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. 1997 May;56(5):299–307. doi: 10.1136/ard.56.5.299

Synovial fluid chondroitin and keratan sulphate epitopes, glycosaminoglycans, and hyaluronan in arthritic and normal knees

C Belcher 1, R Yaqub 1, F Fawthrop 1, M Bayliss 1, M Doherty 1
PMCID: PMC1752377  PMID: 9175930

Abstract

OBJECTIVES—To determine concentrations of chondroitin sulphate (CS) and keratan sulphate (KS) epitopes, glycosaminoglycans (GAGs) and hyaluronan (HA) in knee synovial fluid (SF) from normal subjects and patients with osteoarthritis (OA) or rheumatoid arthritis (RA), to test whether these variables may be used as markers of the OA process.
METHODS—OA was subdivided into large joint OA (LJOA), nodal generalised OA (NGOA), and OA with calcium pyrophosphate crystal deposition (CPA). Clinical assessment of inflammation (0-6) was undertaken on OA and RA knees. Knee SF was examined by enzyme linked immunosorbent assay for: CS epitopes, using monoclonal antibodies 3-B-3 and 7-D-4; KS epitope using monoclonal antibody 5-D-4; and HA, using biotinylated HA binding region of cartilage proteoglycan. Total sulphated GAGs were measured by dye binding with 1:9 dimethylmethylene blue.
RESULTS—Increased SF 3-B-3 concentrations and 3-B-3/GAG ratio were found in OA, compared with RA or normal knees, with higher 3-B-3 and 3-B-3/GAG in LJOA and NGOA than in CPA. SF 7-D-4 and 7-D-4/GAG were reduced in RA, compared with normal and OA; SF 5-D-4 was reduced in OA compared with normal. GAG and HA concentrations were decreased in both OA and RA. No correlations with radiographic scores were observed, but SF 7-D-4 was lower in `inflamed' compared with `non-inflamed' RA and OA knees. In patients with bilateral samples there were strong correlations between right and left knees for all SF variables.
CONCLUSIONS—Changed concentrations of SF CS and KS can be detected in OA with a profile that differs from that seen in RA. Clinical subgrouping and local joint inflammation may influence these measures, supporting different pathogenesis within OA subgroups and requirement for careful patient characterisation in SF studies.



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Figure 1  .

Figure 1  

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Correlation between measurement of 3-B-3 in left and right knees of individual patients. When tested by Spearman's rank correlation, r=0.7324, p<0.001.

Figure 2  .

Figure 2  

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Comparison between RA, OA, and normal knees for all epitopes measured. The central solid line represents the median, with the box representing the middle 50% of the data. The error bar cap lines mark the 10th and 90th percentiles. Dots represent individual data points outside the 10th and 90th percentiles.

Figure 3  .

Figure 3  

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Comparison between RA, OA, and normal knees for ratio of chondroitin sulphate and keratan sulphate epitopes to total sulphated glycosaminoglycans. The central solid line represents the median, with the box representing the middle 50% of the data. The error bar cap lines mark the 10th and 90th percentiles. Dots represent individual data points outside the 10th and 90th percentiles.

Figure 4  .

Figure 4  

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Comparison between the OA subclasses NGOA, LJOA, and CPA for all epitopes measured. The central solid line represents the median, with the box representing the middle 50% of the data. The error bar cap lines mark the 10th and 90th percentiles. Dots represent individual data points outside the 10th and 90th percentiles.

Figure 5  .

Figure 5  

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Comparison between the OA subclasses NGOA, LJOA, and CPA for ratio of chondroitin sulphate and keratan sulphate epitopes to total sulphated glycosaminoglycans. The central solid line represents the median, with the box representing the middle 50% of the data. The error bar cap lines mark the 10th and 90th percentiles. Dots represent individual data points outside the 10th and 90th percentiles.

Selected References

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