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Larrañaga-Vera A, Toti KS, Flatow JS, Haraczy AJ, Warnick E, Rao H, Gao ZG, Sussman SM, Mediero A, Leucht P, Jacobson KA, Cronstein BN. Novel alendronate-CGS21680 conjugate reduces bone resorption and induces new bone formation in post-menopausal osteoporosis and inflammatory osteolysis mouse models. Arthritis Res Ther 2022; 24:265. [PMID: 36494860 PMCID: PMC9733060 DOI: 10.1186/s13075-022-02961-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
Loss of bone is a common medical problem and, while it can be treated with available therapies, some of these therapies have critical side effects. We have previously demonstrated that CGS21680, a selective A2A adenosine receptor agonist, prevents bone loss, but its on-target toxicities (hypotension, tachycardia) and frequent dosing requirements make it unusable in the clinic. We therefore generated a novel alendronate-CGS21680 conjugate (MRS7216), to target the agonist to bone where it remains for long periods thereby diminishing the frequency of administration and curtailing side effects. MRS7216 was synthesized from CGS21680 by sequential activation of the carboxylic acid moiety and reacting with an appropriate amino acid (PEG, alendronic acid) under basic conditions. MRS7216 was tested on C57BL/6J (WT) mice with established osteoporosis (OP) and WT or A2A KO mice with wear particle-induced inflammatory osteolysis (OL). Mice were treated weekly with MRS7216 (10mg/kg). Bone formation was studied after in vivo labeling with calcein/Alizarin Red, and μCT and histology analyses were performed. In addition, human primary osteoblasts and osteoclasts were cultured using bone marrow discarded after hip replacement. Receptor binding studies demonstrate that MRS7216 efficiently binds the A2A adenosine receptor. MRS7216-treated OP and OL mice had significant new bone formation and reduced bone loss compared to vehicle or alendronate-treated mice. Histological analysis showed that MRS7216 treatment significantly reduced osteoclast number and increased osteoblast number in murine models. Interestingly, cultured human osteoclast differentiation was inhibited, and osteoblast differentiation was stimulated by the compound indicating that MRS7216 conjugates represent a novel therapeutic approach to treat osteoporosis and osteolysis.
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Affiliation(s)
- Ane Larrañaga-Vera
- Division of Translational Medicine, Department of Medicine, NYU Langone Health, 550 First Avenue, Medical Science Building, Room, New York, NY, 251, USA
| | - Kiran S Toti
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - James S Flatow
- Division of Translational Medicine, Department of Medicine, NYU Langone Health, 550 First Avenue, Medical Science Building, Room, New York, NY, 251, USA
| | - Alexandra J Haraczy
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Eugene Warnick
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Harsha Rao
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Zhan-Guo Gao
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sarah M Sussman
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Aranzazu Mediero
- Division of Translational Medicine, Department of Medicine, NYU Langone Health, 550 First Avenue, Medical Science Building, Room, New York, NY, 251, USA
- Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Philipp Leucht
- Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, New York, USA
- Department of Cell Biology, New York University Grossman School of Medicine, New York, NY, USA
| | - Kenneth A Jacobson
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Bruce N Cronstein
- Division of Translational Medicine, Department of Medicine, NYU Langone Health, 550 First Avenue, Medical Science Building, Room, New York, NY, 251, USA.
- Division of Rheumatology, Department of Medicine, NYU Langone Health, New York, NY, USA.
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2
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Siverino C, Freitag L, Arens D, Styger U, Richards RG, Moriarty TF, Stadelmann VA, Thompson K. Titanium Wear Particles Exacerbate S. epidermidis-Induced Implant-Related Osteolysis and Decrease Efficacy of Antibiotic Therapy. Microorganisms 2021; 9:microorganisms9091945. [PMID: 34576840 PMCID: PMC8468325 DOI: 10.3390/microorganisms9091945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/04/2021] [Accepted: 09/08/2021] [Indexed: 12/28/2022] Open
Abstract
Total joint arthroplasty (TJA) surgeries are common orthopedic procedures, but bacterial infection remains a concern. The aim of this study was to assess interactions between wear particles (WPs) and immune cells in vitro and to investigate if WPs affect the severity, or response to antibiotic therapy, of a Staphylococcus epidermidis orthopedic device-related infection (ODRI) in a rodent model. Biofilms grown on WPs were challenged with rifampin and cefazolin (100 µg/mL) to determine antibiotic efficacy. Neutrophils or peripheral blood mononuclear cells (PBMCs) were incubated with or without S. epidermidis and WPs, and myeloperoxidase (MPO) and cytokine release were analyzed, respectively. In the ODRI rodent model, rats (n = 36) had a sterile or S. epidermidis-inoculated screw implanted in the presence or absence of WPs, and a subgroup was treated with antibiotics. Bone changes were monitored using microCT scanning. The presence of WPs decreased antibiotic efficacy against biofilm-resident bacteria and promoted MPO and pro-inflammatory cytokine production in vitro. WPs exacerbated osteolytic responses to S. epidermidis infection and markedly reduced antibiotic efficacy in vivo. Overall, this work shows that the presence of titanium WPs reduces antibiotic efficacy in vitro and in vivo, induces proinflammatory cytokine release, and exacerbates S. epidermidis-induced osteolysis.
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Affiliation(s)
- Claudia Siverino
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - Linda Freitag
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - Daniel Arens
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - Ursula Styger
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - R. Geoff Richards
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - T. Fintan Moriarty
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
| | - Vincent A. Stadelmann
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
- Department of Teaching, Research and Development, Schulthess Clinic, 8008 Zürich, Switzerland
| | - Keith Thompson
- AO Research Institute Davos, 7270 Davos-Platz, Switzerland; (C.S.); (L.F.); (D.A.); (U.S.); (R.G.R.); (T.F.M.); (V.A.S.)
