Introduction Acetylcholinesterase (AChE), a vital component of cholinergic neurotransmission, exhibits various noncholinergic functions. To understand its functional role in degenerative conditions like knee osteoarthritis (KOA), the specific activity of AChE in the synovium of OA knees (grades I—IV) was estimated, and the values were correlated with disease severity. Methods Forty patients with KOA were recruited and categorized into four groups based on the Kellgren–Lawrence classification of KOA as grades I, II, III, and IV, with ten patients in each group. Patient demographic information, including sex, age, pain duration, and visual analog scale (VAS) score, were  collected and analyzed, along with the specific activity of synovial fluid AChE. Results The majority of patients with KOA were 41–85 years of age, with a mean age of 64 ± 8.5 years. The VAS score analysis indicated that as the disease progressed, the pain was significantly higher. The specific activity of AChE in grades I, II, III, and IV was found to be 0.66, 0.98, 0.57, and 0.41 mU/mg of protein, respectively. Among the four grades, grade II KOA showed a significant increase in the AChE activity when compared with other grades of KOA (p < 0.05), followed by grade I. Conclusion Our findings indicate that the increase in AChE activity in KOA grades I and II may facilitate localized inflammation and promote cartilage degeneration in early stages. Therefore, the enzymatic function of AChE can be considered a potential therapeutic target in KOA after validating the finding with larger cohort studies.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • Synovial acetylcholinesterase (AChE) activity is elevated in the early stages of Knee Osteoarthritis (KOA). • Increased AChE activity in the early stages of KOA suggests its potential role as a mediator of active inflammation and cartilage degeneration. • AChE can be considered as a potential therapeutic target in the early stages of joint degenerative conditions like KOA. </entry> </row> </tbody> </tgroup> </Table>

Evidence for acetylcholinesterase as an early mediator in knee osteoarthritis: insights from synovial fluid analyses

期刊论文
发表日期：

2026年1月6日

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Christo David Jefrey,
Mohanty Aman Kumar,
Saravanaraman Ponne,
Manoharan Praveen,
Chinnadurai Raj Kumar

摘要

Introduction

Acetylcholinesterase (AChE), a vital component of cholinergic neurotransmission, exhibits various noncholinergic functions. To understand its functional role in degenerative conditions like knee osteoarthritis (KOA), the specific activity of AChE in the synovium of OA knees (grades I—IV) was estimated, and the values were correlated with disease severity.

Methods

Forty patients with KOA were recruited and categorized into four groups based on the Kellgren–Lawrence classification of KOA as grades I, II, III, and IV, with ten patients in each group. Patient demographic information, including sex, age, pain duration, and visual analog scale (VAS) score, were collected and analyzed, along with the specific activity of synovial fluid AChE.

Results

The majority of patients with KOA were 41–85 years of age, with a mean age of 64 ± 8.5 years. The VAS score analysis indicated that as the disease progressed, the pain was significantly higher. The specific activity of AChE in grades I, II, III, and IV was found to be 0.66, 0.98, 0.57, and 0.41 mU/mg of protein, respectively. Among the four grades, grade II KOA showed a significant increase in the AChE activity when compared with other grades of KOA (p < 0.05), followed by grade I.

Conclusion

Our findings indicate that the increase in AChE activity in KOA grades I and II may facilitate localized inflammation and promote cartilage degeneration in early stages. Therefore, the enzymatic function of AChE can be considered a potential therapeutic target in KOA after validating the finding with larger cohort studies.

Key Points

• Synovial acetylcholinesterase (AChE) activity is elevated in the early stages of Knee Osteoarthritis (KOA).

• Increased AChE activity in the early stages of KOA suggests its potential role as a mediator of active inflammation and cartilage degeneration.

• AChE can be considered as a potential therapeutic target in the early stages of joint degenerative conditions like KOA.