The effect of different intraarticular drug applications to the antioxidation system and lipid peroxidation in gonarthrosis

Abstract

Oxidative stress and lipid peroxidation may have a role in pathogenesis of knee osteoarthritis (gonarthrosis). In this study, we investigated both the role of disease mechanisms, lipid peroxidation and antioxidant defense system and the effects of different intraarticular therapies on antioxidant enzyme activity and lipid peroxidation in gonarthrosis. A total of 75 patients with knee pain who were diagnosed as gonarthrosis according to the American College of Rheumatology (ACR) criteria were included in this study, and randomly and equally divided into 5 groups. Only intraarticular salin was applied to the control group (Group 1). Intraarticular high molecular weight hyaluronic asit (HA, hylan G-F 20) treatment was given to Group 2 for 3 weeks. Intraarticular metil prednizolon acetate were administered to Group 3. Intraarticular low molecular weight HA, hyaluronan treatment was given to Group 4 for 5 weeks. Intraarticular tenoxicam treatment was given to Group 5. Blood and synovial fluid samples were taken from all the patients for biochemical analysis, and the following parameters were measured: Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA). After the treatment synovial fluid MDA levels were significantly decreased in each group according to control group. No significant change was found in MDA, SOD, GSH-Px and catalase activities in hemolysate. CAT enzymatic activity was not present in synovial fluid. Synovial fluid SOD and GSH-Px activities were increased after the treatment but this augmentation was not significant statistically. In gonarthrosis, different intraarticular therapies may diminish lipid peroxidation in synovial fluid. In the future, to assess the effectiveness of gonarthrosis treatment in addition to clinical criteria, such as the MDA to be used as a routine biochemical measurements can be made for further research.