الفهرس 
Subject and methodsOnly 14 pages are availabe for public view
 |  | from | 139 |  |  |
| | | from | 139 | | |
Abstract
The aim of this work was to estimate the level of TGF-f31in
both serum and synovial fluids of patients with primary OA of the
knee and to assess the potential usefulness of its measurement
as a marker of disease severity versus radiographic grading of
kneeOA.
Thirty patients with primary knee OA were included in this
study. All of them had effusion either in one or both knees. They
fulfilled the American College of Rheumatology Criteria for
classification and reporting of OA(AJtman et al 0,1986).
They were twenty four females (80 %) and six males (20%).
Their age ranged between 39 and 68 years with a mean of 56.7:1:
7.64 years. The disease duration ranged between 2 to 12 years
with a mean of 6.3 :I: 2.92years.
Patients who had associated diseases either acute
inflammatory conditions, diabetes, chronic hepatitis, chronic
inflammatory iOint disease e.g. RA, SLE were excluded from the
study. Another Twenty nonnal subiects were included in the
study as a control group. They were age and sex matched.
94
_____________ SUMMARY and CONCLUSION
A thorough clinical examination was performed for each
patient as follows :
-Body weight, height ,and B.M.I.
-Joint symptoms and signs.
-Pain score as assessed according to visual analogue scale.
-Plain radiographs were taken for both knees. Grading of
radiographic findings was done according to kellgren and
Lawrence (1957)
-The presence of osteophytes was also detected and they were
graded according to Thomas et al.,(1975).
-Routine laboratory investigations such as complete blood picture,
erythrocyte sedimentation rate, and hemoglobin.
-Estimation of TGF-J31in patients (serum and synovial fluid) and
controls (serum) using ELISA technique.
The findings of this study were as follow :
-Patients with knee OA had significantly higher body weight and
B.M.I.than the control group (p<O.05).
95
____________ SUMMARY and CONCLUSION
-There were highly statistically significant differences between
both groups as regards ESR and HB (p<0.001)
-As regards pain severi1y grading in OA patients, 6 patients (20%)
had grade II, 14 patients (46.7%) had grade III and 10 patients
(33.3%) had grade IV.
-As regards x-ray grading in OA patients,5 patients (16.7%) had
grade 0-1, 10 patients (33.3%) had grade II, 7 patients (23.3%)
had grade III, and 8 patients (26.7%) had grade IV.
-As regards grading of osteophyte score, 5 patients (16.7%) had
no osteophyte, 10 patients (33.3%) had grade I, 6 patients (20%)
had grade II and 9 patients (30%) had grade III.
-The mean level of serum TFG-,H in OA patients showed a
statistically significant increase (p<0.05) as compared to controls.
-The mean level of synovial TGF-,H in OA patients was 7.5 folds
higher than the serum level indicating intra-articular production.
-A highly significant difference was found (p<O.OO1)between the
level of serum TGF-,H and pain severi1y grading in OA patients.
- A significant difference was found (p<0.05) between the level of
synovial TGF-J31and pain severi1y grading in OA patients.
96
_____________ SUMMARY and CONCLUSION
-A highly significant difference was found (p<O.001) between the
level of serum TGF-JH and x-ray grading in OA patients.
-A significant difference was found (p<O.05) between the level of
synovial TGF-J31and x-ray grading in OA patients.
-A highly significant difference was found (p<O.001) between the
level of serum TGF-J31 and grading of osteophyte score in OA
patients.
-A significant difference was found (p<O.05) between the level of
synovial TGF-J31and grading of osteophyte score in OA patients.
-There were significant correlations between serum TGF-J31 and
age, 8.M.!., disease duration, pain severity grading, x-.ray grade
and grading of osteophyte score.
-There were significant correlations between synovial TGF-IH
and age, disease duration, pain severity grading, x-ray grade
and grading of osteophyte score.
-There was a significant correlation (p<O.05) between serum and
synovial TGFJ31in OA patients.
97
------------- SUMMARY and CONCLUSION
In conclusion, our results support the hypothesis that TGF-
(31 has a role in the pathogenesis of OA.TGF-J31levels was
significantly elevated in patients with knee OA. Measurement of
TGF-J31,either in serum or in synovial flUid, was found to be a
useful marker that reflects the severity of OA as measured radiologically.