الفهرس 
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Abstract
Osteoarthritis (OA) is the most common clinical chronic joint disease with cartilage degeneration, damage and bone hyperplasia. Knee OA has an estimated prevalence between 12 % and 35 % in the general population and is considered the leading cause of musculoskeletal disability in the elderly population worldwide (Zhang, et al., 2010)In the past, OA was defined as a simple process of “wear and tear” but during the last few decades many studies have shown that it is a more complex disease of unknown aetiology (Ackerman, et al., 2017).Currently, Radiography is currently the ‘gold’ standard for diagnosis and monitoring OA, but plain x-ray is rather insensitive as it provides little or no information on soft tissues although it does provide an indirect measure of cartilage loss via measurement of joint space width. Therefore, x-rays can only diagnose OA at relatively advanced stages of the disease when there is already irreparable damage to the joint(s) (Lotz, et al., 2014).Consequently, new more sensitive and less invasive tools are required for both early diagnosis and monitoring disease progression. Over the years, a series of markers have been proposed that may aid the synthesis or degradation of the joint tissues. However, despite the active research in this field, currently no single marker is sufficiently validated for its use in OA diagnosis (Lotz, et al., 2014; Kraus, et al., 2015).The endothelins family, with three members including endothelin-1(ET-1), endothelin-2, and endothelin-3, is originally identified in the vascular endothelial system (Kowalczyk, et al., 2015). ET-1 is the main type among the three isoforms. In addition to vasoconstrictive and mitogenic properties (Rapoport, et al., 2014), ET-1 also plays a potential role in cartilage damage, which is a clear mechanism of OA development. Recent evidence showed the promoting effects of ET-1 on cartilage degradation through inducing MMP release (Roy-Beaudry, et al., 2003; Khatib, et al., 2007). we therefore came to the hypothesis that ET-1 may be a great regulator in OA development and progression.This study investigated the plasma and synovial levels of ET-1 in patients with primary knee osteoarthritis compared to healthy controls and explore its relationship to radiographic grades and ultrasonographic findings.This Study included 2 groups of 40 participants each. In the patient group, there were 11 males and 29 females with age ranged from 46 to 59 years, while in the control group there were 14 males and 26 females with age ranged from 47 to 61 years.In conclusion, serum ET-1 level was higher in patients with primary knee OA than healthy controls. Serum and synovial ET-1 concentrations were positively correlated with KL grades as they were higher in patients with advanced OA than those with early OA. they were also correlated with ultrasonographic cartilage thickness grade. So, they could be potential biomarkers that may reflect the severity of OA.