Effects of glycosaminoglycan polysulphate in the treatment of chondrocalcinosis.

The effect of intra-articular injections of glycosaminoglycan polysulphate (Arteparon) on pain, joint mobility, inflammatory reactions, cartilage calcification and the urinary excretion of inorganic pyrophosphate was studied in 12 patients with chondrocalcinosis. All cases were bilateral and the less affected homologous joint served as an untreated control. The patients were followed over a one-year period. The glycosaminoglycan polysulphate treatment brought about a significant reduction of pain (p less than 0.01) and improvement of joint mobility (p less than 0.001). This effect continued for the whole one-year follow-up period, but could not be seen in the control joints. After the treatment period of 2-7 weeks there was a marked decrease in cartilage calcification paralleled with an increase in the excretion of inorganic pyrophosphate.

[Serum keratan sulfate studies and their significance in the evaluation of cartilage degradation in degenerative and inflammatory joint diseases]. / Szérum keratán szulfát vizsgálatok és jelentöségük a porcdegradáció megítélésében degeneratív és gyulladásos ízületi betegségekben.

Fragments of high density cartilage proteoglycan (aggrecan) are released during either the normal or pathological turnover of cartilage proteoglycans, which fragments diffuse into the synovial fluids and then appear in the serum. The keratan sulphate (KS; a glycosaminoglycan side chain of aggrecan) is resistant to enzymatic degradation, it has a relatively low clearance and has a "standard" serum level indicating the actual level of cartilage (proteoglycan) breakdown. Using anti-KS monoclonal antibody in ELISA (enzyme-linked immunosorbent assay), we measured serum KS levels in patients with different joint diseases. The highest KS content (595 ng/ml) was measured in the sera of patients with articular chondrocalcinosis (calcium pyrophosphate crystal deposition disease/pseudogout). Slightly lower KS levels were determined in osteoarthrosis (OA; 578 ng/ml) and much less in rheumatoid arthritis (RA; 421 ng/ml). All these patient groups (either with degenerative or inflammatory joint diseases) expressed slightly higher KS levels compared to control blood donors (295 ng/ml). However, there were remarkable variations between these diseased groups, i. e., KS levels in patients with RA were significantly lower than in patients with OA (p < 0.001) and this difference was more pronounced in rheumatoid patients with I-II Steinbrocker stage (370 ng/ml) or in those treated with non-steroid anti-inflammatory drugs (NSAIDs) (382 ng/ml). Keratan sulphate levels in RA patients chronically treated with corticosteroid (460 ng/ml) or auro-thiomalat (473 ng/ml) indicate that these drugs may influence the cartilage metabolism more effectively than the NSAIDs.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of arteparon on the formation of calcium phosphate and calcium pyrophosphate crystals--comparative experimental study]. / Wirkung von Arteparon auf die Bildung von Calciumphosphat- und Calciumpyrophosphatkristallen--Vergleichende experimentelle Untersuchung.

The influence of Arteparon on crystal formation in vitro has been examined in calcium orthophosphate and in calcium pyrophosphate mixtures. Similar factors may be operative in the cartilage calcification processes, and thus in chondrocalcinosis. Authors have ascertained that Arteparon - like chondroitin sulphate - inhibits crystal separation. The optimal concentration for this inhibition lies in the range of the proteoglycan content of normal cartilage. Where there are physiological phosphate-pyrophosphate ratios and a low magnesium concentration, it is certain that Arteparon has an inhibiting effect. Apart from the spatial structure of the substance, the importance of negative charge density for the inhibition of separation of calcium phosphate and pyrophosphate crystals is thought to contribute to this effect of Arteparon.