Objectives: In view of clinical similarities between polyarticular osteoarthritis (POA) with metacarpophalangeal joint involvement and the arthropathy of Haemochromatosis, it was hypothesized that chondral damage in both disorders may be due to localized iron overload. Accordingly it was predicted that the concentration of ferritin in synovial fluid (SF), would be higher in OA patients with HFE gene mutations than in HFE wild type (wt) OA patients. The aim of this study was to test this proposition.Methods: Patients with knee OA and other rheumatic diseases who required diagnostic or therapeutic arthrocentesis were studied. Participants underwent HFE genotyping. SF samples were assayed for ferritin and also for cytokines and matrix metalloproteinases implicated in chondral damage.Results: Seventy three patients with diverse rheumatic disorders were recruited. Of the 29 patients who had knee OA, 15 were wt and 14 were heterozygous for HFE mutations (C282Y or H63D). Mean SF ferritin concentrations in the wt and heterozygous OA groups were 273 ng/mL and 655 ng/mL respectively (P = 0.0146). In contrast, no statistically significant difference in serum ferritin concentrations was observed between OA patients with and without HFE gene mutations. Conclusions: In osteoarthritic SF the ferritin concentrations segregate according to HFE genotype. The higher concentrations of ferritin observed in the SF of OA patients with HFE gene mutations is consistent with the possibility that chronic localized iron overload in the joints of subjects with HFE gene mutations may contribute to the pathogenesis of OA and perhaps directly or indirectly to chondral resorption.
Carroll, GJ., Sharma, G., Upadhyay, A., & Jazayeri, J. (2010). Ferritin concentrations in synovial fluid are higher in Osteoarthritis (OA) patients with HFE gene mutations (C282Y or H63D). Scandinavian Journal of Rheumatology, 39(5), 413-420. https://doi.org/10.3109/03009741003677449