Biomechanics and repair of articular cartilage

The most important function of the joints relies on excellent lubrication and the uniform distribution of impact loads onto the underlying bones, together with damping effects. In most joint disorders, as the lesion is limited to the joint surface, it becomes necessary to repair the joint surface. In this article, repair with an artificial composite osteochondral device (COD) is reported, as is biological resurfacing with cultured chondrocytes. The COD consists of polyvinyl alcohol (PVA) hydrogel as artificial cartilage and titanium fiber mesh (TFM) as porous artificial bone. PVA solution was impregnated into the pores of TFM by injection molding, and these two materials were bound together by a gelling process to create the COD. The key problem, i.e., to attain quick and firm attachment to the underlying bone, was addressed by creating this COD, in which the TFM interface allows not only firm attachment of the PVA gel but also strong attachment to the joint surface through bony ingrowth. For the purpose of simulating partial hemiarthroplasty for the femoral head, 30 COD prostheses were implanted into canine femoral heads. Histological findings of the acetabular cartilage and synovial membrane, as well as findings of attachment of the prosthesis to bone, were examined for an 18-month period after the operation. No particular pathological changes in acetabular cartilage were found, and firm attachment of the devices to bone was confirmed. These results indicate that the COD could be a very promising joint repair material.

Effect of different solvents and crosslinkers on cytocompatibility of Type II collagen scaffolds for chondrocyte seeding

Type II collagen extracted from porcine costal cartilage was evaluated as scaffolds for cartilage tissue engineering. Chemical crosslinkers were employed to improve the mechanical properties and the resistance toward degradation. Films and porous scaffolds were prepared from collagen solutions dissolved in 3% acetic acid (designated A) or in deionized water (designated W) and crosslinked by an epoxy (designated E) or by a carbodiimide (designated C). Immortalized rat chondrocytes and rabbit chondrocytes were used to assess cytocompatibility of crosslinked collagen matrices. Cell adhesion rate onto the films made by different preparations ranked in the order of WE > or = WC > AC > or = AE. Cell proliferation ranked in the order of AC > WC > AE > or = WE. Cells maintained round morphology only on AC and WC films. In 3-D seeding, AC scaffolds also were found to be the most cytocompatible. WC scaffolds, however, had better dimensional stability. It was concluded that Type II collagen scaffolds, when prepared by using deionized water as the solvent and carbodiimide as the crosslinker, could promote chondrocyte growth and matrix production.

Mapping critical sites in collagen II for rational design of gene-engineered proteins for cell-supporting materials

Collagen II is the most abundant protein of cartilage and forms a network of fibrils extended by proteoglycans that enables cartilage to resist pressure. The surface of the collagen fibril serves as a platform for the attachment of collagen IX, growth factors, and cells. In this study we examined the mechanism of the interaction of chondrocytes with recombinant versions of procollagen II, in which one of the four blocks of 234 amino acids that define repeating D periods of the collagen triple helix has been deleted. Analysis of the attachment of chondrocytes to collagen II variants with deleted D periods indicated that the collagen II monomer contains randomly distributed sites critical for cell binding. However, as was shown by spreading and migration assays, the D4 period, which is between residues 703 to 936, contains amino acids critical for cell motility. We also showed that binding, spreading, and migration of chondrocytes through three-dimensional nanofibrillar collagenous matrices are controlled by an interaction of the collagen triple helix with beta1 integrins. The results of this study provide a basis for the rational design of a scaffold containing genetically engineered collagen with a high density of specific sites of interaction.

The role of periosteum in cartilage repair

Periosteum, which can be grown in cell and whole tissue cultures, may meet one or more of the three prerequisites for tissue engineered cartilage repair. Periosteum contains pluripotential mesenchymal stem cells with the potential to form either cartilage or bone. Because it can be transplanted as a whole tissue, it can serve as its own scaffold or a matrix onto which other cells and/or growth factors can be adhered. Finally, it produces bioactive factors that are known to be chondrogenic. The chondrocyte precursor cells reside in the cambium layer. These vary in total density and volume with age and in different donor sites. The advantages of whole tissue periosteal transplants for cartilage repair include the fact that this tissue meets the three primary requirements for tissue engineering: a source of cells, a scaffold for delivering and retaining them, and a source of local growth factors. Many growth factors that regulate chondrocytes and cartilage development are synthesized by periosteum in conditions conducive to chondrogenesis. These include transforming growth factor-beta 1, insulinlike growth factor-1, growth and differentiation factor-5, bone morphogenetic protein-2, integrins, and the receptors for these molecules. By additional study of the molecular events in periosteal chondrogenesis, it may be possible to optimize its capacity for articular cartilage repair.

Biochemical composition of equine carpal articular cartilage is influenced by short-term exercise in a site-specific manner

It was hypothesized that cartilage macro-molecular characteristics are influenced by exercise intensity and by location within a joint.

OBJECTIVE

To determine the macromolecular characteristics of carpal articular cartilage at common and uncommon sites of pathology in horses undergoing high or low intensity exercise, and to compare this composition between exercise groups.

DESIGN

Twelve horses (19.3+/-0.9 years) were assigned to exercise groups. Each group underwent 19 weeks high-intensity treadmill training (N=6) or low-intensity exercise (N=6). Dorsal and palmar test sites were identified on radial, intermediate and third carpal articular surfaces after euthanasia. Cartilage was collected from each site, freeze-dried and assessed for water content. Hydroxyproline, glycosaminoglycan and DNA analyses were performed on cartilage from each test site. Adjacent cartilage underwent histological preparation and assessment for chondrocyte numerical density at each site and proteoglycan distribution through the depth of cartilage.

RESULTS

Dorsal cartilage had a higher collagen content, DNA content, and chondrocyte numerical density, but lower glycosaminoglycan content than palmar cartilage. Cartilage from horses undergoing high-intensity training had a significantly higher glycosaminoglycan content than cartilage from horses undergoing low-intensity exercise, with maximal difference being observed in cartilage from dorsal radial and dorsal intermediate carpal articular surfaces. Overall no effect of exercise on collagen was observed, but at sites predisposed to clinical lesions cartilage from horses undergoing high-intensity training contained significantly less collagen than from horses undergoing low-intensity exercise. Distribution of proteoglycan was non-uniform in 52% of the sections examined, with superficial loss of toluidine blue staining primarily at dorsal sites and in the high-intensity exercise group.

CONCLUSIONS

These results indicate that topographical and exercise related differences exist in carpal cartilage composition, and that the effect of exercise on overall composition and distribution within the cartilage was maximal at sites predisposed to clinical lesions. These findings could indicate that the combined effect of exercise and local load variations within a joint may lead to a risk of exceeding the physiologic threshold at high load sites that are predisposed to clinical injury.

In vitro generation of scaffold independent neocartilage

A novel serum-free culture system was developed in an attempt to generate a three-dimensional hyalinelike neocartilage independent of polymer scaffolds. Neocartilage disks as much as 1.5 mm thick were produced, which were characterized by synthesis of the normal articular cartilage collagens and proteoglycans. In contrast to growth in serum-containing media, chondrocytes from juveniles maintained in static culture under defined serum-free conditions deposited an extracellular matrix that accumulated in the form of tissue disks. Electron microscopic evaluation of neocartilage disks revealed collagenous matrices characteristic of articular cartilage from human infants. The neocartilage did not show terminal chondrocyte differentiation as shown by the absence of Type X collagen production and lack of cellular hypertrophy. Although chondrocytes from preadolescent donor cartilage recapitulated embryonic development in the absence of exogenous factors, chondrocytes from articular cartilage from adults failed to produce neocartilage when grown under identical conditions. This is the first demonstration that autocrine morphogens are sufficient to guide production of hyaline cartilage in vitro. In addition to providing a unique model system to compare the healing response of mature and immature articular chondrocytes, this technology may be of clinical importance in the development of new biomaterials for repair of articular cartilage defects.

