title: Synovial fluid chondroitin and keratan sulphate epitopes, glycosaminoglycans, and hyaluronan in arthritic and normal knees.
abstract: OBJECTIVE
  To determine concentrations of chondroitin sulphate (CS) and keratan sulphate (KS) epitopes, glycosaminoglycans (GAGs) and hyaluronan (HA) in knee synovial fluid (SF) from normal subjects and patients with osteoarthritis (OA) or rheumatoid arthritis (RA), to test whether these variables may be used as markers of the OA process.
  
  
  METHODS
  OA was subdivided into large joint OA (LJOA), nodal generalised OA (NGOA), and OA with calcium pyrophosphate crystal deposition (CPA). Clinical assessment of inflammation (0-6) was undertaken on OA and RA knees. Knee SF was examined by enzyme linked immunosorbent assay for: CS epitopes, using monoclonal antibodies 3-B-3 and 7-D-4; KS epitope using monoclonal antibody 5-D-4; and HA, using biotinylated HA binding region of cartilage proteoglycan. Total sulphated GAGs were measured by dye binding with 1:9 dimethylmethylene blue.
  
  
  RESULTS
  Increased SF 3-B-3 concentrations and 3-B-3/GAG ratio were found in OA, compared with RA or normal knees, with higher 3-B-3 and 3-B-3/GAG in LJOA and NGOA than in CPA. SF 7-D-4 and 7-D-4/GAG were reduced in RA, compared with normal and OA; SF 5-D-4 was reduced in OA compared with normal. GAG and HA concentrations were decreased in both OA and RA. No correlations with radiographic scores were observed, but SF 7-D-4 was lower in 'inflamed' compared with 'non-inflamed' RA and OA knees. In patients with bilateral samples there were strong correlations between right and left knees for all SF variables.
  
  
  CONCLUSIONS
  Changed concentrations of SF CS and KS can be detected in OA with a profile that differs from that seen in RA. Clinical subgrouping and local joint inflammation may influence these measures, supporting different pathogenesis within OA subgroups and requirement for careful patient characterisation in SF studies.
authors.affiliation: Rheumatology Unit, City Hospital, Nottingham.
authors.forename: C
authors.initials: C
authors.lastname: Belcher
authors.forename: R
authors.initials: R
authors.lastname: Yaqub
authors.forename: F
authors.initials: F
authors.lastname: Fawthrop
authors.forename: M
authors.initials: M
authors.lastname: Bayliss
authors.forename: M
authors.initials: M
authors.lastname: Doherty
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D002809:Chondroitin Sulfates / Q000032:analysis / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D000939:Epitopes / Q000032:analysis; D005260:Female; D006025:Glycosaminoglycans / Q000032:analysis*; D006801:Humans; D006820:Hyaluronic Acid / Q000032:analysis; D007632:Keratan Sulfate / Q000032:analysis / Q000276:immunology; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000378:metabolism*; D013582:Synovial Fluid / Q000737:chemistry*
chemical_list: D015415:Biomarkers; D000939:Epitopes; D006025:Glycosaminoglycans; D006820:Hyaluronic Acid; D002809:Chondroitin Sulfates; D007632:Keratan Sulfate