- Correspondence: ; Tel.: +41-81-414-2325
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3
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Mahatma MM, Jayasuriya RL, Hughes D, Hoggard N, Buckley SC, Gordon A, Hamer AJ, Tomouk MW, Kerry RM, Eastell R, Wilkinson JM. Effect of denosumab on osteolytic lesion activity after total hip arthroplasty: a single-centre, randomised, double-blind, placebo-controlled, proof of concept trial. THE LANCET. RHEUMATOLOGY 2021; 3:e195-e203. [PMID: 38279382 DOI: 10.1016/s2665-9913(20)30394-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 01/28/2024]
Abstract
BACKGROUND Osteolysis causes recurrent pain and disability after total hip arthroplasty. We investigated the effect of the human monoclonal antibody denosumab on osteolytic lesion activity in patients undergoing revision total hip arthroplasty surgery to show the biological proof of concept for a non-surgical treatment for the disease. METHODS We did a phase 2, randomised, double-blind, placebo-controlled, proof of concept superiority trial at Sheffield Teaching Hospitals, Sheffield, UK. Eligible patients aged 30 years or older and scheduled for revision surgery for symptomatic, radiographically confirmed osteolysis were randomly allocated (1:1) to subcutaneous denosumab (60 mg single-dose) or placebo by an independent pharmacist using a random number table. The primary outcome was the between-group difference in osteoclast number per mm of bone surface of biopsies taken from the osteolytic membrane-bone interface at surgery 8 weeks later, measured by quantitative histomorphometry in all patients who underwent revision surgery. Adverse events were analysed in all randomly assigned participants. This trial is registered with the EU Clinical Trials Register (EudraCT 2011-000541-20). FINDINGS Between Dec 12, 2012, and June 24, 2018, 51 patients were assessed for eligibility, of whom 24 were randomly assigned to study treatment. Two patients had their revision surgery cancelled for unrelated reasons, leaving 22 patients (ten in the denosumab group) for analysis of the primary outcome. There were 83% fewer osteoclasts at the osteolysis membrane-bone interface in the denosumab versus the placebo group (median 0·05 per mm [IQR 0·11] vs 0·30 mm [0·40], p=0·011). No deaths or treatment-related serious adverse events occurred. Seven adverse events, including one severe adverse event, occurred in four (36%) of 11 patients in the denosumab group. In the placebo group ten adverse events, including three severe adverse events, occurred in five (38%) of 13 patients. INTERPRETATION To our knowledge, this is the first clinical trial of an investigational drug for osteolysis that shows tissue-specific biological efficacy. These results justify the need for future trials that target earlier-stage disease to test for clinical efficacy in reducing the need for revision surgery. FUNDING Amgen.
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Affiliation(s)
- Mohit M Mahatma
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Raveen L Jayasuriya
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - David Hughes
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Nigel Hoggard
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Simon C Buckley
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Andrew Gordon
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Andrew J Hamer
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Robert M Kerry
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Richard Eastell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK; Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
| | - Jeremy M Wilkinson
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK; Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK.
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4
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Hu X, Yin Z, Chen X, Jiang G, Yang D, Cao Z, Li S, Liu Z, Peng D, Dou P. Tussilagone Inhibits Osteoclastogenesis and Periprosthetic Osteolysis by Suppressing the NF-κB and P38 MAPK Signaling Pathways. Front Pharmacol 2020; 11:385. [PMID: 32317967 PMCID: PMC7146087 DOI: 10.3389/fphar.2020.00385] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/12/2020] [Indexed: 11/17/2022] Open
Abstract
Background Aseptic prosthetic loosening is one of the main factors causing poor prognosis of limb function after joint replacement and requires troublesome revisional surgery. It is featured by wear particle-induced periprosthetic osteolysis mediated by excessive osteoclasts activated in inflammatory cell context. Some natural compounds show antiosteoclast traits with high cost-efficiency and few side effects. Tussilagone (TUS), which is the main functional extract from Tussilago farfara generally used for relieving cough, asthma, and eliminating phlegm in traditional medicine has been proven to appease several RAW264.7-mediated inflammatory diseases via suppressing osteoclast-related signaling cascades. However, whether and how TUS can improve aseptic prosthetic loosening via modulating osteoclast-mediated bone resorption still needs to be answered. Methods We established a murine calvarial osteolysis model to detect the preventative effect of TUS on osteolysis in vivo. Micro-CT scanning and histomorphometric analysis were used to determine the variation of bone resorption and osteoclastogenesis. The anti–osteoclast-differentiation and anti–bone-resorption bioactivities of TUS in vitro were investigated using bone slice resorption pit evaluation, and interference caused by cytotoxicity of TUS was excluded according to the CCK-8 assay results. Quantitative polymerase chain reaction (qPCR) analysis was applied to prove the decreased expression of osteoclast-specific genes after TUS treatment. The inhibitory effect of TUS on NF-κB and p38 MAPK signaling pathways was testified by Western blot and NF-κB-linked luciferase reporter gene assay. Results TUS better protected bones against osteolysis in murine calvarial osteolysis model with reduced osteoclasts than those in the control group. In vitro studies also showed that TUS exerted antiosteoclastogenesis and anti–bone-resorption effects in both bone marrow macrophages (BMMs) and RAW264.7 cells, as evidenced by the decline of osteoclast-specific genes according to qPCR. Western blotting revealed that TUS treatment inhibited IκBα degradation and p38 phosphorylation. Conclusions Collectively, our studies proved for the first time that TUS inhibits osteoclastogenesis by suppressing the NF-κB and p38 MAPK signaling pathways, therefore serving as a potential natural compound to treat periprosthetic osteolysis-induced aseptic prosthetic loosening.