EPR oxygen mapping (EPROM) of engineered cartilage grown in a hollow-fiber bioreactor

A novel electron paramagnetic resonance (EPR)-based oxygen mapping procedure (EPROM) is applied to cartilage grown in a single-, hollow-fiber bioreactor (HFBR) system. Chondrocytes harvested from the sterna of 17-day-old chick embryos were inoculated into an HFBR and produced hyaline cartilage over a period of 4 weeks. Tissue oxygen maps were generated according to the EPROM technique (Velan et al., Magn Reson Med 2000;43:804-809) by making use of the line-broadening effects of oxygen on the signal generated from nitroxide spin probes. In addition, the effect on oxygen consumption of the addition of cyanide to the tissue was investigated. Cyanide is a potent inhibitor of oxidative phosphorylation, and accordingly, given the constant provision of oxygen to the tissue, it would be expected to increase oxygen levels within the HFBR. The EPROM measurements showed a significant increase in oxygen concentration in the cartilage after the addition of cyanide. In contrast to other methods for studying oxygen in cartilage, EPROM can provide direct, noninvasive visualization of local concentrations in three dimensions.

Tissue-engineered fabrication of an osteochondral composite graft using rat bone marrow-derived mesenchymal stem cells

This study tested the tissue engineering hypothesis that construction of an osteochondral composite graft could be accomplished using multipotent progenitor cells and phenotype-specific biomaterials. Rat bone marrow-derived mesenchymal stem cells (MSCs) were culture-expanded and separately stimulated with transforming growth factor-beta1 (TGF-beta1) for chondrogenic differentiation or with an osteogenic supplement (OS). MSCs exposed to TGF-beta1 were loaded into a sponge composed of a hyaluronan derivative (HYAF-11) for the construction of the cartilage component of the composite graft, and MSCs exposed to OS were loaded into a porous calcium phosphate ceramic component for bone formation. Cell-loaded HYAFF-11 sponge and ceramic were joined together with fibrin sealant, Tisseel, to form a composite osteochondral graft, which was then implanted into a subcutaneous pocket in syngeneic rats. Specimens were harvested at 3 and 6 weeks after implantation, examined with histology for morphologic features, and stained immunohistochemically for type I, II, and X collagen. The two-component composite graft remained as an integrated unit after in vivo implantation and histologic processing. Fibrocartilage was observed in the sponge, and bone was detected in the ceramic component. Observations with polarized light indicated continuity of collagen fibers between the ceramic and HYAFF-11 components in the 6-week specimens. Type I collagen was identified in the neo-tissue in both sponge and ceramic, and type II collagen in the fibrocartilage, especially the pericellular matrix of cells in the sponge. These data suggest that the construction of a tissue-engineered composite osteochondral graft is possible with MSCs and different biomaterials and bioactive factors that support either chondrogenic or osteogenic differentiation.

Cationic polymer-mediated genetic transduction into cultured human chondrosarcoma-derived HCS-2/8 cells

The usefulness of three types of cationic polymer, i.e., degraded polyamidoamine (PAMAM) dendrimer (SuperFect Transfection Reagent; Oiagen), linear polyethylenimine (PEI; ExGen 500; Euromedex), and branched PEI in gene delivery into chondrocytes was examined comparatively. A plasmid vector containing the Escherichia coli LacZ (pSES.beta) was combined with one of the three cationic polymers at various molar ratios and the resultant complex (polyplex) was used to transduce a human chondrocyte-like cell line, HCS-2/8. Gene expression was evaluated by an O-nitrophenyl beta-D-galactopyranoside (ONPG) assay and by staining with 0.05% 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside (X-gal; Nacalai Tesque). The ONPG assay showed that the highest delivery rate was achieved when 2microg of pSES.beta was combined with either 21 microg of dendrimer, 1.7microg of linear PEI, or 2.0microg of branched PEI. At the same DNA/polymer ratios, the proportions of X-gal-stained cells were also the highest (31.3 +/- 7.5%, 30.3 +/- 9.0%, and 8.3 +/- 3.1%, respectively). LacZ expression reached the highest level 3 days after the dendrimer-mediated transduction, and gradually declined, returning to the background level on day 14. Possible cytotoxicity was examined by trypan blue staining and phase contrast microscopic observations. Neither cytotoxicity nor morphological change was induced at the optimal dose of each polymer. The cationic polymers, particularly the degraded dendrimer and linear PEI, would be a useful nonviral vector for gene delivery to cells of chondrocytes.

Treatment of intrinsic sphincter deficiency using autologous ear chondrocytes as a bulking agent

Intrinsic sphincter deficiency (ISD) is frequently treated with collagen bulking at the bladder neck. The standard material used, Contigen, biodegrades over 3-19 months requiring repeated injections to maintain efficacy. The study objective was to evaluate use of autologous ear chondrocytes for treatment of ISD. Women with documented ISD had harvest of auricular cartilage. Chondrocytes were isolated from the cartilage and expanded in culture and formulated with calcium alginate to form an injectable gel. Thirty-two patients received a single outpatient injection just distal to the bladder neck. Outcome measures included voiding diary, quality-of-life scores, incontinence severity grading, and pad weight testing. Incontinence grading indicated 16 patients dry, and 10 improved at 12 months for a total of 26 of 32 (81.3%) dry and improved after one treatment. Only four patients had a 12-month pad weight test over 2.2 g. Quality-of-life scores improved significantly after treatment. There was a decrease in incontinence impact scores in all categories. The urogenital distress inventory declined for all categories except bladder emptying and lower abdominal pain. Endoscopic treatment of ISD with autologous chondrocytes is safe, effective, and durable with 50 % of patients dry 12 months after one injection. Twenty-six of 32 patients dry or improved at 3 months after the injection maintained the effect at the 12-month visit.

Injection molding of chondrocyte/alginate constructs in the shape of facial implants

Over one million patients per year undergo some type of procedure involving cartilage reconstruction. Polymer hydrogels, such as alginate, have been shown to be effective carriers for chondrocytes in subcutaneous cartilage formation. The goal of our current study was to develop a method to create complex structures (nose bridge, chin, etc.) with good dimensional tolerance to form cartilage in specific shapes. Molds of facial implants were prepared using Silastic ERTV. Suspensions of chondrocytes in 2% alginate were gelled by mixing with CaSO(4) (0.2 g/mL) and injected into the molds. Constructs of various cell concentrations (10, 25, and 50 million/mL) were implanted in the dorsal aspect of nude mice and harvested at times up to 30 weeks. Analysis of implanted constructs indicated progressive cartilage formation with time. Proteoglycan and collagen constructs increased with time to approximately 60% that of native tissue. Equilibrium modulus likewise increased with time to 15% that of normal tissue, whereas hydraulic permeability decreased to 20 times that of native tissue. Implants seeded with greater concentrations of cells increased proteoglycan content and collagen content and equilibrium and decreased permeability. Production of shaped cartilage implants by this technique presents several advantages, including good dimensional tolerance, high sample-to-sample reproducibility, and high cell viability. This system may be useful in the large-scale production of precisely shaped cartilage implants.

Long-term results of the endoscopic correction of vesicoureteral reflux in children using autologous chondrocytes

PURPOSE

Endoscopic correction of vesicoureteral reflux continues to attract research of many autologous and nonautologous substances. We previously reported on the initial results of a clinical trial using endoscopic injection of autologous chondrocytes to correct vesicoureteral reflux in children and now present our greater than 1-year followup results.

MATERIALS AND METHODS

A total of 29 children (47 ureters) with grades II to IV vesicoureteral reflux were treated at 2 centers. Each child underwent cystoscopy and posterior auricular cartilage harvesting at the initial setting. Chondrocytes were grown in culture during a 6-week period. Patients returned for transurethral injection of autologous chondrocytes into the ureterovesical junction of the refluxing ureters. Ultrasound was performed at 1 month, 1 year, and 2 and 3 years after implantation, and a voiding cystourethrogram or radionuclide cystogram at 3 months and 1 year after injection. If reflux persisted re-treatment with stored chondrocytes was offered.

