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Lewis JA, Nemke B, Lu Y, Sather NA, McClendon MT, Mullen M, Yuan SC, Ravuri SK, Bleedorn JA, Philippon MJ, Huard J, Markel MD, Stupp SI. A bioactive supramolecular and covalent polymer scaffold for cartilage repair in a sheep model. Proc Natl Acad Sci U S A 2024; 121:e2405454121. [PMID: 39106310 PMCID: PMC11331086 DOI: 10.1073/pnas.2405454121] [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: 03/18/2024] [Accepted: 07/01/2024] [Indexed: 08/09/2024] Open
Abstract
Regeneration of hyaline cartilage in human-sized joints remains a clinical challenge, and it is a critical unmet need that would contribute to longer healthspans. Injectable scaffolds for cartilage repair that integrate both bioactivity and sufficiently robust physical properties to withstand joint stresses offer a promising strategy. We report here on a hybrid biomaterial that combines a bioactive peptide amphiphile supramolecular polymer that specifically binds the chondrogenic cytokine transforming growth factor β-1 (TGFβ-1) and crosslinked hyaluronic acid microgels that drive formation of filament bundles, a hierarchical motif common in natural musculoskeletal tissues. The scaffold is an injectable slurry that generates a porous rubbery material when exposed to calcium ions once placed in cartilage defects. The hybrid material was found to support in vitro chondrogenic differentiation of encapsulated stem cells in response to sustained delivery of TGFβ-1. Using a sheep model, we implanted the scaffold in shallow osteochondral defects and found it can remain localized in mechanically active joints. Evaluation of resected joints showed significantly improved repair of hyaline cartilage in osteochondral defects injected with the scaffold relative to defects injected with the growth factor alone, including implantation in the load-bearing femoral condyle. These results demonstrate the potential of the hybrid biomimetic scaffold as a niche to favor cartilage repair in mechanically active joints using a clinically relevant large-animal model.
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Affiliation(s)
- Jacob A. Lewis
- Department of Biomedical Engineering, Northwestern University, Evanston, IL60208
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL60611
| | - Brett Nemke
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI53706
| | - Yan Lu
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI53706
| | - Nicholas A. Sather
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL60611
| | - Mark T. McClendon
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL60611
| | - Michael Mullen
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO81657
| | - Shelby C. Yuan
- Department of Biomedical Engineering, Northwestern University, Evanston, IL60208
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL60611
| | - Sudheer K. Ravuri
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO81657
| | - Jason A. Bleedorn
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI53706
| | - Marc J. Philippon
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO81657
| | - Johnny Huard
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO81657
| | - Mark D. Markel
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI53706
| | - Samuel I. Stupp
- Department of Biomedical Engineering, Northwestern University, Evanston, IL60208
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL60611
- Department of Chemistry, Northwestern University, Evanston, IL60208
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL60208
- Department of Medicine, Northwestern University, Chicago, IL60611
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2
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Torres-Torrillas M, Damiá E, Peláez P, Miguel-Pastor L, Cuervo B, Cerón JJ, Carrillo JM, Rubio M, Sopena JJ. Intra-osseous infiltration of adipose mesenchymal stromal cells and plasma rich in growth factors to treat acute full depth cartilage defects in a rabbit model: Serum osteoarthritis biomarkers and macroscopical assessment. Front Vet Sci 2022; 9:1057079. [PMID: 36605767 PMCID: PMC9807624 DOI: 10.3389/fvets.2022.1057079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Intra-articular infiltration of plasma rich in growth factors (PRGF) and adipose mesenchymal stromal cells (AMSCs) are known to inhibit osteoarthritis progression. However, in severely affected patients, the treatment cannot reach the deeper layers of the articular cartilage; thus, its potential is limited. To overcome this limitation, intra-osseous infiltrations have been suggested. The purpose of this study is to assess the impact of intra-osseous infiltration therapies on serum biomarkers of osteoarthritis and to assess cartilage regeneration macroscopically. Materials and methods A total of 80 rabbits were divided into four groups based on the intra-osseous treatment administered on the day of surgery: control, PRGF, AMSCs and a combination of PRGF + AMSCs. In addition, all groups received a single intra-articular administration of PRGF on the same day. Serum biomarker levels were measured before infiltration and 28-, 56-, and 84-days post infiltration, and macroscopical assessment was conducted at 56- and 84-days follow-up post infiltration. Results In the PRGF + AMSCs group, significantly lower concentrations of hyaluronic acid and type II collagen cleavage neoepitope were recorded at all time points during the study, followed by PRGF, AMSCs and control groups. Regarding macroscopical assessment, lower scores were obtained in PRGF + AMSCs group at all study times. Discussion The results suggest that the combination of intra-articular PRGF with intra-osseous PRGF or AMSCs achieves better results in rabbits with acute chondral defects and that intra-osseous infiltration is a safe procedure.
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Affiliation(s)
- Marta Torres-Torrillas
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation, CEU-UCH Chair of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Elena Damiá
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation, CEU-UCH Chair of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Pau Peláez
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation, CEU-UCH Chair of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Laura Miguel-Pastor
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation, CEU-UCH Chair of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Belén Cuervo
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation, CEU-UCH Chair of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - José J. Cerón
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence, Campus Mare Nostrum, University of Murcia, Murcia, Spain
| | - José M. Carrillo
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation, CEU-UCH Chair of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
| | - Mónica Rubio
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation, CEU-UCH Chair of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,*Correspondence: Mónica Rubio ✉
| | - Joaquín J. Sopena
- Bioregenerative Medicine and Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation, CEU-UCH Chair of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
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3
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Torres-Torrillas M, Damiá E, Cerón JJ, Carrillo JM, Peláez P, Miguel L, Del Romero A, Rubio M, Sopena JJ. Treating Full Depth Cartilage Defects with Intraosseous Infiltration of Plasma Rich in Growth Factors: An Experimental Study in Rabbits. Cartilage 2021; 13:766S-773S. [PMID: 34861782 PMCID: PMC8804721 DOI: 10.1177/19476035211057246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Intraarticular (IA) administration of platelet-rich plasma (PRP) has been proposed as a new strategy to halt osteoarthritis (OA) progression. In patients with severe OA, its potential is limited because it is unable to reach the subchondral bone, so a new strategy is needed, and intraosseous (IO) infiltration has been suggested. The purpose is to assess the impact of IA together with IO infiltration of plasma rich in growth factors (PRGF) in serum hyaluronic acid (HA) and type II collagen cleavage neoepitope (C2C) levels. DESIGN A total of 32 rabbits were included in the study and randomly divided into 2 groups: control and treatment. A 4-mm chondral defect was created in the medial femoral condyle and IA followed by IO infiltration were performed. Serum C2C and HA levels were measured using enzyme-linked immunosorbent assay (ELISA) tests before infiltration and 28, 56, and 84 days post-infiltration. RESULTS Significant lower C2C serum levels were obtained in treatment group (IA + IO infiltration of PRGF) at 84 days post-infiltration than in control group (IA infiltration of PRGF + IO infiltration of saline solution), while no significant differences between groups were reported at any other study times. Regarding HA, at 56 days post-infiltration, greater significant levels were seen in the treatment group. However, at 84 days post-infiltration, no significant differences were obtained, although lower levels were reported in the treatment group. CONCLUSIONS Despite inconclusive, the results suggest that the combination of IA and IO infiltration with PRGF may enhance cartilage and subchondral bone regeneration, but further studies are needed.
