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MR Vol.13 No.4 indexに戻る
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MODERN RHEUMATOLOGY
Vol.13 No.4 |
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Neurogenic inflammation in osteoarthritis
of the knee |
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| Tomoyuki Saito1 |
(1) Department of Orthopaedic Surgery, Yokohama
City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama,
236-0004, Japan
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| Abstract |
| The synovium in a knee joint has
an extensive neural network in the somatic and autonomic nervous
systems. In medial compartmental osteoarthritis of the knee, neuropeptides
were most abundant, with an especially large number of substance
P and calcitonin gene-related peptide-immunoreactive free nerve
endings. Some of the substance P-positive nerve endings were surrounded
by monocytes. Substance P and calcitonin gene-related peptide were
found more frequently in the medial than in the lateral or suprapatellar
areas. Substance P-positive free nerve endings showed more dendritic
morphologic features in the medial region than those in the lateral
and suprapatellar regions, and small nerves were accompanied by
newly developed vessels in synovial villi. In the medial region,
the synovitis was more remarkable than in the lateral region. Patients
suffering from medial compartmental osteoarthritis of the knee
complain of pain on the anteromedial portion of the knee joint
when walking or standing. Therefore, these findings suggest that
free nerve endings containing substance P may be implicated in
the development and persistence of inflammatory synovitis and the
pain pathway in osteoarthritis of the knee. |
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| Key words |
| Osteoarthritis of the knee - Neurogenic
inflam-mation - Neuropeptide - Synovitis |
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