RESULTS

At 3-month followup initial chondrocyte injection corrected reflux in 55% of ureters (27 of 47) while a second or third injection was successful in additional 15 of 29 patients, resulting in an overall success rate of 86% (42 of 49) ureters and 25 of 29 patients. At 1-year followup reflux correction was maintained in 70% of ureters (32 of 46) and 65% of patients (19 of 29). The 1-year followup results after re-treatment of 3 ureters were not available. In those patients in whom implantation failed cystoscopy revealed evidence of volume loss and shifting of subureteral mounds to account for loss of the antireflux effect. Three patients underwent successful open ureteroneocystostomy for failed autologous chondrocyte implantation. There were no significant complications.

CONCLUSIONS

Transurethral injection of autologous chondrocytes to correct vesicoureteral reflux in children is safe and reasonably effective. There is a relapse rate which must be considered. Changes in the formulation of the material have been made to enhance implant reliability and increase long-term success.

Tissue engineered stents created from chondrocytes

PURPOSE

Trauma, operations or instrumentation of the urethra or ureter may lead to stricture disease. The use of a natural urethral stent made of autologous tissue would be advantageous due to its biocompatibility. In this study we investigated the feasibility of engineering cartilage stents in vitro and in vivo.

MATERIALS AND METHODS

We fabricated 40 cylinders 10 mm. long with an inner and outer diameter of 5 and 9 mm., respectively, from polyglycolic acid mesh coated with 50:50 polylactic-co-glycolic acid. Chondrocytes isolated from bovine shoulders were seeded onto the tubular polymer scaffolds at a seeding density of 60 x 106 cells per ml. Scanning electron microscopy was performed to determine the even distribution of chondrocytes throughout the polymer scaffolds. We implanted 20 cylinders under the skin of nude mice and 20 were cultured in stirred bio-reactors. Cytological characteristics, collagen content and mechanical durability were evaluated 4 and 10 weeks after cell seeding.

RESULTS

Gross examination of the engineered stents showed the solid, glistening appearance of cartilaginous tissue. Cytological analyses with hematoxylin and eosin, trichrome, alcian blue and safranin O confirmed cartilage, and the deposition of collagen and glycosaminoglycan in each group. Increased deposition of collagen and glycosaminoglycan was observed in the stents created in vivo. Biomechanical testing demonstrated that the cartilaginous cylinders in each group were readily elastic and withstood high degrees of pressure.

CONCLUSIONS

This study demonstrates the feasibility of creating cartilaginous stents in vitro and in vivo using chondrocyte seeded polymer matrices. This technology may be useful clinically for stricture disease in the genitourinary tract.

Tissue engineering in urology

Techniques that are aimed at regeneration of human tissues and organs (tissue engineering) have recently entered into clinical practice. Tissue engineering is currently among the fastest growing areas in medicine, and involves the application of the principles of biology and engineering to the development of functional substitutes for damaged tissues. One of the main limitations of reconstructive surgery in the genitourinary tract is the lack of autologous tissue. This could be changed by the ability to cultivate the patient's own tissues in vitro, or by stimulating the cells in vivo into regeneration of new tissues. The present review discusses how tissue engineering can be used to regenerate some of the tissues of the genitourinary tract. Even though these methods have only recently been introduced clinically into genitourinary medicine, numerous scientific studies have been reported that indicate that these techniques may be of great importance in the near future.

High-efficiency non-viral transfection of primary chondrocytes and perichondrial cells for ex-vivo gene therapy to repair articular cartilage defects

BACKGROUND

Primary perichondrial cells and chondrocytes have been used to repair articular cartilage defects in tissue engineering studies involving various animal models. Transfection of these cells with a gene that induces chondrocytic phenotype may form an ideal method to affect tissue engineering of articular cartilage.

DESIGN

A protocol for high-efficiency transfection of primary perichondrial and cartilage cells was optimized. Plasmids carrying the marker beta-galactosidase (beta-gal), PTHrP and TGF-beta1 genes driven by a strong mammalian promoter were transfected into primary perichondrial cells and chondrocytes. A three-step method was used to achieve high efficiency of transfection: (1) permeabilization of primary cells using a mild detergent, (2) association of plasmid DNAs with a polycationic (poly-l-lysine) core covalently linked to a receptor ligand (transferrin), (3) introduction of cationic liposomes to form the quaternary complex. For in-vivo assessment, polylactic acid (PLA) scaffolds seeded with beta-gal transfected perichondrial cells were implanted into experimentally created osteochondral defects in rabbit knees for 1 week.

RESULTS

The efficiency of transfection was determined to be over 70%in vitro. The transformed cells continued to express beta-gal, in vivo for the entire test period of 7 days. Furthermore, primary perichondrial cells transfected with TGF-beta1 and PTHrP over-expressed their cognate gene products.

CONCLUSION

The ability to transfect autologous primary perichondrial cells and chondrocytes with high efficiency using a non-viral system may form a first step towards tissue engineering with these transformed cells to repair articular cartilage defects.

Long-term survival of regenerated cartilage on a large joint surface

The one-year survival of regenerated cartilage on a large articular surface is presented using the McDowell in vivo model. The model provides a mechanically shielded environment in which regenerated cartilage can be protected from intra-articular stresses while normal joint motion is maintained. New tissue was allowed to grow from bleeding subchondral bone for 12 weeks at which time the original mechanical environment was reintroduced. Our study showed that neo-cartilage would grow to cover the entire joint surface of a patella and could survive for one year. Histologic observations indicated a maturing hyaline-like tissue. Biomechanical analyses showed that the regenerated cartilage became stiffer and less permeable within the time of this study. Biochemical evaluations demonstrated stable properties out to the longest time point. Control specimens, which were not shielded from stress, showed insignificant amounts of new tissue growing on the patellar surfaces.

The current status of tissue cryopreservation

Cryopreservation plays an important role in tissue banking and will assume even greater importance when tissue engineering becomes an everyday reality. For some tissue grafts, living cells are unnecessary and adequate preservation methods are usually available. For other tissues living and functioning cells are needed and preservation methods are much less advanced. The basic requirements for cell recovery can usually be defined if a few basic biophysical properties of the cell are known and some standard measurements of the effect of cryobiological variables are carried out. The problems in tissue cryopreservation are not usually due to difficulties in preserving the living cells per se, but arise from the properties of the integrated cell/matrix systems upon which tissue function almost always depends. Some examples of such difficulties are described. It is concluded that the formation of ice, through both direct and indirect effects, is probably fundamental to these difficulties, and this is why vitrification seems to be the most likely way forward. However, two major problems still to be overcome are cryoprotectant toxicity and recrystallization during rewarming. Less obvious, and certainly less well understood is chilling injury - damage caused by reduction in temperature per se; this may yet turn out to be of fundamental importance.

Growth-factor-induced healing of partial-thickness defects in adult articular cartilage

OBJECTIVE

We have previously shown (Hunziker and Rosenberg, J Bone Joint Surg 1996;78A:721-33) that synovial cells can be induced to migrate into partial-thickness articular cartilage defects, therein to proliferate and subsequently to deposit a scar-like tissue. We now wished to ascertain whether these synovial cells could be stimulated to transform into chondrocytes, and thus to lay down cartilage tissue, by the timely introduction of a differentiation factor.

DESIGN

Partial-thickness defects were created in the knee-joint cartilage of adult miniature pigs. These were then filled with a fibrin matrix containing a free chemotactic/mitogenic factor and a liposome-encapsulated chondrogenic differentiation one. Tissue was analyzed (immuno)histochemically at 2, 6 and 12 months.