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Affiliation(s)
- Marta Torres-Torrillas
- Bioregenerative Medicine and Applied
Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal
Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation CEU-UCH Chair
of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU
Universities, Valencia, Spain
| | - Elena Damiá
- Bioregenerative Medicine and Applied
Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal
Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation CEU-UCH Chair
of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU
Universities, Valencia, Spain
| | - José J. Cerón
- Interdisciplinary Laboratory of
Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence, Campus
Mare Nostrum, University of Murcia, Murcia, Spain
| | - José M. Carrillo
- Bioregenerative Medicine and Applied
Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal
Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation CEU-UCH Chair
of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU
Universities, Valencia, Spain
| | - Pau Peláez
- Bioregenerative Medicine and Applied
Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal
Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation CEU-UCH Chair
of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU
Universities, Valencia, Spain
| | - Laura Miguel
- Bioregenerative Medicine and Applied
Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal
Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation CEU-UCH Chair
of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU
Universities, Valencia, Spain
| | - Ayla Del Romero
- Bioregenerative Medicine and Applied
Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal
Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation CEU-UCH Chair
of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU
Universities, Valencia, Spain
| | - Mónica Rubio
- Bioregenerative Medicine and Applied
Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal
Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation CEU-UCH Chair
of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU
Universities, Valencia, Spain,Mónica Rubio, Bioregenerative Medicine and
Applied Surgery Research Group, Department of Animal Medicine and Surgery, CEU
Cardenal Herrera University, CEU Universities, C/Tirant lo Blanc 7, Alfara del
Patriarca, 46115 Valencia, Spain.
| | - Joaquín J. Sopena
- Bioregenerative Medicine and Applied
Surgery Research Group, Department of Animal Medicine and Surgery, CEU Cardenal
Herrera University, CEU Universities, Valencia, Spain,García Cugat Foundation CEU-UCH Chair
of Medicine and Regenerative Surgery, CEU Cardenal Herrera University, CEU
Universities, Valencia, Spain
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Enomoto T, Akagi R, Ogawa Y, Yamaguchi S, Hoshi H, Sasaki T, Sato Y, Nakagawa R, Kimura S, Ohtori S, Sasho T. Timing of Intra-Articular Injection of Synovial Mesenchymal Stem Cells Affects Cartilage Restoration in a Partial Thickness Cartilage Defect Model in Rats. Cartilage 2020; 11:122-129. [PMID: 29989441 PMCID: PMC6921951 DOI: 10.1177/1947603518786542] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We investigated the effect of administration of intra-articular mesenchymal stem cells (MSCs) on cartilage repair at different timings, and the distribution of MSCs in the knee. DESIGN A partial thickness cartilage defect (PTCD) was created on the medial femoral condyle in 14-week-old Sprague-Dawley rats. Intra-articular injection of 1 × 106 MSCs was performed at 3 time points, namely at the time of surgery (0w group), at 1 week after surgery (1w group), and at 2 weeks after surgery (2w group). For the control, 50 μL phosphate-buffered saline was injected at the time of surgery. The femoral condyles were collected at 6 weeks after creation of PTCD and assessed histologically. To investigate the distribution of MSCs, fluorescent-labeled MSCs were injected into the knee joint. RESULTS In the control group, the cartilage lesion was distinguishable from surrounding cartilage. In the 0w group, hypocellularity and a slight decrease in safranin O stainability were observed around the injured area, but cartilage was restored to a nearly normal condition. In contrast, in the 1w and 2w groups, the cartilage surface was irregular and safranin O stainability in the injured and surrounding areas was poor. Histological score in the 0w group was significantly better than in the control, 1w, and 2w groups. At 1 day postinjection, fluorescent-labeled MSCs were mostly distributed in synovium. However, no migration into the PTCD was observed. CONCLUSIONS Early intra-articular injection of MSCs was effective in enhancing cartilage healing in a rat PTCD model. Injected MSCs were distributed in synovium, not in cartilage surrounding the PTCD.
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Affiliation(s)
- Takahiro Enomoto
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryuichiro Akagi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuya Ogawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.,Center for Preventive Medical Sciences, Musculoskeletal Disease, Chiba University, Chiba, Japan
| | - Satoshi Yamaguchi
- College of Liberal Arts and Sciences, Chiba University, Chiba, Japan
| | - Hiroko Hoshi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshihide Sasaki
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Sato
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryosuke Nakagawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Seiji Kimura
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.,Center for Preventive Medical Sciences, Musculoskeletal Disease, Chiba University, Chiba, Japan
| | - Seiji Ohtori
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takahisa Sasho
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.,Center for Preventive Medical Sciences, Musculoskeletal Disease, Chiba University, Chiba, Japan
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5
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Akatsu Y, Enomoto T, Yamaguchi S, Tahara M, Fukawa T, Endo J, Hoshi H, Yamamoto Y, Sasaki T, Takahashi K, Akagi R, Sasho T. Age-dependent differences in response to partial-thickness cartilage defects in a rat model as a measure to evaluate the efficacy of interventions for cartilage repair. Cell Tissue Res 2018; 375:425-435. [PMID: 30259137 DOI: 10.1007/s00441-018-2914-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 08/17/2018] [Indexed: 12/18/2022]
Abstract
The objectives of this study are (1) to examine age-dependent longitudinal differences in histological responses after creation of partial-thickness articular cartilage defects (PTCDs) in rats and to use this model (2) to objectively evaluate the effectiveness of interventions for cartilage repair. Linear PTCDs were created at a depth of 100 μm in the weight-bearing region of the medial femoral condyle in rats of different ages (3 weeks, 6 weeks, 10 weeks and 14 weeks). One day, one week, two weeks, four weeks and twelve weeks after PTCD generation, spontaneous healing was evaluated histologically and immunohistochemically. Effects of interventions comprising mesenchymal stem cells (MSCs) or platelet-rich plasma (PRP) or both on 14-week-old PTCD rats were evaluated and compared with natural courses in rats of other ages. Younger rats exhibited better cartilage repair. Cartilage in 3-week-old and 6-week-old rats exhibited nearly normal restoration after 4-12 weeks. Cartilage in 14-week-old rats deteriorated over time and early signs of cartilage degeneration were observed. With injection of MCSs alone or MSCs + PRP, 14-week-old PTCD rats showed almost the same reparative cartilage as 6-week-old rats. With injection of PRP, 14-week-old PTCD rats showed almost the same reparative cartilage as 10-week-old rats. This model will be of great use to objectively compare the effects of interventions for small cartilage lesions and may help to advance the development of disease-modifying osteoarthritis drugs.