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Affiliation(s)
- Xuantao Hu
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziqing Yin
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xia Chen
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Guangyao Jiang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Daishui Yang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziqin Cao
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shuai Li
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zicheng Liu
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Dan Peng
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Pengcheng Dou
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
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5
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Wu YH, Taya Y, Kuraji R, Ito H, Soeno Y, Numabe Y. Dynamic microstructural changes in alveolar bone in ligature‐induced experimental periodontitis. Odontology 2019; 108:339-349. [DOI: 10.1007/s10266-019-00471-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/06/2019] [Indexed: 11/28/2022]
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6
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Wang L, Bai J, Wang Q, Ge G, Lin J, Xu N, Xu C, Xu Y, Wang Y, Geng D. Inhibition of protein phosphatase 2A attenuates titanium-particle induced suppression of bone formation. Int J Biol Macromol 2019; 142:142-151. [PMID: 31521663 DOI: 10.1016/j.ijbiomac.2019.09.084] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/11/2019] [Indexed: 12/12/2022]
Abstract
Peri-prosthetic osteolysis (PPO) often generates after total joint arthroplasty, which can bring implant failure and following revision surgery. Wear debris shed from prostheses strongly enhances bone resorption and attenuates bone formation in osteolytic process. We previously proved that suppression of protein phosphatase 2A (PP2A), a major serine-threonine phosphatase, inhibited wear-debris-induced osteoclastogenesis and alleviated local osteolysis. Whether PP2A inhibition facilitates osteoblastogenesis and bone formation in the osteolytic sites remains unclear. Here, we observed that PP2A inhibition with a selective inhibitor attenuated particle-induced bone destruction by accelerating osteoblast differentiation and promoting bone regeneration. Meanwhile, we proved inhibition of PP2A alleviated the inhibition of osteogenic differentiation by titanium particles in MC3T3-E1 cells. In addition, PP2A inhibition increased β-catenin expression and enhanced β-catenin nuclear translocation, compared with that in the vehicle group. ICG-001, a specific inhibitor of β-catenin, was further applied and was found to weaken the effect of PP2A inhibition on β-catenin expression and nuclear translocation. Therefore, we demonstrated PP2A inhibition exerts protective effects on osteogenic differentiation mainly by activating Wnt/β-catenin signaling pathway. Thus, all the results further revealed PP2A could be a promising target for treating PPO and other bone related diseases.
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Affiliation(s)
- Liangliang Wang
- Department of Orthopaedics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, PR China
| | - Jiaxiang Bai
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Qing Wang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Gaoran Ge
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Jiayi Lin
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Nanwei Xu
- Department of Orthopaedics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, PR China
| | - Chao Xu
- Department of Orthopaedics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, PR China
| | - Yaozeng Xu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Yuji Wang
- Department of Orthopaedics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, PR China; Department of Orthopedic Surgery and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, United States.
| | - Dechun Geng
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, PR China.
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7
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Hu B, Wu H, Shi Z, Ying Z, Zhao X, Lin T, Hong J, Wang Y, Yang Y, Cai X, Yan S. Effects of sequential treatment with intermittent parathyroid hormone and zoledronic acid on particle-induced implant loosening: Evidence from a rat model. J Orthop Res 2019; 37:1489-1497. [PMID: 30644138 DOI: 10.1002/jor.24217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 12/26/2018] [Indexed: 02/04/2023]
Abstract
Particle-induced implant loosening is a major challenge to long-term survival of joint prostheses. Administration of intermittent parathyroid hormone (PTH) has shown potential in the treatment of cases of early-stage periprosthetic osteolysis, while sequential administration of intermittent PTH (iPTH) and bisphosphonates (Bps) has achieved significant effects on treatment of postmenopausal osteoporosis. The objective of this study was to determine whether sequential treatment could preserve bone mass and implant fixation during a pathological course of peri-implant osteolysis in a rat model. Ninety male Sprague Dawley rats were randomly divided into nine groups, four of which were used for confirmation of establishment of the peri-implant osteolysis model at two time points, while the other five were used to determine the efficiency of the sequential treatment on peri-implant osteolysis. Implant fixation and peri-implant bone mass were evaluated using biomechanical testing, micro-CT analysis, and histology at 6 and 12 weeks postoperative. The biomechanical test demonstrated that the maximum loading force during a push-out test was significantly elevated in the sequential treatment group compared to the osteolysis group and iPTH withdrawal group at 12 weeks. Peri-implant bone morphology also indicated a robust increase in bone volume in the sequential treatment group. Sequential administration of iPTH and Bps was effective in preventing experimental peri-implant osteolysis, resulting in improved implant fixation and increased peri-implant bone volume. Clinical significance: The innovative application of sequential treatment in peri-implant osteolysis could be used clinically to improve the prognosis of patients with early-stage periprosthetic osteolysis. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1489-1497, 2019.
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Affiliation(s)
- Bin Hu
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
| | - Haobo Wu
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
| | - Zhongli Shi
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
| | - Zhimin Ying
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
| | - Xiang Zhao
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
| | - Tiao Lin
- Department of Orthopedic Surgery, First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2nd Road, Guangzhou, People's Republic of China
| | - Jianqiao Hong
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
| | - Yangxin Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
| | - Yute Yang
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 Qingchun East Road, Hangzhou, People's Republic of China
| | - Xunzi Cai
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
| | - Shigui Yan
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, People's Republic of China.,Orthopedic Research Institute of Zhejiang University, No. 88 Jiefang Road, Hangzhou, People's Republic of China
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8
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Immobilization of Denosumab on Titanium Affects Osteoclastogenesis of Human Peripheral Blood Monocytes. Int J Mol Sci 2019; 20:ijms20051002. [PMID: 30813507 PMCID: PMC6429431 DOI: 10.3390/ijms20051002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/01/2019] [Accepted: 02/21/2019] [Indexed: 01/03/2023] Open
Abstract
Immobilization of proteins has been examined to improve implant surfaces. In this study, titanium surfaces were modified with nanofunctionalized denosumab (cDMAB), a human monoclonal anti-RANKL IgG. Noncoding DNA oligonucleotides (ODN) served as linker molecules between titanium and DMAB. Binding and release experiments demonstrated a high binding capacity of cDMAB and continuous release. Human peripheral mononuclear blood cells (PBMCs) were cultured in the presence of RANKL/MCSF for 28 days and differentiated into osteoclasts. Adding soluble DMAB to the medium inhibited osteoclast differentiation. On nanofunctionalized titanium specimens, the osteoclast-specific TRAP5b protein was monitored and showed a significantly decreased amount on cDMAB-titanium in PBMCs + RANKL/MCSF. PBMCs on cDMAB-titanium also changed SEM cell morphology. In conclusion, the results indicate that cDMAB reduces osteoclast formation and has the potential to reduce osteoclastogenesis on titanium surfaces.