RESULTS

Defects became filled with cartilage-like tissue which registered positive for all major cartilage-matrix components; it remained compositionally stable throughout the entire follow-up period.

CONCLUSION

Although still requiring considerable refinement, our one-step, growth-factor-based treatment strategy has the basic potential to promote intrinsic healing of partial-thickness articular cartilage defects, thus obviating the need for transplanting cells or tissue.

Cartilage tissue engineering using thyroid chondrocytes on a type I collagen matrix

OBJECTIVE/HYPOTHESIS

Reconstructive procedures of the head and neck often require materials that offer long-term structural support. A problem that many surgeons have encountered is identifying a material that offers this support without rejection of the implanted material This has led many surgeons to prefer autologous cartilage However, autologous cartilage is of limited supply. Cartilage tissue engineering has become a new modality that allows investigators to harvest a small piece of cartilage and extract its chondrocytes for expansion in culture. These chondrocytes are applied to a matrix that will act as a scaffold and allow for cartilage growth. Finding a compatible matrix seems to be the limiting step in the progress of this research. We describe a new approach of tissue creation using bovine collagen matrices as templates onto which cells are seeded.

STUDY DESIGN

Laboratory research.

METHODS

Chondrocytes obtained from thyroid cartilage of dogs were seeded onto bovine collagen type I matrices and grown in vitro. Chondrocyte seeded matrices were evaluated histologically.

RESULTS

Thyroid chondrocytes expressed themselves phenotypically by producing type II collagen in the presence of this type I collagen matrix.

CONCLUSIONS

This study offers the preliminary findings on an exciting new type of matrix worth exploring in the ability to successfully engineer cartilage.

Apoptosis in normal and osteoarthritic human articular cartilage

OBJECTIVES

To investigate whether apoptosis occurs in osteoarthritis (OA), and if this phenomenon is modulated by human recombinant interleukin 1beta (hrIL1beta).

METHODS

Human articular cartilage samples were obtained at the time of hip arthroplasty because of femoral neck fracture (normal cartilage) (n=4) or advanced coxarthrosis (OA cartilage) (n=14). Apoptotic chondrocytes, isolated by collagenase digestion and cultivated for 24 hours, or present in situ in frozen cartilage sections, were quantified by fluorescent microscopy using two apoptosis markers: the TUNEL reaction, which detects nuclear DNA fragmentation, and Annexin-V-fluos, which labels at the membrane level the externalisation of phosphatidylserine.

RESULTS

In OA cartilage 18-21% of chondrocytes showed apoptotic features, compared with 2-5% in normal cartilage. The results were similar for the two comparative studies (in situ and in vitro) and for both apoptosis markers. Moreover, hrIL1beta increased the apoptosis rate in vitro in a dose dependent manner in OA and normal chondrocytes.

CONCLUSION

These results suggest that apoptosis may be an important factor in the evolution of OA and may be a new target for treatment of OA.

Engineering autogenous cartilage in the shape of a helix using an injectable hydrogel scaffold

OBJECTIVE

Previous successful efforts to tissue engineer cartilage for an auricle have used an immunocompromised nude mouse xenograft model. Subsequent efforts in an immunocompetent autogenous animal model have been less successful because of an inflammatory response directed against the foreign scaffold polymer used to provide an auricular shape. We studied an alternative polymer material and surgical technique to engineer autogenous cartilage in the shape of a human ear helix using injectable hydrogel scaffolding, Pluronic F-127 (polyethylene oxide and polypropylene oxide).

SUBJECT

Yorkshire swine.

MATERIAL AND METHODS

Fresh autogenous chondrocytes were suspended in a biodegradable, biocompatible co-polymer hydrogel, Pluronic F-127, at a concentration of 3 x 10(7) cells/mL. To support the contour of the implant, a skin fold channel in the shape of the helix of a human ear was created in the skin in three sites on the ventral surface of the animal. The cell-hydrogel suspension was injected through the skin fold channel. For controls, injections were made into identical channels using either cells alone or the Pluronic F-127 without cells. After 10 weeks, the specimens were excised and examined both grossly and histologically.

RESULTS

Grossly, all implants retained a helical-like shape. Excised specimens possessed flexible characteristics consistent with elastic cartilage. The specimens could be folded and twisted and on release of mechanical pressure would instantly return to the original shape. Histological evaluation of the implants using H&E, Safranin O, trichrome blue, and Verhoeff's stains demonstrated findings consistent with mature elastic cartilage. Control injection of hydrogel alone demonstrated no evidence of cartilage formation and control injection of chondrocytes alone showed evidence only of disassociated elastic cartilage.

CONCLUSION

Injection of autologous porcine auricular chondrocytes suspended in a biodegradable, biocompatible hydrogel of Pluronic F-127 resulted in the formation of cartilage tissue in the approximate size and shape of a human ear helix. This preliminary method extends the concept of auricular tissue engineering from an immunocompromised xenograft animal model to an immunocompetent autologous animal model.

Radiofrequency energy-induced heating of bovine articular cartilage using a bipolar radiofrequency electrode

Radiofrequency energy is used for thermal-assisted chondroplasty to treat grade II and III chondromalacia with the lowest possible energy setting that achieves the desired result. The purpose of this in vitro study was to determine the temperature changes associated with the use of radiofrequency energy delivered at different settings to bovine articular cartilage using a bipolar electrode. Cartilage samples were placed in a temperature-controlled (37 degrees C) saline bath for the delivery of radiofrequency energy. A fluoroptic thermometry probe was positioned to record the temperatures at the electrode-tissue interface. The electrode was activated for 2 seconds at settings of V2-120, V2-60, V2-40, and V2-20 in two modes: ablation and desiccation. Additionally, the cartilage samples were visually inspected to determine changes in appearance. The highest average temperatures were as follows: ablation mode, 78.5 degrees C (V2-120), 62.6 degrees C (V2-60), 58.1 degrees C (V2-40), and 54.1 degrees C (V2-20); desiccation mode, 71.8 degrees C (V2-120), 61.4 degrees C (V2-60), 57.7 degrees C (V2-40), and 53.3 degrees C (V2-20). There were statistically significant increases in temperatures associated with each of the respective settings. There were no substantial visual changes produced by the V2-20 settings, while the other settings produced a gradation of effects. These data provide information to help guide the use of a bipolar radiofrequency electrode and electrosurgical system for thermal-assisted chondroplasty.

Phosphorylation of SOX9 by cyclic AMP-dependent protein kinase A enhances SOX9's ability to transactivate a Col2a1 chondrocyte-specific enhancer

Sox9 is a high-mobility-group domain-containing transcription factor required for chondrocyte differentiation and cartilage formation. We used a yeast two-hybrid method based on Son of Sevenless (SOS) recruitment to screen a chondrocyte cDNA library and found that the catalytic subunit of cyclic AMP (cAMP)-dependent protein kinase A (PKA-Calpha) interacted specifically with SOX9. Next we found that two consensus PKA phosphorylation sites within SOX9 could be phosphorylated by PKA in vitro and that SOX9 could be phosphorylated by PKA-Calpha in vivo. In COS-7 cells cotransfected with PKA-Calpha and SOX9 expression plasmids, PKA enhanced the phosphorylation of wild-type SOX9 but did not affect phosphorylation of a SOX9 protein in which the two PKA phosphorylation sites (S(64) and S(211)) were mutated. Using a phosphospecific antibody that specifically recognized SOX9 phosphorylated at serine 211, one of the two PKA phosphorylation sites, we demonstrated that addition of cAMP to chondrocytes strongly increased the phosphorylation of endogenous Sox9. In addition, immunohistochemistry of mouse embryo hind legs showed that Sox9 phosphorylated at serine 211 was principally localized in the prehypertrophic zone of the growth plate, corresponding to the major site of expression of the parathyroid hormone-related peptide (PTHrP) receptor. Since cAMP has previously been shown to effectively increase the mRNA levels of Col2a1 and other specific markers of chondrocyte differentiation in culture, we then asked whether PKA phosphorylation could modulate the activity of SOX9. Addition of 8-bromo-cAMP to chondrocytes in culture increased the activity of a transiently transfected SOX9-dependent 48-bp Col2a1 chondrocyte-specific enhancer; similarly, cotransfection of PKA-Calpha increased the activity of this enhancer. Mutations of the two PKA phosphorylation consensus sites of SOX9 markedly decreased the PKA-Calpha activation of this enhancer by SOX9. PKA phosphorylation and the mutations in the consensus PKA phosphorylation sites of SOX9 did not alter its nuclear localization. In vitro phosphorylation of SOX9 by PKA resulted in more efficient DNA binding. We conclude that SOX9 is a target of cAMP signaling and that phosphorylation of SOX9 by PKA enhances its transcriptional and DNA-binding activity. Because PTHrP signaling is mediated by cAMP, our results support the hypothesis that Sox9 is a target of PTHrP signaling in the growth plate and that the increased activity of Sox9 might mediate the effect of PTHrP in maintaining the cells as nonhypertrophic chondrocytes.

