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Fellows CR, Matta C, Zakany R, Khan IM, Mobasheri A. Adipose, Bone Marrow and Synovial Joint-Derived Mesenchymal Stem Cells for Cartilage Repair. Front Genet 2016; 7:213. [PMID: 28066501 PMCID: PMC5167763 DOI: 10.3389/fgene.2016.00213] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 11/22/2016] [Indexed: 01/15/2023] Open
Abstract
Current cell-based repair strategies have proven unsuccessful for treating cartilage defects and osteoarthritic lesions, consequently advances in innovative therapeutics are required and mesenchymal stem cell-based (MSC) therapies are an expanding area of investigation. MSCs are capable of differentiating into multiple cell lineages and exerting paracrine effects. Due to their easy isolation, expansion, and low immunogenicity, MSCs are an attractive option for regenerative medicine for joint repair. Recent studies have identified several MSC tissue reservoirs including in adipose tissue, bone marrow, cartilage, periosteum, and muscle. MSCs isolated from these discrete tissue niches exhibit distinct biological activities, and have enhanced regenerative potentials for different tissue types. Each MSC type has advantages and disadvantages for cartilage repair and their use in a clinical setting is a balance between expediency and effectiveness. In this review we explore the challenges associated with cartilage repair and regeneration using MSC-based cell therapies and provide an overview of phenotype, biological activities, and functional properties for each MSC population. This paper also specifically explores the therapeutic potential of each type of MSC, particularly focusing on which cells are capable of producing stratified hyaline-like articular cartilage regeneration. Finally we highlight areas for future investigation. Given that patients present with a variety of problems it is unlikely that cartilage regeneration will be a simple "one size fits all," but more likely an array of solutions that need to be applied systematically to achieve regeneration of a biomechanically competent repair tissue.
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Affiliation(s)
| | - Csaba Matta
- Faculty of Health and Medical Sciences, University of SurreyGuildford, UK
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of DebrecenDebrecen, Hungary
| | - Roza Zakany
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of DebrecenDebrecen, Hungary
| | - Ilyas M. Khan
- Centre for NanoHealth, Swansea University Medical SchoolSwansea, UK
| | - Ali Mobasheri
- Faculty of Health and Medical Sciences, University of SurreyGuildford, UK
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Queen's Medical CentreNottingham, UK
- King Fahd Medical Research Center, King AbdulAziz UniversityJeddah, Saudi Arabia
- Sheik Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis with Stem Cells, King AbdulAziz UniversityJeddah, Saudi Arabia
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Bone marrow lesions in hip osteoarthritis are characterized by increased bone turnover and enhanced angiogenesis. Osteoarthritis Cartilage 2016; 24:1745-1752. [PMID: 27233775 DOI: 10.1016/j.joca.2016.05.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/07/2016] [Accepted: 05/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Bone marrow lesions (BML), previously denoted bone marrow edema, are detected as water signals by magnetic resonance imaging (MRI). Previous histologic studies were unable to demonstrate any edematous changes at the tissue level. Therefore, our aim was to investigate the underlying biological mechanisms of the water signal in MRI scans of bone affected by BML. METHODS Tetracycline labeling in addition to water sensitive MRI scans of 30 patients planned for total hip replacement surgery was undertaken. Twenty-one femoral heads revealed BML on MRI, while nine were negative and used as controls (CON). Guided by the MRI images cylindrical biopsies were extracted from areas with BML in the femoral heads. Tissue sections from the biopsies were subjected to histomorphometric image analyses of the cancellous bone envelope. RESULTS Patients with BML exhibited an average 40- and 18-fold increase of bone formation rate and mineralizing surface, respectively. Additionally, samples with BML demonstrated 2-fold reduction of marrow fat and 28-fold increase of woven bone. Immunohistochemical analysis showed a 4-fold increase of angiogenesis markers CD31 and von Willebrand Factor (vWF) in the BML-group compared to CON. CONCLUSION This study indicates that BML are characterized by increased bone turnover, vascularity and angiogenesis in keeping with it being a reparatory process. Thus, the water signal, which is the hallmark of BML on MRI, is most probably reflecting increased tissue vascularity accompanying increased remodeling activity.
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Fellows CR, Matta C, Mobasheri A. Applying Proteomics to Study Crosstalk at the Cartilage-Subchondral Bone Interface in Osteoarthritis: Current Status and Future Directions. EBioMedicine 2016; 11:2-4. [PMID: 27614393 PMCID: PMC5049982 DOI: 10.1016/j.ebiom.2016.08.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Christopher R Fellows
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom
| | - Csaba Matta
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of Debrecen, Debrecen H-4032, Hungary
| | - Ali Mobasheri
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom.
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Yasui Y, Ross AW, Murawski CD, Kennedy JG. Authors' Reply. Arthroscopy 2016; 32:1491-3. [PMID: 27495854 DOI: 10.1016/j.arthro.2016.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/12/2016] [Indexed: 02/02/2023]
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Numan AT, Al-Joda AM, Jawad NK. Relationship between Serum Visfatin and Obesity in Lead-Exposed Obese Subjects and Patients with Osteoarthritis. Health (London) 2016. [DOI: 10.4236/health.2016.84033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Steinbeck MJ, Eisenhauer PT, Maltenfort MG, Parvizi J, Freeman TA. Identifying Patient-Specific Pathology in Osteoarthritis Development Based on MicroCT Analysis of Subchondral Trabecular Bone. J Arthroplasty 2016; 31:269-77. [PMID: 26411393 DOI: 10.1016/j.arth.2015.08.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 07/21/2015] [Accepted: 08/12/2015] [Indexed: 02/01/2023] Open
Abstract
The goal of this study was to identify alternative mechanisms of osteoarthritis pathology by analyzing subchondral bone. Femoral condyle samples were collected from post-menopausal female patients with knee osteoarthritis undegoing total knee arthroplasty. In the majority of patients, subchondral trabecular bone volume doubled under a region of the medial femoral condyle with full-thickness cartilage deterioration. However, in a subset of patients the bone volume in this region remained constant. This subset also had larger areas of vascular penetration in the calcified cartilage of the lateral condyle concurrent with increased vascular endothelial growth factor expression. Subtyping by subchondral bone characteristics identified a unique population, which lacked the sclerotic bone characteristic of late-stage osteoarthritis. Identification of subtypes within the osteoarthritis population allows investigation of alternate disease pathologies.
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Affiliation(s)
- Marla J Steinbeck
- School of Biomedical Engineering, Science & Health Systems, Drexel University, Philadelphia, Pennsylvania; Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Peter T Eisenhauer
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Javad Parvizi
- Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Theresa A Freeman
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
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Huesa C, Ortiz AC, Dunning L, McGavin L, Bennett L, McIntosh K, Crilly A, Kurowska-Stolarska M, Plevin R, van 't Hof RJ, Rowan AD, McInnes IB, Goodyear CS, Lockhart JC, Ferrell WR. Proteinase-activated receptor 2 modulates OA-related pain, cartilage and bone pathology. Ann Rheum Dis 2015; 75:1989-1997. [PMID: 26698846 PMCID: PMC5099200 DOI: 10.1136/annrheumdis-2015-208268] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/24/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Proteinase-activated receptor 2 (PAR2) deficiency protects against cartilage degradation in experimental osteoarthritis (OA). The wider impact of this pathway upon OA-associated pathologies such as osteophyte formation and pain is unknown. Herein, we investigated early temporal bone and cartilage changes in experimental OA in order to further elucidate the role of PAR2 in OA pathogenesis. METHODS OA was induced in wild-type (WT) and PAR2-deficient (PAR2-/-) mice by destabilisation of the medial meniscus (DMM). Inflammation, cartilage degradation and bone changes were monitored using histology and microCT. In gene rescue experiments, PAR2-/- mice were intra-articularly injected with human PAR2 (hPAR2)-expressing adenovirus. Dynamic weight bearing was used as a surrogate of OA-related pain. RESULTS Osteophytes formed within 7 days post-DMM in WT mice but osteosclerosis was only evident from 14 days post induction. Importantly, PAR2 was expressed in the proliferative/hypertrophic chondrocytes present within osteophytes. In PAR2-/- mice, osteophytes developed significantly less frequently but, when present, were smaller and of greater density; no osteosclerosis was observed in these mice up to day 28. The pattern of weight bearing was altered in PAR2-/- mice, suggesting reduced pain perception. The expression of hPAR2 in PAR2-/- mice recapitulated osteophyte formation and cartilage damage similar to that observed in WT mice. However, osteosclerosis was absent, consistent with lack of hPAR2 expression in subchondral bone. CONCLUSIONS This study clearly demonstrates PAR2 plays a critical role, via chondrocytes, in osteophyte development and subchondral bone changes, which occur prior to PAR2-mediated cartilage damage. The latter likely occurs independently of OA-related bone changes.
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Affiliation(s)
- Carmen Huesa
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, UK
| | - Ana C Ortiz
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, UK
| | - Lynette Dunning
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, UK
| | - Laura McGavin
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, UK
| | - Louise Bennett
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
| | - Kathryn McIntosh
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Anne Crilly
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, UK
| | | | - Robin Plevin
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Rob J van 't Hof
- Institute of Ageing and Chronic Diseases, University of Liverpool, Liverpool, UK
| | - Andrew D Rowan
- Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - Iain B McInnes
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
| | - Carl S Goodyear
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
| | - John C Lockhart
- Institute of Biomedical & Environmental Health Research, University of the West of Scotland, Paisley, UK
| | - William R Ferrell
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
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Cui Z, Crane J, Xie H, Jin X, Zhen G, Li C, Xie L, Wang L, Bian Q, Qiu T, Wan M, Xie M, Ding S, Yu B, Cao X. Halofuginone attenuates osteoarthritis by inhibition of TGF-β activity and H-type vessel formation in subchondral bone. Ann Rheum Dis 2015; 75:1714-21. [PMID: 26470720 PMCID: PMC5013081 DOI: 10.1136/annrheumdis-2015-207923] [Citation(s) in RCA: 167] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 09/20/2015] [Indexed: 12/28/2022]
Abstract
Objectives Examine whether osteoarthritis (OA) progression can be delayed by halofuginone in anterior cruciate ligament transection (ACLT) rodent models. Methods 3-month-old male C57BL/6J (wild type; WT) mice and Lewis rats were randomised to sham-operated, ACLT-operated, treated with vehicle, or ACLT-operated, treated with halofuginone. Articular cartilage degeneration was graded using the Osteoarthritis Research Society International (OARSI)-modified Mankin criteria. Immunostaining, flow cytometry, RT-PCR and western blot analyses were conducted to detect relative protein and RNA expression. Bone micro CT (μCT) and CT-based microangiography were quantitated to detect alterations of microarchitecture and vasculature in tibial subchondral bone. Results Halofuginone attenuated articular cartilage degeneration and subchondral bone deterioration, resulting in substantially lower OARSI scores. Specifically, we found that proteoglycan loss and calcification of articular cartilage were significantly decreased in halofuginone-treated ACLT rodents compared with vehicle-treated ACLT controls. Halofuginone reduced collagen X (Col X), matrix metalloproteinase-13 and A disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS 5) and increased lubricin, collagen II and aggrecan. In parallel, halofuginone-attenuated uncoupled subchondral bone remodelling as defined by reduced subchondral bone tissue volume, lower trabecular pattern factor (Tb.pf) and increased thickness of subchondral bone plate compared with vehicle-treated ACLT controls. We found that halofuginone exerted protective effects in part by suppressing Th17-induced osteoclastic bone resorption, inhibiting Smad2/3-dependent TGF-β signalling to restore coupled bone remodelling and attenuating excessive angiogenesis in subchondral bone. Conclusions Halofuginone attenuates OA progression by inhibition of subchondral bone TGF-β activity and aberrant angiogenesis as a potential preventive therapy for OA.
