| 柏中喜,何永正,许明军.体外冲击波对膝骨性关节炎大鼠模型的治疗效果及其机制探讨[J].中国康复,2025,40(10):588-593 |
| 体外冲击波对膝骨性关节炎大鼠模型的治疗效果及其机制探讨 |
| The therapeutic effect and mechanism of extracorporeal shock wave on knee osteoarthritis rat model |
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| DOI：10.3870/zgkf.2025.10.002 |
| 中文关键词: 体外冲击波 膝骨关节炎 软骨基质 |
| 英文关键词: extracorporeal shock wave knee osteoarthritis cartilage matrix |
| 基金项目:湖北省中医药管理局中医药科研项目（ZY2023F072） |
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| 中文摘要: |
| 目的：研究体外冲击波（ESWT）对膝骨性关节炎（KOA）大鼠模型的治疗效果及其机制。方法：将44只大鼠随机分为正常组、模型组、药物组、冲击波组（每组11只），除正常组外均建立KOA动物模型。药物组以1 mg/kg美洛昔康灌胃，冲击波组采用ESWT治疗，正常组、模型组不予干预。采用Mankin评分评价大鼠膝关节损伤严重程度；采用压痛仪、热痛仪测定大鼠压痛、热痛阈值；采用酶联免疫吸附试验（ELISA）法检测血清中肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）、白细胞介素9（IL-9）水平及关节液基质金属蛋白酶3（MMP-3）、基质金属蛋白酶9（MMP-9）、Ⅱ型胶原水平；采用苏木精-伊红（HE）染色观察关节软骨组织形态，免疫印迹法检测滑膜组织半胱氨酸蛋白酶1（Caspase-1）、消皮素D（GSDMD）蛋白表达。结果：与正常组比较，模型组、药物组及冲击波组大鼠Mankin评分、TNF-α、IL-1β、IL-9、MMP-3、MMP-9、滑膜组织Caspase-1、GSDMD蛋白表达升高（P<0.05），压痛、热痛阈值、Ⅱ型胶原降低（P<0.05）。与模型组比较，药物组、冲击波组Mankin评分、TNF-α、IL-1β、IL-9、MMP-3、MMP-9、滑膜组织Caspase-1、GSDMD蛋白表达降低（P<0.05），冲击波组最低（P<0.05），压痛、热痛阈值、Ⅱ型胶原升高（P<0.05），冲击波组最高（P<0.05）。模型组细胞排列明显异常，胞间可见大量炎性浸润，药物组、冲击波组关节软骨组织形态得到明显改善，胞间可见炎性浸润减少，冲击波组形态趋于正常。结论：ESWT可降低KOA大鼠Mankin评分及压痛、热痛阈值，抑制MMP-3、MMP-9及Caspase-1、GSDMD蛋白表达，减轻炎性反应，促进Ⅱ型胶原合成，有利于改善KOA大鼠膝关节组织形态，提升KOA治疗的短期效果。 |
| 英文摘要: |
| Objective: To study the therapeutic effect and mechanism of extracorporeal shock wave therapy (ESWT) on knee osteoarthritis (KOA) rat model. Methods: Totally, 44 rats were randomly divided into normal group, model group, drug group and shock wave group (11 in each group). KOA animal model was established in all rats except normal group. The drug group was given 1 mg/kg meloxicam, shock wave group received ESWT, normal group and model group were not interfered. The severity of knee joint injury was evaluated by Mankin score. Tenderness and heat pain threshold of rats were measured by tenderness meter and heat pain meter. Serum levels of tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β), IL-9, matrix metalloproteinase 3 (MMP-3), MMP-9 and type II collagen were detected by ELISA. The morphology of articular cartilage was observed by HE staining. The expression levels of cysteinyl aspartate specific proteinase-1 (Caspase-1) and gasdermin-D (GSDMD) in synovial tis-sue were detected by Western blot. Results: Compared with normal group, Mankin score, TNF-α, IL-1β, IL-9, MMP-3, MMP-9, Caspase-1 and GSDMD protein expression in synovium tissue were increased in model group, drug group and shock wave group, and tenderness, heat pain threshold and type II collagen were decreased (P<0.05). Compared with model group, Mankin score, TNF-α, IL-1β, IL-9, MMP-3, MMP-9, Caspase-1 and GSDMD protein expression in synovium tissue were decreased in meloxicam group and shock wave group, the lowest in shock wave group (P<0.05), tenderness, heat pain threshold and type II collagen were increased, and the highest in shock wave group (P<0.05). The cell arrangement of the model group was obviously abnormal, and a large number of inflammatory infiltrates could be seen between cells. The articular cartilage morphology was significantly improved in the meloxicam group and the shock wave group, and the inflammatory infiltration between cells was reduced, and the shock wave group tended to be normal. Conclusion: ESWT can reduce the Mankin score, tenderness and heat pain threshold of KOA rats, inhibit the release of MMP-3, MMP-9, Caspase-1, GSDMD protein expression and inflammatory response, and promote the synthesis of type II collagen, which is conducive to improving the knee joint morphology of KOA rats and improving the short-term effect of KOA treatment. |
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