Loss of fibula in mice overexpressing Hoxc11

This study demonstrates severe malformations of the appendicular skeleton in mice overexpressing Hoxc11. Consistent with the endogenous expression pattern, the most conspicuous defect in Hoxc11 overexpressing neonates is aplasia/hypoplasia of the fibula. This is preceded at day 15.5 of embryonic development by marked reduction of chondrocyte proliferation, lack of PTHR expressing prehypertrophic cells, and the absence of hypertrophic and calcifying chondrocytes. Combined with the lack of an overt phenotype in the majority of Hoxc11 overexpressing embryos at day 13.5, the data suggest inhibition of chondrocyte differentiation during the elongation phase of the fibula bone as a primary effect of elevated Hoxc11 expression. This interpretation is further corroborated by Hoxc11 reporter gene expression in the joint areas at embryonic day 15.5, suggesting an involvement of the periarticular perichondrium in generating the mutant phenotype.

Platelet supernatant promotes proliferation of auricular chondrocytes and formation of chondrocyte mass

Recently proposed procedures for in vitro generation of new cartilage may be difficult to perform in humans because so many chondrocytes are needed for tissue engineering. In this study the authors investigated new, efficient, low-cost techniques for the isolation and culture of chondrocytes from the ear cartilage of the rabbit. They performed a low-density monolayer culture with a low concentration (0.5%, 1%) of human platelet supernatant and observed cell proliferation (seeding efficiency, deoxyribonucleic acid synthesis), matrix synthesis (glycosaminoglycan synthesis), and the expression of type I and type II collagen (reverse transcriptase polymerase chain reaction). Seeding efficiency was increased in 1% of platelet supernatant-treated cultures by two to three times compared with untreated controls. One percent platelet supernatant had increased the incorporation of [3H]-thymidine by 1.9 to 2.5 times at 72 hours compared with controls. Glycosaminoglycan synthesis was increased in platelet supernatant-treated chondrocytes at 96 hours compared with controls. Chondrocytes treated with 1% platelet supernatant showed a decreased expression of the type II collagen gene. Supplementation with a high concentration (10%) of the platelet supernatant provided the conditions for in vitro chondrocyte mass formation. These results indicate that proliferation and matrix synthesis of auricular chondrocytes is stimulated by a low concentration of platelet supernatant. On the other hand, chondrocytes were immobilized by a high concentration of platelet supernatant. Platelet supernatant may be useful as an inexpensive autologous source of multiple growth factors to enhance chondrocyte proliferation, and also may play the role of scaffold for chondrocytes. Additional investigation is underway to generate culture conditions that promote the differentiation as well as the proliferation of chondrocytes.

Roles of bone morphogenetic protein type I receptors and Smad proteins in osteoblast and chondroblast differentiation

The biological effects of type I serine/threonine kinase receptors and Smad proteins were examined using an adenovirus-based vector system. Constitutively active forms of bone morphogenetic protein (BMP) type I receptors (BMPR-IA and BMPR-IB; BMPR-I group) and those of activin receptor-like kinase (ALK)-1 and ALK-2 (ALK-1 group) induced alkaline phosphatase activity in C2C12 cells. Receptor-regulated Smads (R-Smads) that act in the BMP pathways, such as Smad1 and Smad5, also induced the alkaline phosphatase activity in C2C12 cells. BMP-6 dramatically enhanced alkaline phosphatase activity induced by Smad1 or Smad5, probably because of the nuclear translocation of R-Smads triggered by the ligand. Inhibitory Smads, i.e., Smad6 and Smad7, repressed the alkaline phosphatase activity induced by BMP-6 or the type I receptors. Chondrogenic differentiation of ATDC5 cells was induced by the receptors of the BMPR-I group but not by those of the ALK-1 group. However, kinase-inactive forms of the receptors of the ALK-1 and BMPR-I groups blocked chondrogenic differentiation. Although R-Smads failed to induce cartilage nodule formation, inhibitory Smads blocked it. Osteoblast differentiation induced by BMPs is thus mediated mainly via the Smad-signaling pathway, whereas chondrogenic differentiation may be transmitted by Smad-dependent and independent pathways.

Characterization of an in vitro model of elastic fiber assembly

Elastic fibers consist of two morphologically distinct components: elastin and 10-nm fibrillin-containing microfibrils. During development, the microfibrils form bundles that appear to act as a scaffold for the deposition, orientation, and assembly of tropoelastin monomers into an insoluble elastic fiber. Although microfibrils can assemble independent of elastin, tropoelastin monomers do not assemble without the presence of microfibrils. In the present study, immortalized ciliary body pigmented epithelial (PE) cells were investigated for their potential to serve as a cell culture model for elastic fiber assembly. Northern analysis showed that the PE cells express microfibril proteins but do not express tropoelastin. Immunofluorescence staining and electron microscopy confirmed that the microfibril proteins produced by the PE cells assemble into intact microfibrils. When the PE cells were transfected with a mammalian expression vector containing a bovine tropoelastin cDNA, the cells were found to express and secrete tropoelastin. Immunofluorescence and electron microscopic examination of the transfected PE cells showed the presence of elastic fibers in the matrix. Biochemical analysis of this matrix showed the presence of cross-links that are unique to mature insoluble elastin. Together, these results indicate that the PE cells provide a unique, stable in vitro system in which to study elastic fiber assembly.

Endoscopic correction of vesicoureteral reflux in children using autologous chondrocytes: preliminary results

PURPOSE

Previous approaches to the endoscopic correction of vesicoureteral reflux have used foreign bulking substances, raising concern regarding safety and long-term efficacy. We describe the results of a clinical trial using transurethral injection of autologous chondrocytes to correct vesicoureteral reflux in children.

MATERIALS AND METHODS

A total of 29 children (46 ureters) with grades II to IV vesicoureteral reflux were treated at 2 sites. Each child underwent cystoscopy and ear cartilage biopsy at the initial setting. Chondrocytes were grown in culture for 6 weeks. Patients then returned for transurethral injection of chondrocytes into the bladder trigone to correct reflux. Ultrasound was performed 1 month and radionuclide cystography was done 3 months postoperatively to confirm reflux resolution. When reflux persisted, repeat treatment with stored chondrocytes was offered.

RESULTS

Initial chondrocyte injection corrected reflux in 26 of the 46 ureters (57%), while secondary injection was successful in 12 of 19 (63%). Overall reflux was corrected in 38 of the 46 ureters (83%) and in 24 of the 29 patients (83%). There were no significant complications.

CONCLUSIONS

Transurethral injection of autologous chondrocytes to correct vesicoureteral reflux in children appears to be an effective and safe technique that holds promise for treating this congenital abnormality in a minimally invasive fashion.

