title: The innervation of synovium of human osteoarthritic joints in comparison with normal rat and sheep synovium.
abstract: OBJECTIVE
  To study whether osteoarthritis (OA) in the knee is associated with a change of the innervation pattern in the synovial layer.
  
  
  METHODS
  In synovial tissue from the normal knee joint of rat and sheep we studied the presence of vessels and of nerve fibres using transmission electron microscopy and immunohistochemistry. Synovial material was also obtained from patients who underwent total knee replacement surgery. This material was examined for inflammatory changes, and the presence of vessels and nerve fibres was assessed.
  
  
  RESULTS
  The synovium in the parapatellar region of the normal knee joint of rat and sheep exhibited a dense capillary and neuronal network. It was entered by calcitonin gene-related peptide containing sensory fibres and tyrosine hydroxylase-positive sympathetic nerve fibres. Synovial material from patients with knee OA exhibited different degrees of inflammation. Synovial material without inflammation exhibited a similar vascular and neuronal network as the normal knee joint from rat and sheep. However, in synovium with inflammatory changes we found a significant decrease of nerve fibres in depth ranges close to the synovial lining layer depending on the degree of inflammation whereas deeper regions were less affected.
  
  
  CONCLUSIONS
  Inflammatory changes in the synovium of OA joints are associated with a massive destruction of the capillary and neuronal network which is present in normal synovium. Due to the disappearance of the sensory fibres it is unlikely that OA pain is initiated directly in the synovium. The loss of normally innervated vascularisation may have multiple consequences for the physiological functions of the synovium.
authors: Department of Physiology, University Hospital Jena, Friedrich Schiller University, D-07743 Jena, Germany. Annett.Eitner@med.uni-jena.de
authors: A
authors: A
authors: Eitner
authors: J
authors: J
authors: Pester
authors: S
authors: S
authors: Nietzsche
authors: G O
authors: GO
authors: Hofmann
authors: H-G
authors: HG
authors: Schaible
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism; D002196:Capillaries / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000098:blood supply / Q000294:innervation* / Q000473:pathology*; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology / Q000648:ultrastructure; D020370:Osteoarthritis, Knee / Q000473:pathology* / Q000503:physiopathology*; D051381:Rats; D017208:Rats, Wistar; D012756:Sheep; D013045:Species Specificity; D013583:Synovial Membrane / Q000098:blood supply / Q000294:innervation* / Q000473:pathology*
chemical_list: D015740:Calcitonin Gene-Related Peptide
keywords: Inflammation; Innervation; Osteoarthritis; Synovium; Vascularisation