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Affiliation(s)
- Yorikazu Akatsu
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Takahiro Enomoto
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Satoshi Yamaguchi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Masamichi Tahara
- Department of Orthopaedic Surgery, Chiba-East-Hospital, Chiba, Japan
| | - Taisuke Fukawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Jun Endo
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Hiroko Hoshi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Yohei Yamamoto
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Toshihide Sasaki
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Kazuhisa Takahashi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Ryuichiro Akagi
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Takahisa Sasho
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. .,Center for Preventive Medicine, Musculoskeletal Disease and Pain, Chiba University, Chiba, Japan.
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Ribitsch I, Mayer RL, Egerbacher M, Gabner S, Kańduła MM, Rosser J, Haltmayer E, Auer U, Gültekin S, Huber J, Bileck A, Kreil DP, Gerner C, Jenner F. Fetal articular cartilage regeneration versus adult fibrocartilaginous repair: secretome proteomics unravels molecular mechanisms in an ovine model. Dis Model Mech 2018; 11:11/7/dmm033092. [PMID: 29991479 PMCID: PMC6078409 DOI: 10.1242/dmm.033092] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 05/18/2018] [Indexed: 12/27/2022] Open
Abstract
Osteoarthritis (OA), a degenerative joint disease characterized by progressive cartilage degeneration, is one of the leading causes of disability worldwide owing to the limited regenerative capacity of adult articular cartilage. Currently, there are no disease-modifying pharmacological or surgical therapies for OA. Fetal mammals, in contrast to adults, are capable of regenerating injured cartilage in the first two trimesters of gestation. A deeper understanding of the properties intrinsic to the response of fetal tissue to injury would allow us to modulate the way in which adult tissue responds to injury. In this study, we employed secretome proteomics to compare fetal and adult protein regulation in response to cartilage injury using an ovine cartilage defect model. The most relevant events comprised proteins associated with the immune response and inflammation, proteins specific for cartilage tissue and cartilage development, and proteins involved in cell growth and proliferation. Alarmins S100A8, S100A9 and S100A12 and coiled-coil domain containing 88A (CCDC88A), which are associated with inflammatory processes, were found to be significantly upregulated following injury in adult, but not in fetal animals. By contrast, cartilage-specific proteins like proteoglycan 4 were upregulated in response to injury only in fetal sheep postinjury. Our results demonstrate the power and relevance of the ovine fetal cartilage regeneration model presented here for the first time. The identification of previously unrecognized modulatory proteins that plausibly affect the healing process holds great promise for potential therapeutic interventions. Summary: Secretome proteomics identifies differential regulation of inflammation modulators during fetal and adult articular cartilage defect healing, offering novel strategies for therapy.
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Affiliation(s)
- Iris Ribitsch
- VETERM, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna 1210, Austria
| | - Rupert L Mayer
- Department of Analytical Chemistry, Faculty of Chemistry, University of Vienna, Vienna 1090, Austria
| | - Monika Egerbacher
- Histology & Embryology, Department of Pathobiology, University of Veterinary Medicine Vienna, Vienna 1210, Austria
| | - Simone Gabner
- Histology & Embryology, Department of Pathobiology, University of Veterinary Medicine Vienna, Vienna 1210, Austria
| | - Maciej M Kańduła
- Department of Biotechnology, Boku University Vienna, Vienna 1180, Austria.,Institute of Bioinformatics, Johannes Kepler University, Linz 4040, Austria
| | - Julie Rosser
- VETERM, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna 1210, Austria
| | - Eva Haltmayer
- VETERM, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna 1210, Austria
| | - Ulrike Auer
- Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna 1210, Austria
| | - Sinan Gültekin
- VETERM, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna 1210, Austria
| | - Johann Huber
- Teaching and Research Farm Kremesberg, Clinical Unit for Herd Health Management in Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Vienna 1210, Austria
| | - Andrea Bileck
- Department of Analytical Chemistry, Faculty of Chemistry, University of Vienna, Vienna 1090, Austria
| | - David P Kreil
- Department of Biotechnology, Boku University Vienna, Vienna 1180, Austria
| | - Christopher Gerner
- Department of Analytical Chemistry, Faculty of Chemistry, University of Vienna, Vienna 1090, Austria
| | - Florien Jenner
- VETERM, University Equine Hospital, University of Veterinary Medicine Vienna, Vienna 1210, Austria
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7
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Gurer B, Cabuk S, Karakus O, Yilmaz N, Yilmaz C. In vivo cartilage tissue engineering. J Orthop Surg Res 2018; 13:107. [PMID: 29739464 PMCID: PMC5941486 DOI: 10.1186/s13018-018-0823-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 04/26/2018] [Indexed: 02/07/2023] Open
Abstract
Background Biologic treatment options for cartilage injuries require chondrocyte expansion using cell culture. Clinical application is accomplished in two surgical sessions and is expensive. If isolation of chondrocytes and stimulus for proliferation and extracellular matrix synthesis can be achieved in vivo, the treatment can be performed in one session and the cost can be reduced. Methods A 2.5-cm diameter full-thickness chondral defect was created in the knees of five groups of sheep. In one group, some of the chondral tissues obtained from the creation of the defect were diced into small pieces and were placed into the defect and were covered with a collagen membrane (MIV group). In the other group, the collagen membrane was soaked in collagenase prior to usage. In the next group, the collagen membrane was soaked in both collagenase and growth factors. Matrix-induced autologous chondrocyte implantation (MACI) was applied to another group in two sessions, and the last group was left untreated. After 15 weeks of follow-up, repair tissues were compared macroscopically, histomorphometrically, and biochemically for tissue concentrations of glycosaminoglycan and type II collagen. Results MACI and MIV groups demonstrated better healing than others and were similar. Addition of collagenase or growth factors did not improve the results. Addition of collagenase did not have detrimental effect on the surrounding cartilage. Conclusions With the described method, it is possible to obtain comparable results with MACI. Further studies are also needed to see if it works similarly in humans.