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9
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Li D, Wang H, Li Z, Wang C, Xiao F, Gao Y, Zhang X, Wang P, Peng J, Cai G, Zuo B, Shen Y, Qi J, Qian N, Deng L, Song W, Zhang X, Shen L, Chen X. The inhibition of RANKL expression in fibroblasts attenuate CoCr particles induced aseptic prosthesis loosening via the MyD88-independent TLR signaling pathway. Biochem Biophys Res Commun 2018; 503:1115-1122. [DOI: 10.1016/j.bbrc.2018.06.128] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 06/22/2018] [Indexed: 01/04/2023]
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10
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Li D, Wang C, Li Z, Wang H, He J, Zhu J, Zhang Y, Shen C, Xiao F, Gao Y, Zhang X, Li Y, Wang P, Peng J, Cai G, Zuo B, Yang Y, Shen Y, Song W, Zhang X, Shen L, Chen X. Nano-sized Al 2O 3 particle-induced autophagy reduces osteolysis in aseptic loosening of total hip arthroplasty by negative feedback regulation of RANKL expression in fibroblasts. Cell Death Dis 2018; 9:840. [PMID: 30082761 PMCID: PMC6079072 DOI: 10.1038/s41419-018-0862-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 06/30/2018] [Accepted: 07/06/2018] [Indexed: 12/25/2022]
Abstract
Aseptic loosening is mainly caused by wear debris generated by friction that can increase the expression of receptor activation of nuclear factor (NF)-κB (RANKL). RANKL has been shown to support the differentiation and maturation of osteoclasts. Although autophagy is a key metabolic pathway for maintaining the metabolic homeostasis of cells, no study has determined whether autophagy induced by Al2O3 particles is involved in the pathogenesis of aseptic loosening. The aim of this study was to evaluate RANKL levels in patients experiencing aseptic loosening after total hip arthroplasty (THA) and hip osteoarthritis (hOA) and to consequently clarify the relationship between RANKL and LC3II expression. We determined the levels of RANKL and autophagy in fibroblasts treated with Al2O3 particles in vitro while using shBECN-1 interference lentivirus vectors to block the autophagy pathway and BECN-1 overexpression lentivirus vectors to promote autophagy. We established a novel rat model of femoral head replacement and analyzed the effects of Al2O3 particles on autophagy levels and RANKL expression in synovial tissues in vivo. The RANKL levels in the revision total hip arthroplasty (rTHA) group were higher than those in the hOA group. In patients with rTHA with a ceramic interface, LC3II expression was high, whereas RANKL expression was low. The in vitro results showed that Al2O3 particles promoted fibroblast autophagy in a time- and dose-dependent manner and that RANKL expression was negatively correlated with autophagy. The in vivo results further confirmed these findings. Al2O3 particles induced fibroblast autophagy, which reduced RANKL expression. Decreasing the autophagy level promoted osteolysis and aseptic prosthetic loosening, whereas increasing the autophagy level reversed this trend.
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Affiliation(s)
- De Li
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenglong Wang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhuokai Li
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiye He
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junfeng Zhu
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuehui Zhang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Shen
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Xiao
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Gao
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Zhang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Li
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peng Wang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianping Peng
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guiquan Cai
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Zuo
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuehua Yang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Shen
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weidong Song
- Department of Orthopedic Surgery, Sun Yat-Sen memorial hospital affiliated to Sun Yat-Sen university, Guangzhou, China
| | - Xiaoling Zhang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Lei Shen
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Xiaodong Chen
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Landgraeber S, Samelko L, McAllister K, Putz S, Jacobs JJ, Hallab NJ. CoCrMo alloy vs. UHMWPE Particulate Implant Debris Induces Sex Dependent Aseptic Osteolysis Responses In Vivo using a Murine Model. Open Orthop J 2018; 12:115-124. [PMID: 29785221 PMCID: PMC5897965 DOI: 10.2174/1874325001812010115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 11/22/2022] Open
Abstract
Background: The rate of revision for some designs of total hip replacements due to idiopathic aseptic loosening has been reported as higher for women. However, whether this is environmental or inherently sex-related is not clear. Objective: Can particle induced osteolysis be sex dependent? And if so, is this dependent on the type of implant debris (e.g. metal vs polymer)? The objective of this study was to test for material dependent inflammatory osteolysis that may be linked to sex using CoCrMo and implant grade conventional polyethylene (UHMWPE), using an in vivo murine calvaria model. Methods: Healthy 12 week old female and male C57BL/6J mice were treated with UHMWPE (1.0um ECD) or CoCrMo particles (0.9um ECD) or received sham surgery. Bone resorption was assessed by micro-computed tomography, histology and histomorphometry on day 12 post challenge. Results: Female mice that received CoCrMo particles showed significantly more inflammatory osteolysis and bone destruction compared to the females who received UHMWPE implant debris. Moreover, females challenged with CoCrMo particles exhibited 120% more inflammatory bone loss compared to males (p<0.01) challenged with CoCrMo implant debris (but this was not the case for UHMWPE particles). Conclusion: We demonstrated sex-specific differences in the amount of osteolysis resulting from CoCrMo particle challenge. This suggests osteo-immune responses to metal debris are preferentially higher in female compared to male mice, and supports the contention that there may be inherent sex related susceptibility to some types of implant debris.
