Disease-specific expression patterns of proteases in synovial tissues.
To assess whether protease expression patterns can be discriminated according to matrix degradation mechanisms in aseptic prosthesis loosening (APL), rheumatoid arthritis (RA), and osteoarthritis (OA), we immunohistochemically examined the expressions of matrix metalloproteinase-1 and cathepsins B, D, and L in periprosthetic synovial-like interface tissues from 32 patients with failed prosthetic hips, from 29 RA-patients with hip synovial membranes, and from 35 patients with primary OA. Numerical values, calculated for the positivity of each protease, were used to rank the staining patterns, and a multivariate analysis was carried out to examine the discriminant probabilities. As a result of stepwise linear discriminant analyses, the three groups were successfully discriminated with probabilities of 100%, 62.1%, and 77.1%, respectively. Cathepsin L was significantly related to the discrimination of APL from RA and primary OA. Disease-specific protease activation pathways might exist, and cathepsin L can be a key enzyme for APL pathogenesis.


METHODS
Prognostic study, level III (retrospective study).
Kido
Akira
A
Department of Orthopedic Surgery, Nara Medical University, Nara, Japan. akirakid@naramed-u.ac.jp
Pap
Geza
G
Kawate
Kenji
K
Roessner
Albert
A
Takakura
Yoshinori
Y
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip; D002401:Cathepsin B / Q000032:analysis; D002402:Cathepsin D / Q000032:analysis; D056668:Cathepsin L; D002403:Cathepsins / Q000032:analysis; D003546:Cysteine Endopeptidases / Q000032:analysis; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007150:Immunohistochemistry; D016014:Linear Models; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000032:analysis; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D010447:Peptide Hydrolases / Q000032:analysis*; D011379:Prognosis; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013583:Synovial Membrane / Q000201:enzymology* / Q000473:pathology
D002403:Cathepsins; D010447:Peptide Hydrolases; D003546:Cysteine Endopeptidases; D002401:Cathepsin B; C534281:CTSL protein, human; D056668:Cathepsin L; D002402:Cathepsin D; D020781:Matrix Metalloproteinase 1