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Affiliation(s)
- B Gurer
- Mersin University Medical School, Mersin, Turkey.,Omer Halis Demir University Hospital, Nigde, Turkey
| | - S Cabuk
- Department of Orthopedics and Traumatology, Mersin University Medical School, Mersin, Turkey
| | - O Karakus
- Omer Halis Demir University Hospital, Nigde, Turkey. .,Fatih Sultan Mehmet Teaching and Research Hospital, İstanbul, Turkey. .,, İstanbul, Turkey.
| | - N Yilmaz
- Department of Histology and Embryology, Mersin University Medical School, Mersin, Turkey
| | - C Yilmaz
- Department of Orthopedics and Traumatology, Mersin University Medical School, Mersin, Turkey
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8
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Gürer B, Yılmaz C, Yılmaz ŞN, Çabuk S, Bölgen N. A novel strategy for cartilage tissue engineering: Collagenase-loaded cryogel scaffolds in a sheep model. INT J POLYM MATER PO 2017. [DOI: 10.1080/00914037.2017.1327433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Burak Gürer
- Department of Orthopedics and Traumatology, Medical School, Mersin University, Mersin, Turkey
| | - Cengiz Yılmaz
- Department of Orthopedics and Traumatology, Medical School, Mersin University, Mersin, Turkey
| | - Ş. Necat Yılmaz
- Department of Histology and Embryology, Medical School, Mersin University, Mersin, Turkey
| | - Sertan Çabuk
- Department of Orthopedics and Traumatology, Medical School, Mersin University, Mersin, Turkey
| | - Nimet Bölgen
- Chemical Engineering Department, Engineering Faculty, Mersin University, Mersin, Turkey
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Chondrogenic cells respond to partial-thickness defects of articular cartilage in adult rats: an in vivo study. J Mol Histol 2016; 47:249-58. [PMID: 26956364 DOI: 10.1007/s10735-016-9668-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 03/04/2016] [Indexed: 01/11/2023]
Abstract
The purpose of this study was to establish a partial-thickness articular cartilage defects model in adult rats and explore the respond of chondrogenic cells to the cartilage injury. Forty-five adult Sprague-Dawley rats were divided into operated group, sham-operated group and control group. Partial-thickness cartilage defects were created on the weight-bearing region of femoral condyles by a converted ophthalmic knife. Rats were exposed to 5-bromo-2'-deoxyuridine (BrdU) for five consecutive days and were sacrificed 1, 2 and 4 weeks after surgery. Evaluations of macroscopic and histological changes were made. Chondrocyte apoptosis was evaluated by TUNEL assay. Immunofluorescence staining of CD105 and BrdU, double staining of CD105/integrin α5β1 and CD105-positive cells counting were performed for evaluations of cells around the defects. Cartilage softening and fibrillation with chondrocyte apoptosis were observed around the injury site after surgery. Results of histological scores indicated no significant difference between one time point and a successive time point for either group. CD105-positive cells and BrdU-label-retaining cells were observed around the linear injury. And cells counting showed the number of CD105-positive cells increased at later time points (P < 0.05). Immunofluorescence double staining demonstrated co-localization of CD105 and integrin α5β1 in activated cells around the defects. We establish a partial-thickness cartilage defects model in adult rats and demonstrate this injury may lead to activation of putative progenitor cells. In addition, the activated cells express integrin α5β1 specially, which may help in early discovery of osteoarthritis.
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Vilela CA, Correia C, Oliveira JM, Sousa RA, Espregueira-Mendes J, Reis RL. Cartilage Repair Using Hydrogels: A Critical Review of in Vivo Experimental Designs. ACS Biomater Sci Eng 2015; 1:726-739. [DOI: 10.1021/acsbiomaterials.5b00245] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- C. A. Vilela
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life
and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- Orthopaedic
Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal
| | - C. Correia
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
| | - J. M. Oliveira
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - R. A. Sousa
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
| | - J. Espregueira-Mendes
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life
and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- Clínica
do Dragão, Espregueira-Mendes Sports Centre, Porto, Portugal
| | - R. L. Reis
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
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Mukoyama S, Sasho T, Akatsu Y, Yamaguchi S, Muramatsu Y, Katsuragi J, Fukawa T, Endo J, Hoshi H, Yamamoto Y, Takahashi K. Spontaneous repair of partial thickness linear cartilage injuries in immature rats. Cell Tissue Res 2014; 359:513-520. [PMID: 25407523 DOI: 10.1007/s00441-014-2041-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 10/16/2014] [Indexed: 11/29/2022]
Abstract
Partial thickness articular cartilage injuries (PTCIs) were not previously thought to heal spontaneously. Immature rats have the capacity for spontaneous repair of PTCIs, although it is a long-term process. Our aim has been to examine the spontaneous repair response mechanism in immature rats. Single linear PTCIs were created in 3-week-old and 12-week-old rats in the direction of joint motion. On day 1 and at 1, 2, and 4 weeks after PTCI, evaluations of histological changes and immunohistology at the injury site and in the surrounding cartilage were performed. Anti-CD105 and anti-CD166 antibodies (as stem cell markers to identify mesenchymal stem cells in reparative cartilage tissue) were used for immunohistological evaluations. To determine whether endogenous repair ability existed in articular cartilage, an ex vivo experiment was also carried out. Femoral condyles with PTCIs were incubated in Dulbecco's modified Eagle's medium containing 10% fetal bovine serum for 1 day and for 1 and 2 weeks. Histological changes were subsequently examined. Immature cartilage showed a higher repair response than did mature cartilage, and the response occurred immediately after PTCI. In immature rats, CD105- and CD166-positive cells were found in the superficial and transitional zones of the articular cartilage. Few CD166-positive cells were identified in mature articular cartilage. No significant in vivo differences in the spontaneous repair responses to PTCIs were observed between mature and immature groups. Thus, the repair response to PTCIs seems to be associated not only with CD105- and CD166-positive cells, but also with other perichondral factors.
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Affiliation(s)
- Shunsuke Mukoyama
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan.
| | - Takahisa Sasho
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Yorikazu Akatsu
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Satoshi Yamaguchi
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Yuta Muramatsu
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Joe Katsuragi
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Taisuke Fukawa
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Jun Endo
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Hiroko Hoshi
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Yohei Yamamoto
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
| | - Kazuhisa Takahashi
- Graduate School of Medicine, Orthopedic Surgery, Chiba University, Chiba, Japan
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Vandeweerd JM, Hontoir F, Kirschvink N, Clegg P, Nisolle JF, Antoine N, Gustin P. Prevalence of naturally occurring cartilage defects in the ovine knee. Osteoarthritis Cartilage 2013; 21:1125-31. [PMID: 23707753 DOI: 10.1016/j.joca.2013.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 04/22/2013] [Accepted: 05/13/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the prevalence, anatomical location and severity of cartilage defects in the stifle (knee) within a population of adult ewes (N = 65). MATERIALS AND METHODS Articular cartilage (AC) of the distal femur, proximal tibia and patella was assessed using Osteoarthritis Research Society International (OARSI) recommendations for macroscopic and microscopic scoring of ovine cartilage. Synovial fluid analysis and histology of the synovial membrane were performed. All limbs were examined by computed tomography. RESULTS Twenty-eight sheep (n = 28; 43%) presented at least one score 2 or score 3 lesion. Twenty-two (n = 22; 34%) sheep were macroscopically normal. Most frequent localizations of lesions were: axial aspect of the central third of the medial tibial condyle (32.7% of the lesions), middle third of the medial femoral condyle (29.4%), middle third of the articular surface of the patella (9.8%), and axial aspect of the central third of the lateral tibial condyle (9.8%). Grade of macroscopic lesions was significantly (H (3) = 29.31, P 0.000) affected by age. Macroscopic score correlated well with histological changes that can be found in osteoarthritis (OA) (r 0.83; P 0.000). Neither clinical signs of OA, nor cytological and histological signs of inflammation were identified, while imaging abnormalities were very rare. CONCLUSIONS Our data seem to indicate that naturally occurring OA exists in ageing sheep, at least subclinically. It might be useful to take into account prevalent cartilage defects at baseline in studies using ovine models.
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Affiliation(s)
- J-M Vandeweerd
- Integrated Veterinary Research Unit, Namur Research Institute for Life Sciences, Department of Veterinary Medicine, University of Namur, Belgium.
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13
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Kim M, Hong B, Lee J, Kim SE, Kang SS, Kim YH, Tae G. Composite System of PLCL Scaffold and Heparin-Based Hydrogel for Regeneration of Partial-Thickness Cartilage Defects. Biomacromolecules 2012; 13:2287-98. [DOI: 10.1021/bm3005353] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mihye Kim
- School of Materials
Science and Engineering and Department of
Nanobio Materials and Electronics, Gwangju Institute of Science and Technology, Gwangju, 500-712,
Korea
| | - Bohee Hong
- School of Materials
Science and Engineering and Department of
Nanobio Materials and Electronics, Gwangju Institute of Science and Technology, Gwangju, 500-712,
Korea
| | - Jongman Lee
- School of Materials
Science and Engineering and Department of
Nanobio Materials and Electronics, Gwangju Institute of Science and Technology, Gwangju, 500-712,
Korea
| | - Se Eun Kim
- College
of Veterinary
Medicine, Chonnam National University, Gwang-ju, 500-757, Korea
| | - Seong Soo Kang
- College
of Veterinary
Medicine, Chonnam National University, Gwang-ju, 500-757, Korea
| | - Young Ha Kim
- Department of Chemistry, Chung-Ang University, 221 Heukseok-dong,
Dongiak-gu, Seoul 156-755, Korea
| | - Giyoong Tae
- School of Materials
Science and Engineering and Department of
Nanobio Materials and Electronics, Gwangju Institute of Science and Technology, Gwangju, 500-712,
Korea
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Repeated platelet concentrate injections enhance reparative response of microfractures in the treatment of chondral defects of the knee: an experimental study in an animal model. Arthroscopy 2012; 28:688-701. [PMID: 22277762 DOI: 10.1016/j.arthro.2011.09.016] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 09/19/2011] [Accepted: 09/21/2011] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the histology and biomechanics of repair cartilage after microfractures with and without repeated local injections of platelet concentrate for the treatment of full-thickness focal chondral defects of the knee. METHODS A full-thickness chondral lesion on the medial femoral condyle was created in 30 sheep and treated with microfractures. Animals were divided into 2 groups, according to postoperative treatment: in group 1 we performed 5 weekly injections of autologous conditioned plasma, whereas group 2 did not undergo further treatments. Animals were killed at 3, 6, and 12 months after treatment. Macroscopic, histologic, and biomechanical evaluations were performed. Differences between groups at each time interval and differences over time within groups were analyzed for each outcome. Significance was set at P < .05. RESULTS Group 1 showed significantly better macroscopic, histologic, and biomechanical results than group 2 at each time interval. Analysis of time effect within groups showed that in group 1, quality of repair tissue significantly improved from 3 to 6 months after treatment and remained stable over time for all the outcomes; in group 2 a significant histologic and mechanical deterioration was observed between 6 and 12 months' follow-up. CONCLUSIONS Five repeated local injections of autologous conditioned plasma after microfractures in the treatment of full-thickness cartilage injuries promoted a better and more durable reparative response than isolated microfractures, although they did not produce hyaline cartilage. CLINICAL RELEVANCE Periodical intra-articular injections of platelet concentrate after microfractures may improve cartilage repair and prevent further degenerative changes.
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15
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A study of the anatomy and injection techniques of the ovine stifle by positive contrast arthrography, computed tomography arthrography and gross anatomical dissection. Vet J 2012; 193:426-32. [PMID: 22264645 DOI: 10.1016/j.tvjl.2011.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 12/09/2011] [Accepted: 12/15/2011] [Indexed: 11/22/2022]
Abstract
Although ovine stifle models are commonly used to study osteoarthritis, meniscal pathology and cruciate ligament injuries and repair, there is little information about the anatomy of the joint or techniques for synovial injections. The objectives of this study were to improve anatomical knowledge of the synovial cavities of the ovine knee and to compare intra-articular injection techniques. Synovial cavities of 24 cadaver hind limbs from 12 adult sheep were investigated by intra-articular resin, positive-contrast arthrography, computed tomography (CT) arthrography and gross anatomical dissection. Communication between femoro-patellar, medial femoro-tibial and lateral femoro-tibial compartments occurred in all cases. The knee joint should be considered as one synovial structure with three communicating compartments. Several unreported features were observed, including a communication between the medial femoro-tibial and lateral femoro-tibial compartments and a latero-caudal recess of the lateral femoro-tibial compartment. No intermeniscal ligament was identified. CT was able to define many anatomical features of the stifle, including the anatomy of the tendinous synovial recess on the lateral aspect of the proximal tibia under the combined tendon of the peroneus tertius, extensor longus digitorum and extensor digiti III proprius. An approach for intra-articular injection into this recess (the subtendinous technique) was assessed and compared with the retropatellar and paraligamentous techniques. All three injection procedures were equally successful, but the subtendinous technique appeared to be most appropriate for synoviocentesis and for injections in therapeutic research protocols with less risk of damaging the articular cartilage.