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Affiliation(s)
- Zhuang Cui
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Janet Crane
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hui Xie
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Xin Jin
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Gehua Zhen
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Changjun Li
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Liang Xie
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Long Wang
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Qin Bian
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tao Qiu
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mei Wan
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Min Xie
- Department of Pharmaceutical Chemistry, Gladstone Institute of Cardiovascular Disease, University of California, San Francisco, California, USA
| | - Sheng Ding
- Department of Pharmaceutical Chemistry, Gladstone Institute of Cardiovascular Disease, University of California, San Francisco, California, USA
| | - Bin Yu
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xu Cao
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, Maryland, USA
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Orth P, Madry H. Advancement of the Subchondral Bone Plate in Translational Models of Osteochondral Repair: Implications for Tissue Engineering Approaches. TISSUE ENGINEERING PART B-REVIEWS 2015; 21:504-20. [PMID: 26066580 DOI: 10.1089/ten.teb.2015.0122] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Subchondral bone plate advancement is of increasing relevance for translational models of osteochondral repair in tissue engineering (TE). Especially for therapeutic TE approaches, a basic scientific knowledge of its chronological sequence, possible etiopathogenesis, and clinical implications are indispensable. This review summarizes the knowledge on this topic gained from a total of 31 translational investigations, including 1009 small and large animals. Experimental data indicate that the advancement of the subchondral bone plate frequently occurs during the spontaneous repair of osteochondral defects and following established articular cartilage repair approaches for chondral lesions such as marrow stimulation and TE-based strategies such as autologous chondrocyte implantation. Importantly, this subchondral bone reaction proceeds in a defined chronological and spatial pattern, reflecting both endochondral ossification and intramembranous bone formation. Subchondral bone plate advancement arises earlier in small animals and defects, but is more pronounced at the long term in large animals. Possible etiopathologies comprise a disturbed subchondral bone/articular cartilage crosstalk and altered biomechanical conditions or neovascularization. Of note, no significant correlation was found so far between subchondral bone plate advancement and articular cartilage repair. This evidence from translational animal models adverts to an increasing awareness of this previously underestimated pathology. Future research will shed more light on the advancement of the subchondral bone plate in TE models of cartilage repair.
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Affiliation(s)
- Patrick Orth
- 1 Center of Experimental Orthopedics, Saarland University , Homburg, Germany .,2 Department of Orthopedic Surgery, Saarland University Medical Center , Homburg, Germany
| | - Henning Madry
- 1 Center of Experimental Orthopedics, Saarland University , Homburg, Germany .,2 Department of Orthopedic Surgery, Saarland University Medical Center , Homburg, Germany
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Lu S, Lam J, Trachtenberg JE, Lee EJ, Seyednejad H, van den Beucken JJJP, Tabata Y, Kasper FK, Scott DW, Wong ME, Jansen JA, Mikos AG. Technical Report: Correlation Between the Repair of Cartilage and Subchondral Bone in an Osteochondral Defect Using Bilayered, Biodegradable Hydrogel Composites. Tissue Eng Part C Methods 2015; 21:1216-25. [PMID: 26177155 DOI: 10.1089/ten.tec.2015.0117] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The present work investigated correlations between cartilage and subchondral bone repair, facilitated by a growth factor-delivering scaffold, in a rabbit osteochondral defect model. Histological scoring indices and microcomputed tomography morphological parameters were used to evaluate cartilage and bone repair, respectively, at 6 and 12 weeks. Correlation analysis revealed significant associations between specific cartilage indices and subchondral bone parameters that varied with location in the defect (cortical vs. trabecular region), time point (6 vs. 12 weeks), and experimental group (insulin-like growth factor-1 only, bone morphogenetic protein-2 only, or both growth factors). In particular, significant correlations consistently existed between cartilage surface regularity and bone quantity parameters. Overall, correlation analysis between cartilage and bone repair provided a fuller understanding of osteochondral repair and can help drive informed studies for future osteochondral regeneration strategies.
