OBJECTIVE: In recent years, a great number of studies have investigated the possible role of reactive oxygen species (ROS) in the aetiology and pathogenesis of osteoarthritis (OA). The aim of this study was to investigate plasma and synovial fluid lipid peroxidation and nonenzymatic antioxidants in patients with primary osteoarthritis of the knee (KOA) and age- and sex-matched healthy controls.

METHODS: Peripheral blood and synovial fluid samples obtained from 35 patients with primary KOA (mean age 59 +/- 11 years, mean disease duration 9 +/- 6 years) and 26 healthy volunteers (mean age 40 +/- 12 years), were analyzed. Primary KOA was diagnosed according to the clinical, laboratory, and radiologic criteria.
The levels of malondialdehyde (MDA), one of the end products of lipid peroxidation, in plasma, erythrocytes and synoval fluid, were measured fluorometrically as 2-thiobarbituric acid-reactive substance (TBARS) by the Ohkawa method. Ceruloplasmin levels in serum and synoval fluid, were detected by enzyme-linked immunosorbent assay (ELISA). Kinetics methods were used to determine levels of albumin, bilirubin and urea acid in serum and synovial fluid. The levels of antioxidant vitamins A and E in serum were determined by high performance liquid chromatography (HPLC).

RESULTS: KOA patients had significantly higher MDA level in plasma when compared with the controls (p=.002). Ceruloplasmin levels was higher in serum and synovial of KOA patients than in the control group, but not statistical significantly. Urea acid concentration was significantly decreased in synovial fluid of KOA patients when compared to control subjects (p=.026). The levels of serum and synovial fluid albumin, bilirubin, and vitamin A and E remained unaltered.

CONCLUSION: KOA patients have high level of lipid peroxidation with compensatory changes in the levels of some noenzymatic antioxidants. These results suggested that oxidant stress plays a very important role in the pathogenesis of KOA.

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