Tissue engineering of biphasic joint cartilage transplants

In isolated posttraumatic or idiopathic joint defects the chondral layers and adjacent subchondral spongy bone are usually destructed. For regeneration we suggest the in vitro formation of a cartilage-coated biomaterial carriers (biphases) in order to fill the correspondingjoint defects. In this study Biocoral, a natural coralline material made of calcium carbonate, and calcite, a synthetic calcium carbonate, were used as supports for the cultivation of bovine chondrocytes in a three-dimensional polymer fleece. The cell-polymer-structure was affixed to the biomaterial with a fibrin-cell-solution. The artificial cartilage formed a new matrix and fused with the underlying biomaterial. The results indicate a promising technical approach to anchor tissue engineered cartilage in joint defects.

Human cartilage engineering: chondrocyte extraction, proliferation, and characterization for construct development

To date, many efforts to engineer cartilage have focused on matrix construction with the goal of producing a durable construct as cartilage replaces the resorbing matrix. However, the importance of matrix construction is at least matched by the challenge of efficient chondrocyte extraction, culture expansion, and prevention of dedifferentiation. This challenge is underscored by the large number of chondrocytes needed for a clinically significant construct such as an ear. Because human rib provides a large, readily available source of hyaline cartilage, the authors evaluated human rib chondrocyte extraction and found that maximum viable cell yield occurred after a 6-hour digestion. They also evaluated human microtic auricular remnant chondrocyte extraction and identified fibroblast contamination as a shortcoming of this potential source of chondrocytes. Initially, rib chondrocytes proliferated in vitro with a doubling time of approximately 1 week. As the cells were passaged, proliferation decreased such that the cells stopped proliferating and adopted a large, spindle-shaped morphology by passage 6. Interestingly, no increase in proliferation was noted when rib chondrocytes were stimulated with transforming growth factor beta 1, bone morphogenetic protein 2, and basic fibroblast growth factor. The major obstacles to the use of autologous rib chondrocytes in matrix construction are the low cell yield from a small piece of rib and the limited proliferation that these cells will undergo in vitro. Further investigation of culture systems and mitogenic cytokines may help resolve these limitations.

Identification of a splice variant of neutrophil collagenase (MMP-8)

We have identified a splice variant of human neutrophil collagenase (MMP-8) transcript (MMP-8alt) that has a 91 bp insertion between codons for amino acid residues 34 and 35 of MMP-8 cDNA. This splice variant encodes an open reading frame for a 444 residue protein, lacking a secretory signal sequence. Our data suggested that, as opposed to the original MMP-8, the translation product of MMP-8alt is not a secreted protein; nevertheless, it is enzymatically active. Further studies aimed at identifying the physiological substrates of MMP-8alt protein may lead to uncover novel roles it plays in cellular physiology.

Long-term insulin-secretory function of islets of Langerhans encapsulated with a layer of confluent chondrocytes for immunoisolation

Islet transplantation is a potential cure for diabetes mellitus. The major problem for broad clinical application remains the prevention of transplant rejection without major side effects. Immunoisolation is an experimental strategy to prevent rejection by separating the transplanted cells from the host immune system using a barrier device. Current methods use artificial, not completely inert materials as barrier devices and induce an unwanted foreign-body (FB) reaction. Using the recipients of own cells for encapsulation, the FB reaction could be prevented. This study describes a new method of encapsulation of islets of Langerhans within a capsule of chondrocytes, which may serve as an immunoisolation barrier utilizing the immunoprivileged properties of the chrondrocyte matrix, and demonstrates the functional survival of the encapsulated islets in vitro.

Collagen in tissue-engineered cartilage: types, structure, and crosslinks

The function of articular cartilage as a weight-bearing tissue depends on the specific arrangement of collagen types II and IX into a three-dimensional organized collagen network that can balance the swelling pressure of the proteoglycan/water gel. To determine whether cartilage engineered in vitro contains a functional collagen network, chondrocyte-polymer constructs were cultured for up to 6 weeks and analyzed with respect to the composition and ultrastructure of collagen by using biochemical and immunochemical methods and scanning electron microscopy. Total collagen content and the concentration of pyridinium crosslinks were significantly (57% and 70%, respectively) lower in tissue-engineered cartilage that in bovine calf articular cartilage. However, the fractions of collagen types II, IX, and X and the collagen network organization, density, and fibril diameter in engineered cartilage were not significantly different from those in natural articular cartilage. The implications of these findings for the field of tissue engineering are that differentiated chondrocytes are capable of forming a complex structure of collagen matrix in vitro, producing a tissue similar to natural articular cartilage on an ultrastructural scale.

Bmp-2 downstream targets in mesenchymal development identified by subtractive cloning from recombinant mesenchymal progenitors (C3H10T1/2)

ABmp-dependent in vitro model was used to identify cDNAs during the manifestation of mesenchymal lineages. This model involves the recombinant expression of Bmps (Bmp-2, Bmp-4-7) in murine mesenchymal C3H10T1/2 progenitors, which leads to the differentiation into three lineages: the osteogenic, the chondrogenic and the adipogenic lineage, albeit in varying efficiencies. By subtractive cloning, 21 Bmp-2-regulated cDNAs from C3H10T1/2 mesenchymal progenitors were identified; 20 were related to known sequences and 1 was not. During mouse embryonic development, many of these cDNAs are expressed in chondrogenic, osteogenic, and in adipogenic tissues. Novel findings include a G0/G1 switch gene (G0S2), which was demonstrated to be predominantly expressed in adipose tissue during late murine embryonic development. Furthermore, the membrane-standing glycoprotein autotaxin (ATX) is expressed, at precartilage condensations, joint regions, and during tooth development. An as yet undescribed cDNA, 29A, which encodes a putative secreted factor, is expressed in developing osteo-/chondrogenic tissues of vertebrae, ribs, tooth, and the limb bud. C3H10T1/2-progenitors, therefore, may serve as a legitimate model for the investigation of the Bmp-mediated events during mesenchymal differentiation.

The occurrence of intracellular chondroitin sulfate

Suspensions of chondrocytes were prepared by treatment with trypsin of the epiphyses of tibias and femurs of 13-day-old chick embryos. After washing to remove the matrix, such suspensions readily incorporate radioactive sulfate into both intracellular and extracellular chondroitin sulfate. Following disruption of the cells, the cell constituents were fractionated by centrifugation. Fractions obtained from cells incubated for 10 minutes showed a concentration of radioactivity in the material which sediments at 10,000 to 20,000 g. At this time the radioactivity of the extracellular chondroitin sulfate is low, but at 1 hour the radioactivity of the intracellular material is relatively unchanged, while that of the extracellular polysaccharide is markedly increased. Following incubation of the chondrocyte suspensions in a tissue culture medium, the intracellular chondroitin sulfate was isolated. This was compared with chondroitin sulfate isolated from the cartilage matrix. Chemical analysis and infrared spectroscopy indicated that both the intracellular and extracellular polysaccharides consist of a mixture of chondroitin sulfuric acids A and C. A portion of the chondroitin sulfate is not sulfated.

