The effect of different intraarticular drug applications to the antioxidation system and  lipid peroxidation in gonarthrosis: Gonartrozda farklı eklem içi ilaç uygulamalarının  antioksidan sistem ve lipid peroksidasyonu üzerine etkisi

Ahmet Aslan; Nevres Hürriyet Aydoğan; Mücahit İlhan; Remzi Arif Özerdemoğlu; İrfan Altuntaş; Hüseyin Yorgancıgil

doi:10.5455/GMJ-30-2011-55

Authors

Ahmet Aslan 1Afyonkarahisar Devlet Hastanesi Ortopedi ve Travmatoloji Kliniği, Afyonkarahisar
Nevres Hürriyet Aydoğan Ankara Eğitim ve Araştırma Hastanesi, 2. Ortopedi ve Travmatoloji, Ankara
Mücahit İlhan Eğirdir Kemik Eklem Hastalıkları Tedavi ve Rehabilitasyon Hastanesi, Ortopedi ve Travmatoloji Kliniği, Isparta
Remzi Arif Özerdemoğlu Özel Sema Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul
İrfan Altuntaş Muğla Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya Anabilim Dalı, Muğla
Hüseyin Yorgancıgil Süleyman Demirel Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Isparta

DOI:

https://doi.org/10.5455/GMJ-30-2011-55

Keywords:

Antioxidant enzymes, intraarticular treatment, gonarthrosis, malondialdehyde, synovial fluid

Abstract

Oxidative stress and lipid peroxidation may have a role in pathogenesis of knee osteoarthritis (gonarthrosis). In this study, we investigated both the role of disease mechanisms, lipid peroxidation and antioxidant defense system and the effects of different intraarticular therapies on antioxidant enzyme activity and lipid peroxidation in gonarthrosis. A total of 75 patients with knee pain who were diagnosed as gonarthrosis according to the American College of Rheumatology (ACR) criteria were included in this study, and randomly and equally divided into 5 groups. Only intraarticular salin was applied to the control group (Group 1). Intraarticular high molecular weight hyaluronic asit (HA, hylan G-F 20) treatment was given to Group 2 for 3 weeks. Intraarticular metil prednizolon acetate were administered to Group 3. Intraarticular low molecular weight HA, hyaluronan treatment was given to Group 4 for 5 weeks. Intraarticular tenoxicam treatment was given to Group 5. Blood and synovial fluid samples were taken from all the patients for biochemical analysis, and the following parameters were measured: Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA). After the treatment synovial fluid MDA levels were significantly decreased in each group according to control group. No significant change was found in MDA, SOD, GSH-Px and catalase activities in hemolysate. CAT enzymatic activity was not present in synovial fluid. Synovial fluid SOD and GSH-Px activities were increased after the treatment but this augmentation was not significant statistically. In gonarthrosis, different intraarticular therapies may diminish lipid peroxidation in synovial fluid. In the future, to assess the effectiveness of gonarthrosis treatment in addition to clinical criteria, such as the MDA to be used as a routine biochemical measurements can be made for further research.

Metrics

Metrics Loading ...

References

Greenwald RA. Oxygen radicals, inflamation, and arthritis: pathophysiological considerations and implications for treatment. Semin Arthritis Rheum 1991;20(4):219-40.

Sutipornpalangkul W, Morales NP, Charoencholvanich K, Harnroongroj T. Lipid peroxidation, glutathione, vitamin E, and antioxidant enzymes in synovial fluid from patients with osteoarthritis. Int J Rheum Dis 2009;12(4):324-8.

Uysal G.F, Başaran S. Diz osteoartriti. Türk Fiz Tıp Rehab Derg 2009;55(Supl.1):1-7.

Aydogan NH, Baydar ML, Atay T, Perktas I, Baykal BY, Özmeriç A. The effect of arthroscopic surgery and intraarticular drug injection to the antioxidation system and lipid peroxidation at osteoarthritis of knee. Saudi Med J 2008;29(3):397-402.

Regan EA, Bowler RP, Crapo JD. Joint fluid antioxidants are decreased in osteoarthritic joints compared to joints with macroscopically intact cartilage and subacute injury. Osteoarthritis Cartilage 2008;16(4):515-21.