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Affiliation(s)
- Steven Lu
- 1 Department of Bioengineering, Rice University , Houston, Texas
| | - Johnny Lam
- 1 Department of Bioengineering, Rice University , Houston, Texas
| | | | - Esther J Lee
- 1 Department of Bioengineering, Rice University , Houston, Texas
| | - Hajar Seyednejad
- 1 Department of Bioengineering, Rice University , Houston, Texas
| | | | - Yasuhiko Tabata
- 3 Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University , Kyoto, Japan
| | - F Kurtis Kasper
- 4 Department of Orthodontics, University of Texas School of Dentistry at Houston , Houston, Texas
| | - David W Scott
- 5 Department of Statistics, Rice University , Houston, Texas
| | - Mark E Wong
- 6 Department of Oral and Maxillofacial Surgery, University of Texas School of Dentistry at Houston , Houston, Texas
| | - John A Jansen
- 2 Department of Biomaterials, Radboudumc , Nijmegen, The Netherlands
| | - Antonios G Mikos
- 1 Department of Bioengineering, Rice University , Houston, Texas
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Chang G, Xia D, Chen C, Madelin G, Abramson SB, Babb JS, Saha PK, Regatte RR. 7T MRI detects deterioration in subchondral bone microarchitecture in subjects with mild knee osteoarthritis as compared with healthy controls. J Magn Reson Imaging 2015; 41:1311-7. [PMID: 24979471 PMCID: PMC9982830 DOI: 10.1002/jmri.24683] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/30/2014] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To determine how subchondral bone microarchitecture is altered in patients with mild knee osteoarthritis. MATERIALS AND METHODS This study had Institutional Review Board approval. We recruited 24 subjects with mild radiographic knee osteoarthritis and 16 healthy controls. The distal femur was scanned at 7T using a high-resolution 3D FLASH sequence. We applied digital topological analysis to assess bone volume fraction, markers of trabecular number (skeleton density), trabecular network osteoclastic resorption (erosion index), plate-like structure (surface), rod-like structure (curve), and plate-to-rod ratio (surface-curve ratio). We used two-tailed t-tests to compare differences between osteoarthritis subjects and controls. RESULTS 7T magnetic resonance imaging (MRI) detected deterioration in subchondral bone microarchitecture in both medial and lateral femoral condyles in osteoarthritis subjects as compared with controls. This was manifested by lower bone volume fraction (-1.03% to -5.43%, P < 0.04), higher erosion index (+8.49 to +22.76%, P < 0.04), lower surface number (-2.31% to -9.63%, P < 0.007), higher curve number (+6.85% to +16.93%, P < 0.03), and lower plate-to-rod ratio (-7.92% to -21.71%, P < 0.05). CONCLUSION The results provide further support for the concept that poor subchondral bone quality is associated with osteoarthritis and may serve as a potential therapeutic target for osteoarthritis interventions. J. Magn. Reson. Imaging 2015;41:1311-1317. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Gregory Chang
- Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, New York, New York, USA.,Department of Radiology, NYU Langone Medical Center, Center for Biomedical Imaging, New York, New York, USA.,Address reprint requests to: G.C., Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, 333 E. 38 St., 6 Fl., Rm. 6–210, New York, NY, 10016.
| | - Ding Xia
- Department of Radiology, NYU Langone Medical Center, Center for Biomedical Imaging, New York, New York, USA
| | - Cheng Chen
- Departments of Radiology and Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Guillaume Madelin
- Departments of Radiology and Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Steven B. Abramson
- Department of Medicine, NYU Langone Medical Center, New York, New York, USA
| | - James S. Babb
- Department of Radiology, NYU Langone Medical Center, Center for Biomedical Imaging, New York, New York, USA
| | - Punam K. Saha
- Departments of Radiology and Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
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Schultz M, Molligan J, Schon L, Zhang Z. Pathology of the calcified zone of articular cartilage in post-traumatic osteoarthritis in rat knees. PLoS One 2015; 10:e0120949. [PMID: 25807537 PMCID: PMC4373850 DOI: 10.1371/journal.pone.0120949] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/27/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives This study aimed to investigate the pathology occurring at the calcified zone of articular cartilage (CZC) in the joints afflicted with post-traumatic osteoarthritis (PTOA). Methods Rats underwent bilateral anterior cruciate ligament (ACL) transection and medial meniscectomy to induce PTOA. Sham surgery was performed on another five rats to serve as controls. The rats were euthanized after four weeks of surgery and tibial plateaus were dissected for histology. The pathology of PTOA, CZC area and the tidemark roughness at six pre-defined locations on the tibial plateaus were quantified by histomorphometry. Results PTOA developed in the knees, generally more severe at the medial plateau than the lateral plateau, of rats in the experimental group. The CZC area was unchanged in the PTOA joints, but the topographic variations of CZC areas that presented in the control knees were reduced in the PTOA joints. The tidemark roughness decreased in areas of the medial plateau of PTOA joints and that was inversely correlated with the Mankin’s score of PTOA pathology. Conclusion Reduced tidemark roughness and unchanged CZC area differentiate PTOA from primary osteoarthritis, which is generally believed to have the opposite pathology at CZC, and may contribute to the distinct disease progression of the two entities of arthropathy.
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Affiliation(s)
- Melissa Schultz
- Center of Anatomical Science, Saint Louis University, St. Louis, Missouri, United States of America
| | - Jeremy Molligan
- Orthobiologic Laboratory, Medstar Union Memorial Hospital, Baltimore, Maryland, United States of America
| | - Lew Schon
- Orthobiologic Laboratory, Medstar Union Memorial Hospital, Baltimore, Maryland, United States of America
| | - Zijun Zhang
- Orthobiologic Laboratory, Medstar Union Memorial Hospital, Baltimore, Maryland, United States of America
- * E-mail:
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Li G, Yin J, Gao J, Cheng TS, Pavlos NJ, Zhang C, Zheng MH. Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther 2014; 15:223. [PMID: 24321104 PMCID: PMC4061721 DOI: 10.1186/ar4405] [Citation(s) in RCA: 479] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 12/02/2013] [Indexed: 12/11/2022] Open
Abstract
Osteoarthritis (OA) is a major cause of disability in the adult population. As a
progressive degenerative joint disorder, OA is characterized by cartilage damage,
changes in the subchondral bone, osteophyte formation, muscle weakness, and
inflammation of the synovium tissue and tendon. Although OA has long been viewed as a
primary disorder of articular cartilage, subchondral bone is attracting increasing
attention. It is commonly reported to play a vital role in the pathogenesis of OA.
Subchondral bone sclerosis, together with progressive cartilage degradation, is
widely considered as a hallmark of OA. Despite the increase in bone volume fraction,
subchondral bone is hypomineralized, due to abnormal bone remodeling. Some
histopathological changes in the subchondral bone have also been detected, including
microdamage, bone marrow edema-like lesions and bone cysts. This review summarizes
basic features of the osteochondral junction, which comprises subchondral bone and
articular cartilage. Importantly, we discuss risk factors influencing subchondral
bone integrity. We also focus on the microarchitectural and histopathological changes
of subchondral bone in OA, and provide an overview of their potential contribution to
the progression of OA. A hypothetical model for the pathogenesis of OA is
proposed.
