Glucocorticoid treatment may prevent long term damage to joints

02 Sep 2011

Joint injury can result in irreversible damage of cartilage which, despite treatment and surgery, often eventually leads to osteoarthritis (OA) in later life. New research published in BioMed Central's open access journal Arthritis Research & Therapy demonstrates that short term treatment of damaged cartilage with glucocorticoids can reduce long term degenerative changes and may provide hope for prevention of OA after injury.

A normal joint is covered by a layer of cartilage containing proteoglycans such as aggrecan and lubricating fluid containing glycosaminoglycans (GAG) such as hyaluronic acid. In a double whammy, after injury proteoglycans and other molecules in cartilage begin to break down and the synthesis of these proteoglycans within cartilage is reduced. Additionally proinflammatory cytokines such as TNFα, IL-1β, and IL-6 are released into the synovial fluid after injury and further increase GAG loss from cartilage. 

Using a 'worst-case scenario' system in which cartilage was subjected to mechanical injury and bombarded with immune system-stimulating bio-molecules (TNFα and IL-6) the glucocorticoid  dexamethasone (DEX) was able to reduce GAG loss and restore proteoglycan synthesis levels to normal. 

Prof Alan Grodzinsky from the MIT Center for Biomedical Engineering said, "Glucocorticoid injections are sometimes used to relieve the pain of established osteoarthritis, but there are concerns about long-term use. Our results suggest that short-term glucocorticoid treatment after joint injury may help restore components of cartilage to preinjury levels and consequently may prevent the long term changes which lead to osteoarthritis."

-ENDS-

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Notes to Editors

1. Effects of Short-Term Glucocorticoid Treatment on Changes in Cartilage Matrix Degradation and Chondrocyte Gene Expression Induced by Mechanical Injury and Inflammatory Cytokines

Yihong C.S. Lu, Christopher Evans and Alan J Grodzinsky

Arthritis Research & Therapy 2011, 13:R142 doi:10.1186/ar3456

Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central's open access policy.

2. Arthritis Research & Therapy is an international, peer-reviewed online journal, publishing original research, reviews, commentaries and reports on cellular and molecular mechanisms of arthritis, musculoskeletal conditions and systemic autoimmune rheumatic diseases and translation of this knowledge into advances in clinical care.