Chondrogenesis, studied with the electron microscope

The role of the cells in the fabrication of a connective tissue matrix, and the structural modifications which accompany cytodifferentiation have been investigated in developing epiphyseal cartilage of fetal rat by means of electron microscopy. Differentiation of the prechondral mesenchymal cells to chondroblasts is marked by the acquisition of an extensive endoplasmic reticulum, enlargement and concentration of the Golgi apparatus, the appearance of membrane-bounded cytoplasmic inclusions, and the formation of specialized foci of increased density in the cell cortex. These modifications are related to the secretion of the cartilage matrix. The matrix of young hyaline cartilage consists of groups of relatively short, straight, banded collagen fibrils of 10 to 20 mmicro and a dense granular component embedded in an amorphous ground substance of moderate electron density. It is postulated that the first phase of fibrillogenesis takes place at the cell cortex in dense bands or striae within the ectoplasm subjacent to the cell membrane. These can be resolved into sheaves of "primary" fibrils of about 7 to 10 mmicro. They are supposedly shed (by excortication) into the matrix space between the separating chondroblasts, where they may serve as "cores" of the definitive matrix fibrils. The diameter of the fibrils may subsequently increase up to threefold, presumably by incorporation of "soluble" or tropocollagen units from the ground substance. The chondroblast also discharges into the matrix the electrondense amorphous or granular contents of vesicles derived from the Golgi apparatus, and the mixed contents of large vacuoles or blebs bounded by distinctive double membranes. Small vesicles with amorphous homogeneous contents of moderate density are expelled in toto from the chondroblasts. In their subsequent evolution to chondrocytes, both nucleus and cytoplasm of the chondroblasts undergo striking condensation. Those moving toward the osteogenic plate accumulate increasingly large stores of glycogen. In the chondrocyte, the enlarged fused Golgi vesicles with dense contents, massed in the juxtanuclear zone, are the most prominent feature of the cytoplasm. Many of these make their way to the surface to discharge their contents. The hypertrophied chondrocytes of the epiphyseal plate ultimately yield up their entire contents to the matrix.

Intracellular synthesis of chondroitin sulfate

In autoradiograms of slices of costal cartilage, incubated for 4 hours in a salt solution containing S³⁵-sulfate and then washed extensively and dehydrated, about 85 per cent of the radioactivity was assignable to the chondrocytes. From alkaline extracts of similarly prepared slices of cartilage, 64 to 83 per cent of the total sulfur-35 in the slices was isolated as chondroitin sulfate by chromatography on an anion-exchange resin. In view of the estimate that only about 15 per cent of the radioactivity was in the matrix, the isolation of 64 to 83 per cent of the total sulfur-35 as chondroitin sulfate is a strong argument that the chondrocytes are the loci in which chondroitin sulfate(s) is synthesized.

Turnover of the organic matrix of cartilage and bone as visualized by autoradiography

Tibiae and humeri were removed from suckling rats at intervals of time after intraperitoneal injection of C(14)-L-phenylalanine, C(14)-L-leucine, S(35)-sulfate, or Ca(45) Cl(2). Autoradiograms of sections of the bones were prepared. Ca(45) was removed from sections treated with dilute acetic acid; neither the concentration of S(35) nor that of C(14) was thereby markedly decreased. The S(35) was removed from the demineralized sections on incubation in a solution of testicular hyaluronidase; the C(14) was not. These results are interpreted as indicating that most of the S(35) was present in the bones as chondroitin sulfate and that most of the C(14) in the bones was present as protein. In the epiphyses, the C(14) was initially concentrated in the proliferaing and hypertrophic chondrocytes, as was the S(35). Secretion of S(35)- and C(14)-labeled materials into the matrix followed. Thereafter, however, although the S(35)-labeled material (chondroitin sulfate) persisted in the matrix, albeit at a diminished concentration, and was incorporated into metaphyseal bone, the C(14)-labeled material (protein) was almost completely removed from the matrix. When rats were given repeated doses of 17-beta-estradiol benzoate so as to inhibit resorption of their metaphyses, repeated doses of S(35)-sulfate were discerned as strata of S(35) in their metaphyses. This was not the case if the rats received repeated doses of C(14)-L-phenylalanine or C(14)-L-leucine. On the basis of the results in these experiments it is suggested that although a portion of the chondroitin sulfate produced by the chondrocytes of the epiphyseal plate is retained and becomes part of the cores of metaphyseal spicules of bone, the protein of the proteinpolysaccharide is somehow removed before calcification of the cartilage ensues.

[Structure of the retinoic acid receptor and its functional analysis using a mutated receptor]

RA shows a variety of actions including the teratogenicity at pharmacological doses, but its physiological roles remain unclear. Recently, receptors for RA, RARs, have been identified and shown to belong to the nuclear receptor superfamily. We introduced a mutation, which was originally identified in the thyroid hormone receptor gene, causing dominantly inherited thyroid hormone resistance, to the equivalent position in RAR, and showed that the mutated RAR demonstrated a dominant-negative phenotypes. We next expressed the mutated RAR specifically in chondrogenic cells in mice. From the analysis of mice phenotypes, we unveiled the chondrogenic cells as a novel vital RA target in skeletal development. The results simultaneously indicated that RA specifies cervical identities through the regulation of homeobox genes.

In vitro experimental research of rabbit condrocytes biostimulation with diode laser Ga-Al-As: a preliminary study

The scope of our study was to verify the effects of a new diode laser device with active material composed of Gallium, Aluminum and Arsenic (Ga-Al-As) configured as MOCVD (780 nm., 3000 mW) for the biostimulation of the cartilage cells in vitro. The condrocytes cells, withdrawn from the cartilage of the medial condyle of the femur of the rabbit, were cultivated, incubated and subject to biostimulation treatment with the laser. The condrocytes cells were placed in 24 Petri dishes at the concentration of 0.25 x 10(5)/ml and divided into 4 groups: 3 group (I, II, III) were treated with the laser and the fourth group (IV) was used as the control group. At the end of the treatment, all four groups, were evaluated with a MTT test and a cell count of the condrocytes cells. Group III (300 J, 1 Watt, 300 Hz, 10' of exposure time with a pulsating emission) provided the best results in terms of cell viability (MTT test) and for the number of cells found in the dishes when compared to the other treated groups and the control group. The results obtained with the use of this new diode laser Ga-Al-As device in the biostimulation of the cartilage tissue, permits us to consider the use of this device clinically.

Transcriptional induction of cyclooxygenase-2 gene by okadaic acid inhibition of phosphatase activity in human chondrocytes: co-stimulation of AP-1 and CRE nuclear binding proteins

The involvement of serine/threonine protein phosphatases in signaling pathways that control the expression of the cyclooxygenase-2 (COX-2) gene in human chondrocytes was examined. Okadaic acid (OKA), an inhibitor of protein phosphatases 1 (PP-1) and 2A (PP-2A), induced a delayed, time-dependent increase in the rate of COX-2 gene transcription (runoff assay) resulting in increased steady-state mRNA levels and enzyme synthesis. The latter response was dose dependent over a narrow range of 1-30 nmol/L with declining expression and synthesis of COX-2 at higher concentrations due to cell toxicity. The delayed increase in COX-2 mRNA expression was accompanied by the induction of the proto-oncogenes c-jun, junB, junD, and c-fos (but not FosB or Fra-1). Increased phosphorylation of CREB-1/ATF-1 transcription factors was observed beginning at 4 h and reached a zenith at 8 h. Gel-shift analysis confirmed the up-regulation of AP-1 and CRE nuclear binding proteins, though there was little or no OKA-induced nuclear protein binding to SP-1, AP-2, NF-kappaB or NF-IL-6 regulatory elements. OKA-induced nuclear protein binding to 32P-CRE oligonucleotides was abrogated by a pharmacological inhibitor of protein kinase A (PKA), KT-5720; the latter compound also inhibited OKA-induced COX-2 enzyme synthesis. Calphostin C (CalC), an inhibitor of PKC isoenzymes, had little effect in this regard. Inhibition of 12P-CRE binding was also observed in the presence of an antibody to CREB-binding protein (265-kDa CBP), an integrator and coactivator of cAMP-responsive genes. The binding to 32P-CRE was unaffected in the presence of excess radioinert AP-1 and COX-2 NF-IL-6 oligonucleotides, although a COX-2 CRE-oligo competed very efficiently. 32P-AP-1 consensus sequence binding was unaffected by incubation of chondrocytes with KT-5720 or CalC, but was dramatically diminished by excess radioinert AP-1 and CRE-COX-2 oligos. Supershift analysis in the presence of antibodies to c-Jun, c-Fos, JunD, and JunB suggested that AP-1 complexes were composed of c-Fos, JunB, and possibly c-Jun. OKA has no effect on total cellular PKC activity but caused a delayed time-dependent increase in total PKA activity and synthesis. OKA suppressed the activity of the MAP kinases, ERK1/2 in a time-dependent fashion, suggesting that the Raf-1/MEKK1/MEK1/ERK1,2 cascade was compromised by OKA treatment. By contrast, OKA caused a dramatic increase in SAPK/JNK expression and activity, indicative of an activation of MEKK1/JNKK/SAPK/JNK pathway. OKA stimulated a dose-dependent activation of CAT activity using transfected promoter-CAT constructs harboring the regulatory elements AP-1 (c-jun promoter) and CRE (CRE-tkCAT). We conclude that in primary phenotypically stable human chondrocytes, COX-2 gene expression may be controlled by critical phosphatases that interact with phosphorylation dependent (e.g., MAP kinases:AP-1, PKA:CREB/ATF) signaling pathways. AP-1 and CREB/ATF families of transcription factors may be important substrates for PP-1/PP-2A in human chondrocytes.

