Investigation of serum IL - 1β level in patients with knee osteoarthritis

Nội dung text: Investigation of serum IL - 1β level in patients with knee osteoarthritis

1. Journal of military parmaco-medicine n 07-2017 INVESTIGATION OF SERUM IL-1β LEVEL IN PATIENTS WITH KNEE OSTEOARTHRITIS Nguyen Ngoc Chau*; Doan Van De* SUMMARY Objects: To evaluate serum level of IL-1β and a relation between the IL-1β and inflammatory factors in patients with knee osteoarthritis (OA). Subjects and methods: 43 patients were diagnosed with knee osteoarthritis and 40 healthy individuals were selected. The study had focused on gender, age, VAS (Visual Analog Scale) index, ESR (Erythrocyte Sedimentation Rate) and serum level of IL-1β. Results: - The mean level of IL-1β in the knee OA patients was higher than that in control group (116.5 ng/mL vs. 1.7 ng/mL; p < 0.01). - There was a correlation between level of IL-1β, VAS (r = 0.41; p < 0.05), and ESR (r = 0.55; p < 0.05). Conclusions: There was an increase of IL-1β level and correlation between IL-1β level and some inflammatory symptoms in knee OA patients * Keywords: Osteoarthritis; IL-1β level. INTRODUCTION Studies showed that there are some factors playing important role in the Osteoarthritis is one of the common pathogenesis of osteoarthritis such as: forms of arthritic diseases [3]. The earliest interleukin-1 beta (IL-1β), tumor necrosis manifestation is the articular cartilage factor-alpha (TNF-α) [4, 8]. Therefore, damage, followed by the changes on the we performed this study to: Quantify serum joint surface and the formation of osteophytes, TNF-α levels and find out the relation finally leads to deformity of the joints, between the IL-1β and inflammatory reduced joint mobility and disability. factors of patients with knee osteoarthritis treated at 103 Military Hospital. So far, there have been numerous studies on the clinical and subclinical SUBJECTS AND METHODS features of osteoarthritis, as well as the 1. Study subjects. etiology, pathogenesis and methods of * Patients with osteoarthritis: treatment of osteoarthritis. Through these 43 patients were definitely diagnosed studies, there are many theories about with osteoarthritis and treated in the the etiology, the pathogenesis and the Rheumatology and Endocrinology Department changes in joints of osteoarthritis [10]. of 103 Hospital. * 103 Military Hospital Corresponding author: Nguyen Ngoc Chau (chau70@gmail.com) Date received: 10/07/2017 Date accepted: 08/08/2017 138
2. Journal of military phrmaco-medicine n O7-2017 * Control group: - Pain levels of joints were assessed based 40 healthy individuals were selected by on VAS; ESR of the subjects was measured. these criteria: - Definitive diagnosis of osteoarthritis was made based on 1991 ACR criteria [5]. - Not related to other arthritic diseases. * Serum IL-1β quantification: - Not related to infectious diseases. Serum IL-1β was quantified by - Consistent with the study group about immunoassay technique with the use of the ratio of male and female. flow cytometry principles on fluorescent 2. Methods. microparticles using the Bio-Plex kit and performed at the Immunoassay Laboratory A cross-sectional, case-control, descriptive of the Research Center of Military Pharmacy study. and Medicine, Military Medical University. * Medical examination and diagnosis: * Method of data analysis: - Patient’s and control’s information, Collected data were analyzed by medical including medical history, age, gender were statistic method using Microsoft Excel collected. 2013 Software. RESULTS AND DISCUSSION 1. Clinical characteristics and IL-1β concentration of studied objects. Table 1: Gender characteristics of studied objects. Gender Patient group Control group p n (%) n (%) Female 36 (83.72) 33 (82.5) > 0.05 Male 7 (16.28) 7 (17.5) > 0.05 p < 0.01 < 0.01 The study was performed on 43 patients with knee osteoarthritis, the incidence of female is higher than male with a statistically significant difference (83.72% vs 16.28%; p < 0.01. This difference may relate to endocrine factors, pregnancy The sex ratio of patients with osteoarthritis in this study was also consistent with many authors’ results suggesting that osteoarthritis is more common in women than men, especially after the age of 50. Table 2: Distribution of age group of patients with knee osteoarthritis. Age group Patient Female Male n (43) Percentage n (36) Percentage n (7) Percentage < 50 5 11.63 4 11.11 1 14.29 50 - 59 25 58.34 20 55.56 5 71.42 ≥ 60 13 30.23 12 33.33 1 14.29 Χ ± SD 53.2 ± 9.02 50.6 ± 8.62 56.6 ± 10.71 139
