Boiogito, a Kampo medicine, improves hydrarthrosis in a rat model of knee osteoarthritis.

BACKGROUND: Hydrarthrosis, which is associated with knee pain and limited range of motion, decreases the quality of life (QOL) of patients with osteoarthritis (OA). The Kampo medicine boiogito is prescribed for the treatment of knee OA with hydrarthrosis; however, its precise mechanisms of action remain unknown. The purposes of this study were to assess the pharmacological effects of boiogito and its mechanisms of action on joint effusion in rats with surgically induced OA. METHODS: A rat OA model was produced by transecting the anterior (cranial) cruciate ligament, medial collateral ligament, and medial meniscus in the right knee joints of 7-week-old female Wistar rats. The rats were given chow containing boiogito (1 or 2%) or indomethacin (0.002 %) for 4 weeks after surgical transection. Levels of interleukin-1ß (IL-1ß) and hyaluronic acid (HA) were measured by enzyme-linked immunosorbent assay. Knee joint pain was assessed using an incapacitance tester. Osmotic water permeability in cultured rabbit synovial cells was assessed using stopped-flow analysis. RESULTS: Increased synovial fluid volume and knee joint pain were observed in rats with surgically induced OA. In rats with OA, levels of IL-1ß and HA in the articular cavity were higher but concentration of HA in synovial fluid was lower than in sham-operated rats, suggesting excessive synovial fluid secretion. Administration of boiogito improved hydrarthrosis, IL-1ß, and HA concentrations and alleviated knee joint pain in rats with OA. Indomethacin reduced IL-1ß and knee joint pain but failed to improve hydrarthrosis or HA concentration in rats with OA. Osmotic water permeability in synovial cells, which is related to the function of the water channel aquaporin, was decreased by treatment with boiogito. CONCLUSION: Boiogito ameliorates the increased knee joint effusion in rats with OA by suppressing pro-inflammatory cytokine IL-1ß production in the articular cavity and regulating function of water transport in the synovium. The improvement of hydrarthrosis by boiogito results in the increased HA concentration in synovial fluid, thus reducing joint pain. Boiogito may be a clinically useful treatment of QOL in patients with OA with hydrarthrosis.

The evaluation of gene polymorphisms associated with autoinflammatory syndrome in patients with palindromic rheumatism complicated by intermittent hydrarthrosis.

OBJECTIVES: Palindromic rheumatism (PR) is a type of acute arthritis or periarthritis characterized by recurrence, paroxysmal, or intermittent disease attacks and occasionally progresses to other types of rheumatic disease. PR patients who are anti-citrullinated protein antibodies (ACPA)-negative have a high prevalence of MEFV gene polymorphisms, and intermittent hydrarthrosis (IH) is also associated with MEFV polymorphisms. The purpose of this study was to evaluate the clinical characteristics of and autoinflammatory syndrome-associated gene polymorphisms in patients with PR and IH and to identify predictive factors for developing other rheumatic diseases. METHODS: Six PR patients (four females; median age at disease onset, 20.0 years; median age at evaluation, 47.0 years) were retrospectively evaluated for clinical features and polymorphisms in genes responsible for autoinflammatory diseases. RESULTS: All six patients fulfilled the diagnostic criteria for PR and showed clinical feature of IH. Two presented with recurrent fever. All six patients were negative for rheumatoid factor and ACPA and had normal articular X-ray findings. Among the six patients, MEFV gene polymorphisms known to cause FMF were identified in four, CIAS1 mutation was observed in one, and TNFRSFIA mutation was observed in one. Colchicine was effective in three patients with MEFV polymorphisms. The other five patients continued to experience PR, although three patients achieved remission with medication. CONCLUSIONS: PR presenting with IH might be associated with gene polymorphisms responsible for autoinflammatory diseases; colchicine appears to be effective in these patients.Key Point• Palindromic rheumatism with intermittent hydrarthrosis might be associated with gene polymorphisms responsible for autoinflammatory diseases.

[Evaluation of the efficacy of orgotein in a series of patients with hydrarthrosis of the knee]. / Valutazione della efficacia della orgoteina in una casistica di idrartro del ginocchio.

A study was carried out to verify the efficacy of intra-articular orgotein in patients with different forms of hydrarthrosis of the knee. The results confirm the value of orgotein for the local treatment of osteoarthritic joint swellings. However in the presence of marked exudative synovitis processes (chronic primary polyarthritis), the use of orgotein is of limited value.

The treatment of idiopathic and secondary hydrarthrosis of the knee by intra-articular Rifamycin SV.

Fifty-three patients, 28 females and 25 males, aged from 21 to 68 years, affected with mono- and bilateral intermittent hydrarthrosis of the knee and of a non-inflammatory nature, were included in an open study. All of the knees involved were treated with intra-articular infiltrations with Rifamycin SV. The weekly dosage of Rifamycin SV was 500 mg; the average duration of treatment was 6 weeks. Follow-up 1 year after the end of treatment showed a decrease or regression in joint effusion in all of the knees treated.

Transport time for salicylates from blood to joint fluid-- a test of histopathology of the synovial membrane.

Samples of blood and joint fluid, from sixty patients who had taken Bufferin, were examined for salicylates. The earliest appreance of salicylates occurred in blood between 3 and 13 minutes after intake, and in joint fluid between 11 and 36 minutes. The individual time lapse from the first appearance of salicylates in blood to that in joint fluid, designated the transport time, varied presumably with the changes of the synovial membrane caused by diseases; it was small in synovitis following trauma or focal infection and in osteoarthritis of short duration; it was greater in osteoarthritis, psoriatic arthritis, and rheumatoid arthritis of longer duration, and it showed great variations in immediate traumatic synovitis. Salicylates attained maximum concentration in joint fluid 100 to 155 minutes after intake. Similar factors as above probably accounted for the differences in these time intervals.