title: Human aggrecanase generated synovial fluid fragment levels are elevated directly after knee injuries due to proteolysis both in the inter globular and chondroitin sulfate domains.
abstract: OBJECTIVE
  To examine different aggrecanase generated fragments in synovial fluid (SF) from patients with acute and chronic knee injuries and from knee healthy subjects.
  
  
  METHODS
  We prepared SF-D1 samples from acute (n=35) and chronic (n=35) knee injury patients and knee healthy subjects (n=10). Aggrecan fragments were analyzed in the SF-D1 samples by quantitative (G1, ARGS, KEEE and G3 antibodies) and non-quantitative (GRGT and AGEG antibodies) Western blot.
  
  
  RESULTS
  ARGS-SELE, ARGS-chondroitin sulfate (CS)1, GRGT-, GLGS- and AGEG-G3 fragments were the main ARGS and G3 fragments in injured and reference samples. In the acute injury samples the concentrations of these fragments were increased compared to the reference, and the level of the ARGS-SELE remained elevated for at least 2 years after the joint injury. Both SF ARGS fragments and aggrecanase generated G3 fragments had high sensitivity and specificity as biomarkers in distinguishing injured from healthy knee joints, although the ARGS fragments had higher area under the receiver operating characteristic curve (AUC) values for injuries (74-86%) than the G3 fragments (AUC values 63-68%).
  
  
  CONCLUSIONS
  Our results suggest that during the acute phase after knee injury there is an increased aggrecanase activity against both the interglobular domain (IGD) and the CS2 cleavage sites of joint cartilage aggrecan. This increase in SF aggrecanolytic fragments is present for several years after the injury. SF ARGS fragments are better biomarkers than the aggrecanase generated G3-fragments in distinguishing injured from healthy knee joints.
authors.affiliation: Department of Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden. andre.struglics@med.lu.se
authors.forename: A
authors.initials: A
authors.lastname: Struglics
authors.forename: M
authors.initials: M
authors.lastname: Hansson
authors.forename: L S
authors.initials: LS
authors.lastname: Lohmander
mesh_terms: D000328:Adult; D053674:Aggrecans / Q000032:analysis / Q000378:metabolism*; D015153:Blotting, Western; D002358:Cartilage, Articular / Q000378:metabolism*; D016022:Case-Control Studies; D002809:Chondroitin Sulfates / Q000378:metabolism; D010450:Endopeptidases / Q000032:analysis / Q000378:metabolism*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D059748:Proteolysis; D012680:Sensitivity and Specificity; D013582:Synovial Fluid / Q000378:metabolism*; D055815:Young Adult
chemical_list: D053674:Aggrecans; D002809:Chondroitin Sulfates; D010450:Endopeptidases; C083641:aggrecanase