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Effects of hyaluronan on nitric oxide levels and superoxide dismutase activities in synovial fluid in knee osteoarthritis

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Abstract

The aim of the present study was to evaluate the effects of hyaluronan (HA) on nitric oxide (NO) levels and superoxide dismutase (SOD) enzyme activities in synovial fluid (SF) in the treatment of patients with knee osteoarthritis (OA). SF samples were aspirated from OA patients before the commencement of the treatment (n = 23) and 6 weeks after they were treated with HA products. NO levels and SOD activities were compared between the pre- and post-treatment of OA patients and of the control group (n = 10). SF NO levels were significantly higher in patients with OA before the commencement of the treatment compared with the post-treatment (p < 0.001) and the control groups. The SF SOD activity of patients before the commencement of the treatment was lower than the values in the controls and post-treatment (p < 0.001). There is no significant correlation between SF NO and SOD levels and the radiographic changes of the OA knee according to Kellgren–Lawrence grading (p > 0.05). Also, the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) pain scores and physical function scores were gradually improved. These findings made us think that SF NO was a potent mediator in cartilage damage in OA, whereas SOD was an antioxidant mediator in the same process. Exogenous HA injections might reduce the NO levels and increase SOD activities in synovial fluid. These effects also do not seem to be dependent on the radiographic grading of the OA knee. More comprehensive studies are needed to clarify a possible clinical significance of this topic, and we suggest that this is an important area for further research into new treatment options.

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Abbreviations

HA:

hyaluronan

MMP:

matrix metalloproteinases

NBT:

nitroblue tetrazolium

NO:

nitric oxide

OA:

osteoarthritis

ROS:

reactive oxygen species

SOD:

superoxide dismutase

WOMAC:

Western Ontario and McMaster Universities Osteoarthritis index

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Acknowledgment

We thank Dr. Cahit Özer for his help with the statistical analysis. We also thank Dr. Cenk Özkan for obtaining the SF samples of the control group.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Faculty of Medicine, Mustafa Kemal University, 31100, Antakya, Hatay, Turkey

    Aydıner Kalacı, Bahadır Aslan & Ahmet Nedim Yanat

  2. Department of Medical Biology and Genetics, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey

    H. Ramazan Yılmaz & Efkan Uz

  3. Department of Biochemistry, Faculty of Medicine, Mustafa University, Antakya, Hatay, Turkey

    Sadık Söğüt

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  1. Aydıner Kalacı
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  2. H. Ramazan Yılmaz
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Correspondence to Aydıner Kalacı.

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Kalacı, A., Yılmaz, H.R., Aslan, B. et al. Effects of hyaluronan on nitric oxide levels and superoxide dismutase activities in synovial fluid in knee osteoarthritis. Clin Rheumatol 26, 1306–1311 (2007). https://doi.org/10.1007/s10067-006-0504-y

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  • DOI: https://doi.org/10.1007/s10067-006-0504-y

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