Bone morphogenetic proteins and bFGF exert opposing regulatory effects on PTHrP expression and inorganic pyrophosphate elaboration in immortalized murine endochondral hypertrophic chondrocytes (MCT cells)

A fundamental question in endochondral development is why the expression of parathyroid hormone-related protein (PTHrP), which inhibits chondrocyte maturation and mineralization, becomes attenuated at the stage of chondrocyte hypertrophy. To address this question, we used clonal, phenotypically stable SV40-immortalized murine endochondral chondrocytes that express a growth-arrested hypertrophic phenotype in culture (MCT cells). Addition of individual cytokines to the medium of MCT cells revealed that bone morphogenetic protein (BMP)-6, which commits chondrocytes to hypertrophy, markedly inhibited PTHrP production. This activity was shared by three other osteogenic bone morphogenetic proteins (BMP-2, BMP-4, and BMP-7) and by transforming growth factor beta (TGF-beta), which all inhibited the level of PTHrP mRNA. In contrast, basic fibroblast growth factor (bFGF), an inhibitor of chondrocyte maturation to hypertrophy, induced PTHrP in MCT cells and antagonized the effects of BMP-2, BMP-4, BMP-6, and BMP-7 and TGF-beta on PTHrP expression. Opposing effects of bFGF and BMPs also were exerted on the elaboration of inorganic pyrophosphatase (PPi), which regulates the ability of hypertrophic chondrocytes to mineralize the matrix. Specifically, BMP-2 and BMP-4, but not BMP-6 and BMP-7, shared the ability of TGF-beta to induce PPi release, and this activity was inhibited by bFGF in MCT cells. Our results suggest that effects on PTHrP expression could contribute to the ability of BMP-6 to promote chondrocyte maturation. BMPs and bFGF exert opposing effects on more than one function in immortalized hypertrophic chondrocytes. Thus, the normal decrease in bFGF responsiveness that accompanies chondrocyte hypertrophy may function in part by removing the potential for bFGF to induce PTHrP expression and to oppose the effects of BMPs. MCT cells may be useful in further understanding the mechanisms regulating the differentiation and function of hypertrophic chondrocytes.

Artificial cavitation nuclei significantly enhance acoustically induced cell transfection

The efficiency of ultrasound-mediated gene transfection was enhanced three- to fourfold, compared to previous results, through the use of green fluorescent protein reporter gene, cultured immortalized human chondrocytes and artificial cavitation nuclei in the form of Albunex. Cells were exposed to 1.0-MHz ultrasound transmitted through the bottom of six-well culture plates containing immortalized chondrocytes, media, DNA at a concentration of 40 micrograms/mL and Albunex at 50 x 10(6) bubbles/mL. Transfection efficiency increased linearly with ultrasound exposure pressure with a transfection threshold observed at a spatial average peak positive pressure (SAPP) of 0.12 MPa and reaching about 50% of the living cells when exposed to 0.41 MPa SAPP for 20 s. Adding fresh Albunex at 50 x 10(6) bubbles/mL prior to sequential 1-s, 0.32- or 0.41-MPa exposures increased transfection with each exposure, reaching 43% transfection after four exposures. Efficient in vitro and in vivo transfection now appear possible with these enhancements.

In vitro prefabrication of human cartilage shapes using fibrin glue and human chondrocytes

We report the first generation of human cartilage from fibrin glue using a technique of molding chondrocytes in fibrin glue developed in our laboratory. Human costal chondrocytes were suspended in cryoprecipitate and polymerized into a human nasal shape with bovine thrombin. After culture in vitro for 4 weeks, this construct was implanted subcutaneously into a nude mouse. The final construct harvested after 4 weeks in vivo demonstrated some preservation of its original features. Histological analysis showed features of native cartilage, including matrix synthesis and viable chondrocytes by nuclear staining. Biochemical analysis demonstrated active matrix production. Biomechanical testing was performed. To our knowledge this is the first reported creation of human cartilage from fibrin glue, and the first creation of human cartilage in vitro. This technique may become a promising means of engineering precisely designed autogenous cartilage for human reconstruction.

Expression of indian hedgehog, bone morphogenetic protein 6 and gli during skeletal morphogenesis

A complex signaling pathway involving members of the Hedgehog, Bone morphogenetic protein (Bmp) and Gli families regulates early patterning events in fetal skeletogenesis (Hui and Joyner, 1993. A mouse model of Greig cephalopolysyndactyly syndrome: the extra-toes mutation contains an intragenic deletion of the Gli3 gene. Nat. Genet. 3, 241-246; Bitgood and McMahon, 1995. Hedgehog and Bmp genes are coexpressed at many diverse sites of cell-cell interaction in the mouse embryo. Dev. Biol. 172, 126-138; Lanske et al., 1996. PTH/PTHrP receptor in early development and Indian hedgehog-regulated bone growth. Science 273, 663-666; Vortkamp et al., 1996. Regulation of rate of cartilage differentiation by Indian hedgehog and PTH-related protein. Science 273, 613-622). Hedgehog genes encode secreted proteins that mediate patterning and growth through the induction of secondary signals (reviewed in Hammerschmidt et al., 1997. The world according to hedgehog. Trends Genet. 13, 14-21). Two potential targets of Ihh are bmp6 and gli (Johnson et al., 1995. Patched overexpression alters wing disc size and pattern: transcriptional and post-transcriptional effects on hedgehog targets. Development 121, 4161-4170; Dominguez et al., 1996. Sending and receiving the hedgehog signal: control by the Drosophila Gli protein Cubitus interruptus. Science 272, 1621-1625; Marigo et al., 1996. Sonic hedgehog differentially regulates expression of GLI and GLI3 during limb development. Dev. Biol. 180, 273-283). We investigated the molecular similarities and differences between fetal and postnatal skeletal development by analyzing the coincident and complimentary expression domains of indian hedgehog (ihh), bmp6 and gli in adjacent sections throughout the process of skeletogenesis. In almost all of the skeletal tissues examined, the expression domains of ihh and bmp6 were adjacent to one another and this region was surrounded by gli-expressing cells. These observations are in keeping with the proposed function of gli as a negative regulator of Ihh signaling and the induction of Bmps by Hedgehog proteins (Roberts et al., 1995. Sonic hedgehog is an endodermal signal inducing Bmp-4 and Hox genes during induction and regionalization of the chick hindgut. Development 121, 3163-3174; Kawakami et al., 1996. BMP signaling during bone pattern determination in the developing limb. Development 122, 3557-3566). By puberty, ihh, bmp6 and gli transcripts were no longer detected in the growth plate, despite the fact that physeal chondrocytes continued to hypertrophy and differentiate. Although bmp6 was expressed, ihh transcripts were not found in primordia of intramembranous bones, nor in cells lining the future articular surfaces. Collectively our findings suggest that ihh participates in, but is not required for chondrocyte hypertrophy.