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Affiliation(s)
- Stefan Landgraeber
- Department of Orthopaedics, University Hospital Essen, University of Duisburg-Essen, Hufelandstrabe 55, 45122 Essen, Germany
| | - Lauryn Samelko
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, U.S.A
| | - Kyron McAllister
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, U.S.A
| | - Sebastian Putz
- Department of Orthopaedics, University Hospital Essen, University of Duisburg-Essen, Hufelandstrabe 55, 45122 Essen, Germany
| | - Joshua J Jacobs
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, U.S.A
| | - Nadim James Hallab
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, U.S.A
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12
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Surface characteristics of bioactive Ti fabricated by chemical treatment for cartilaginous-integration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 78:495-502. [DOI: 10.1016/j.msec.2017.03.250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/23/2017] [Accepted: 03/26/2017] [Indexed: 12/23/2022]
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13
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Melatonin attenuates titanium particle-induced osteolysis via activation of Wnt/β-catenin signaling pathway. Acta Biomater 2017; 51:513-525. [PMID: 28088671 DOI: 10.1016/j.actbio.2017.01.034] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/05/2017] [Accepted: 01/10/2017] [Indexed: 12/28/2022]
Abstract
Wear debris-induced inhibition of bone regeneration and extensive bone resorption were common features in peri-prosthetic osteolysis (PPO). Here, we investigated the effect of melatonin on titanium particle-stimulated osteolysis in a murine calvariae model and mouse-mesenchymal-stem cells (mMSCs) culture system. Melatonin inhibited titanium particle-induced osteolysis and increased bone formation at osteolytic sites, confirmed by radiological and histomorphometric data. Furthermore, osteoclast numbers decreased dramatically in the low- and high-melatonin administration mice, as respectively, compared with the untreated animals. Melatonin alleviated titanium particle-induced depression of osteoblastic differentiation and mineralization in mMSCs. Mechanistically, melatonin was found to reduce the degradation of β-catenin, levels of which were decreased in presence of titanium particles both in vivo and in vitro. To further ensure whether the protective effect of melatonin was mediated by the Wnt/β-catenin signaling pathway, ICG-001, a selective β-catenin inhibitor, was added to the melatonin-treated groups and was found to attenuate the effect of melatonin on mMSC mineralization. We also demonstrated that melatonin modulated the balance between receptor activator of nuclear factor kappa-B ligand and osteoprotegerin via activation of Wnt/β-catenin signaling pathway. These findings strongly suggest that melatonin represents a promising candidate in the treatment of PPO. STATEMENT OF SIGNIFICANCE Peri-prosthetic osteolysis, initiated by wear debris-induced inhibition of bone regeneration and extensive bone resorption, is the leading cause for implant failure and reason for revision surgery. In the current study, we demonstrated for the first time that melatonin can induce bone regeneration and reduce bone resorption at osteolytic sites caused by titanium-particle stimulation. These effects might be mediated by activating Wnt/β-catenin signaling pathway and enhancing osteogenic differentiation. Meanwhile, the ability of melatonin to modulate the balance between receptor activator of nuclear factor kappa-B ligand and osteoprotegerin mediated by Wnt/β-catenin signaling pathway, thereby suppressing osteoclastogenesis, may be implicated in the protective effects of melatonin on titanium-particle-induced bone resorption. These results suggested that melatonin can be considered as a promising therapeutic agent for the prevention and treatment of peri-prosthetic osteolysis.
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Bechtold JE, Swider P, Goreham-Voss C, Soballe K. Experimental and Numerical Models of Complex Clinical Scenarios; Strategies to Improve Relevance and Reproducibility of Joint Replacement Research. J Biomech Eng 2016; 138:021008. [PMID: 26720312 DOI: 10.1115/1.4032368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Indexed: 12/26/2022]
Abstract
This research review aims to focus attention on the effect of specific surgical and host factors on implant fixation, and the importance of accounting for them in experimental and numerical models. These factors affect (a) eventual clinical applicability and (b) reproducibility of findings across research groups. Proper function and longevity for orthopedic joint replacement implants relies on secure fixation to the surrounding bone. Technology and surgical technique has improved over the last 50 years, and robust ingrowth and decades of implant survival is now routinely achieved for healthy patients and first-time (primary) implantation. Second-time (revision) implantation presents with bone loss with interfacial bone gaps in areas vital for secure mechanical fixation. Patients with medical comorbidities such as infection, smoking, congestive heart failure, kidney disease, and diabetes have a diminished healing response, poorer implant fixation, and greater revision risk. It is these more difficult clinical scenarios that require research to evaluate more advanced treatment approaches. Such treatments can include osteogenic or antimicrobial implant coatings, allo- or autogenous cellular or tissue-based approaches, local and systemic drug delivery, surgical approaches. Regarding implant-related approaches, most experimental and numerical models do not generally impose conditions that represent mechanical instability at the implant interface, or recalcitrant healing. Many treatments will work well in forgiving settings, but fail in complex human settings with disease, bone loss, or previous surgery. Ethical considerations mandate that we justify and limit the number of animals tested, which restricts experimental permutations of treatments. Numerical models provide flexibility to evaluate multiple parameters and combinations, but generally need to employ simplifying assumptions. The objectives of this paper are to (a) to highlight the importance of mechanical, material, and surgical features to influence implant-bone healing, using a selection of results from two decades of coordinated experimental and numerical work and (b) discuss limitations of such models and the implications for research reproducibility. Focusing model conditions toward the clinical scenario to be studied, and limiting conclusions to the conditions of a particular model can increase clinical relevance and research reproducibility.