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Yuan XL, Meng HY, Wang YC, Peng J, Guo QY, Wang AY, Lu SB. Bone-cartilage interface crosstalk in osteoarthritis: potential pathways and future therapeutic strategies. Osteoarthritis Cartilage 2014; 22:1077-89. [PMID: 24928319 DOI: 10.1016/j.joca.2014.05.023] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/22/2014] [Accepted: 05/28/2014] [Indexed: 02/02/2023]
Abstract
Currently, osteoarthritis (OA) is considered a disease of the entire joint, which is not simply a process of wear and tear but rather abnormal remodelling and joint failure of an organ. The bone-cartilage interface is therefore a functioning synergistic unit, with a close physical association between subchondral bone and cartilage suggesting the existence of biochemical and molecular crosstalk across the OA interface. The crosstalk at the bone-cartilage interface may be elevated in OA in vivo and in vitro. Increased vascularisation and formation of microcracks associated with abnormal bone remodelling in joints during OA facilitate molecular transport from cartilage to bone and vice versa. Recent reports suggest that several critical signalling pathways and biological factors are key regulators and activate cellular and molecular processes in crosstalk among joint compartments. Therapeutic interventions including angiogenesis inhibitors, agonists/antagonists of molecules and drugs targeting bone remodelling are potential candidates for this interaction. This review summarised the premise for the presence of crosstalk in bone-cartilage interface as well as the current knowledge of the major signalling pathways and molecular interactions that regulate OA progression. A better understanding of crosstalk in bone-cartilage interface may lead to development of more effective strategies for treating OA patients.
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Affiliation(s)
- X L Yuan
- Institute of Orthopedics, Chinese PLA General Hospital, Fuxing 28# Road, Beijing, China
| | - H Y Meng
- Institute of Orthopedics, Chinese PLA General Hospital, Fuxing 28# Road, Beijing, China
| | - Y C Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Fuxing 28# Road, Beijing, China
| | - J Peng
- Institute of Orthopedics, Chinese PLA General Hospital, Fuxing 28# Road, Beijing, China
| | - Q Y Guo
- Institute of Orthopedics, Chinese PLA General Hospital, Fuxing 28# Road, Beijing, China
| | - A Y Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Fuxing 28# Road, Beijing, China.
| | - S B Lu
- Institute of Orthopedics, Chinese PLA General Hospital, Fuxing 28# Road, Beijing, China
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Lu S, Lam J, Trachtenberg JE, Lee EJ, Seyednejad H, van den Beucken JJJP, Tabata Y, Wong ME, Jansen JA, Mikos AG, Kasper FK. Dual growth factor delivery from bilayered, biodegradable hydrogel composites for spatially-guided osteochondral tissue repair. Biomaterials 2014; 35:8829-8839. [PMID: 25047629 DOI: 10.1016/j.biomaterials.2014.07.006] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/02/2014] [Indexed: 12/11/2022]
Abstract
The present work investigated the use of biodegradable hydrogel composite scaffolds, based on the macromer oligo(poly(ethylene glycol) fumarate) (OPF), to deliver growth factors for the repair of osteochondral tissue in a rabbit model. In particular, bilayered OPF composites were used to mimic the structural layers of the osteochondral unit, and insulin-like growth factor-1 (IGF-1) and bone morphogenetic protein-2 (BMP-2) were loaded into gelatin microparticles and embedded within the OPF hydrogel matrix in a spatially controlled manner. Three different scaffold formulations were implanted in a medial femoral condyle osteochondral defect: 1) IGF-1 in the chondral layer, 2) BMP-2 in the subchondral layer, and 3) IGF-1 and BMP-2 in their respective separate layers. The quantity and quality of osteochondral repair was evaluated at 6 and 12 weeks with histological scoring and micro-computed tomography (micro-CT). While histological scoring results at 6 weeks showed no differences between experimental groups, micro-CT analysis revealed that the delivery of BMP-2 alone increased the number of bony trabecular islets formed, an indication of early bone formation, over that of IGF-1 delivery alone. At 12 weeks post-implantation, minimal differences were detected between the three groups for cartilage repair. However, the dual delivery of IGF-1 and BMP-2 had a higher proportion of subchondral bone repair, greater bone growth at the defect margins, and lower bone specific surface than the single delivery of IGF-1. These results suggest that the delivery of BMP-2 enhances subchondral bone formation and that, while the dual delivery of IGF-1 and BMP-2 in separate layers does not improve cartilage repair under the conditions studied, they may synergistically enhance the degree of subchondral bone formation. Overall, bilayered OPF hydrogel composites demonstrate potential as spatially-guided, multiple growth factor release vehicles for osteochondral tissue repair.
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Affiliation(s)
- Steven Lu
- Department of Bioengineering, Rice University, P.O. Box 1892, MS-142, Houston, TX 77005-1892, USA
| | - Johnny Lam
- Department of Bioengineering, Rice University, P.O. Box 1892, MS-142, Houston, TX 77005-1892, USA
| | - Jordan E Trachtenberg
- Department of Bioengineering, Rice University, P.O. Box 1892, MS-142, Houston, TX 77005-1892, USA
| | - Esther J Lee
- Department of Bioengineering, Rice University, P.O. Box 1892, MS-142, Houston, TX 77005-1892, USA
| | - Hajar Seyednejad
- Department of Bioengineering, Rice University, P.O. Box 1892, MS-142, Houston, TX 77005-1892, USA
| | | | - Yasuhiko Tabata
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Mark E Wong
- Department of Surgery, Division of Oral and Maxilofacial Surgery, The University of Texas School of Dentistry at Houston, Houston, USA
| | - John A Jansen
- Department of Biomaterials, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Antonios G Mikos
- Department of Bioengineering, Rice University, P.O. Box 1892, MS-142, Houston, TX 77005-1892, USA.
| | - F Kurtis Kasper
- Department of Bioengineering, Rice University, P.O. Box 1892, MS-142, Houston, TX 77005-1892, USA.
