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Johnson AJ, Barron SM, Nichols JA, Cruz-Almeida Y. Association of Muscle Quality and Pain in Adults With Symptomatic Knee Osteoarthritis, Independent of Muscle Strength: Findings From a Cross-Sectional Study. Arthritis Rheumatol 2024; 76:1062-1070. [PMID: 38403452 DOI: 10.1002/art.42834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/05/2024] [Accepted: 02/20/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE Knee osteoarthritis (OA) is a leading cause of chronic pain in adults and shows wide interindividual variability, with peripheral and central factors contributing to the pain experience. Periarticular factors, such as muscle quality (eg, echo intensity [EI] and shear wave velocity [SWV]), may contribute to knee OA pain; however, the role of muscle quality in OA symptoms has yet to be fully established. METHODS Twenty-six adults (age >50 years) meeting clinical criteria for knee OA were included in this cross-sectional study. Quantitative ultrasound imaging was used to quantify EI and SWV in the rectus femoris of the index leg. Pearson correlations followed by multiple linear regression was used to determine associations between muscle quality and pain, controlling for strength, age, sex, and body mass index. RESULTS EI and SWV were significantly associated with movement-evoked pain (b = 0.452-0.839, P = 0.024-0.029). Clinical pain intensity was significantly associated with SWV (b = 0.45, P = 0.034), as were pressure pain thresholds at the medial (b = -0.41, P = 0.025) and lateral (b = -0.54, P = 0.009) index knee joint line, adjusting for all covariates. Pain interference was significantly associated with knee extension strength (b = -0.51, P = 0.041). CONCLUSION These preliminary findings suggest that EI and SWV may impact knee OA pain and could serve as malleable treatment targets. Findings also demonstrate that muscle quality is a unique construct, distinct from muscle strength, which may impact pain and treatment outcomes. More research is needed to fully understand the role of muscle quality in knee OA.
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Gundogdu K, Gundogdu G, Demirkaya Miloglu F, Demirci T, Tascı SY, Abd El-Aty AM. Anti-Inflammatory Effects of Boric Acid in Treating Knee Osteoarthritis: Biochemical and Histopathological Evaluation in Rat Model. Biol Trace Elem Res 2024; 202:2744-2754. [PMID: 37770671 DOI: 10.1007/s12011-023-03872-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/14/2023] [Indexed: 09/30/2023]
Abstract
This study aimed to examine the anti-inflammatory properties of boric acid (BA) in treating knee osteoarthritis (KOA) in rats, evaluating its biochemical and histopathological therapeutic effects. A KOA rat model was induced by injecting monosodium iodoacetate into the knee joint. Random assignment was performed for the experimental groups as follows: group-1(control), group-2(KOA control), group-3 (BA:4 mg/kg, orally), group-4(BA:10 mg/kg, orally), group-5(BA:4 mg/kg, intra-articularly), and group-6(BA:10 mg/kg, intra-articularly). The rats received 100 µL of BA intra-articularly on days 1, 7, 14, and 21 or 1 mL orally once a day (5 days/week) for 4 weeks. Serum levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and activity of matrix metalloproteinase-13 (MMP-13) were measured. Histopathological and immunohistochemical analyses were performed on knee joint samples using specific antibodies for IL-1β, TNF-α, MMP-13, and nitric oxide synthase-2 (NOS-2). Group-2 exhibited higher serum IL-1β and TNF-α levels and MMP-13 activity than group-1 (P < 0.05). However, IL-1β and TNF-α levels and MMP-13 activity were lower in all treatment groups than in group-2, with statistically significant reductions observed in groups-4, 5, and 6. Histopathologically, group-2 displayed joint space narrowing, cartilage degeneration, and deep fissures. Groups-5 and 6 demonstrated significant joint space enlargement, articular cartilage tissue regeneration, and immunostaining patterns similar to those in group-1. Immunohistochemically, group-2 showed significant increases in IL-1β, TNF-α, MMP-13, and NOS-2 expression. However, all treatment groups exhibited reductions in these expression levels compared to group-2, with statistically significant decreases observed in groups-5 and 6 (P < 0.01). BA shows potential efficacy in reducing inflammation in experimental KOA model in rats. It may be a promising therapeutic agent for KOA, warranting further clinical studies for validation.
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Affiliation(s)
- Koksal Gundogdu
- Department of Orthopedics and Traumatology, Denizli State Hospital, Denizli, Turkey
| | - Gulsah Gundogdu
- Department of Physiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
| | - Fatma Demirkaya Miloglu
- Department of Analytical Chemistry, Faculty of Pharmacy, Ataturk University, Erzurum, Turkey
| | - Tuba Demirci
- Department of Histology and Embryology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Seymanur Yılmaz Tascı
- Department of Physiology, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Turkey
| | - A M Abd El-Aty
- Department of Medical Pharmacology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
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Nielsen FK, Sørensen FB, Egund N, Boel LW, Holm C, Jurik AG. Bone marrow lesions in knee osteoarthritis assessed by dynamic contrast-enhanced MRI with histopathological correlations. Acta Radiol 2024:2841851241251639. [PMID: 38766869 DOI: 10.1177/02841851241251639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
BACKGROUND Bone marrow lesions (BMLs) in knee osteoarthritis (OA) have been assessed histopathologically and by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI); however, a direct comparison of the results has not been reported. PURPOSE To evaluate and compare the findings by DCE-MRI and histopathology of subchondral BMLs in knee OA. MATERIAL AND METHODS In total, 19 patients with medial tibiofemoral knee OA undergoing total knee arthroplasty were analyzed. Preoperative MRI, including a DCE sequence, was performed, and bone biopsies were obtained from the resected specimens corresponding to BML areas. The contrast enhancement by DCE-MRI was analyzed using semi-quantitative (area under the curve [AUC]), peak enhancement [PE]), and quantitative (Ktrans, Kep) methods. Enhancement in the medial OA compartment was compared with similar areas in a normal lateral compartment, and the DCE characteristics of BMLs were correlated with semi-quantitatively graded histopathological features. RESULTS AUC and PE were significantly higher in medial tibial and femoral BMLs compared with the values in the lateral condyles; Ktrans and Kep were only significantly higher in the tibial plateau. In the tibia, AUC and PE were significantly correlated with the grade of vascular proliferation, and PE also with the degree of marrow fibrosis. There was no significant correlation between AUC/PE and histopathological findings in the femur and no correlation between quantitative DCE parameters and histopathological findings. CONCLUSION BML characteristics by semi-quantitative DCE in the form of AUC and PE may be used as parameters for the degree of histopathological vascularization in the bone marrow whereas quantitative DCE data were less conclusive.
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Affiliation(s)
| | | | - Niels Egund
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Lene Warner Boel
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Carsten Holm
- Department of Orthopaedic Surgery, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Anne Grethe Jurik
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
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Holm PM, Blankholm AD, Nielsen JL, Bandholm T, Wirth W, Wisser A, Kemnitz J, Eckstein F, Schrøder HM, Wernbom M, Skou ST. Effects of neuromuscular control and strengthening exercises on MRI-measured thigh tissue composition and muscle properties in people with knee osteoarthritis - an exploratory secondary analysis from a randomized controlled trial. Semin Arthritis Rheum 2024; 65:152390. [PMID: 38340609 DOI: 10.1016/j.semarthrit.2024.152390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/19/2023] [Accepted: 01/18/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To investigate the effects of adding strength training to neuromuscular control exercises on thigh tissue composition and muscle properties in people with radiographic-symptomatic knee osteoarthritis (KOA). METHODS In this exploratory secondary analysis of a randomized controlled trial, using a complete-case approach, participants performed 12 weeks of twice-weekly neuromuscular control exercise and patient education (NEMEX, n = 34) or NEMEX plus quadriceps strength training (NEMEX+ST, n = 29). Outcomes were MRI-measured inter- and intramuscular adipose tissue (InterMAT, IntraMAT), quadriceps muscle cross-sectional area (CSA), knee-extensor strength, specific strength (strength/lean CSA) and 30 s chair-stands. Between-group effects were compared using a mixed model analysis of variance. RESULTS At 12 weeks, responses to NEMEX+ST overlapped with NEMEX for all outcomes. Both groups reduced InterMAT (NEMEX+ST=25 %, NEMEX=21 %); between-group difference: 0.8cm2 (95 % CI: -0.1, 1.7). NEMEX+ST decreased IntraMAT (2 %) and NEMEX increased IntraMAT (4 %); between-group difference 0.1 %-points (-0.3, 0.5). Both groups increased quadriceps CSA and lean CSA (CSA minus IntraMAT), improved knee-extensor strength and specific strength, and improved chair-stand performance with a trend towards greater effects in NEMEX+ST. CONCLUSION Adding strength training to 12 weeks of neuromuscular control exercises provided largely similar effects to neuromuscular control exercises alone in decreasing InterMAT and IntraMAT, in improving knee-extensor strength, CSA and in improving performance-based function in KOA persons, with a trend towards greater effects with additional strength training. Notably, both groups substantially reduced InterMAT and improved specific strength (an index of muscle quality). Our hypothesis-generating work warrants exploration of the roles played by InterMAT and IntraMAT in exercise effects in KOA.
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Affiliation(s)
- Pætur M Holm
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands.
| | | | - Jakob L Nielsen
- Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Thomas Bandholm
- Department of Orthopaedic Surgery & Department of Clinical Research, Copenhagen University Hospital - Amager and Hvidovre, Denmark; Physical Medicine & Rehabilitation Research Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital - Amager and Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Wolfgang Wirth
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute of Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany
| | - Anna Wisser
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute of Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany
| | - Jana Kemnitz
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute of Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
| | - Felix Eckstein
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology & Ludwig Boltzmann Institute of Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany
| | - Henrik M Schrøder
- Department of Orthopedic Surgery, Næstved-Slagelse-Ringsted Hospitals, Næstved, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Mathias Wernbom
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Søren T Skou
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Valsamidou E, Amerikanou C, Tzavara C, Skarpas G, Mariolis-Sapsakos TD, Zoumpoulakis P, Kaliora AC. A standardized nutraceutical supplement contributes to pain relief, improves quality of life and regulates inflammation in knee osteoarthritis patients; A randomized clinical trial. Heliyon 2023; 9:e20143. [PMID: 37809749 PMCID: PMC10559924 DOI: 10.1016/j.heliyon.2023.e20143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
Osteoarthritis (OA) is a degenerative disease of the joints that affects greatly the elderly population and the health care systems and is on the increase due to aging and obesity. Interventions aim at palliative care and pharmaceutical therapies entail serious adverse events. Whereas polyphenols constitute a promising holistic approach in the arsenal of physicians, trials investigating biomarkers and questionnaires are scarce. As such, a randomized controlled trial (RCT) was conducted to evaluate the potency of a standardized polyphenolic supplement in the management of systemic inflammation, oxidative stress, pain and general quality of life (QoL) in patients with osteoarthritis. Sixty subjects were randomized to receive either a polyphenol supplement (curcuma phospholipid, rosemary extract, resveratrol, ascorbic acid), or an active comparator (ascorbic acid) twice, daily for 12 weeks. The group that received the polyphenols exhibited significantly lower symptoms of pain and improved physical function and QoL as it was depicted by validated questionnaires, compared to the control group. Furthermore, post intervention, inflammation was restrained in the polyphenol group. Since systemic inflammation promotes local inflammation, the decrease of pain herein might be attributed to the attenuation of systemic inflammation by the polyphenols.
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Affiliation(s)
- Evdokia Valsamidou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave. 17677, Athens, Greece
- Qualia Pharma, 2 Kalavriton, 14564, Kifissia, Athens, Greece
| | - Charalampia Amerikanou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave. 17677, Athens, Greece
| | - Chara Tzavara
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave. 17677, Athens, Greece
| | - George Skarpas
- Evgenidio Clinic Agia Trias, 20 Papadiamantopoulou Str, Ilissia, 11852, Greece
| | | | - Panagiotis Zoumpoulakis
- Department of Food Science and Technology, University of West Attica, Ag. Spyridonos, Egaleo, Athens, 12243, Greece
- Institute of Chemical Biology, National Hellenic Research Foundation, 48 Vas. Constantinou Ave., 11635, Athens, Greece
| | - Andriana C. Kaliora
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Ave. 17677, Athens, Greece
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Chen M, Fu W, Xu H, Liu CJ. Tau deficiency inhibits classically activated macrophage polarization and protects against collagen-induced arthritis in mice. Arthritis Res Ther 2023; 25:146. [PMID: 37559125 PMCID: PMC10410869 DOI: 10.1186/s13075-023-03133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Tau protein serves a pro-inflammatory function in neuroinflammation. However, the role of tau in other inflammatory disorders such as rheumatoid arthritis (RA) is less explored. This study is to investigate the role of endogenous tau and the potential mechanisms in the pathogenesis of inflammatory arthritis. METHODS We established collagen-induced arthritis (CIA) model in wild-type and Tau-/- mice to compare the clinical score and arthritis incidence. Micro-CT analysis was used to evaluate bone erosion of ankle joints. Histological analysis was performed to assess inflammatory cell infiltration, cartilage damage, and osteoclast activity in the ankle joints. Serum levels of pro-inflammatory cytokines were measured by ELISA. The expression levels of macrophage markers were determined by immunohistochemistry staining and quantitative real-time PCR. RESULTS Tau expression was upregulated in joints under inflammatory condition. Tau deletion in mice exhibited milder inflammation and protected against the progression of CIA, evidenced by reduced serum levels of pro-inflammatory cytokines and attenuated bone loss, inflammatory cell infiltration, cartilage damage, and osteoclast activity in the ankle joints. Furthermore, tau deficiency led to the inhibition of classically activated type 1 (M1) macrophage polarization in the synovium. CONCLUSION Tau is a previously unrecognized critical regulator in the pathogenesis of RA and may provide a potential therapeutic target for autoimmune and inflammatory joint diseases.
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Affiliation(s)
- Meng Chen
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, China
| | - Wenyu Fu
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
| | - Huiyun Xu
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, China
| | - Chuan-Ju Liu
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA.
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
- Department of Cell Biology, New York University Grossman School of Medicine, New York, NY, USA.
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Maccarone MC, Scanu A, Coraci D, Masiero S. The Potential Role of Spa Therapy in Managing Frailty in Rheumatic Patients: A Scoping Review. Healthcare (Basel) 2023; 11:1899. [PMID: 37444733 PMCID: PMC10340743 DOI: 10.3390/healthcare11131899] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Frailty is not limited to the elderly, as patients with rheumatic diseases can also experience this condition. The present scoping review aimed to investigate the possibility of using the health resort setting as an alternative location for managing rheumatic patients with frailty. The research resulted in finding several in vitro, in vivo, and clinical studies, resulting in evidence supporting the effectiveness of spa treatments in reducing pain, improving function, and managing comorbidity in rheumatic diseases. Additionally, spa treatments were demonstrated to modulate the MAPK/ERK pathway and the NF-kB pathway's activation and to reduce proinflammatory molecules' secretion in rheumatic diseases, thus suggesting their potential effective role in the regulation of inflammaging in frailty. Moreover, the health resort setting may offer potential resources to reduce risk factors, such as drug consumption, inactivity, and disease severity, and may serve as a setting for developing prevention protocols for frailty. Future research should explore innovative approaches, such as exercise training and early diagnostics, for the overall management of frailty in rheumatic patients in the spa setting.
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Affiliation(s)
- Maria Chiara Maccarone
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Via Giustiniani 2, 35128 Padua, Italy;
| | - Anna Scanu
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
- Department of Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Daniele Coraci
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
| | - Stefano Masiero
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Via Giustiniani 2, 35128 Padua, Italy;
- Neurorehabilitation Unit, Department of Neuroscience, University of Padua, 35128 Padua, Italy; (A.S.); (D.C.)
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Gundogdu K, Gundogdu G, Miloglu FD, Demirci T, Tascı SY, El-aty AMA. Anti-inflammatory Effects of Boric Acid in Treating Knee Osteoarthritis: Biochemical and Histopathological Evaluation in Rat Models.. [DOI: 10.21203/rs.3.rs-3091978/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Objective: This study aimed to examine the anti-inflammatory properties of boric acid(BA) in treatingknee osteoarthritis(KOA) in rats, evaluating its biochemical and histopathological therapeutic effects.
Methods: The KOA rat model was induced by injecting monosodium iodoacetate into the knee joint. Random assignment was performed for the experimental groups as follows: group-1(control), group-2(KOA control), group-3(BA:4 mg/kg,orally), group-4(BA:10 mg/kg,orally), group-5 (BA:4 mg/kg,intra-articularly), and group-6(BA:10 mg/kg,intra-articularly). The rats received 100 µL of BA intra-articularly on days 1,7,14, and 21 or 1 mL orally once a day (5 days/week) for 4 weeks. Serum levels of interleukin-1β (IL-1β), tumor necrosis factor-α(TNF-α), and matrix metalloproteinase-13(MMP-13) were measured. Histopathological and immunohistochemical analyses were performed on knee joint samples using specific antibodies for IL-1β, TNF-α, MMP13, and nitric oxide synthase-2(NOS-2).
Results. Group-2 exhibited higher serum levels of IL-1β, TNF-α, and MMP-13 than group-1(P<0.05). However, these levels were lower in all treatment groups compared to group-2, with statistically significant reductions observed in groups-4,5, and 6. Histopathologically, group-2 displayed joint space narrowing, cartilage degeneration, and deep fissures. Groups-5 and 6 demonstrated significant joint space enlargement, articular cartilage tissue regeneration, and immunostaining patterns similar to those in group-1. Immunohistochemically, group-2 showed significant increases in IL-1β, TNF-α, MMP-13, and NOS-2 expression. However, all treatment groups exhibited reductions in these expression levelscompared to group-2, with statistically significant decreases observed in groups-5 and 6(P<0.01).
Conclusions. BA shows potential efficacy in reducing inflammation in experimental KOA models in rats. It may be a promising therapeutic agent for KOA, warranting further clinical studies for validation.
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Ngo L, Knothe Tate ML. A spike in circulating cytokines TNF-α and TGF-β alters barrier function between vascular and musculoskeletal tissues. Sci Rep 2023; 13:9119. [PMID: 37277369 DOI: 10.1038/s41598-023-30322-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/21/2023] [Indexed: 06/07/2023] Open
Abstract
Molecular transport between the circulatory and musculoskeletal systems regulates articular joint physiology in health and disease. Osteoarthritis (OA) is a degenerative joint disease linked to systemic and local inflammation. Inflammatory events involve cytokines, which are secreted by cells of the immune system and modulate molecular transport across tissue interfaces (referred to as tight junction [TJ] barrier function). In a previous study from our group, OA knee joint tissues were shown to exhibit size separation of different sized molecules delivered as a single bolus to the heart (Ngo et al. in Sci. Rep. 8:10254, 2018). Here, in a follow up study of parallel design, we test the hypothesis that two common cytokines, with multifaceted roles in the etiology of osteoarthritis as well as immune state in general, modulate the barrier function properties of joint tissue interfaces. Specifically, we probe the effect of an acute cytokine increase (spike) on molecular transport within tissues and across tissue interfaces of the circulatory and musculoskeletal systems. A single bolus of fluorescent-tagged 70 kDa dextran, was delivered intracardially, either alone, or with either the pro-inflammatory cytokine TNF-α or the anti-inflammatory cytokine TGF-β, to skeletally mature (11 to 13-month-old) guinea pigs (Dunkin-Hartley, a spontaneous OA animal model). After five minutes' circulation, whole knee joints were serial sectioned and fluorescent block face cryo-imaged at near-single-cell resolution. The 70 kDa fluorescent-tagged tracer is analogous in size to albumin, the most prevalent blood transporter protein, and quantification of tracer fluorescence intensity gave a measure of tracer concentration. Within five minutes, a spike (acute doubling) in circulating cytokines TNF-α or TGF-β significantly disrupted barrier function between the circulatory and musculoskeletal systems, with barrier function essentially abrogated in the TNF-α group. In the entire volume of the joint (including all tissue compartments and the bounding musculature), tracer concentration was significantly decreased in the TGF-β- and TNF-α- compared to the control-group. These studies implicate inflammatory cytokines as gatekeepers for molecular passage within and between tissue compartments of our joints and may open new means to delay the onset and mitigate the progression of degenerative joint diseases such as OA, using pharmaceutical and/or physical measures.
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Affiliation(s)
- Lucy Ngo
- MechBio Team, Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Melissa L Knothe Tate
- Blue Mountains World Interdisciplinary Innovation Institute, New South Wales, Australia.
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Johnson AJ, Buchanan T, Laffitte Nodarse C, Valdes Hernandez PA, Huo Z, Cole JH, Buford TW, Fillingim RB, Cruz-Almeida Y. Cross-Sectional Brain-Predicted Age Differences in Community-Dwelling Middle-Aged and Older Adults with High Impact Knee Pain. J Pain Res 2022; 15:3575-3587. [PMID: 36415658 PMCID: PMC9676000 DOI: 10.2147/jpr.s384229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose Knee OA-related pain varies in impact across individuals and may relate to central nervous system alterations like accelerated brain aging processes. We previously reported that older adults with chronic musculoskeletal pain had a significantly greater brain-predicted age, compared to pain-free controls, indicating an "older" appearing brain. Yet this association is not well understood. This cross-sectional study examines brain-predicted age differences associated with chronic knee osteoarthritis pain, in a larger, more demographically diverse sample with consideration for pain's impact. Patients and Methods Participants (mean age = 57.8 ± 8.0 years) with/without knee OA-related pain were classified according to pain's impact on daily function (ie, impact): low-impact (n=111), and high-impact (n=60) pain, and pain-free controls (n=31). Participants completed demographic, pain, and psychosocial assessments, and T1-weighted magnetic resonance imaging. Brain-predicted age difference (brain-PAD) was compared across groups using analysis of covariance. Partial correlations examined associations of brain-PAD with pain and psychosocial variables. Results Individuals with high-impact chronic knee pain had significantly "older" brains for their age compared to individuals with low-impact knee pain (p < 0.05). Brain-PAD was also significantly associated with clinical pain, negative affect, passive coping, and pain catastrophizing (p's<0.05). Conclusion Our findings suggest that high impact chronic knee pain is associated with an older appearing brain on MRI. Future studies are needed to determine the impact of pain-related interference and pain management on somatosensory processing and brain aging biomarkers for high-risk populations and effective intervention strategies.
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Affiliation(s)
- Alisa J Johnson
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Taylor Buchanan
- Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - Chavier Laffitte Nodarse
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Pedro A Valdes Hernandez
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Zhiguang Huo
- Department of Biostatistics, College of Public Health & Health Professions College of Medicine, University of Florida, Gainesville, FL, USA
| | - James H Cole
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK,Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Thomas W Buford
- Department of Medicine, University of Alabama, Birmingham, AL, USA
| | - Roger B Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA,Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, USA,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA,Correspondence: Yenisel Cruz-Almeida, University of Florida, PO Box 103628, 1329 SW 16th Street, Ste 5180, Gainesville, FL, 32608, USA, Tel +1 352-294-8584, Fax +1 352-273-5985, Email
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11
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Breakthrough of extracellular vesicles in pathogenesis, diagnosis and treatment of osteoarthritis. Bioact Mater 2022; 22:423-452. [PMID: 36311050 PMCID: PMC9588998 DOI: 10.1016/j.bioactmat.2022.10.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Osteoarthritis (OA) is a highly prevalent whole-joint disease that causes disability and pain and affects a patient's quality of life. However, currently, there is a lack of effective early diagnosis and treatment. Although stem cells can promote cartilage repair and treat OA, problems such as immune rejection and tumorigenicity persist. Extracellular vesicles (EVs) can transmit genetic information from donor cells and mediate intercellular communication, which is considered a functional paracrine factor of stem cells. Increasing evidences suggest that EVs may play an essential and complex role in the pathogenesis, diagnosis, and treatment of OA. Here, we introduced the role of EVs in OA progression by influencing inflammation, metabolism, and aging. Next, we discussed EVs from the blood, synovial fluid, and joint-related cells for diagnosis. Moreover, we outlined the potential of modified and unmodified EVs and their combination with biomaterials for OA therapy. Finally, we discuss the deficiencies and put forward the prospects and challenges related to the application of EVs in the field of OA.
