Die Lokalisation des Neurokinin 1-Rezeptors im Hüftgelenk von Patienten mit schmerzhafter Osteoarthrose

 

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Zusammenfassung

Einleitung: Verschiedene Studien konnten zeigen, dass Substanz P (SP) enthaltende afferente Nervenfasern eine Rolle bei der Entzündungsinduktion und der Schmerzwahrnehmung in Arthrosegelenken spielen. Die Effekte des Neuropeptids SP werden hauptsächlich über den Tachykinin Rezeptor Neurokinin 1 (NK1-R) vermittelt. Studienziel: Das Ziel der vorliegenden Studie war es, den NK1-R erstmalig in menschlichem Gelenkgewebe darzustellen. Methodik: Drei Patienten mit schmerzhafter Osteoarthrose der Hüfte (Gruppe 1) und drei Fälle mit medialer Oberschenkelhalsfraktur ohne Gelenkdegeneration (Gruppe 2, Kontrollgruppe) wurden zur Implantation einer Hüftendoprothese die Gelenkkapsel reseziert. In Gruppe 1 entfernten wir zusätzlich das Bindegewebe der Fossa acetabuli. Die Gewebe wurden daraufhin immersionsfixiert, am Kryotom in 50 µm Schichten geschnitten und der NK1-R immunhistochemisch nachgewiesen. Ergebnisse: Der NK1-Rezeptor konnte in beiden Gruppen identifiziert werden. Er war auf der Wand von venösen Gefäßen, auf Schwann Zellen von Nervenbündeln und auf Nervenfasern lokalisiert. Das Verteilungsmuster des Rezeptors auf den verschiedenen Gewebsstrukturen war in beiden Gruppen vergleichbar, allerdings schien die Anzahl der Zellen mit NK1-Immunreaktivität in der Osteoarthrosegruppe höher zu sein als in der Vergleichsgruppe. Schlussfolgerung: Mit der vorliegenden Studie konnte erstmalig der NK1-R in menschlichem Gelenkgewebe nachgewiesen werden. Die Dichte der NK1-R-positiven Strukturen schien in der Osteoarthrosegruppe höher zu sein als in der Kontrollgruppe. Die Lokalisation des Rezeptors auf verschiedenen Zelltypen legt multiple Effekte von SP in normalen und osteoarthrotischen Gelenken nahe.

Abstract

Introduction: Recent studies on osteoarthritis have focused on nociceptive substance P (SP) containing afferent nerve fibres. The effects of SP are known to be mainly mediated by the tachykinin receptor neurokinin 1 (NK1-R). Aim: The aim of the present study was to demonstrate the NK1-R in human joint tissues. Methods: The hip joint capsule of three patients with painful hip osteoarthritis (Group 1), three patients with femoral neck fracture showing no cartilage destruction (Group 2, controls) and the soft tissue of the fossa acetabuli of Group 1 were resected during hip arthroplasty implantation. The tissue samples were cut into small blocks and immersion-fixed in Zamboni's fixative. The specimens were frozen, cut into 50 µm sections and immunostained using a standard immunohistochemical staining protocol. Results: In Groups 1 and 2 the NK1-receptor was localised in the wall of venous vessels, on Schwann cells of nerve bundles and on nerve fibres. In the osteoarthritis group the staining pattern was similar but the number of NK1-bearing cell structures seemed to be enhanced. Conclusions: The present study provides the first evidence of NK1-R in the human hip joint. In patients with painful osteoarthritis the density of NK1-R-positive cell structures seemed to be increased. The localisation of the NK1 receptor on different cell types suggests multiple effects of SP in normal and osteoarthritic joints.

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Dr. med. G. Saxler

Klinik und Poliklinik für Orthopädie · Universität Duisburg-Essen

45122 Essen

Phone: 02 01/40 89/21 39

Fax: 02 01/40 89/27 22

Email: guido.saxler@uni-essen.de