Levels of Hormones in Plasma and in Synovial Fluid of Knee Joint of Patients with Rheumatoid Arthritis
Hladiny hormónov v plazme a v synovialnej tekutine kolenného kĺbu pri reumatoidnej artritíde
Východisko.
Dysfunkcia endokrinneho systému sa považuje za rizikový faktor vzniku reumatoidnej artritídy. Cieľom práce bolo vyšetrenie hladín vybraných hormónov v plazme a v exudátoch kolenného kĺbu u pacientov s reumatoidnou artritídou alebo osteartrózou, ktoré by mohli ovplyvňovať lokálny priebeh zápalu.
Metódy a výsledky.
Vyšetrilo sa 39 pacientov s reumatoidnou artritídou (22 žien, 17 mužov) a l2 osôb s osteoartrózou (6 mužov a 6 žien). V plazme a v exudáte z kolena sa stanovili hladiny kortizolu, 17-beta estradiolu, progesterónu, dehydroepiandrosterónu, testosterónu, aldosterónu, prolaktínu, inzulínu a C-peptidu použitím radioimunologických súprav. V plazme pacientov s reumatoidnou artritídou sa v porovnaní s osteoartrózou zistili zvýšené hladiny 17-beta estradiolu a inzulínu. Plazmatické koncentrácie ostatných sledovaných hormónov sa signifikantne nelíšili. V zápalovom exudáte kolena reumatikov sa našli zvýšené hladiny 17-beta estradiolu, progesterónu a aldosterónu. Hladiny ostatných hormónov v exudátoch reumatikov a pacientov s osteoartrózou sa signifikantne nelíšili. Stanovenie pomeru hladín 17-beta estradiolu ku kortizolu resp. dehydroepiandrosterónu alebo testosterónu však ukázalo zvýšené podiely estrogénov nad androgénmi a glukokortikoidami v exudátoch reumatikov.
Závery.
Výsledky ukázali, že nami sledované steroidné a peptidické hormóny sa dostávajú do exudátu kolenného kĺbu a po prvý raz bola popísaná prítomnosť inzulínu, aldosterónu a C-peptidu v synovialnej tekutine kolenného kĺbu. U reumatikov sa zistila výrazna prevaha hladín prozápalovo pôsobiacich estrogénov nad androgénami, čo ukazuje, že estrogény môžu aj lokálnym pôsobením ovplyvnovať priebeh zápaloveho procesu.
Klúčové slová:
steroidné a peptidické hormóny, exudát kolena, reumatoidná artritída, osteoartróza.
Authors:
L. Macho; J. Rovenský 1; Z. Rádiková; R. Imrich; O. Greguška 1; M. Vigaš
Authors place of work:
Ústav experimentálnej endokrinológie SAV, Bratislava
; Národný ústav reumatických chorôb, Piešťa
1
Published in the journal:
Čas. Lék. čes. 2007; 146: 292-296
Category:
Original Article
Summary
Background.
Dysfunction of endocrine system is very likely one of the important risk factors involved in the pathogenesis of rheumatoid arthritis. The aim of the present study was to investigate the levels of selected hormones in plasma and in synovial fluid of knee joint of patients with rheumatoid arthritis or with osteoarthritis, which could affect the inflammatory processes.
Methods and Results.
Thirty nine patients with rheumatoid arthritis (22 females and 17 males) and 12 patients with osteoarthritis (6 females and 6 males) were investigated. Concentrations of the following hormones were determined in plasma and synovial fluids: cortisol, 17-beta-estradiol, progesterone, dehydroepiandrosterone, aldosterone, testosterone, prolactin, insulin and C-peptide by using radioimmunoassay kits. Increased levels of 17-beta-estradiol and insulin were found in patients with rheumatoid arthritis as compared to those with osteoarthritis. The plasma concentrations of other hormones under study were not significantly different in these groups of patients. Higher levels of 17-beta estradiol, progesterone and aldosterone were noted in inflammatory knee exudate of patients with rheumatoid arthritis. The levels of other hormones in exudates of patients with rheumatoid arthritis and those with osteoarthritis were not significantly different. The ratio of 17-beta estradiol / cortisol, 17-beta estradiol / testosterone and 17-beta estradiol / dehydroepiandrosterone showed increased proportions of estrogens over androgens or glucocorticoids in exudate from patients with rheumatoid arthritis.
Conclusions.
These results demonstrated that steroid and peptide hormones are transferred to synovial fluid of knee. The presence of insulin, C-peptide and aldosterone was described for the first time in synovial fluid. In patients with rheumatoid arthritis a predomination of the levels of proinflammatory estrogens over androgens was found in knee exudate. Also the levels of aldosterone and progesterone were elevated in inflammation knee exudate. This suggests that these hormones present in synovial fluid may affect the local rheumatoid inflammatory processes.
Key words:
steroid and peptidic hormones, synovial fluid, rheumatoid arthritis, osteoarthritis.
Štítky
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistČlánok vyšiel v časopise
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