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12
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Rodríguez-Vargas GS, Santos-Moreno P, Rubio-Rubio JA, Bautista-Niño PK, Echeverri D, Gutiérrez-Castañeda LD, Sierra-Matamoros F, Navarrete S, Aparicio A, Saenz L, Rojas-Villarraga A. Vascular Age, Metabolic Panel, Cardiovascular Risk and Inflammaging in Patients With Rheumatoid Arthritis Compared With Patients With Osteoarthritis. Front Cardiovasc Med 2022; 9:894577. [PMID: 35865390 PMCID: PMC9295407 DOI: 10.3389/fcvm.2022.894577] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
IntroductionThe risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5–2 times higher than the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level. The aim of the study was to compare vascular age (VA) in RA patients under a strict treat-to-target (T2T) strategy with Osteoarthritis (OA) patients without strict follow up and to assess the influence of inflammaging (chronic, sterile, low-grade inflammation related to aging) and metabolic markers on VA.Materials and MethodsThis was an analytical cross-sectional study. Patients with RA (under a strict a T2T strategy) and OA patients without strict clinical follow-up were included. Patients with a history of uncontrolled hypertension, CVD, and/or current smoking were excluded. Sociodemographic, physical activity, and toxic exposure data were obtained. Waist-hip ratio and body mass index (BMI) were measured. DAS-28 (RA) and inflammatory markers, lipid profile, and glycaemia were analyzed. Pulse wave velocity (PWV) was measured (oscillometric method, Arteriograph-TensioMed®). VA was calculated based on PWV. Eleven components of inflammaging [six interleukins, three metalloproteinases (MMP), and two tissue inhibitors of metalloproteinases (TIMP)] were evaluated (Luminex® system). Univariate and bivariate analyzes (Mann Whitney U and chi-square) and correlations (Spearmans Rho) were done to compare the two groups.ResultsA total of 106 patients (74% women) were included, 52/RA and 54/OA. The mean age was 57 (Interquartile range - IQR 9 years). The BMI, waist circumference, and weight were higher in patients with OA (p < 0.001). RA patients had low disease activity (DAS-28-CRP). There were no differences in VA, inflammaging nor in PWV between the two groups. VA had a positive, but weak correlation, with age and LDL. In group of RA, VA was higher in those who did not receive methotrexate (p = 0.013). LDL levels correlated with MMP1, TIMP1, and TIMP2.ConclusionsWhen comparing RA patients with low levels of disease activity with OA patients with poor metabolic control, there are no differences in VA. Furthermore, methotrexate also influences VA in RA patients. This shows that implemented therapies may have an impact on not only the inflammatory state of the joint but also CVD risk.
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Affiliation(s)
- Gabriel-Santiago Rodríguez-Vargas
- Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
- Rheumatology, Biomab - Center for Rheumatoid Arthritis, Bogotá, Colombia
- *Correspondence: Gabriel-Santiago Rodríguez-Vargas
| | | | | | | | - Darío Echeverri
- Cardiovascular Prevention Program, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
| | - Luz-Dary Gutiérrez-Castañeda
- Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | | | - Stephania Navarrete
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | - Anggie Aparicio
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | - Luis Saenz
- Cardiovascular Prevention Program, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
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Dai Z. A literature review on plant-based foods and dietary quality in knee osteoarthritis. Eur J Rheumatol 2022; 11. [PMID: 35535585 PMCID: PMC11184961 DOI: 10.5152/eurjrheum.2022.21134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 01/25/2022] [Indexed: 02/18/2024] Open
Abstract
This literature review summarizes the role of plant-based foods and diet quality in osteoarthritis, particularly knee osteoarthritis, in observational studies and clinical trials published during 2015- 2020. The included studies have suggested favorable results on reducing the prevalence, pain, and cartilage changes related to osteoarthritis and inflammatory and oxidation markers such as inter- leukin-1, interleukin-6, tumor necrosis factor, and lipid peroxidation. Due to the lack of large lon- gitudinal cohorts to study whole foods or diets concerning knee osteoarthritis, findings from the cross-sectional studies or clinical trials require further validation, particularly in well-designed clinical trials and a more extended follow-up period. Potential mechanisms on the role of plant-based foods in body weight, inflammation, and microbiome were explored to explain their protective associations with osteoarthritis. However, most evidence examining the relationship between the microbiome and osteoarthritis joint pain is conducted in preclinical animal studies, and few observational studies show a positive association between Streptococcus species and local joint inflammation in the knee. Given the close links of plant-based foods on obesity, inflammation, and microbiome, data on the role of whole foods or diets in the change in knee osteoarthritis pain through the lens of microbial composition can provide more certainty regarding the utilization of microbiome as a potential thera- peutic target.
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Affiliation(s)
- Zhaoli Dai
- Charles Perkins Centre, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
- College of Medicine & Public Health Flinders University, Australia
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14
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Harpagophytum procumbens Root Extract Mediates Anti-Inflammatory Effects in Osteoarthritis Synoviocytes through CB2 Activation. Pharmaceuticals (Basel) 2022; 15:ph15040457. [PMID: 35455454 PMCID: PMC9026917 DOI: 10.3390/ph15040457] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/30/2022] [Accepted: 04/07/2022] [Indexed: 02/01/2023] Open
Abstract
The endocannabinoid system is involved in the nociceptive and anti-inflammatory pathways, and a lowered expression of CB2 receptors has been associated with inflammatory conditions, such as osteoarthritis (OA). This suggests that CB2 modulators could be novel therapeutic tools to treat OA. In the present study, the involvement of Harpagophytum procumbens root extract, a common ingredient of nutraceuticals used to treat joint disorders, in CB2 modulation has been evaluated. Moreover, to clarify the effects of the pure single components, the bioactive constituent, harpagoside, and the main volatile compounds were studied alone or in a reconstituted mixture. Human fibroblast-like synoviocytes, extracted by joints of patients, who underwent a total knee replacement, were treated with an H. procumbens root extract dissolved in DMSO (HPEDMSO). The effectiveness of HPEDMSO to affect CB2 pathways was studied by analyzing the modulation of cAMP, the activation of PKA and ERK MAP kinase, and the modulation of MMP-13 production. HPEDMSO was able to inhibit the cAMP production and MAP kinase activation and to down-regulate the MMP-13 production. Pure compounds were less effective than the whole phytocomplex, thus suggesting the involvement of synergistic interactions. Present findings encourage further mechanistic studies and support the scientific basis of the use of H. procumbens in joint disorders.
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15
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Ni J, Au M, Kong H, Wang X, Wen C. Lycium barbarum polysaccharides in ageing and its potential use for prevention and treatment of osteoarthritis: a systematic review. BMC Complement Med Ther 2021; 21:212. [PMID: 34404395 PMCID: PMC8371808 DOI: 10.1186/s12906-021-03385-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 07/29/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Lycium barbarum polysaccharide (LBP), the most abundant functional component of wolfberry, is considered a potent antioxidant and an anti-ageing substance. This review aims to outline the hallmarks of ageing in the pathogenesis of osteoarthritis (OA), followed by the current understanding of the senolytic effect of LBP and its potential use in the prevention and treatment of OA. This will be discussed through the lens of molecular biology and herbal medicine. METHODS A literature search was performed from inception to March 2020 using following keywords: "Lycium barbarum polysaccharide", "DNA damage", antioxidant, anti-apoptosis, anti-inflammation, anti-ageing, osteoarthritis, chondrocytes, fibroblasts, osteoblasts, osteoclasts, and "bone mesenchymal stem cell". The initial search yielded 2287 papers, from which 35 studies were selected for final analysis after screening for topic relevancy by the authors. RESULTS In literature different in vitro and in vivo ageing models are used to demonstrate LBP's ability to reduce oxidative stress, restore mitochondrial function, mitigate DNA damage, and prevent cellular senescence. All the evidence hints that LBP theoretically attenuates senescent cell accumulation and suppresses the senescence-associated secretory phenotype as observed by the reduction in pro-inflammatory cytokines, like interleukin-1beta, and matrix-degrading enzymes, such as MMP-1 and MMP-13. However, there remains a lack of evidence on the disease-modifying effect of LBP in OA, although its chondroprotective, osteoprotective and anti-inflammatory effects were reported. CONCLUSION Our findings strongly support further investigations into the senolytic effect of LBP in the context of age-related OA.
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Affiliation(s)
- Junguo Ni
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Manting Au
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Hangkin Kong
- Department of Applied Biology and Chemical Technology, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Xinluan Wang
- Centre for Translational Medical Research and Development, Shenzhen Institutes of Advanced Technology, Chinese Academy of Science, Shen Zhen, China
| | - Chunyi Wen
- Department of Biomedical Engineering, Faculty of Engineering, Hong Kong Polytechnic University, Kowloon, Hong Kong.
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Scanu A, Tognolo L, Maccarone MC, Masiero S. Immunological Events, Emerging Pharmaceutical Treatments and Therapeutic Potential of Balneotherapy on Osteoarthritis. Front Pharmacol 2021; 12:681871. [PMID: 34276372 PMCID: PMC8278055 DOI: 10.3389/fphar.2021.681871] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/18/2021] [Indexed: 01/17/2023] Open
Affiliation(s)
- Anna Scanu
- Rheumatology Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy.,Department of Neurosciences, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy
| | - Lucrezia Tognolo
- Department of Neurosciences, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy
| | - Maria Chiara Maccarone
- Department of Neurosciences, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy
| | - Stefano Masiero
- Department of Neurosciences, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy
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Zhang C, Wang Y, Hu C, Sun K, Yu D, Tian S. Plantamajoside Ameliorates Inflammatory Response of Chondrocytes via Regulating NF- κB/NLRP3 Inflammasome Pathway. J BIOMATER TISS ENG 2021. [DOI: 10.1166/jbt.2021.2634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The damage of articular cartilage in osteoarthritis involves the oxidative stress and inflammation. The aim of the present study was to explore the role of plantamajoside (PM) in chondrocytes and elucidate the underlying mechanism. The cell viability following treatment with PM or lipopolysac-charide
(LPS) was assessed by cell counting kit-8 (CCK-8). Enzyme-Linked Immunosorbent Assay (ELISA) was supplied to determine the levels of pro-inflammatory cytokines. Moreover, the oxidative stress-related markers were evaluated via assay kits. TUNEL assay was employed to stain the apoptotic cells.