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16
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Kim M, Kim SE, Kang SS, Kim YH, Tae G. The use of de-differentiated chondrocytes delivered by a heparin-based hydrogel to regenerate cartilage in partial-thickness defects. Biomaterials 2011; 32:7883-96. [DOI: 10.1016/j.biomaterials.2011.07.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 07/05/2011] [Indexed: 12/25/2022]
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17
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Tsuruoka H, Sasho T, Yamaguchi S, Ikegawa N, Saito M, Akagi R, Ochiai N, Nakagawa K, Nakajima A, Fallouh L, Takahashi K. Maturation-dependent spontaneous healing of partial thickness cartilage defects in infantile rats. Cell Tissue Res 2011; 346:263-71. [PMID: 22006252 DOI: 10.1007/s00441-011-1259-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 09/21/2011] [Indexed: 11/29/2022]
Abstract
Partial-thickness articular cartilage defects (PTCDs) do not heal spontaneously and are thought to be a predisposing factor for the development of osteoarthritis. Younger and smaller animals have a better healing capacity for many types of injuries including those to articular cartilage. Our aim was to examine the longitudinal histological changes of immature murine articular cartilage after the creation of small PTCDs and to compare them to PTCDs in mature cartilage. Single linear PTCDs were created in 3-week-old and 16-week-old rats in the direction of joint motion. At 6 and 12 weeks after PTCD creation, histological changes were examined in the defect sites and surrounding cartilage. Immature cartilage showed a higher repair capability than mature cartilage. Although repaired immature cartilage had fibrocartilage, it exhibited better quality than any PTCD model, except for a fetus model and comparable quality to full-thickness cartilage defects (FTCD) after bone marrow stimulation. Elucidation of the underlining mechanisms that immature cartilage possesses for repairing PTCDs is necessary in order to aid the prevention or develop treatment for osteoarthritis.
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Affiliation(s)
- Hiroaki Tsuruoka
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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18
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Hurtig MB, Buschmann MD, Fortier LA, Hoemann CD, Hunziker EB, Jurvelin JS, Mainil-Varlet P, McIlwraith CW, Sah RL, Whiteside RA. Preclinical Studies for Cartilage Repair: Recommendations from the International Cartilage Repair Society. Cartilage 2011; 2:137-52. [PMID: 26069576 PMCID: PMC4300779 DOI: 10.1177/1947603511401905] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Investigational devices for articular cartilage repair or replacement are considered to be significant risk devices by regulatory bodies. Therefore animal models are needed to provide proof of efficacy and safety prior to clinical testing. The financial commitment and regulatory steps needed to bring a new technology to clinical use can be major obstacles, so the implementation of highly predictive animal models is a pressing issue. Until recently, a reductionist approach using acute chondral defects in immature laboratory species, particularly the rabbit, was considered adequate; however, if successful and timely translation from animal models to regulatory approval and clinical use is the goal, a step-wise development using laboratory animals for screening and early development work followed by larger species such as the goat, sheep and horse for late development and pivotal studies is recommended. Such animals must have fully organized and mature cartilage. Both acute and chronic chondral defects can be used but the later are more like the lesions found in patients and may be more predictive. Quantitative and qualitative outcome measures such as macroscopic appearance, histology, biochemistry, functional imaging, and biomechanical testing of cartilage, provide reliable data to support investment decisions and subsequent applications to regulatory bodies for clinical trials. No one model or species can be considered ideal for pivotal studies, but the larger animal species are recommended for pivotal studies. Larger species such as the horse, goat and pig also allow arthroscopic delivery, and press-fit or sutured implant fixation in thick cartilage as well as second look arthroscopies and biopsy procedures.
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Ganguly K, McRury ID, Goodwin PM, Morgan RE, Augé WK. Native Chondrocyte Viability during Cartilage Lesion Progression: Normal to Surface Fibrillation. Cartilage 2010; 1:306-11. [PMID: 26069561 PMCID: PMC4297056 DOI: 10.1177/1947603510373918] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Early surgical intervention for articular cartilage disease is desirable before full-thickness lesions develop. As early intervention treatments are designed, native chondrocyte viability at the treatment site before intervention becomes an important parameter to consider. The purpose of this study is to evaluate native chondrocyte viability in a series of specimens demonstrating the progression of articular cartilage lesions to determine if the chondrocyte viability profile changes during the evolution of articular cartilage disease to the level of surface fibrillation. DESIGN Osteochondral specimens demonstrating various degrees of articular cartilage damage were obtained from patients undergoing knee total joint replacement. Three groups were created within a patient harvest based on visual and tactile cues commonly encountered during surgical intervention: group 1, visually and tactilely intact surfaces; group 2, visually intact, tactilely soft surfaces; and group 3, surface fibrillation. Confocal laser microscopy was performed following live/dead cell viability staining. RESULTS Groups 1 to 3 demonstrated viable chondrocytes in all specimens, even within the fibrillated portions of articular cartilage, with little to no evidence of dead chondrocytes. Chondrocyte viability profile in articular cartilage does not appear to change as disease lesion progresses from normal to surface fibrillation. CONCLUSIONS Fibrillated partial-thickness articular cartilage lesions are a good therapeutic target for early intervention. These lesions retain a high profile of viable chondrocytes and are readily diagnosed by visual and tactile cues during surgery. Early intervention should be based on matrix failure rather than on more aggressive procedures that further corrupt the matrix and contribute to chondrocyte necrosis of contiguous untargeted cartilage.
