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Also, in patients with chronic cholestasis, impaired delivery of bile salts to the duodenum results in malabsorption of lipids and fat-soluble vitamins, leading to deficiencies in vitamins A, D, E, and K (see Chapters 31 and 52)

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4.4 Interactions between cartilage and synovium 4.4.1 Interplay between cytokines released by chondrocytes and synovial cells When cartilage is damaged, chondrocytes release proteoglycan fragments, type II collagen fragments, and diverse injury-associated factors that synovial cell surface pattern recognition receptors (PRRs) can detect, prompting synovial hyperplasia and proinflammatory cytokine secretion (139)