The components of nuclear factor-κB (NF-κB) pathway and NLRP3 inflammasome were estimated by western blot analysis. LPS-insulted cell viability of ATDC5 was restored by PM. PM alleviated the inflammatory response and oxidative stress of ATDC5 cells induced by LPS.
Furthermore, it was found that the apoptotic cells were reduced following PM treatment. The protein levels of NF-κB, IκB kinase β (IKKβ) and NLRP3 inflammasome were decreased by PM. These results suggested that PM protected the ATDC5 cells
from LPS stimulation, alleviated the inflammatory response may through regulating the NF-κB and NLRP3 inflammasome.
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Affiliation(s)
- Chi Zhang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266555, P. R. China
| | - Yuanhe Wang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266555, P. R. China
| | - Chuan Hu
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266555, P. R. China
| | - Kang Sun
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266555, P. R. China
| | - Dingzhu Yu
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266555, P. R. China
| | - Shaoqi Tian
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266555, P. R. China
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Cai X, Yuan S, Zeng Y, Wang C, Yu N, Ding C. New Trends in Pharmacological Treatments for Osteoarthritis. Front Pharmacol 2021; 12:645842. [PMID: 33935742 PMCID: PMC8085504 DOI: 10.3389/fphar.2021.645842] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/16/2021] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis (OA) is the leading cause of function loss and disability among the elderly, with significant burden on the individual and society. It is a severe disease for its high disability rates, morbidity, costs, and increased mortality. Multifactorial etiologies contribute to the occurrence and development of OA. The heterogeneous condition poses a challenge for the development of effective treatment for OA; however, emerging treatments are promising to bring benefits for OA management in the future. This narrative review will discuss recent developments of agents for the treatment of OA, including potential disease-modifying osteoarthritis drugs (DMOADs) and novel therapeutics for pain relief. This review will focus more on drugs that have been in clinical trials, as well as attractive drugs with potential applications in preclinical research. In the past few years, it has been realized that a complex interaction of multifactorial mechanisms is involved in the pathophysiology of OA. The authors believe there is no miracle therapeutic strategy fitting for all patients. OA phenotyping would be helpful for therapy selection. A variety of potential therapeutics targeting inflammation mechanisms, cellular senescence, cartilage metabolism, subchondral bone remodeling, and the peripheral nociceptive pathways are expected to reshape the landscape of OA treatment over the next few years. Precise randomized controlled trials (RCTs) are expected to identify the safety and efficacy of novel therapies targeting specific mechanisms in OA patients with specific phenotypes.
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Affiliation(s)
- Xiaoyan Cai
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Shiwen Yuan
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yanting Zeng
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Cuicui Wang
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Na Yu
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Changhai Ding
- Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Park HM, Lee JH, Lee YJ. Positive Association of Serum Alkaline Phosphatase Level with Severe Knee Osteoarthritis: A Nationwide Population-Based Study. Diagnostics (Basel) 2020; 10:diagnostics10121016. [PMID: 33261160 PMCID: PMC7760969 DOI: 10.3390/diagnostics10121016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
Serum alkaline phosphatase (ALP), a well-known marker of hepatobiliary and bone disorders, has recently been discovered to be a biochemical marker of cardiometabolic diseases and chronic low-grade inflammation. We aimed to evaluate the association of serum ALP level with knee osteoarthritis in the general population. The study included 3060 men and women aged ≥50 years who participated in the 2009–2011 Korea National Health and Nutrition Examination Survey. The participants were categorized into three groups based on log-transformed serum ALP level as follows: T1 (1.74–2.32), T2 (2.33–2.43), and T3 (2.44–3.01). Their radiographs were evaluated by two well-trained radiologists using the Kellgren–Lawrence (KL) grading system. After excluding those with KL Grade 0, we categorized the remaining participants into two groups, a severe osteoarthritis group (KL Grade 4) and a non-severe osteoarthritis group (KL Grades 1 to 3). The odds ratios (ORs) with 95% confidence intervals (CIs) of severe osteoarthritis according to the tertiles of log-transformed serum ALP levels of patients with osteoarthritis were calculated using a weighted multivariate logistic regression analysis. Compared with T1, the adjusted ORs (95% CIs) for severe osteoarthritis of the T3 serum ALP group was 1.613 (1.087–2.394; p = 0.018) after adjusting for the confounding variables. Conclusively, serum ALP activity was independently and positively associated with severe knee osteoarthritis in middle-aged and older adults.
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Affiliation(s)
- Hye-Min Park
- Department of Family Medicine, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea;
- Department of Medicine, Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea;
| | - Jun-Hyuk Lee
- Department of Medicine, Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea;
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do 16995, Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea;
- Correspondence: ; Tel.: +82-2-2019-3481
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20
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Methylprednisolone acetate mitigates IL1β induced changes in matrix metalloproteinase gene expression in skeletally immature ovine explant knee tissues. Inflamm Res 2020; 70:99-107. [PMID: 33226449 DOI: 10.1007/s00011-020-01421-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/01/2020] [Accepted: 11/04/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE AND DESIGN This study aimed at evaluating the effect of methylprednisolone (MPA) on messenger ribonucleic acid (mRNA) expression levels in immature ovine knee joint tissue explants following interleukin (IL)1β induction and to assess responsiveness of the explants. MATERIAL OR SUBJECTS Explants were harvested from the articular cartilage, synovium, and infrapatellar fat pad (IPFP) from immature female sheep. TREATMENT Methylprednisolone. METHODS The samples were allocated into six groups: (1) control, (2) MPA (10-3 M), (3) MPA (10-4 M), (4) IL1β, (5) IL1β + 10-3 M MPA, or (6) IL1β + 10-4 M MPA. mRNA expression levels for molecules relevant to inflammation, cartilage degradation/anabolism, activation of innate immunity, and adipose tissue/hormones were quantified. Fold changes with MPA treatment were compared via the comparative CT method. RESULTS Methylprednisolone treatment significantly suppressed MMPs consistently across the cartilage (MMP1, MMP3, and MMP13), synovium (MMP1 and MMP3), and IPFP (MMP13) (all p < 0.05). Other genes that were less consistently suppressed include endogenous IL1β (cartilage) and IL6 (IPFP) (all p < 0.05), and others not affected either by IL-1 exposure or subsequent MPA include TGFβ1, TLR4, and adipose-related molecules. CONCLUSIONS Methylprednisolone significantly mitigated IL1β induced mRNA expression for MMPs in the immature cartilage, synovium, and IPFP, but the extent of the responsiveness was tissue-, location-, and gene-specific.
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21
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Yeh YT, Liang CC, Chang CL, Hsu CY, Li PC. Increased risk of knee osteoarthritis in patients using oral N-acetylcysteine: a nationwide cohort study. BMC Musculoskelet Disord 2020; 21:531. [PMID: 32778089 PMCID: PMC7418329 DOI: 10.1186/s12891-020-03562-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/03/2020] [Indexed: 12/20/2022] Open
Abstract
Background Knee osteoarthritis (OA) is known to be a progressive degenerative disorder; however, recent evidence suggests that inflammatory mediators contribute to cartilage degradation. Studies have reported that N-acetylcysteine (NAC) had a promising effect on the reduction of the synthesis of proinflammatory and structural mediators by synovial cells. Given the lack of relevant clinical trials, we conducted this study to determine the relationship between NAC use and risk of knee OA. Methods We designed a retrospective cohort study from 2000 to 2013. Patients who received oral NAC over 28 days within 1 year after the first prescription were defined as the case group, whereas those without NAC use were considered as candidates of the control group. We adopted 1:4 propensity-score matching by age, sex, index year, and comorbidities to obtain the control group. The primary outcome was a new diagnosis of knee OA during the follow-up period. Results Our study sample comprised 12,928 people who used NAC and 51,715 NAC nonusers. NAC users had a significantly higher incidence of osteoarthritis (adjusted hazard ratio: 1.42, P < .001) than did NAC nonusers. Also, in analyses stratified by age group and sex, all subgroups exhibited a significantly higher incidence of knee osteoarthritis (P < .0001) among NAC users than among NAC nonusers. The use of oral NAC was associated with nearly four-fold increased the risk of knee OA in the young age group. Conclusions Long-term use of oral NAC is associated with a higher risk of knee OA.