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Affiliation(s)
- Kumkum Ganguly
- B-Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - Peter M. Goodwin
- Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - Wayne K. Augé
- NuOrtho Surgical, Inc., Fall River, MA, USA,Center for Orthopaedic and Sports Performance Research, Inc., Santa Fe, NM, USA,Wayne K. Augé II, MD, Center for Orthopaedic and Sports Performance Research, Inc., 936 Vista Jemez Court, Santa Fe, NM 87505, USA ;
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Kaplan LD, Lu Y, Snitzer J, Nemke B, Hao Z, Biro S, Albiero W, Stampfli HF, Markel M, Popkin C, Baum SZ. The effect of early hyaluronic acid delivery on the development of an acute articular cartilage lesion in a sheep model. Am J Sports Med 2009; 37:2323-7. [PMID: 19723621 DOI: 10.1177/0363546509339579] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Partial-thickness articular cartilage lesions occur with knee trauma and may progress to osteoarthritis. This study evaluates the effectiveness of hyaluronic acid on cartilage healing after acute knee injury in sheep. HYPOTHESIS Early administration of hyaluronic acid to an acute cartilage injury will prevent chondrocyte death and improve cartilage metabolism. STUDY DESIGN Controlled laboratory study. METHODS A 10 x 10 mm partial-thickness articular cartilage lesion was created on the medial condyle of 16 adult sheep stifles (hindlimbs). Eight sheep received intra-articular hyaluronic acid injections at days 0, 8, and 15, and 8 controls received saline. Contralateral stifles were nonoperated controls. All sheep were sacrificed at 12 weeks after surgery. Synovial fluid was drawn before surgery and after euthanasia for collagen II, nitric oxide, and interleukin-1 beta analysis. The medial condyle was analyzed by gross appearance, confocal laser microscopy for cell viability, histologic analysis for cartilage morphology, and dimethylmethylene blue assay for proteoglycan. RESULTS At 12 weeks, histologic analysis revealed that the hyaluronic acid group had significantly better scores than the saline group (P = .001). The hyaluronic acid group had significantly greater glycosaminoglycan content than the saline group (P = .011), and showed a trend of reduced chondrocyte death compared with the saline group (P = .07). Synovial fluid showed no significant differences between the groups in collagen II, nitric oxide, and interleukin-1 beta levels. CONCLUSION The results demonstrated that early administration of hyaluronic acid shows a significant improvement in cartilage histologic analysis and increased glycosaminoglycan content after acute traumatic cartilage injury. CLINICAL RELEVANCE Early hyaluronic acid treatment for acute partial-thickness articular cartilage lesions may decrease or delay articular degeneration.
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Affiliation(s)
- Lee D Kaplan
- Division of Sports Medicine, Department of Orthopaedics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
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Effects of firocoxib therapy on progression of osteoarthritis in a canine model. CURRENT ORTHOPAEDIC PRACTICE 2009. [DOI: 10.1097/bco.0b013e3181981d4d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hurtig M, Chubinskaya S, Dickey J, Rueger D. BMP-7 protects against progression of cartilage degeneration after impact injury. J Orthop Res 2009; 27:602-11. [PMID: 18985691 DOI: 10.1002/jor.20787] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In vivo studies were used to characterize a model of cartilage injury leading to osteoarthritis progression in the medial femorotibial joint of sheep. In three subsequent studies, bilateral impact injuries were created and one joint received intraarticular injections of 340 microg of rhBMP-7 protein in a collagen particle carrier while the contralateral knee received the vehicle alone. Sheep were allocated to three groups that received intraarticular injections on day 0 (group A), 21 (group B), or 90 (group C) after experimental knee injury. In each group the, joints were evaluated for signs of osteoarthritis progression 90 days after the last treatment using India ink stained area, OARSI histological scoring, cartilage sGAG content, immunostaining for apoptosis (TUNEL), caspase-3, collagen degradation (Col 2 3/4C short collagen epitope), and the endogenous (pro-) form of BMP-7 protein. Knee joints that received rhBMP-7 immediately after injury had small focal lesions at the injury site that did not progress into the surrounding cartilage. Joints that received BMP-7 3 weeks after injury were improved and had limited progression compared to controls, but joints that received the protein 12 weeks after injury had no statistically significant improvement. These studies suggest that BMP-7 may be chondroprotective after traumatic injury in patients if it is administered within 3 to 4 weeks of the index injury. The mechanism of protection after sublethal injury appeared to be an increased survival of chondrocytes that are able to participate in the repair process.
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Affiliation(s)
- Mark Hurtig
- Department of Clinical Studies, University of Guelph, 50 McGilvray Lane, Guelph, ON, Canada, N1G 2W1.
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Hunziker EB, Stähli A. Surgical suturing of articular cartilage induces osteoarthritis-like changes. Osteoarthritis Cartilage 2008; 16:1067-73. [PMID: 18308590 PMCID: PMC2657041 DOI: 10.1016/j.joca.2008.01.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Accepted: 01/14/2008] [Indexed: 02/02/2023]
Abstract
INTRODUCTION In clinical tissue-engineering-based approaches to articular cartilage repair, various types of flap are frequently used to retain an implanted construct within the defect, and they are usually affixed by suturing. We hypothesize that the suturing of articular cartilage is associated with a loss of chondrocytes from, and osteoarthritis-like changes within, the perisutural area. MATERIALS AND METHODS We established a large, partial-thickness defect model in the femoral groove of adult goats. The defects were filled with bovine fibrinogen to support a devitalized flap of autologous synovial tissue, which was sutured to the surrounding articular cartilage with single, interrupted stitches. The perisutural and control regions were analyzed histologically, histochemically and histomorphometrically shortly after surgery and 3 weeks later. RESULTS Compared to control regions, chondrocytes were lost from the perisutural area even during the first few hours of surgery. During the ensuing 3 weeks, the numerical density of cells in the perisutural area decreased significantly. The cell losses were associated with a loss of proteoglycans from the extracellular matrix. Shortly after surgery, fissures were observed within the walls of the suture channels. By the third week, their surface density had increased significantly and they were filled with avascular mesenchymal tissue. CONCLUSIONS The suturing of articular cartilage induces severe local damage, which is progressive and reminiscent of that associated with the early stages of osteoarthritis. This damage could be most readily circumvented by adopting an alternative mode of flap affixation, such as gluing with a biological adhesive.
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Affiliation(s)
- Ernst B. Hunziker
- Corresponding author: Prof. Ernst B. Hunziker, DST Research Center, Department of Clinical Research, University of Bern, Murtenstrasse 35, P.O. Box 54, 3010 Bern, Switzerland. Tel: +41 31 632 8685; Fax: +41 31 632 4955; E-mail:
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Jansen EJP, Emans PJ, Douw CM, Guldemond NA, Van Rhijn LW, Bulstra SK, Kuijer R. One intra-articular injection of hyaluronan prevents cell death and improves cell metabolism in a model of injured articular cartilage in the rabbit. J Orthop Res 2008; 26:624-30. [PMID: 18176946 DOI: 10.1002/jor.20569] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to determine the effect of one intra-articular injection of hyaluronan on chondrocyte death and metabolism in injured cartilage. Twenty-three 6-month-old rabbits received partial-thickness articular cartilage defects created on each medial femoral condyle. In order to examine the effect on articular cartilage surrounding iatrogenic cartilage lesions, which can occur during arthroscopic procedures, Study 1 was performed: in 14 rabbits both knees were immediately rinsed with 0.9% NaCl. Experimental knees were treated with hyaluronan. Six rabbits were sacrificed at 2 days; eight rabbits 3 months postoperatively. Histomorphometric analysis was used for studying cell death in cartilage next to the defect. In order to examine the effect on longer lasting lesions, more reflecting the clinical situation, Study 2 was performed: after 6 months knee joints of nine rabbits were (i) irrigated with 0.9% NaCl, (ii) treated with hyaluronan after irrigation with 0.9% NaCl, or (iii) sham-treated. After 7 days patellas were used to study the chondrocyte metabolism by measuring the [(35)S]sulfate incorporation. Study 1: Two days postoperatively, in hyaluronan-treated cartilage the percentage of dead cells was 6.7%, which was significantly lower compared to 16.2% in saline-treated cartilage. After 3 months the percentages of dead cells in both groups were statistically similar. Study 2: Hyaluronan treatment resulted in significantly higher [(35)S]sulfate incorporation compared to knees irrigated with 0.9% NaCl. These results suggest a potential role for hyaluronan in preventing cell death following articular cartilage injury. One injection of hyaluronan improved cartilage metabolism in knees with 6-month-old cartilage defects.