3. Journal of military parmaco-medicine n 07-2017 The mean age of patients was 53.2 ± 9.02, the mean age of male patients was (56.6 ± 10.71) higher than that of female patients (50.6 ± 8.62) (p > 0.05). The most common age group was 50 - 59 (58.34%). This result was also consistent with a previous study by Vu Dinh Chinh, in which the mean age of patients with osteoarthritis was 50 - 60 [1]. Table 3: Pain levels (VAS) and erythrocyte sedimentation rate (ESR) of studied objects. Indexes Patients (n = 43) Control group (n = 40) p Pain levels (VAS) 5.2 ± 1.2 (-) Erythrocyte sedimentation rate 33.3 ± 16.3 11.5 ± 6.7 < 0.01 (ESR) - mm Joint pain is an important symptom and usually occurs early in the progress of knee osteoarthritis [3, 4]. The results of our study showed that the pain level of patients was at average 5.2 ± 1.2 (2.8 - 8.2). This level of pain had a high prevalence in patients with knee osteoarthritis. This result was also similar to the result of studies by Nguyen Mai Hong [2], Anna Angelova [5], the pain symptom of patients was also at an average level. Pain symptom was seen in all patients with osteoarthritis, which was explained by the damage of the joint itself as well as there was an inflammatory condition at various levels [4, 10]. The inflammation manifestation was also clearly expressed when assessing the erythrocyte sedimentation rate of patients [4]. In this study, there was a statistically significant difference (p < 0.01) between the patient group (33.3 mm) and the control group (11.5 mm). Table 4: Serum IL-1β concentration of studied subjects. Patient ( Χ ± SD) Control ( Χ ± SD) Cytokine p Male Female Male Female p (n = 7) (n = 36) (n = 7) (n = 33) 135.8 ± 117.6 110.3 ± 135.7 > 0.05 1.4 ± 0.3 1.8 ± 1.6 > 0.05 IL-1β (pg/mL) 116.5 ± 125.4 1.7 ± 1.2 < 0.01 Median value of IL-β 75.4 2.1 concentration IL-1β is one of the typical cytokines of the inflammatory reaction that occurs in the body. Previous studies have also shown that there has been a certain role of inflammatory reaction in the pathogenesis of osteoarthritis [4, 8, 9]. In our study, patient group had markedly high concentration of IL-1β than the control group (mean concentration: 116.5 ± 125.4 pg/mL vs. 1.7 ± 1.2 median concentration: 75.4 pg/mL vs. 2.1 pg/mL). 140
4. Journal of military phrmaco-medicine n O7-2017 This is the new data in patients with osteoarthritis. The level of pain partly reflects knee osteoarthritis who are Vietnamese. the inflammatory reaction as well as This result had further contribution of inflammatory factors [4]. evidence to the role of IL-1β in inflammatory In vitro and in vivo studies have reactions in the pathogenesis of osteoarthritis demonstrated that IL-1β and TNF-α were [9, 10]. prominent catabolic cytokines involved in the articular cartilage destruction progress in 2. The relation between IL-1β and osteoarthritis. Therein, IL-1β was known as some clinical and subclinical factors of a functional regulatory factor of chondrocytes. patients with knee osteoarthritis. Recent studies have shown that IL-1β For joint diseases, pain level is one of was capable of triggering the synthesis of the main symptoms. Assessing pain levels most of the proteinase enzymes that is one of the important symptoms of damage the cartilage tissue [4, 8, 9]. 10 9 8 7 6 VAS 5 4 3 2 y = 0.0038x + 4.7649 r² = 0.1716 1 0 0 100 200 300 400 500 IL-1 beta (pg/mL) Chart 1: The correlation between IL-1β concentration and pain level in patients with knee osteoarthritis. The result showed that serum IL-1β concentration had a moderate positive correlation with pain level of patients with knee osteoarthritis (y = 0.0038x + 4.7649; r = 0.41; p < 0.05). 141
5. Journal of military parmaco-medicine n 07-2017 80 70 60 50 40 ESR (mm) ESR 30 y = 0.0713x + 24.948 20 r² = 0.3023 10 0 0 100 200 300 400 500 IL-1 beta (pg/ml) Chart 2: The correlation between IL-1β concentration and ESR in patients with knee osteoarthritis. The result showed that serum IL-1β However, synovitis at different levels concentration had a moderate proportional still occurred in both early and late stage correlation with ESR of patients with knee of osteoarthritis. osteoarthritis (y = 0.0713x + 24.948; r = 0.55; It has been observed that there was an p < 0.05). increase of preinflammatory cytokines in Thus, the results even demonstrated osteoarthritis at very early stage and clearly that IL-1β played a certain role in synovitis commonly occurred in the late stage of osteoarthritis, with the participation the inflammatory reaction of osteoarthritis of activated T-lymphocytes invading into through the correlation of IL-1β concentration the synovial membrane of the joint. with pain level and erythrocyte sedimentation rate. It seemed that the level of catabolic enzymes and inflammatory mediators The results of this study approved the (such as prostaglandins and nitric oxide in evidence that osteoarthritis, particularly the synovial fluid and in the tissues of knee osteoarthritis, had inflammation condition the degenerative joints) had a positive at various levels. correlation with the concentration of Osteoarthritis was not considered as cytokines such as IL-1 and TNF-α [7, 10]. classical arthritis because there was no Therefore, therapies have been studied presence of neutrophils (especially in the that affect the expression or effects of early stage of the disease) and no systemic these cytokines in the treatment of manifestations of inflammation [3, 10]. osteoarthritis [11]. 142
6. Journal of military phrmaco-medicine n O7-2017 CONCLUSIONS Bệnh h ọc c ơ x ươ ng kh ớp n ội khoa. NXB Giáo dục Vi ệt Nam. 2011, tr.140-153. The results of the study showed that 5. Anna Angelova, Elena M.Ilieva. there was an increase in serum IL-1β Effectiveness of high intensity laser therapy concentration (116.5 ± 125.4 pg/mL vs. for reduction of pain in knee osteoarthritis. 1.7 ± 1.2 pg/mL) and a proportional correlation Pain Research and Management. 2016, pp.1-11. with some symptoms of inflammatory 6. Altman R.D. Criteria for classification of reaction: VAS (r = 0.41; p < 0.05) and clinical osteoarthritis. J Rheumatol Suppl. 1991, ESR (r = 0.55; p < 0.05) in patients with 27, pp.10-12. knee osteoarthritis. 7. Benito M.J, Veale D.J, Bresnihan et al. Synovial tissue inflammation in early and late REFERENCES osteoarthritis. Ann Rheum Dis. 2005, 64 (9), 1. Vũ Đình Chính, Đinh Th ị Di ệu H ằng, pp.1263-1267. Nguy ễn Th ị Nga. Nghiên c ứu th ực tr ạng b ệnh 8. Krasnokutsky S, Attur M, Palmer G, thoái hóa kh ớp g ối và m ột s ố y ếu t ố liên quan Samuels J, Abramson SB. Current concepts in ở ng ười t ừ 40 tu ổi tr ở lên t ại m ột s ố vùng the pathogenesis of osteoarthritis. Osteoarthritis nông thôn t ỉnh H ải D ươ ng. T ạp chí Nội khoa. Cartilage. 2008, 16, Suppl 3, S1-3. 2009 , số 4, tr.102-111. 9. Goldring S.R, Goldring M.B. The role of 2. Nguy ễn Mai H ồng. Nghiên c ứu giá tr ị cytokines in cartilage matrix degeneration in của n ội soi trong ch ẩn đoán và điều tr ị thoái osteoarthritis. Clin Orthop Relat Res. 2004, hóa kh ớp g ối. Lu ận án Ti ến s ỹ Y h ọc. H ọc vi ện 427 (Suppl), S27-36. Quân y. 2011. 10. Tannenbaum T, Russell A.S. Osteoarthritis, 3. Nguy ễn Phú Kháng, Đoàn V ăn Đệ, Mechanisms in Rheumatology. 2001, pp.105-113. Đỗ Th ị Minh Thìn và CS. Thoái hóa kh ớp. 11. Zheng W.J, Tang F.L, Li J, Zhang F.C, Bệnh h ọc n ội khoa: B ệnh kh ớp - N ội ti ết. NXB Li Z.G et al. Evaluation of efficacy and safety Quân đội Nhân dân. 2008, tr.53-59. of diacerein in knee osteoarthritis in Chinese 4. Nguy ễn Th ị Ng ọc Lan, Nguy ễn V ĩnh Ng ọc, patients. Chin Med Sci J. 2006, Jun, 21 (2), Nguy ễn V ăn Hùng và CS. Thoái hóa kh ớp. pp.75-80. 143