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Affiliation(s)
- Ying-Ting Yeh
- Department of Physical Medicine and Rehabilitation Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chung-Chao Liang
- Department of Physical Medicine and Rehabilitation Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chia-Ling Chang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Pei-Chen Li
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
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de Campos GC, Tieppo AM, de Almeida Jr CS, Hamdan PC, Alves WM, de Rezende MU. Target-based approach for osteoarthritis treatment. World J Orthop 2020; 11:278-284. [PMID: 32572364 PMCID: PMC7298451 DOI: 10.5312/wjo.v11.i6.278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 02/06/2023] Open
Abstract
There is still no definitive treatment for knee osteoarthritis (OA). We are certainly far from a consensus on the best form of treatment or on an effective treatment recommendation. There are reasons for the current equivocal treatment recommendations in the face of this very serious health problem. The greatest of these reasons, undoubtedly, is the great complexity of the factors involved in the development and progression of knee OA and the complex pathophysiology including mechanical, inflammatory, metabolic, post-traumatic, molecular, genetic, and psychological changes. For several years, an attempt has been made to correlate different patient phenotypes to different patterns of response to treatment, thus creating the possibility of developing specific treatments for certain groups of patients and theoretically allowing better treatment efficacy. However, in practice we still find totally different responses and evolutions even in individuals belonging to the same phenotype. Thus, classification by phenotypes, despite being an advance, is not sufficient. The present article proposes a fragmented look at each of the many factors or targets involved in the genesis and evolution of OA. Therefore, we propose not the treatment of OA per se but the management of an individual set of targets to achieve personalized OA management. We believe that, paradoxically, by fragmenting the view of the disease we will be able to treat our patients more holistically in an individualized way.
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Affiliation(s)
- Gustavo C de Campos
- Department of Orthopedics and Traumatology, Hospital de Clínicas da Universidade Estadual de Campinas, Campinas, SP 13083-887, Brazil
| | - Antonio M Tieppo
- Department of Physiatrics, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP 01221-020, Brazil
| | - Cyro S de Almeida Jr
- Department of Physiatrics, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP 01221-020, Brazil
| | - Paulo C Hamdan
- Departamento de Medicina Esportiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ 21941-901, Brazil
| | - Wilson M Alves
- Ortopedia, Pontifícia Universidade Católica de Campinas, Campinas, SP 13087-571, Brazil
| | - Márcia U de Rezende
- Instituto de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP 05403-010, Brazil
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Rao PB, Mandal I, Tripathy S, Bandyopadhyay D, Tripathy S, Singh N, Panda A. Preventive Epidural Analgesia in Bilateral Single-Stage Knee Arthroplasty: A Randomized Controlled Trial. Pain Ther 2020; 9:241-248. [PMID: 31900815 PMCID: PMC7203305 DOI: 10.1007/s40122-019-00145-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Although controversial, pre-emptive analgesia has shown some promise in preventing altered pain perception and reducing pain amplification after surgery. Hence, it has the potential to be more effective than a similar analgesic regimen started after surgery with an appropriate combination of patient category and analgesic modality. Hence, the present study was undertaken to evaluate the effect of preventive epidural analgesia in reducing pain severity and duration after bilateral single-stage knee arthroplasty. METHODS Fifty patients, 18-70 years, with American Society of Anesthesiologists physical status class I & II posted for bilateral single-stage knee replacement under regional anesthesia were randomly allocated into preventive versus postoperative epidural analgesia group to compare severity of post-operative pain, analgesic consumption, day of mobilization, C-reactive protein (CRP) levels, and hospital stay. RESULTS The pain score after surgery [2.0 (1.5, 2.0); 3.0 (1.5, 3.0), p = 0.005] and day of mobilization [(2. 92 ± 0. 28; 3. 31 ± 0. 48; p value 0.02)] were significantly lesser in the preventive epidural group. However, there was no difference in the hospital stay (9.92 ± 3.71 and 9.00 ± 2.12, p = 0.95) and analgesic consumption (65.38 ± 37.55 and 73.08 ± 43.85, p = 0.30). The preventive group had a larger drop in CRP and experienced a lesser number of days with pain after surgery as compared to the controls [(64.29 ± 21.29); (142.37 ± 80.04), p = 0.0001]. Six patients in the preemptive group (24%) and 13 of the control group (24 vs. 56.5%; p = 0.02) had chronic postsurgical pain. CONCLUSIONS Preventive epidural analgesia reduces the severity and number of chronic pain days after bilateral single-stage knee replacement. TRIAL REGISTRATION The study was registered in the Indian national registry (CTRI/2017/03/008240 on 28/03/2017).
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Affiliation(s)
- Parnandi Bhaskar Rao
- Department of Anaesthesiology, All India Institute of Medical Science, Sijua, Bhubaneswar, India.
| | - Indraprava Mandal
- Department of Anaesthesiology, All India Institute of Medical Science, Sijua, Bhubaneswar, India
| | - Sujit Tripathy
- Department of Orthopaedics, All India Institute of Medical Science, Sijua, Bhubaneswar, India
| | - Debapriya Bandyopadhyay
- Department of Biochemistry, All India Institute of Medical Science, Sijua, Bhubaneswar, India
| | - Swagata Tripathy
- Department of Anaesthesiology, All India Institute of Medical Science, Sijua, Bhubaneswar, India
| | - Neha Singh
- Department of Anaesthesiology, All India Institute of Medical Science, Sijua, Bhubaneswar, India
| | - Aparajita Panda
- Department of Anaesthesiology, All India Institute of Medical Science, Sijua, Bhubaneswar, India
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Dalle S, Koppo K. Is inflammatory signaling involved in disease-related muscle wasting? Evidence from osteoarthritis, chronic obstructive pulmonary disease and type II diabetes. Exp Gerontol 2020; 137:110964. [PMID: 32407865 DOI: 10.1016/j.exger.2020.110964] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/15/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022]
Abstract
Muscle loss is an important feature that occurs in multiple pathologies including osteoarthritis (OA), chronic obstructive pulmonary disease (COPD) and type II diabetes (T2D). Despite differences in pathogenesis and disease-related complications, there are reasons to believe that some fundamental underlying mechanisms are inherent to the muscle wasting process, irrespective of the pathology. Recent evidence shows that inflammation, either local or systemic, contributes to the modulation of muscle mass and/or muscle strength, via an altered molecular profile in muscle tissue. However, it remains ambiguous to which extent and via which mechanisms inflammatory signaling affects muscle mass in disease. Therefore, the objective of the present review is to discuss the role of inflammation on skeletal muscle anabolism, catabolism and functionality in three pathologies that are characterized by an eventual loss in muscle mass (and muscle strength), i.e. OA, COPD and T2D. In OA and COPD, most rodent models confirmed that systemic (COPD) or muscle (OA) inflammation directly induces muscle loss or muscle dysfunctionality. However, in a patient population, the association between inflammation and muscular maladaptations are more ambiguous. For example, in T2D patients, systemic inflammation is associated with muscle loss whereas in OA patients this link has not consistently been established. T2D rodent models revealed that increased levels of advanced glycation end-products (AGEs) and a decreased mTORC1 activation play a key role in muscle atrophy, but it remains to be elucidated whether AGEs and mTORC1 are interconnected and contribute to muscle loss in T2D patients. Generally, if any, associations between inflammation and muscle are mainly based on observational and cross-sectional data. There is definitely a need for longitudinal evidence through well-powered randomized control trials that take into account confounders such as age, disease-phenotypes, comorbidities, physical (in) activity etc. This will allow to improve our understanding of the complex interaction between inflammatory signaling and muscle mass loss and hence contribute to the development of therapeutic strategies to combat muscle wasting in these diseases.
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Affiliation(s)
- Sebastiaan Dalle
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Katrien Koppo
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium.
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de Vries BA, van der Heijden RA, Verschueren J, Bos PK, Poot DH, van Tiel J, Kotek G, Krestin GP, Oei EH. Quantitative subchondral bone perfusion imaging in knee osteoarthritis using dynamic contrast enhanced MRI. Semin Arthritis Rheum 2020; 50:177-182. [DOI: 10.1016/j.semarthrit.2019.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 01/12/2023]
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Gut-Joint Axis: The Role of Physical Exercise on Gut Microbiota Modulation in Older People with Osteoarthritis. Nutrients 2020; 12:nu12020574. [PMID: 32098380 PMCID: PMC7071456 DOI: 10.3390/nu12020574] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 02/07/2023] Open
Abstract
Osteoarthritis (OA) is considered one of the most common joint disorders worldwide and its prevalence is constantly increasing due to the global longevity and changes in eating habits and lifestyle. In this context, the role of gut microbiota (GM) in the pathogenesis of OA is still unclear. Perturbation of GM biodiversity and function, defined as ‘gut dysbiosis’, might be involved in the development of inflammaging, one of the main risk factors of OA development. It is well known that physical exercise could play a key role in the prevention and treatment of several chronic diseases including OA, and it is recommended by several guidelines as a first line intervention. Several studies have shown that physical exercise could modulate GM composition, boosting intestinal mucosal immunity, increasing the Bacteroidetes–Firmicutes ratio, modifying the bile acid profile, and improving the production of short chain fatty acids. Moreover, it has been shown that low intensity exercise might reduce the risk of gastrointestinal diseases, confirming the hypothesis of a strict correlation between skeletal muscle and GM. However, up to date, there is still a lack of clinical trials focusing on this research field. Therefore, in this narrative, we aimed to summarize the state-of-the-art of the literature regarding the correlation between these conditions, supporting the hypothesis of a ‘gut–joint axis’ and highlighting the role of physical exercise combined with adequate diet and probiotic supplements in rebalancing microbial dysbiosis.
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Lee JH, Joo YB, Han M, Kwon SR, Park W, Park KS, Yoon BY, Jung KH. Relationship between oxidative balance score and quality of life in patients with osteoarthritis: Data from the Korea National Health and Nutrition Examination Survey (2014-2015). Medicine (Baltimore) 2019; 98:e16355. [PMID: 31305428 PMCID: PMC6641665 DOI: 10.1097/md.0000000000016355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Osteoarthritis (OA) has a multifactorial etiology that includes oxidative stress. Oxidative balance score (OBS) is a well-known indicator of oxidative stress. However, the association between OBS and OA has not been assessed. Thus, this study aimed to investigate the associations of OBS with OA and quality of life (QOL) in patients with OA.By using data from the Korea National Health and Nutrition Examination Survey VI, patients previously diagnosed and/or treated by a physician were considered to have OA regardless of the affected joints. The control group was defined as participants without any form of chronic arthritis. OBS was calculated by combining 10 pro-oxidant and antioxidant factors through a baseline nutritional and lifestyle assessment. Higher OBS scores indicated a predominance of antioxidant exposure. Multivariable logistic regression was used to estimate the adjusted odds ratios (ORs) for OA, and the EuroQoL five-dimensional questionnaire (EQ5D) was used in patients with OA after adjusting for demographic factors and comorbidities.Among the 14,930 participants, 296 patients with OA, and 1,309 controls were included in the analysis. In the age- and sex-adjusted model, the OR of the total OBS for OA was significant. In the full model adjusted for age, sex, education, income, and comorbidities, the total OBS for OA was not significant. Only the non-dietary pro-oxidant OBS had a significant inverse association with OA. The patients with OA who had a high EQ5D score had a higher total OBS than those with a low EQ5D score. The OR of the total OBS for a high EQ5D score was 1.14 in the multivariable logistic regression model. As we analyzed the OBS as a categorical variable (reference = Q1), the ORs of the Q2, Q3, and Q4 (highest) total OBS were 1.43, 2.71, and 2.22, respectively.In the fully adjusted model, the total OBS was not associated with OA. However, a positive association was observed between the total OBS and QOL in the patients with OA, indicating that antioxidative status was associated with better QOL in patients with OA.
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Affiliation(s)
- Joo-Hyun Lee
- Department of Rheumatology, Inje University Ilsan Paik Hospital, Goyang
| | - Young Bin Joo
- Department of Rheumatology, St. Vincent's Hospital, The Catholic University of Korea
| | - Minkyung Han
- Department of Biomedical Systems Informatics, College of Medicine, Yonsei University, Seoul
| | - Seong Ryul Kwon
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Won Park
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Kyung-Su Park
- Department of Rheumatology, St. Vincent's Hospital, The Catholic University of Korea
| | - Bo Young Yoon
- Department of Rheumatology, Inje University Ilsan Paik Hospital, Goyang
| | - Kyong-Hee Jung
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
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Shadyab AH, Terkeltaub R, Kooperberg C, Reiner A, Eaton CB, Jackson RD, Krok-Schoen JL, Salem RM, LaCroix AZ. Prospective associations of C-reactive protein (CRP) levels and CRP genetic risk scores with risk of total knee and hip replacement for osteoarthritis in a diverse cohort. Osteoarthritis Cartilage 2018; 26:1038-1044. [PMID: 29758352 PMCID: PMC6050083 DOI: 10.1016/j.joca.2018.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 03/18/2018] [Accepted: 05/03/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine associations of high-sensitivity C-reactive protein (CRP) levels and polygenic CRP genetic risk scores (GRS) with risk of end-stage hip or knee osteoarthritis (OA), defined as incident total hip (THR) or knee replacement (TKR) for OA. DESIGN This study included a cohort of postmenopausal white, African American, and Hispanic women from the Women's Health Initiative. Women were followed from baseline to date of THR or TKR, death, or December 31, 2014. Medicare claims data identified THR and TKR. Hs-CRP and genotyping data were collected at baseline. Three CRP GRS were constructed: 1) a 4-SNP GRS comprised of genetic variants representing variation in the CRP gene among European populations; 2) a multilocus 18-SNP GRS of genetic variants significantly associated with CRP levels in a meta-analysis of genome-wide association studies; and 3) a 5-SNP GRS of genetic variants significantly associated with CRP levels among African American women. RESULTS In analyses conducted separately among each race and ethnic group, there were no significant associations of ln hs-CRP with risk of THR or TKR, after adjusting for age, body mass index, lifestyle characteristics, chronic diseases, hormone therapy use, and non-steroidal anti-inflammatory drug use. CRP GRS were not associated with risk of THR or TKR in any ethnic group. CONCLUSIONS Serum levels of ln hs-CRP and genetically-predicted CRP levels were not associated with risk of THR or TKR for OA among a diverse cohort of women.
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MESH Headings
- Arthroplasty, Replacement, Hip/statistics & numerical data
- Arthroplasty, Replacement, Knee/statistics & numerical data
- C-Reactive Protein/analysis
- C-Reactive Protein/genetics
- Female
- Genetic Predisposition to Disease/epidemiology
- Genetic Predisposition to Disease/genetics
- Genome-Wide Association Study
- Humans
- Osteoarthritis, Hip/blood
- Osteoarthritis, Hip/etiology
- Osteoarthritis, Hip/genetics
- Osteoarthritis, Hip/surgery
- Osteoarthritis, Knee/blood
- Osteoarthritis, Knee/etiology
- Osteoarthritis, Knee/genetics
- Osteoarthritis, Knee/surgery
- Polymorphism, Single Nucleotide/genetics
- Racial Groups/genetics
- Racial Groups/statistics & numerical data
- Risk Factors
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Affiliation(s)
- A H Shadyab
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA.
| | - R Terkeltaub
- VA San Diego Healthcare System/University of California San Diego, La Jolla, CA, USA
| | - C Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - A Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - C B Eaton
- Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - R D Jackson
- Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - J L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - R M Salem
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - A Z LaCroix
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
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29
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Pérez-Baos S, Prieto-Potin I, Román-Blas JA, Sánchez-Pernaute O, Largo R, Herrero-Beaumont G. Mediators and Patterns of Muscle Loss in Chronic Systemic Inflammation. Front Physiol 2018; 9:409. [PMID: 29740336 PMCID: PMC5928215 DOI: 10.3389/fphys.2018.00409] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/04/2018] [Indexed: 12/25/2022] Open
Abstract
Besides its primary function in locomotion, skeletal muscle (SKM), which represents up to half of human's weight, also plays a fundamental homeostatic role. Through the secretion of soluble peptides, or myokines, SKM interacts with major organs involved in metabolic processes. In turn, metabolic cues from these organs are received by muscle cells, which adapt their response accordingly. This is done through an intricate intracellular signaling network characterized by the cross-talking between anabolic and catabolic pathways. A fine regulation of the network is required to protect the organism from an excessive energy expenditure. Systemic inflammation evokes a catabolic reaction in SKM known as sarcopenia. In turn this response comprises several mechanisms, which vary depending on the nature of the insult and its magnitude. In this regard, aging, chronic inflammatory systemic diseases, osteoarthritis and idiopathic inflammatory myopathies can lead to muscle loss. Interestingly, sarcopenia may persist despite remission of chronic inflammation, an issue which warrants further research. The Janus kinase/signal transducer and activator of transcription (JAK/STAT) system stands as a major participant in muscle loss during systemic inflammation, while it is also a well-recognized orchestrator of muscle cell turnover. Herein we summarize current knowledge about models of sarcopenia, their triggers and major mediators and their effect on both protein and cell growth yields. Also, the dual action of the JAK/STAT pathway in muscle mass changes is discussed. We highlight the need to unravel the precise contribution of this system to sarcopenia in order to design targeted therapeutic strategies.
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Affiliation(s)
- Sandra Pérez-Baos
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Iván Prieto-Potin
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Jorge A Román-Blas
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Olga Sánchez-Pernaute
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Raquel Largo
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Gabriel Herrero-Beaumont
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
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de Visser HM, Mastbergen SC, Ravipati S, Welsing PMJ, Pinto FC, Lafeber FPJG, Chapman V, Barrett DA, Weinans H. Local and systemic inflammatory lipid profiling in a rat model of osteoarthritis with metabolic dysregulation. PLoS One 2018; 13:e0196308. [PMID: 29684084 PMCID: PMC5912715 DOI: 10.1371/journal.pone.0196308] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/10/2018] [Indexed: 01/15/2023] Open
Abstract
Objective Bioactive oxidised lipids (oxylipins) are important signalling mediators, capable of modulating the inflammatory state of the joint and anticipated to be of importance in joint homeostasis and status of osteoarthritis. The aim of this study was to quantify oxylipin levels in plasma and synovial fluid from rats with experimentally induced osteoarthritis to investigate the potential role of oxylipins as a marker in the disease process of early osteoarthritis. Design Forty rats were randomly allocated to a standard or high-fat diet group. After 12 weeks, local cartilage damage was induced in one knee joint in 14 rats of each diet group. The remaining 6 rats per group served as controls. At week 24, samples were collected. Oxylipin levels were quantified by liquid chromatography–mass spectrometry. Results Overall, 31 lipid-derived inflammatory mediators were detected in fasted plasma and synovial fluid. Principal component analysis identified four distinct clusters associated with histopathological changes. Diet induced differences were evident for 13 individual plasma oxylipins, as well as 5,6-EET in synovial fluid. Surgical-model induced differences were evident for three oxylipins in synovial fluid (15-HETE, 8,9-DHET and 17R-ResolvinD1) with a different response in lipid concentrations for synovial fluid and plasma. Conclusions We demonstrate the quantification of oxidised lipids in rat plasma and synovial fluid in a model of early experimental osteoarthritis. Oxylipins in the synovial fluid that were altered as consequence of the surgically induced osteoarthritis were not represented in the plasma. Our findings suggest differential roles of the oxylipins in the local versus peripheral compartment.
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Affiliation(s)
- H. M. de Visser
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S. C. Mastbergen
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- * E-mail:
| | - S. Ravipati
- School of Pharmacy (DAB, FCP) and School of Life Sciences (VC), University of Nottingham, Nottingham, United Kingdom
| | - P. M. J. Welsing
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F. C. Pinto
- School of Pharmacy (DAB, FCP) and School of Life Sciences (VC), University of Nottingham, Nottingham, United Kingdom
| | - F. P. J. G. Lafeber
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - V. Chapman
- School of Pharmacy (DAB, FCP) and School of Life Sciences (VC), University of Nottingham, Nottingham, United Kingdom
- Arthritis Research UK Pain Centre, School of Life Sciences, University of Nottingham, Nottingham, United Kindom
| | - D. A. Barrett
- School of Pharmacy (DAB, FCP) and School of Life Sciences (VC), University of Nottingham, Nottingham, United Kingdom
| | - H. Weinans
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
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Abstract
PURPOSE OF REVIEW Inflammatory changes in joint tissues can be detected by modern imaging techniques in osteoarthritis patients, but may be clinically subtle compared with many other types of arthritis. These changes associate with disease progression and clinical severity, and many inflammatory mediators may have biomarker utility. Moreover, a number of inflammatory mechanisms play a role in animal models of disease, but it is still not clear which mechanisms predominate and might be therapeutically manipulated most effectively. This review highlights specific examples of recent advances published in the past 18 months that have advanced this field. RECENT FINDINGS Clinical investigators now show that synovial inflammation is associated with pain sensitization, and similar to knee osteoarthritis, is a common and important feature of hand osteoarthritis. In addition, recent advances in basic studies demonstrate inflammatory markers and mechanisms related to leukocyte activity, innate immune mechanisms, and the chondrocyte-intrinsic inflammatory response that might provide better opportunities for early detection, prognosis, or therapeutic intervention. SUMMARY Inflammation plays a central role in osteoarthritis pathogenesis, but additional translational work in this field is necessary, as are more clinical trials of anti-inflammatory approaches.
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Fusco M, Skaper SD, Coaccioli S, Varrassi G, Paladini A. Degenerative Joint Diseases and Neuroinflammation. Pain Pract 2017; 17:522-532. [DOI: 10.1111/papr.12551] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/17/2016] [Accepted: 12/17/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Mariella Fusco
- Scientific Information and Documentation Center; Epitech Group; Padua Italy
| | - Stephen D. Skaper
- Department of Pharmaceutical and Pharmacological Sciences; University of Padua; Padua Italy
| | - Stefano Coaccioli
- Department of Internal Medicine and Rheumatology; Santa Maria Hospital; University of Perugia; Terni Italy
| | - Giustino Varrassi
- Department of Anesthesiology and Pain Medicine; School of Dentistry; LUdeS University; La Valletta Malta
- Paolo Procacci Foundation and European League Against Pain; Rome Italy
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Immune Mediators in Osteoarthritis: Infrapatellar Fat Pad-Infiltrating CD8+ T Cells Are Increased in Osteoarthritic Patients with Higher Clinical Radiographic Grading. Int J Rheumatol 2016; 2016:9525724. [PMID: 28070192 PMCID: PMC5192329 DOI: 10.1155/2016/9525724] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/25/2016] [Accepted: 11/09/2016] [Indexed: 01/15/2023] Open
Abstract
Osteoarthritis is a condition of joint failure characterized by many pathologic changes of joint-surrounding tissues. Many evidences suggest the role of both innate and adaptive immunity that interplay, resulting either in initiation or in progression of osteoarthritis. Adaptive immune cells, in particular T cells, have been demonstrated to play a role in the development of OA in animal models. However, the underlying mechanism is yet unclear. Our aim was to correlate the frequency and phenotype of tissue-infiltrating T cells in the synovial tissue and infrapatellar fat pad with radiographic grading. Our results show that CD8+ T cells are increased in osteoarthritic patients with higher radiographic grading. When peripheral blood CD8+ T cells were examined, we show that CD8+ T cells possess a significantly higher level of activation than its CD4+ T cell counterpart (P < 0.0001). Our results suggest a role for CD8+ T cells and recruitment of these activated circulating peripheral blood CD8+ T cells to the knee triggering local inflammation within the knee joint.
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Abstract
Ageing-associated changes that affect articular tissues promote the development of osteoarthritis (OA). Although ageing and OA are closely linked, they are independent processes. Several potential mechanisms by which ageing contributes to OA have been elucidated. This Review focuses on the contributions of the following factors: age-related inflammation (also referred to as 'inflammaging'); cellular senescence (including the senescence-associated secretory phenotype (SASP)); mitochondrial dysfunction and oxidative stress; dysfunction in energy metabolism due to reduced activity of 5'-AMP-activated protein kinase (AMPK), which is associated with reduced autophagy; and alterations in cell signalling due to age-related changes in the extracellular matrix. These various processes contribute to the development of OA by promoting a proinflammatory, catabolic state accompanied by increased susceptibility to cell death that together lead to increased joint tissue destruction and defective repair of damaged matrix. The majority of studies to date have focused on articular cartilage, and it will be important to determine whether similar mechanisms occur in other joint tissues. Improved understanding of ageing-related mechanisms that promote OA could lead to the discovery of new targets for therapies that aim to slow or stop the progression of this chronic and disabling condition.
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Affiliation(s)
- Richard F Loeser
- Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, 3300 Thurston Building, Campus Box 7280, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7280, USA
| | - John A Collins
- Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, 3300 Thurston Building, Campus Box 7280, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599-7280, USA
| | - Brian O Diekman
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, 450 West Drive, Campus Box 7295, Chapel Hill, North Carolina 27599-7295, USA
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