Release of lubricating synovial surfactant by intra-articular steroid.
Abstract: This study was undertaken to determine whether glucocorticosteroids promote the secretion of lubricating surfactant, i.e. surface-active phospholipid (SAPL), into the joint. A standard clinical dose (100 mg) of methylprednisolone acetate (MPA) in 2.5 ml of saline was injected into the load-bearing right radiocarpal joint of five horses and 2.5 ml of saline injected into each of the contralateral joints used as controls. Synovial fluid (SF) was aspirated from all 10 joints before injection and at intervals of 16 and 32 h after injection, and then analysed by standard methods. All test joints showed an elevated level of SAPL, the increases averaging 112% after 16 h and 76% after 32 h, which were highly significant relative to the control joints. A large increase at 16 h was also found in proteolipid as a possible further marker of surfactant release. Significant quantities of proteolipid were also found in human SF. Since intra-articular steroids can dramatically improve joint mobility in both humans and horses, it is proposed that part of the benefit may be derived from improved lubrication arising from the remarkable ability of SAPL to lubricate under high load. Other possible benefits of elevating surfactant levels in the joints include control of cartilage hydration, promotion of macrophage activity and the ability to scavenge oxygen free radicals.
Publication Date: 1998-07-17 PubMed ID: 9667619DOI: 10.1093/rheumatology/37.6.649Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research examines whether glucocorticosteroids, specifically a type called methylprednisolone acetate (MPA), can boost the release of a lubricating surfactant or surface-active phospholipid (SAPL) into a joint area. The results indicate that increased levels of this surfactant can significantly improve joint mobility and may potentially aid in the regulation of cartilage hydration, boost macrophage activity, and aid free-radical elimination.
Study Design and Procedures
- The study was carried out by injecting a typical clinical dosage (100 mg) of methylprednisolone acetate (MPA) mixed with 2.5 ml of saline solution into the weight-supporting right radiocarpal joint of five horses.
- The contralateral joints of each horse were injected with 2.5 ml of saline solution alone to serve as controls for the experiment.
- Synovial fluid, the fluid found between joints, was extracted from all 10 joints prior to injection and again at 16 and 32 hours post-injection. The fluid samples were then analyzed utilizing standardized methods.
Experimental Results
- The results showed that all test joints exhibited an increased level of SAPL, with an average increase of 112% observed after 16 hours and a 76% increase after 32 hours, figures deemed highly significant compared to the control joints.
- A substantial increase was also observed in proteolipid, another potential indicator of surfactant release, after 16 hours.
- A significant amount of proteolipid was also found within the synovial fluid of humans.
Implications and Conclusions
- The research suggests that the administration of intra-articular steroids can significantly improve joint mobility in both horses and humans. This improvement may be partially due to the increased lubrication provided by the SAPL.
- Elevating surfactant levels in joints may also offer potential benefits like controlling cartilage hydration, promoting macrophage function, and supporting the neutralization of oxygen-based free radicals.
- While further research is required, the findings indicate a strong link between glucocorticosteroids and enhanced joint mobility, potentially providing a therapeutic avenue for joint-related issues.
Cite This Article
APA
Hills BA, Ethell MT, Hodgson DR.
(1998).
Release of lubricating synovial surfactant by intra-articular steroid.
Br J Rheumatol, 37(6), 649-652.
https://doi.org/10.1093/rheumatology/37.6.649 Publication
Researcher Affiliations
- Paediatric Respiratory Research Centre, Mater Children's Hospital, Brisbane, Queensland, Australia.
MeSH Terms
- 1,2-Dipalmitoylphosphatidylcholine / metabolism
- Animals
- Anti-Inflammatory Agents / pharmacology
- Carpus, Animal / drug effects
- Carpus, Animal / metabolism
- Horses / physiology
- Injections, Intra-Articular
- Methylprednisolone / analogs & derivatives
- Methylprednisolone / pharmacology
- Methylprednisolone Acetate
- Synovial Fluid / metabolism
Citations
This article has been cited 4 times.- Klawitter JJ, Patton J, More R, Peter N, Podnos E, Ross M. In vitro comparison of wear characteristics of PyroCarbon and metal on bone: Shoulder hemiarthroplasty. Shoulder Elbow 2020 Dec;12(1 Suppl):11-22.
- Sluzalska KD, Liebisch G, Ishaque B, Schmitz G, Rickert M, Steinmeyer J. The Effect of Dexamethasone, Adrenergic and Cholinergic Receptor Agonists on Phospholipid Metabolism in Human Osteoarthritic Synoviocytes. Int J Mol Sci 2019 Jan 15;20(2).
- von Stechow D, Rittmeister M. [Intra-articular injection. Substances and techniques]. Orthopade 2003 Dec;32(12):1127-35.
- Steinmeyer J. Phospholipids and Sphingolipids in Osteoarthritis. Biomolecules 2025 Feb 8;15(2).
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