PECULIARITIES OF INTERCELLULAR SUBSTANCE METABOLISM OF PATIENTS WITH OSTEOARTHRITIS AND CONNECTIVE TISSUE DYSPLASIA

Objective of work: to study the peculiarities of intercellular substance metabolism of patients with osteoarthritis (OA) and connective tissue dysplasia (CTD).

Materials and methods. 95 female patients with OA take part in the study; 70 of them have signs of CTD. Inclusion criteria: female sex, age from 20 to 60 y.o., OA diagnosed on the basis of criteria of the American Association of Rheumatology. Exclusion criteria: injury of the lower extremities in medical history, systemic connective tissue diseases, ovariectomy, prolonged (over 6 months) intake of glucocorticoid hormones. 50 almost healthy women were included into the reference group. Study of clinical phenomena of the CTD of patients with OA was performed, as well as the study of levels of cartilage oligomeric matrix protein (COMP) and glycosaminoglycans (GAGs) in the blood serum.

Results. In 500 of patients examined, OA was revealed with 95 cases (19 %) including combinations with CTD in 70 cases (14 %). Polyosteoarthrosis was revealed with 38 (40 %) patients, isolated gonarthrosis was revealed with 30 (31.5 %) patients, coxarthrosis was revealed with 20 (21 %) patients, and osteoarthritis of ankle joints was revealed with 7 (7.3 %) patients. Increasing of the COMP concetration was revealed with patients with combined pathology of up to 24.15 ± 11.35 μm/l, with OA – up to 18.26 ± 6.35 μm/l, with CTD – up to 14.32 ± 3.96 μm/l. Maximum variability of indicators was marked in the group of people with the combination of OA and CTD. Serum GAG concentrations were increased with female patients with the combined pathology and isolated OA of up to 53.65 ± 21.5 and 46.96 ± 15.82 μm/l, respectively. No increasing of GAG concentration was revealed with patients with CTD.

Conclusion. Increasing of the intercellular substance metabolism is observed with persons that suffer from CTD. To a greater degree, CTD affects the state of the fibrillar component of the intercellular substance as compared to its matrix component. Degradation of cartilage with patients on the CTD background is higher than of patients with isolated OA, which is expressed with the debut of disease at an earlier age. COMP is a sensitive marker of both OA and CTD, which allows considering it as a prospective marker for early laboratory diagnostics of these states, while serum concentrations of GAG do not display the peculiarities of the cartilage metabolism of persons that suffer from CTD.

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