Barbor DA, Harris SR. Oxygen free radicals and antioxidants: A review. Am Pharm 1994;34(9):26-35.

Kurz B, Steinhagen J, Schunke M. Articular chondrocytes and synoviocytes in a co-culture system: Influence on reactive oxygen species-induced cytotoxicity and lipid peroxidation. Cell Tissue Res 1999;296(3):555-63.

Schneider N, Mouithys-Mickalad AL, Lejeune JP, DebyDupont GP, Hoebeke M, Serteyn DA. Synoviocytes, not chondrocytes, release free radicals after cycles of anoxia/reoxygenation. Biochem Biophys Res Commun 2005;334(2):669- 73.

Tiku ML, Yan YP, Chen KY. Hydroxyl radical formation in chondrocytes and cartilage as detected by electron paramagnetic resonance spectroscopy using spin trapping reagents. Free Radic Res 1998;29(3):177-87.

Bates EJ, Johnson CC, Lowther DA. Hyaluronic acid synthesis in articular cartilage. An inhibition by hydrogen peroxide. Biochem Biophys Res Commun 1985;132(2):714-20.

Dıraçoğlu D. Osteoartritte intraartiküler hyalüronik asit tedavisi. Türk Fiz Tıp Rehab Derg 2007;53(4):154-9.

Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P. et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 2003;62(12):1145-55.

Atay T, Aslan A, Baydar M.L, Ceylan B, Baykal B, Kırdemir V. Gonartrozlu hastalarda artroskopik debritman sonrası viskosuplemantasyon uygulamalarının karşılaştırılması. Acta Orthop et Traumatol Turc 2008;42(4):228-33.

Petersson IF, Boegard T, Saxne T, Silman AJ, Svensson B. Radiographic osteoarthritis of the knee classified by the Ahlback and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis 1997;56(8):493-6.

Sun Y, Oberley LW, Li Y. A simple method for clinical assay of superoxide dismutase. Clin Chem 1988;34(3):497-500.

Paglia DE, Valentine WN. Studies on the quantitative and qualitative charaterization of erythrocyte glutathione peroxidase. J Lab Clin Med 1967;70(1):158-69.

Aebi H. Catalase in vitro. Methods Enzymol 1984;105:121-6.

Draper HH, Hadley M. Malondialdehyde determination as index of lipid peroxidation. Methods Enzymol 1990;186:421-31.

Loeser RF, Carlson CS, Del Carlo M, Cole A. Detection of nitrotyrosine in aging and osteoarthritic cartilage: Correlation of oxidative damage with the presence of interleukin-1beta and with chondrocyte resistance to insulin-like growth factor 1. Arthritis Rheum 2002;46(9):2349-57.

Martin JA, Brown T, Heiner A, Buckwalter JA. Post-traumatic osteoarthritis: the role of accelerated chondrocyte senescence. Biorheology 2004;41(3-4):479-91.

Martin JA, Klingelhutz AJ, Moussavi-Harami F, Buckwalter JA. Effects of oxidative damage and telomerase activity on human articular cartilage chondrocyte senescence. J Gerontol A Biol Sci Med Sci 2004;59(4):324-37.

Dijkgraaf LC, Zardeneta G, Cordewener FW, Liem RS, Schmitz JP, de Bont LG, et al. Crosslinking of fibrinogen and fibronectin by free radicals: a possible initial step in adhesion formation in osteoarthritis of the temporomandibular joint. J Oral Maxillofac Surg 2003;61(1):101-11.

Tiku ML, Shah R, Allison GT. Evidence linking chondrocyte lipid peroxidation to cartilage matrix protein degradation. Possible role in cartilage aging and the pathogenesis of osteoarthritis. J Biol Chem 2000;275(26):20069-76.

Raynould JP, Buckland-Wright C, Ward R, Choquette D, Haraoui B, Martel-Pelletier J. et al. Safety and efficiacy of long term intraarticular steroid injections in osteoarthritis of the knee: randomized, double blind, placebo-controlled trial. Arthritis Rheum 2003;48(2):370-7.

Erdem M, Güneş T, Şen C, Bostan B, Aslan H, Özyurt H, Köseoğlu RD. Eklem immobilizasyonu reaktif oksijen ürünlerini artırmaktadır: Deneysel çalışma. Acta Orthop Traumatol Turc 2009;43(5):436-43.

