflammation scores. Increasing synovial transcript levels of the chemokine/receptor pair CCL19/CCR7, identified by microarray and quantitated by real-time PCR, were significantly associated with worse Lysholm scores (Spearman r =-0.86 and -0.79 respectively, p = 0.002).
In patients with traumatic meniscal injury without clinical or radiographic evidence of OA undergoing arthroscopic menisectomy, synovial inflammation was a frequent finding and was associated with increased pain and dysfunction. Synovium with inflammatory infiltrates exhibited a chemokine signature, and expression levels of CCL19 and its receptor CCR7 were strongly associated with symptoms measured by the Lysholm score. Chemokines play a role in the development of synovial inflammation in patients with meniscal pathology and represent potential therapeutic targets to reduce inflammatory symptoms and potentially modulate the long-term risk for the development of OA.
To cite this abstract, please use the following information:
Scanzello, Carla R., McKeon, Brian, Swaim, Bryan H., DiCarlo, Edward, Umoh, Eva, Kanda, Veero, et al; A Specific Chemokine Expression Pattern Is Associated with Synovial Inflammation and Symptoms in Patients with Traumatic Knee Injury Undergoing Arthroscopic Meniscectomy. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :167