In vivo MR spectroscopy using 3 Tesla to investigate the metabolic profiles of joint fluids in different types of knee diseases

Abstract

In vivo proton (H1) magnetic resonance spectroscopy (MRS) has not yet been systematically used to study joint fluids in human knees. The objective of this study, therefore, was to assess the ability of proton MRS to identify the apparent heterogeneous characteristics of metabolic spectra in the joint fluid regions in human knees using a high‐field MRI system. Eighty‐four patients with effusion lesions who were referred for routine knee MR imaging underwent proton MRS with point‐resolved, single‐voxel MR spectroscopy using a clinical 3.0 Tesla MRI system. Thirty‐eight patients were confirmed to have the following: degenerative osteoarthritis, 21 patients (Group 1); traumatic diseases, 12 patients (Group 2); infectious diseases, 4 patients and an inflammatory disease, 1 patient (Group 3). Spectroscopy data were analyzed using the public jMRUI freeware software to obtain lipid metabolites. Nonparametric statistical comparisons were performed to investigate any differences in metabolites among the three disease groups. The major metabolites were vinylic CH=CH lipids around 5.1−5.5 ppm, CH2 lipids around 1.1−1.5 ppm, and CH3 lipids around 0.7−1.0 ppm. Each patient had either a CH=CH lipid peak, CH2 and CH3 lipid peaks, or all three peaks. There were no significant differences among the three groups for the CH3 (normalp=0.9019), CH2 (normalp=0.6406), and CH=CH lipids (p=0.5467) and water (p=0.2853); none of the metabolites could differentiate between any of the three types of diseases. The CH2 lipids in the 38 patients who had confirmed fluid characteristics were significantly correlated with CH3 lipids (italicrho=0.835, p<0.0001). The ratio of CH3 to CH2 was highest in the degenerative disease. In both the degenerative and traumatic diseases, metabolite peaks of the vinylic CH=CH lipids around 5.1−5.5 ppm and of the sum of the CH2 and CH3 lipids around 0.7−1.5 ppm were observed, but in the infectious disease, only a metabolite peak of the sum of the CH2 and CH3 lipids was detected. Although none of the metabolites could statistically significantly differentiate between the three types of diseases, the different lipid metabolite peaks and their ratios in the three disease groups may give us a hint at the different mechanisms of joint fluids in the infectious, degenerative, and traumatic diseases.PACS number(s): 87.61.Ff, 33.25.+k, 87.14.Cc

Metabolic profiling of synovial fluid in human temporomandibular joint osteoarthritis

“…Previous studies mainly focused on the metabolite changes in SF in knee OA. Consistent with our current work, these studies reported changes in lipid, sugar and amino acid derivatives in SF in knee OA ( 22 – 26 ). Zheng et al.…”

“…Previous studies mainly focused on the metabolite changes in SF in knee OA. Consistent with our current work, these studies reported changes in lipid, sugar and amino acid derivatives in SF in knee OA (22)(23)(24)(25)(26). Zheng et al (22) detected 81 metabolites in 25 knee OA patients and 10 controls, and found six metabolites were strongly associated with OA.…”

“…Jin et al. ( 26 ) reported the differences of lipid metabolites among the joints with infectious, degenerative, and traumatic diseases. However, in these studies, a relatively small number of metabolites or samples were detected and analyzed.…”

Differences between infected and noninfected synovial fluid

“…There are few NMR studies looking for biomarkers of SF infection, all of which contain unmatched cohorts or results that are not statistically significant. 14 - 16 …”

Metabolic Signature of Articular Cartilage Following Mechanical Injury: An Integrated Transcriptomics and Metabolomics Analysis

“…Metabolomics profiling provides an unbiased comprehensive analysis of metabolites as the end products of cellular processes in a biological system. Several studies employed either targeted or untargeted metabolomics analysis using NMR or LC-MS platforms in different tissues from OA patients' synovial joints including the bone, cartilage, and synovial tissues while other studies focused on the analysis of body fluids from OA patients as synovial fluid, serum, and urine (Lamers et al, 2005;Shet et al, 2012;Mickiewicz et al, 2015;Jin et al, 2016;Marchev et al, 2017;Carlson et al, 2018;Hinata et al, 2018). These studies revealed possible common metabolic changes associated with OA including amino acid metabolism, glycolysis, TCA cycle, and ATP biosynthesis (reviewed in Rockel and Kapoor, 2018).…”