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15
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Alendronate stimulates osteoprotegerin expression in fibroblasts from periprosthetic membrane. Hip Int 2016; 25:581-4. [PMID: 26351115 DOI: 10.5301/hipint.5000281] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 02/06/2023]
Abstract
PURPOSE Aseptic loosening of an implant after total joint arthroplasty is still a major complication that results from periprosthetic osteolysis. Fibroblasts in the interface membrane express receptor activator of nuclear factor kappa B ligand (RANKL) and stimulate osteoclast formation. Studies demonstrate that through the control of osteoclastic bone loss bisphosphonates inhibit wear particle-induced bone resorption around total hip arthroplasty. The majority of bisphosphonates studies have focused on their effects on osteoblasts and osteoclasts. Little attention has been paid to their action on fibroblasts. METHODS We isolated fibroblasts from the interface membrane that was obtained when revision hip arthroplasty was performed because of aseptic loosening. Fibroblasts were stimulated with alendronate. RANKL and osteoprotegerin (OPG) assays were performed using enzyme-linked immunosorbent assay kit and real time Reverse Transcription- Polymerase Chain Reaction (RT-PCR). RESULTS We found that alendronate stimulated OPG mRNA and protein expression in a time and dose dependent manner. By contrast, alendronate did not affect RANKL expression. CONCLUSIONS The results indicate that alendronate modulated OPG production by fibroblasts from periprosthetic membrane, which may prove helpful for the inhibition of bone loss during aseptic loosening following total joint arthroplasty.
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Chen Y, Hallab NJ, Liao YS, Narayan V, Schwarz EM, Xie C. Antioxidant impregnated ultra-high molecular weight polyethylene wear debris particles display increased bone remodeling and a superior osteogenic:osteolytic profile vs. conventional UHMWPE particles in a murine calvaria model. J Orthop Res 2016; 34:845-51. [PMID: 26495749 PMCID: PMC4842171 DOI: 10.1002/jor.23080] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 10/16/2015] [Indexed: 02/04/2023]
Abstract
Periprosthetic osteolysis remains a major limitation of long-term successful total hip replacements with ultra-high molecular weight polyethylene (UHMWPE) bearings. As intra and extracellular reactive oxygen species are know to contribute to wear debris-induced osteoclastic bone resorption and decreased osteoblastic bone formation, antioxidant doped UHMWPE has emerged as an approach to reduce the osteolytic potential of wear debris and maintain coupled bone remodeling. To test this hypothesis in vivo, we evaluated the effects of crosslinked UHMWPE wear debris particles (AltrX(™) ), versus similar wear particles made from COVERNOX(™) containing UHMWPE (AOX(™) ), in an established murine calvaria model. Eight-week-old female C57B/6 mice (n = 10/Group) received a pre-op micro-CT scan prior to surgical implantation of the UHMWPE particles (2mg), or surgery without particles (sham). Dynamic labeling was performed by intraperitoneal injection of calcein on day 7 and alizarin on day 9, and the calvaria were harvested for micro-CT and histology on day 10. Surprisingly, we found that AOX particles induced significantly more bone resorption (1.72-fold) and osteoclast numbers (1.99-fold) vs. AltrX (p < 0.001). However, AOX also significantly induced 1.64-fold more new bone formation vs. AltrX (p < 0.01). Moreover, while the osteolytic:osteogenic ratio of both particles was very close to 1.0, which is indicative of coupled remodeling, AOX was more osteogenic (Slope = 1.13 ± 0.10 vs. 0.97 ± 0.10). Histomorphometry of the metabolically labeled undecalcified calvaria revealed a consistent trend of greater MAR in AOX vs. AltrX. Collectively, these results demonstrate that anti-oxidant impregnated UHMWPE particles have decreased osteolytic potential due to their increased osteogenic properties that support coupled bone remodeling. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:845-851, 2016.
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Affiliation(s)
- Yu Chen
- Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642,Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Nadim J. Hallab
- Department of Orthopaedics, Rush University, 1735 W Harrison, Chicago, IL 60612
| | - Yen-Shuo Liao
- DePuy, Johnson & Johnson Inc., 700 Orthopaedic Drive, Warsaw, IN 46581
| | - Venkat Narayan
- DePuy, Johnson & Johnson Inc., 700 Orthopaedic Drive, Warsaw, IN 46581
| | - Edward M. Schwarz
- Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642,Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642,To whom correspondence should be addressed: Dr. Edward M. Schwarz, The Center for Musculoskeletal Research, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642, Phone 585-275-3063, FAX 585-275-1121,
| | - Chao Xie
- Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642,Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
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17
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Wang J, Tao Y, Ping Z, Zhang W, Hu X, Wang Y, Wang L, Shi J, Wu X, Yang H, Xu Y, Geng D. Icariin attenuates titanium-particle inhibition of bone formation by activating the Wnt/β-catenin signaling pathway in vivo and in vitro. Sci Rep 2016; 6:23827. [PMID: 27029606 PMCID: PMC4814911 DOI: 10.1038/srep23827] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/14/2016] [Indexed: 12/20/2022] Open
Abstract
Wear-debris-induced periprosthetic osteolysis (PIO) is a common clinical condition following total joint arthroplasty, which can cause implant instability and failure. The host response to wear debris promotes bone resorption and impairs bone formation. We previously demonstrated that icariin suppressed wear-debris-induced osteoclastogenesis and attenuated particle-induced osteolysis in vivo. Whether icariin promotes bone formation in a wear-debris-induced osteolytic site remains unclear. Here, we demonstrated that icariin significantly attenuated titanium-particle inhibition of osteogenic differentiation of mesenchymal stem cells (MSCs). Additionally, icariin increased bone mass and decreased bone loss in titanium-particle-induced osteolytic sites. Mechanistically, icariin inhibited decreased β-catenin stability induced by titanium particles in vivo and in vitro. To confirm icariin mediated its bone-protective effects via the Wnt/β-catenin signaling pathway, we demonstrated that ICG-001, a selective Wnt/β-catenin inhibitor, attenuated the effects of icariin on MSC mineralization in vitro and bone formation in vivo. Therefore, icariin could induce osteogenic differentiation of MSCs and promote new bone formation at a titanium-particle-induced osteolytic site via activation of the Wnt/β-catenin signaling pathway. These results further support the protective effects of icariin on particle-induced bone loss and provide novel mechanistic insights into the recognized bone-anabolic effects of icariin and an evidence-based rationale for its use in PIO treatment.
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Affiliation(s)
- Junhua Wang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Yunxia Tao
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Zichuan Ping
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Wen Zhang
- Orthopedic Institute, Soochow University, 708, ren min Road, Suzhou, 215006, China
| | - Xuanyang Hu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Yijun Wang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Liangliang Wang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Jiawei Shi
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Xiexing Wu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Huilin Yang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Yaozeng Xu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
| | - Dechun Geng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006, China
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Shang JYZ, Zhan P, Jiang C, Zou Y, Liu H, Zhang B, Dai M. Inhibitory Effects of Lanthanum Chloride on Wear Particle-Induced Osteolysis in a Mouse Calvarial Model. Biol Trace Elem Res 2016; 169:303-9. [PMID: 26105543 DOI: 10.1007/s12011-015-0364-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/04/2015] [Indexed: 11/26/2022]
Abstract
Osteolysis is a bone disorder associated with progressive destruction of bone tissues. However, the effects of lanthanum chloride (LaCl3) on osteolysis remain unknown. Therefore, the aim of this study was to determine the effects of LaCl3 on osteolysis in vivo. In a mouse calvarial model, C57BL/6J mice were injected with wear particles with or without LaCl3. Microcomputed tomography, hematoxylin and eosin staining, and tartrate-resistant acid phosphatase staining were performed for the pathological characterization of calvariae, and eight calvariae per group were prepared for the assay of TNF-α, IL-1β, and RANKL secretion using quantitative enzyme-linked immunosorbent assay (ELISA). In mice treated with high-dose LaCl3, particle-induced osteolysis and inflammatory reaction were reduced compared with that in the vehicle-treated control. Moreover, treatment with high-dose LaCl3 suppressed the wear particle-induced decrease in bone mineral content, bone mineral density, and bone volume fraction. Bone destruction and resorption were higher in the LaCl3-treated group than in the saline-treated group but lower than those in the wear particle group. Finally, our results showed that treatment with a high dose of LaCl3 suppressed osteoclastogenesis. Thus, LaCl3 may represent a novel therapeutic agent for the treatment or prevention of wear particle-induced osteolysis and aseptic loosening.
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Affiliation(s)
- Jiang-Yin-Zi Shang
- Department of Orthopedics, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Ping Zhan
- Department of Orthopedics, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Chuan Jiang
- Shanghai Key Laboratory of Orthopedic Implant, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shangai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Zou
- The Chinese People's Liberation Army 94th Hospital, Nanchang, Jiangxi, China
| | - Hucheng Liu
- Department of Orthopedics, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Bin Zhang
- Department of Orthopedics, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Min Dai
- Department of Orthopedics, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China.
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Lu YC, Chang TK, Yeh ST, Fang HW, Lin CY, Hsu LI, Huang CH, Huang CH. The potential role of strontium ranelate in treating particle-induced osteolysis. Acta Biomater 2015; 20:147-154. [PMID: 25841346 DOI: 10.1016/j.actbio.2015.03.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/24/2015] [Accepted: 03/27/2015] [Indexed: 01/28/2023]
Abstract
Ultra high molecular weight polyethylene (UHMWPE) wear-particle-induced osteolysis is one of the major issues affecting the long-term survival of total joint prostheses. Currently, there are no effective therapeutic options to prevent osteolysis from occurring. The aim of this study was to evaluate the role of strontium ranelate (SR) in reducing the risk of particle-induced osteolysis. Forty-eight C57BL/6J ultra-high molecular weight polyethylene (UHMWPE) particle-induced murine calvarial osteolysis models were used. The mice were randomized into four groups as: sham (Group 1), UHMWPE particles (Group 2), and SR with UHMWPE particles (Group 3 and Group 4). Groups 1 to 3 were sacrificed at two weeks and group 4 was sacrificed at the fourth week. The skulls were then analyzed with a high-resolution micro-CT. Histological evaluation was then conducted and osteoclast numbers were analyzed for comparison. Based on the micro-CT, percentage bone volume and trabecular thickness were found to be significantly higher in Group 4 than in Group 2 (p<0.001). Osteoclast numbers in SR treated groups (Group 3 and Group 4) were reduced when compared to groups that did not receive SR treatment (Group 2). These results indicated that SR treatment helps to increase bone volume percentage and trabecular thickness and also suppresses osteoclast proliferation. It is suggested that oral SR treatment could serve as an alternative therapy for preventing particle-induced osteolysis.
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20
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Smith RL, Schwarz EM. Are biologic treatments a potential approach to wear- and corrosion-related problems? Clin Orthop Relat Res 2014; 472:3740-6. [PMID: 24993143 PMCID: PMC4397762 DOI: 10.1007/s11999-014-3765-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
WHERE ARE WE NOW?: Biological treatments, defined as any nonsurgical intervention whose primary mechanism of action is reducing the host response to wear and/or corrosion products, have long been postulated as solutions for osteolysis and aseptic loosening of total joint arthroplasties. Despite extensive research on drugs that target the inflammatory, osteoclastic, and osteogenic responses to wear debris, no biological treatment has emerged as an approved therapy. We review the extensive preclinical research and modest clinical research to date, which has led to the central conclusion that the osteoclast is the primary target. We also allude to the significant changes in health care, unabated safety concerns about chronic immunosuppressive/antiinflammatory therapies, industry's complete lack of interest in developing an intervention for this condition, and the practical issues that have narrowly focused the possibilities for a biologic treatment for wear debris-induced osteolysis. WHERE DO WE NEED TO GO?: Based on the conclusions from research, and the economic, regulatory, and practical issues that limit the future directions toward the development of a biologic treatment, there are a few rational approaches that warrant investigation. These largely focus on FDA-approved osteoporosis therapies that target the osteoclast (bisphosphonates and anti-RANK ligand) and recombinant parathyroid hormone (teriparatide) prophylactic treatment to increase osseous integration of the prosthesis to overcome high-risk susceptibility to aseptic loosening. The other roadblock that must be overcome if there is to be an approved biologic therapy to prevent the progression of periprosthetic osteolysis and aseptic loosening is the development of radiological measures that can quantify a significant drug effect in a randomized, placebo-controlled clinical trial. We review the progress of volumetric quantification of osteolysis in animal studies and clinical pilots. HOW DO WE GET THERE?: Accepting the aforementioned rigid boundaries, we describe the emergence of repurposing FDA-approved drugs for new indications and public (National Institutes of Health, FDA, Centers for Disease Control and Prevention) and private (universities and drug and device manufactures) partnerships as the future roadmap for clinical translation. In the case of biologic treatments for wear debris-induced osteolysis, this will involve combined federal and industry funding of multicenter clinical trials that will be run by thought leaders at large medical centers.
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Affiliation(s)
- R. Lane Smith
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA USA
| | - Edward M. Schwarz
- Department of Orthopaedics, University of Rochester, Rochester, NY USA ,The Center for Musculoskeletal Research, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642 USA
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21
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Prieto-Alhambra D, Lalmohamed A, Abrahamsen B, Arden NK, de Boer A, Vestergaard P, de Vries F. Oral Bisphosphonate Use and Total Knee/Hip Implant Survival: Validation of Results in an External Population-Based Cohort. Arthritis Rheumatol 2014; 66:3233-40. [DOI: 10.1002/art.38789] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 07/15/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Daniel Prieto-Alhambra
- University of Oxford, Oxford, UK, University of Southampton and Southampton General Hospital; Southampton UK
- FIMIM-Parc de Salut Mar, Instituto de Salud Carlos III, IDIAP Jordi Gol Primary Care Research Institute, and Universitat Autònoma de Barcelona; Barcelona Spain
| | - Arief Lalmohamed
- Utrecht University and University Medical Center Utrecht; Utrecht The Netherlands
| | - Bo Abrahamsen
- Gentofte Hospital, Copenhagen, Denmark, and University of Southern Denmark; Odense Denmark
| | - Nigel K. Arden
- University of Oxford, Oxford, UK, and University of Southampton and Southampton General Hospital; Southampton UK
| | | | | | - Frank de Vries
- University of Southampton and Southampton General Hospital, Southampton, UK, Utrecht University, Utrecht, The Netherlands, and Maastricht University Medical Centre and Care and Public Health Research Institute; Maastricht The Netherlands
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22
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The effect of metallic magnesium degradation products on osteoclast-induced osteolysis and attenuation of NF-κB and NFATc1 signaling. Biomaterials 2014; 35:6299-310. [DOI: 10.1016/j.biomaterials.2014.04.044] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/14/2014] [Indexed: 11/23/2022]
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23
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Ouyang Z, Zhai Z, Li H, Liu X, Qu X, Li X, Fan Q, Tang T, Qin A, Dai K. Hypericin suppresses osteoclast formation and wear particle-induced osteolysis via modulating ERK signalling pathway. Biochem Pharmacol 2014; 90:276-87. [PMID: 24950468 DOI: 10.1016/j.bcp.2014.06.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/10/2014] [Accepted: 06/10/2014] [Indexed: 11/25/2022]
Abstract
Osteoclast-induced bone resorption and wear-particle-induced osteolysis leads to prosthetic loosening, one of the most common causes of joint implant failure, resulting in revision surgery. Thus, inhibition of osteoclastic bone resorption, which further prevents wear particle-induced osteolysis, is a potential treatment strategy for prosthetic loosening. Here, we examined the therapeutic effect of hypericin (HP), which was photosensitive, on osteoclastogenesis and wear particle-induced osteolysis in the absence of visible light. HP inhibited RANKL-induced osteoclast differentiation in bone marrow macrophages (BMMs) and RAW264.7 cell line without any evidence of cytotoxicity. The bone-resorbing activity of mature osteoclasts was significantly inhibited by HP. As HP has been previously reported to inhibit signalling pathway such as ERK and NF-κB in other cells, which is also important in osteoclast differentiation. We thus examined the molecular mechanism and showed that HP significantly inhibited the ERK/mitogen-activated protein kinase (MAPK) signalling pathway without affecting nuclear factor kappaB (NF-κB), c-Jun N-terminal kinase (JNK) and p38 signalling in RANKL-stimulated BMMs. Further in vivo studies revealed HP attenuated osteoclast formation and subsequently prevented wear particle-induced bone erosion. Taken together, the results suggest that HP inhibits RANKL-mediated osteoclastogenesis via affecting ERK signalling in vitro and suppresses wear particle-induced osteolysis in vivo. We therefore conclude that HP may be an innovative and safe alternative treatment for osteoclast-related prosthetic loosening.
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Affiliation(s)
- Zhengxiao Ouyang
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China; Department of Orthopaedics, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410012, China
| | - Zanjing Zhai
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Haowei Li
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Xuqiang Liu
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Xinhua Qu
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Xianan Li
- Department of Orthopaedics, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410012, China
| | - