Effects and side effects of radiosynovectomy with yttrium 90 on rheumatic joint cartilage

Kerschbaumer, F.; Bauer, R.; Falser, N; Altmann, H. W.

doi:10.1007/bf00389679

Cited by 22 publications

(13 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, evidence that radiation may be detrimental to articular cartilage is provided by the ultrastructural studies of Kerschbaumer et a1 (12). They found greater matrix disruption and increased formation of vesicles and phagolysosomes in knee cartilage chondrocytes of patients with rheumatoid arthritis after radiosynovectomy with 5 mCi of 90Y (-10,000 rads based on the above formula [ 1 l]), in comparison with controls.…”

Section: Discussionmentioning

confidence: 99%

Suppression of glycosaminoglycan synthesis by articular cartilage, but not of hyaluronic acid synthesis by synovium, after exposure to radiation

Hugenberg

Myers

Brandt

1989

Arthritis & Rheumatism

View full text Add to dashboard Cite

We recently found that injection of 2 mCi of yttrium 90 (90Y; -123,000 rads) into normal canine knees stimulated glycosaminoglycan (GAG) synthesis by femoral condylar cartilage. The present investigation was conducted to determine whether radiation affects cartilage metabolism directly. Rates of GAG synthesis and degradation in normal canine articular cartilage were studied following irradiation. Cultured synovium from the same knees was treated similarly, to determine the effects of irradiation on hyaluronic acid synthesis. Twenty-four hours after exposure to 1,000 rads, 10,000 rads, or 50,000 rads, 35S-GAG synthesis by the cartilage was 93%, 69%, and 37%, respectively, of that in control, nonirradiated cartilage. The effect was not rapidly reversible: 120 hours after exposure to 50,000 rads, GAG synthesis remained at only 28% of the control level. Autoradiography showed marked suppression of 35S uptake by chondrocytes after irradiation. Cartilage GAG degradation was also increased following irradiation: 4 hours and 8 hours after exposure to 50,000 rads, the cartilage GAG concentration was only 66% and 54%, respectively, of that at time 0, while corresponding values for control, nonirradiated cartilage were 90% and 87%. In contrast to its effects on cartilage GAG metabolism, radiation at these levels had no effect on synovial hyaluronic acid synthesis.Although the use of radiation synovectomy for the treatment of refractory localized synovitis is becoming more common (l), little is known about the effects of this treatment on articular cartilage. Since cells that are most susceptible to the effects of radiation are generally those that exhibit a rapid rate of cell division (2), and chondrocytes in normal adult articular cartilage lack mitotic activity (3), radiation might be expected to have little effect on this tissue. In support of this, only minimal histologic alteration has been seen in cartilage following irradiation (2,(4)(5)(6), even with as much as 640,000 rads (6).We recently examined the effects of injection of yttrium 90 (90Y) into normal canine knees (7). While synovium from the irradiated knees exhibited extensive subintimal fibrosis and fibrin deposition, the histologic appearance of articular cartilage from these knees remained normal, suggesting that radiosynovectomy had not damaged the cartilage. Surprisingly, the rate of glycosaminoglycan (GAG) synthesis in articular cartilage from the irradiated knees was an average of 26% higher (ranging to 150% higher) than that in cartilage from the contralateral, nonirradiated knees. This raised the possibility that synovial ablation had stimulated cartilage GAG synthesis, either directly or by modulating the effects of a synovial factor(s) that influences cartilage GAG metabolism. Since direct effects of irradiation on the metabolism of

show abstract

Section: Discussionmentioning

confidence: 99%

Suppression of glycosaminoglycan synthesis by articular cartilage, but not of hyaluronic acid synthesis by synovium, after exposure to radiation

Hugenberg

Myers

Brandt

1989

Arthritis & Rheumatism

View full text Add to dashboard Cite

show abstract

“…33 In patients with rheumatoid arthritis, 8 and 12 weeks after RSO of the knee with 5 mCi 90 Y, both cellular and extracellular matrix damage were found in cartilage biopsy specimens. 34 The chondrocytes underwent a diffuse vesicularshaped transformation 8 weeks after RSO and included large quantities of intracellular particles containing Zr, proving that 90 Y did not selectively enter the synovial cells, as had been previously supposed, 29 but entered the chondrocytes as well. 34 In the matrix, the collagen fibres displayed irregular arrangement, innumerable ruptures and loss of the characteristic sub-banding, with complete disintegration of the fibres in a few places.…”

Section: Discussionmentioning

confidence: 65%

“…34 The chondrocytes underwent a diffuse vesicularshaped transformation 8 weeks after RSO and included large quantities of intracellular particles containing Zr, proving that 90 Y did not selectively enter the synovial cells, as had been previously supposed, 29 but entered the chondrocytes as well. 34 In the matrix, the collagen fibres displayed irregular arrangement, innumerable ruptures and loss of the characteristic sub-banding, with complete disintegration of the fibres in a few places. 34 Using electron microscopy, we found that the surface of cartilage was not only coarse but also greatly split with many crevices.…”

Section: Discussionmentioning

confidence: 65%

“…34 Using electron microscopy, we found that the surface of cartilage was not only coarse but also greatly split with many crevices. 34 On the other hand, in an animal study with healthy dogs, 4-13 weeks after 2-4 mCi 90 Y injection in the knee, GAG synthesis in cartilage cultures from irradiated knees was found to be increased, compared with cultures of the contralateral knee. 16 Morphological abnormalities were not observed in articular cartilage from the irradiated knee, nor did the water content or concentrations of uronic acid or DNA in cartilage from the irradiated knees differ from that in the contralateral knee.…”

Section: Discussionmentioning

confidence: 97%

“…34 In the matrix, the collagen fibres displayed irregular arrangement, innumerable ruptures and loss of the characteristic sub-banding, with complete disintegration of the fibres in a few places. 34 Using electron microscopy, we found that the surface of cartilage was not only coarse but also greatly split with many crevices. 34 On the other hand, in an animal study with healthy dogs, 4-13 weeks after 2-4 mCi 90 Y injection in the knee, GAG synthesis in cartilage cultures from irradiated knees was found to be increased, compared with cultures of the contralateral knee.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Radiation synovectomy with yttrium-90 for persisting arthritis has direct harmful effects on human cartilage that cannot be prevented by co-administration of glucocorticoids: an in vitro study

Jahangier

Jacobs²,

Bijlsma³

et al. 2006

Annals of the Rheumatic Diseases

View full text Add to dashboard Cite

Background: It was recently shown that radiation synovectomy with yttrium-90 ( 90 Y) and glucocorticoids is not superior to intra-articular glucocorticoids alone in the treatment of persistent gonarthritis. In that study, it seemed that in patients treated by radiation synovectomy, progression of radiographic joint damage occurred. Objective: To test in vitro the direct effects of radiation synovectomy with 90 Y on human cartilage. Methods: Human cartilage tissue was exposed to 90 Y, glucocorticoids or the combination. 1:2000 to 1:20 dilutions of the clinical dose of 5 mCi/ml 90 Y and 20 mg/ml glucocorticoids were used. After a 4-day exposure and a subsequent 12-day recovery period, proteoglycan synthesis, proteoglycan release and proteoglycan content were measured. In addition, human synovial tissue was cultured for 4 days with 90 Y or glucocorticoids. Culture supernatants were analysed for cartilage-destructive activity. Results:90 Y, glucocorticoids and the combination inhibited proteoglycan synthesis considerably and dose dependently, an effect that sustained for at least 12 days. Proteoglycan release was transiently increased by 90 Y, an effect that was not changed by addition of glucocorticoids, which had no effect on its own. Proteoglycan content was eventually adversely affected by 90 Y, an effect hardly influenced by glucocorticoids. Neither 90 Y nor glucocorticoids changed the cartilage-destructive properties of synovial tissue. Conclusions:90 Y, but not glucocorticoids, has direct harmful effects on cartilage in vitro. Indirect beneficial effects of 90 Y via inhibition of cartilage-destructive properties of synovial tissue could not be shown. These observations may explain the possible radiographic joint damage on radiation synovectomy.

show abstract

90Y-Labeled Tin Fluoride Colloid as a Promising Therapeutic Agent: Preparation, Characterization, and Biological Study in Rats

Janković

Vranješ-Đurić

Djokić

et al. 2012

Journal of Pharmaceutical Sciences

View full text Add to dashboard Cite

Effects and side effects of radiosynovectomy with yttrium 90 on rheumatic joint cartilage

Cited by 22 publications

References 5 publications

Suppression of glycosaminoglycan synthesis by articular cartilage, but not of hyaluronic acid synthesis by synovium, after exposure to radiation

Suppression of glycosaminoglycan synthesis by articular cartilage, but not of hyaluronic acid synthesis by synovium, after exposure to radiation

Radiation synovectomy with yttrium-90 for persisting arthritis has direct harmful effects on human cartilage that cannot be prevented by co-administration of glucocorticoids: an in vitro study

90Y-Labeled Tin Fluoride Colloid as a Promising Therapeutic Agent: Preparation, Characterization, and Biological Study in Rats

Contact Info

Product

Resources

About