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Affiliation(s)
- Edwin J P Jansen
- Department of Orthopaedic Surgery, University Hospital of Maastricht, Maastricht, The Netherlands.
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Hette K, Rahal SC, Volpi RS, Ferreira DOL, Teixeira CR. Artroscopia do joelho de ovinos. PESQUISA VETERINARIA BRASILEIRA 2008. [DOI: 10.1590/s0100-736x2008000200005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O trabalho teve por objetivo avaliar artroscopicamente a articulação do joelho de ovinos hígidos em diferentes idades, com o intuito de determinar, de acordo com os portais estabelecidos, a capacidade de observação das estruturas. Utilizaram-se 18 animais da raça Santa Inês, divididos em três grupos experimentais eqüitativos, conforme a idade cronológica, sendo: Grupo I, 6-8 meses (peso médio de 25 kg); Grupo II, 2 anos (peso médio de 50 kg); e Grupo III, 3,5-5 anos (peso médio de 55 kg). Foram estabelecidos três portais: (1) portal artroscópico primário, craniolateral; (2) portal para fluxo de drenagem; e (3) portal instrumental, craniomedial. Identificaram-se com facilidade a patela, sulco e bordas trocleares, côndilos medial e lateral do fêmur, e tendão do músculo extensor longo dos dedos. Após a remoção da maior parte do coxim gorduroso infrapatelar com emprego do "shaver" foram visibilizados, ainda com dificuldade, os ligamentos cruzados e os meniscos. Para a identificação dos primeiros foram necessárias movimentos de flexão e extensão e para os meniscos manobras de varo e valgo. O grau de dificuldade foi inversamente proporcional ao tamanho da articulação. Sendo assim, foi possível concluir que os portais artroscópicos utilizados possibilitaram a identificação das principais estruturas articulares, independente da idade, e o método em si teve por vantagem a rápida recuperação pós-operatória dos animais.
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Development of partial-thickness articular cartilage injury in a rabbit model. Clin Orthop Relat Res 2008; 466:487-94. [PMID: 18196436 PMCID: PMC2505122 DOI: 10.1007/s11999-007-0050-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Accepted: 11/02/2007] [Indexed: 01/31/2023]
Abstract
In humans, partial-thickness cartilage lesions frequently result in premature osteoarthritis. While rabbits often are used as a model for partial-thickness cartilage lesions, the natural course of cartilage surrounding such a lesion is largely unknown. We developed a rabbit model of a chronic partial-thickness cartilage defect and asked whether these defects led to (1) deterioration of surrounding cartilage macroscopically and microscopically (increased Mankin score) and (2) disturbances in proteoglycan metabolism. In 55 rabbits, we created a 4-mm-diameter partial-thickness cartilage defect on one medial femoral condyle. The surrounding cartilage was characterized during the course of 26 weeks. Contralateral knees were sham-operated. In experimental knees, we found cartilage softening and fibrillation at 13 and 26 weeks. High Mankin scores observed at 1 week were partially restored at 13 weeks but worsened later and were most pronounced at 26 weeks. Mankin scores in the experimental groups were worse at 1 and 26 weeks when compared with the sham groups. Mankin scores at 26 weeks improved compared with 1 week in the sham groups. Disturbances in proteoglycan metabolism were less evident. In this rabbit model, a partial-thickness cartilage lesion resulted in early markers of degenerative changes resembling the human situation.
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Ameye LG, Deberg M, Oliveira M, Labasse A, Aeschlimann JM, Henrotin Y. The chemical biomarkers C2C, Coll2-1, and Coll2-1NO2 provide complementary information on type II collagen catabolism in healthy and osteoarthritic mice. ACTA ACUST UNITED AC 2007; 56:3336-46. [PMID: 17907187 DOI: 10.1002/art.22875] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Compared with wild-type (WT) mice, biglycan/fibromodulin double-deficient mice develop severe knee osteoarthritis. We undertook this study to compare type II collagen catabolism in the 2 genotypes and to compare the usefulness of 3 biomarkers of collagen degradation (C2C [also known as Col2-3/4C(long mono)] as well as the peptide Coll2-1 and its nitrated form, Coll2-1NO2) for evaluating collagen catabolism in vivo. METHODS In 15 WT mice and 15 biglycan/fibromodulin double-deficient mice, we determined serum levels of C2C at ages 66 and 141 days, and we determined serum levels of Coll2-1 and Coll2-1NO2 at ages 49, 81, 95, and 141 days. Expression of the biomarkers in knee sections was examined using immunohistochemistry. RESULTS The mean concentrations of C2C and Coll2-1 were higher in biglycan/fibromodulin double-deficient mice at all time points. For C2C and Coll2-1, the ratio of the serum concentration in biglycan/fibromodulin double-deficient mice to that in WT mice (the double-deficient:WT ratio) was constant over time and was approximately 1.63 and approximately 1.15, respectively. In contrast, the double-deficient:WT ratio for Coll2-1NO2 varied and, depending on age, was >1 or <1. No significant correlation was found between the expression of the different biomarkers, except for a weak, negative correlation between Coll2-1NO2 and C2C. In both genotypes, antibodies to each biomarker labeled some fibroblasts in the tendons and menisci as well as chondrocytes above the tidemark in articular cartilage. Growth plates were unstained. For each biomarker, extracellular staining was limited to fibrocartilage areas in the tendons and menisci in all mice and was limited to some focal lesions of the cartilage in biglycan/fibromodulin double-deficient mice. CONCLUSION The different double-deficient:WT ratios observed with C2C, Coll2-1, and Coll2-1NO2 in the absence of any correlation between the expression of the 3 biomarkers indicate that these biomarkers give complementary, rather than redundant, information about in vivo type II collagen catabolism.
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Affiliation(s)
- L G Ameye
- Nestlé Research Center, Lausanne, Switzerland.
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