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117
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Zhen G, Cao X. Targeting TGFβ signaling in subchondral bone and articular cartilage homeostasis. Trends Pharmacol Sci 2014; 35:227-36. [PMID: 24745631 DOI: 10.1016/j.tips.2014.03.005] [Citation(s) in RCA: 147] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/27/2014] [Accepted: 03/13/2014] [Indexed: 01/02/2023]
Abstract
Osteoarthritis (OA) is the most common degenerative joint disease and no disease-modifying therapy for OA is currently available. Targeting articular cartilage alone may not be sufficient to halt this disease progression. Articular cartilage and subchondral bone act as a functional unit. Increasing evidence indicates that transforming growth factor β (TGFβ) plays a crucial role in maintaining homeostasis of both articular cartilage and subchondral bone. Activation of extracellular matrix (ECM) latent TGFβ at the appropriate time and location is a prerequisite for its function. Aberrant activation of TGFβ in the subchondral bone in response to an abnormal mechanical loading environment induces formation of osteroid islets at the onset of OA. As a result, alteration of subchondral bone structure changes the stress distribution on the articular cartilage and leads to its degeneration. Thus, inhibition of TGFβ activity in the subchondral bone may provide a new avenue of treatment for OA. In this review we will discuss the role of TGFβ in the homeostasis of articular cartilage and subchondral bone as a novel target for OA therapy.
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Affiliation(s)
- Gehua Zhen
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Ross Building, Room 229, 720 Rutland Ave, Baltimore, MD 21205, USA
| | - Xu Cao
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Ross Building, Room 229, 720 Rutland Ave, Baltimore, MD 21205, USA.
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Abstract
Osteoarthritis (OA) is the predominant form of arthritis worldwide, resulting in a high degree of functional impairment and reduced quality of life owing to chronic pain. To date, there are no treatments that are known to modify disease progression of OA in the long term. Current treatments are largely based on the modulation of pain, including NSAIDs, opiates and, more recently, centrally acting pharmacotherapies to avert pain. This review will focus on the rationale for new avenues in pain modulation, including inhibition with anti-NGF antibodies and centrally acting analgesics. The authors also consider the potential for structure modification in cartilage/bone using growth factors and stem cell therapies. The possible mismatch between structural change and pain perception will also be discussed, introducing recent techniques that may assist in improved patient phenotyping of pain subsets in OA. Such developments could help further stratify subgroups and treatments for people with OA in future.
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Abraham A, Pauly H, Donahue TH. Deleterious effects of osteoarthritis on the structure and function of the meniscal enthesis. Osteoarthritis Cartilage 2014; 22:275-83. [PMID: 24316288 PMCID: PMC3923977 DOI: 10.1016/j.joca.2013.11.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 11/23/2013] [Accepted: 11/26/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The ability of menisci to prevent osteoarthritis (OA) is dependent on the integrity of the complex meniscal entheses, the attachments of the menisci to the underlying subchondral bone (SB). The goal of this study was to determine mechanical and structural changes in meniscal entheses after the onset of OA. DESIGN Healthy and osteoarthritic meniscal entheses were evaluated for changes in histomorphological characteristics, mineralization, and mechanical properties. Glycosaminoglycans (GAG) and calcium in the insertion were evaluated with histological staining techniques. The extent of calcium deposition was assessed and tidemark (TM) integrity was quantified. Changes in the mineralized zone of the insertion were examined using micro-computed tomography (μCT) to determine bone mineral density, cortical zone thickness, and mineralization gradient. Mechanical properties of the entheses were measured using nano-indentation techniques to obtain material properties based on viscoelastic analysis. RESULTS GAG thickness in the calcified fibrocartilage (CFC) zone and calcium content were significantly greater in osteoarthritic anterior meniscal entheses. TM integrity was significantly decreased in OA tissue, particularly in the medial anterior (MA) enthesis. The mineralized zone of osteoarthritic meniscal entheses was significantly thicker than in healthy entheses and showed decreased bone mineral density. Fitting of mineralization data to a sigmoidal Gompertz function revealed a lower rate of increase in mineralization in osteoarthritic tissue. Analysis of viscoelastic mechanical properties revealed increased compliance in osteoarthritic tissue. CONCLUSIONS These data suggest that significant changes occur at meniscal enthesis sites with the onset of OA. Mechanical and structural changes in meniscal entheses may contribute to meniscal extrusion, which has been shown to increase the progression of OA.