Chaturvedi V, Handa R, Rao DN, Wali JP. Estimation & significance of serum & synovial fluid malondialdehyde levels in rheumatoid arthritis. Indian J Med Res 1999;109:170-4.

Halliwell B, Gutteridge JMC. Role of free radicals and catalytic metal ions in human disease. An overview. Methods Enzymol 1990;186:1-85.

Grigolo B, Roseti L, Fiorini M, Facchini A. Enhanced lipid peroxidation in synoviocytes from patients with osteoarthritis. J Rheumatol 2003;30(2):345-7.

Halliwell B. Free radicals, antioxidants and human disease: Curiosity, cause, consequence? Lancet 1994;344(8924):721-4.

Alpaslan C, Bilgihan A, Alpaslan GH, Guner B, Ozgur Yis M, Erbas D. Effect of arthrocentesis and sodium hyaluronate injection on nitrite, nitrate, and thiobarbituric acid-reactive substance levels in the synovial fluid. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89(6):686-90.

McIlwain H, Silverfield JC, Cheatum DE, Poiley J, Taborn J, Ignaczak T. et al. Intraarticular Orgotein in osteoarhritis of knee: a placebo controlled efficacy, safety, and dosage comparison. Am J Med 1989;87(3):295-300.

Ivanova E, Ivanova B. Mechanism of the extracellular antioxidant defend. Exp Pathol Parasitol 2000;4:49-59.

Kalacı A, Uz E, Aslan B, Söğüt S, Özkan C, Yanat AN. Diz osteoartritli hastalarda eklem sıvısında nitrik oksit değerleri ve süperoksit dismutaz enzim aktiviteleri. Eklem Hastalıkları ve Cerrahisi 2007;18(1):13-17.

Ostalowska A, Birkner E, Wiecha M, Kasperczyk S, Kasperczyk A, Kapolka D, et al. Lipid peroxidation and antioxidant enzymes in synovial fluid of patients with primary and secondary osteoarthritis of the knee joint. Osteoarthritis Cartilage 2006;14(2):139-45.

Ozgocmen S, Ardicoglu O, Erdogan H, Fadillioglu E, Gudul H. In vivo effect of celecoxib and tenoxicam on oxidant/antioxidant status of patients with knee osteoarthritis. Ann Clin Lab Sci 2005;35(2):137-43.

Biemond P, Swaak AJ, Penders JM, Beindorff CM, Koster JF. Superoxide production by polymorphonuclear leucocytes in rheumatoid arthritis and osteoarthritis: In vivo inhibition by the antirheumatic drug piroxicam due to interference with the activation of the NADPH-oxidase. Ann Rheum Dis 1986;45(3):249-55.

Burak Cimen MY, Cimen OB, Eskandari G, Sahin G, Erdoğan C, Atik U. In vivo effects of meloxicam, celecoxib, and ibuprofen on free radical metabolism in human erythrocytes. Drug Chem Toxicol 2003;26(3):169-76.

Kırdemir P, Marsan A, Gogus N, Tabak Y, Tekin M. İntraartiküler neostigmin, tramadol ve tenoksikamın analjezik etkilerinin karşılaştırılması. Acta Orthop Traumatol Turc 2001;35(4):358-62.

Karatay S, Kızıltunç A, Yıldırım K, Karanfil RC, Senel K. Effects of different hyaluronic acid products on synovial fluid NO levels in knee osteoarthritis. Clin Rheumatol 2005;24(5):497-501.

Karakurum G, Karakok M, Tarakçıoğlu M, Koçer NE, Kocabaş R, Bağcı C. Comparative effect of intra-articular administration of hyaluronan and/or cortisone with evaluation of malondialdehyde on degenerative osteoarthritis of the rabbit's knee. Tohoku J Exp Med 2003;199(3):127-34.

Uğur M, Tuğuç A, Melikoğlu MA, Yıldırım K, Şenel K. Diz dejeneratif osteoartritli hastalarda intraartiküler hyaluronik asit ile intraartiküler metil prednizolon asetatın etkinliklerinin karşılaştırılması. Eurasian Journal of Medicine 2007;39(3):185- 8.