POLO
Research type
Research Study
Full title
Prospective Longitudinal Effects of Intra-articular Corticosteroid Injection on Synovial Fluid Oxygen
IRAS ID
288760
Contact name
Shing Law
Contact email
Sponsor organisation
University of Oxford / Clinical Trials and Research Governance
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Research Summary
Arthritic joints in patients with rheumatoid arthritis and psoriatic arthritis are characterized by inflammation. It is unclear as to how corticosteroid injection into the joint affect healing. We propose to study the physiological effects of corticosteroid injection into the joint. This will help development of new treatments for patients.
10 rheumatoid and psoriatic arthritis patients with swollen joint(s) who require corticosteroid injection into the joint for their clinical care will be recruited to the study. At the start of the study, I will collect blood samples, joint fluid, joint tissues, and inject corticosteroid into the arthritic joint. At the end of the study, I will collect blood samples, joint fluid and joint tissues. I will examine these samples to identify physiological changes, and which cells are responding to the corticosteroid injection. If successful, this will help us develop better treatments for patients.
Summary of Results
It is unclear whether low oxygen and fat cells in arthritic joint tissue play a role in inflammatory arthritis. Steroid injection into the arthritic joint is routinely used in clinical practice for treatment of knee arthritis in rheumatoid and psoriatic arthritis. Understanding how oxygen levels and cell such as fat cells respond to treatment may provide insight into why inflammatory arthritis develop and how we can treat this better.
This study found steroid injection into the arthritic joint had no effects on arthritic joint fluid oxygen levels. This suggests that the effects of steroid injection may be independent of the joint fluid oxygen levels.
8 pairs of knee joint tissue biopsies from before and after arthritic joint steroid injection were sequenced for gene expression. There were fewer fat cells in the arthritic joint after steroid injection. Fat metabolism genes expression were higher after steroid injection. These results suggest that fat cells in the joint may play a significant role in inflammatory arthritis, the treatment effects of steroid injection, and may be potential targets for new therapies in future.
REC name
North of Scotland Research Ethics Committee 2
REC reference
21/NS/0002
Date of REC Opinion
18 Jan 2021
REC opinion
Favourable Opinion