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Affiliation(s)
- A.C. Abraham
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA
| | - H.M. Pauly
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO 80523, USA
| | - T.L. Haut Donahue
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA,Address correspondence and reprint requests to: T.L. Haut Donahue, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA
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Laiguillon MC, Houard X, Bougault C, Gosset M, Nourissat G, Sautet A, Jacques C, Berenbaum F, Sellam J. Expression and function of visfatin (Nampt), an adipokine-enzyme involved in inflammatory pathways of osteoarthritis. Arthritis Res Ther 2014; 16:R38. [PMID: 24479481 PMCID: PMC3978827 DOI: 10.1186/ar4467] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 01/20/2014] [Indexed: 01/15/2023] Open
Abstract
Introduction Visfatin is an adipokine that may be involved in intertissular joint communication in osteoarthritis (OA). With a homodimeric conformation, it exerts nicotinamide phosphoribosyltransferase (Nampt) enzymatic activity, essential for nicotinamide adenine dinucleotide biosynthesis. We examined the tissular origin and conformation of visfatin/Nampt in human OA joints and investigated the role of visfatin/Nampt in chondrocytes and osteoblasts by studying Nampt enzymatic activity. Methods Synovium, cartilage and subchondral bone from human OA joints were used for protein extraction or incubated for 24 hours in serum-free media (conditioned media), and synovial fluid was obtained from OA patients. Visfatin/Nampt expression in tissular extracts and conditioned media was evaluated by western blot and enzyme-linked immunosorbent assay (ELISA), respectively. Nampt activity was assessed in OA synovium by colorimetric assay. Primary cultures of murine chondrocytes and osteoblasts were stimulated with visfatin/Nampt and pretreated or not with APO866, a pharmacologic inhibitor of Nampt activity. The effect on cytokines, chemokines, growth factors and hypertrophic markers expression was examined by quantitative reverse transcriptase polymerase chain reaction and/or ELISA. Results In tissular explants, conditioned media and synovial fluid, visfatin/Nampt was found as a homodimer, corresponding to the enzymatically active conformation. All human OA joint tissues released visfatin/Nampt (synovium: 628 ± 106 ng/g tissue; subchondral bone: 195 ± 26 ng/g tissue; cartilage: 152 ± 46 ng/g tissue), with significantly higher level for synovium (P <0.0005). Nampt activity was identified ex vivo in synovium. In vitro, visfatin/Nampt significantly induced the expression of interleukin 6, keratinocyte chemoattractant and monocyte chemoattractant protein 1 in chondrocytes and osteoblasts. APO866 decreased the mRNA and protein levels of these pro-inflammatory cytokines in the two cell types (up to 94% and 63% inhibition, respectively). Levels of growth factors (vascular endothelial growth factor, transforming growth factor β) and hypertrophic genes were unchanged with treatment. Conclusion Visfatin/Nampt is released by all human OA tissues in a dimeric enzymatically active conformation and mostly by the synovium, which displays Nampt activity. The Nampt activity of visfatin is involved in chondrocyte and osteoblast activation, so targeting this enzymatic activity to disrupt joint tissue interactions may be novel in OA therapy.
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Karsdal MA, Bay-Jensen AC, Lories RJ, Abramson S, Spector T, Pastoureau P, Christiansen C, Attur M, Henriksen K, Goldring SR, Kraus V. The coupling of bone and cartilage turnover in osteoarthritis: opportunities for bone antiresorptives and anabolics as potential treatments? Ann Rheum Dis 2013; 73:336-48. [PMID: 24285494 DOI: 10.1136/annrheumdis-2013-204111] [Citation(s) in RCA: 151] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Osteoarthritis (OA) is the most common form of arthritic disease, and a major cause of disability and impaired quality of life in the elderly. OA is a complex disease of the entire joint, affecting bone, cartilage and synovium that thereby presents multiple targets for treatment. This manuscript will summarise emerging observations from cell biology, preclinical and preliminary clinical trials that elucidate interactions between the bone and cartilage components in particular. Bone and cartilage health are tightly associated. Ample evidence has been found for bone changes during progression of OA including, but not limited to, increased turnover in the subchondral bone, undermineralisation of the trabecular structure, osteophyte formation, bone marrow lesions and sclerosis of the subchondral plate. Meanwhile, a range of investigations has shown positive effects on cartilage health when bone resorption is suppressed, or deterioration of the cartilage when resorption is increased. Known bone therapies, namely oestrogens, selective oestrogen receptor modifiers (SERMs), bisphosphonates, strontium ranelate, calcitonin and parathyroid hormone, might prove useful for treating two critical tissue components of the OA joint, the bone and the cartilage. An optimal treatment for OA likely targets at least these two tissue components. The patient subgroups for whom these therapies are most appropriate have yet to be fully defined but would likely include, at a minimum, those with high bone turnover.
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Castaño-Betancourt MC, Van Meurs JBJ, Bierma-Zeinstra S, Rivadeneira F, Hofman A, Weinans H, Uitterlinden AG, Waarsing JH. The contribution of hip geometry to the prediction of hip osteoarthritis. Osteoarthritis Cartilage 2013; 21:1530-6. [PMID: 23811490 DOI: 10.1016/j.joca.2013.06.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 06/05/2013] [Accepted: 06/13/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine how well measures of hip geometry can predict radiological incident hip osteoarthritis (HOA) compared to well known clinical risk factors. DESIGN The study population is part of the Rotterdam Study, a prospective population-based cohort. Baseline pelvic radiographs were used to measure hip geometry by two methods: Statistical Shape Models (SSM) and predefined geometry parameters (PGPs). Incident HOA (Kellgren and Lawrence (KL) ≥ 2) was assessed in 688 participants after 6.5 years without radiographic HOA at baseline. The ability to predict HOA was quantified using the area under the Receiver Operating Characteristics (ROC) curve (AUC). RESULTS Comparison of the two methods showed that both contain information that is not captured by the other method. At 6.5 years follow-up 132 hips had incident HOA. Five PGPs (Wiberg angle, Neck Width (NW), Pelvic Width (PW), Hip Axis Length (HAL) and Triangular Index (TI)) and two SSM (modes 5 and 9) were significant predictors of HOA (P = 0.007). Hip geometry added 7% to the prediction obtained by clinical risk factors (AUC = 0.67 (geometry), 0.66 (gender, age, Body Mass Index (BMI)) and combining both: AUC = 0.73, respectively). Mode 12 (associated with position of the femoral head in acetabulum) and Wiberg angle were predictors of HOA in participants without radiological signs at baseline (KL = 0). Although the strength of the prediction decreased for all variables at a longer follow-up, the contribution of hip geometry was still significant (P = 0.01). CONCLUSIONS Hip geometry has a moderate ability to predict HOA in participants with and without initial signs of osteoarthritis (OA), similar to and largely independent of the predictive value of clinical risk factors.
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Affiliation(s)
- M C Castaño-Betancourt
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands; The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, The Netherlands
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Kamimura M, Nakamura Y, Ikegami S, Uchiyama S, Kato H. Joint pain undergoes a transition in accordance with signal changes of bones detected by MRI in hip osteoarthritis. Open Rheumatol J 2013; 7:67-74. [PMID: 24133552 PMCID: PMC3795405 DOI: 10.2174/1874312920130823002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/30/2013] [Accepted: 08/13/2013] [Indexed: 01/02/2023] Open
Abstract
Objectives: In this study, we aimed to investigate whether joint pain is derived from cartilage or bone alterations. Methods: We reviewed 23 hip joints of 21 patients with primary hip osteoarthritis (OA), which were classified into Kellgren–Laurence (KL) grading I to IV. Plain radiographs and magnetic resonance imaging (MRI) were obtained from all of the 23 joints. Two of the 21 patients had bilateral hip OA. Pain was assessed based on the pain scale of Denis. A Welch t test was performed for age, height, weight, body mass index, bone mineral density, and a Mann–Whitney U test was performed for KL grading. Results: Four of 8 hip joints with pain and OA showed broad signal changes detected by MRI. Fourteen hip joints without pain, but with OA did not show broad signal changes by MRI. Collectively, MRI analyses showed that broad signal changes in OA cases without joint pain or with a slight degree of joint pain were not observed, while broad signal changes were observed in OA cases with deteriorated joint pain. Conclusion: Our findings suggest that hip joint pain might be associated with bone signal alterations in the hips of OA patients.
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Affiliation(s)
- Mikio Kamimura
- Center of Osteoporosis and Spinal Disorders: Kamimura Orthopaedic Clinic, Matsumoto 399-0021, Japan
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Liukkonen J, Hirvasniemi J, Joukainen A, Penttilä P, Virén T, Saarakkala S, Kröger H, Jurvelin JS, Töyräs J. Arthroscopic ultrasound technique for simultaneous quantitative assessment of articular cartilage and subchondral bone: an in vitro and in vivo feasibility study. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:1460-1468. [PMID: 23743098 DOI: 10.1016/j.ultrasmedbio.2013.03.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 03/06/2013] [Accepted: 03/25/2013] [Indexed: 06/02/2023]
Abstract
Traditional arthroscopic examination is subjective and poorly reproducible. Recently, we introduced an arthroscopic ultrasound method for quantitative diagnostics of cartilage lesions. Here we describe our investigation of the feasibility of ultrasound arthroscopy for simultaneous measurements of articular cartilage and subchondral bone. Human osteochondral samples (n = 13) were imaged using a clinical 9-MHz ultrasound system. Ultrasound reflection coefficients (R, IRC), the ultrasound roughness index (URI) and the apparent integrated backscattering coefficient (AIB) were determined for both tissues. Mechanical testing, histologic analyses and micro-scale computed tomography imaging were the reference methods. Ultrasound arthroscopies were conducted on two patients. The ultrasound reflection coefficient correlated with the Mankin score and Young's modulus of cartilage (|r| > 0.56, p < 0.05). Ultrasound parameters (R, IRC, AIB) for subchondral bone correlated with the bone surface/volume ratio (|r| > 0.70, p < 0.05) and trabecular thickness (|r| > 0.59, p < 0.05). Furthermore, R and subchondral bone mineral density were significantly correlated (|r| > 0.65, p < 0.05). Arthroscopic ultrasound examination provided diagnostically valuable information on cartilage and subchondral bone in vivo.
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Affiliation(s)
- J Liukkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
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Zhen G, Wen C, Jia X, Li Y, Crane JL, Mears SC, Askin FB, Frassica FJ, Chang W, Yao J, Carrino JA, Cosgarea A, Artemov D, Chen Q, Zhao Z, Zhou X, Riley L, Sponseller P, Wan M, Lu WW, Cao X. Inhibition of TGF-β signaling in mesenchymal stem cells of subchondral bone attenuates osteoarthritis. Nat Med 2013; 19:704-12. [PMID: 23685840 PMCID: PMC3676689 DOI: 10.1038/nm.3143] [Citation(s) in RCA: 709] [Impact Index Per Article: 64.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 02/21/2013] [Indexed: 02/07/2023]
Abstract
Osteoarthritis is a highly prevalent and debilitating joint disorder. There is no effective medical therapy for osteoarthritis due to limited understanding of osteoarthritis pathogenesis. We show that TGF–β1 is activated in the subchondral bone in response to altered mechanical loading in an anterior cruciate ligament transection (ACLT) osteoarthritis mouse model. TGF–β1 concentrations also increased in human osteoarthritis subchondral bone. High concentrations of TGF–β1 induced formation of nestin+ mesenchymal stem cell (MSC) clusters leading to aberrant bone formation accompanied by increased angiogenesis. Transgenic expression of active TGF–β1 in osteoblastic cells induced osteoarthritis. Inhibition of TGF–β activity in subchondral bone attenuated degeneration of osteoarthritis articular cartilage. Notably, knockout of the TGF–β type II receptor (TβRII) in nestin+ MSCs reduced development of osteoarthritis in ACLT mice. Thus, high concentrations of active TGF–β1 in the subchondral bone initiated the pathological changes of osteoarthritis, inhibition of which could be a potential therapeutic approach.
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Affiliation(s)
- Gehua Zhen
- Department of Orthopaedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Daniels AH. Ghost-face cystic degeneration pattern of the odontoid process. Spine J 2013; 13:202-3. [PMID: 23265940 DOI: 10.1016/j.spinee.2012.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 11/16/2012] [Indexed: 02/03/2023]
Affiliation(s)
- Alan H Daniels
- Department of Orthopaedics, Warren Alpert Medical School of Brown University, 593 Eddy St, Providence, RI 02903, USA
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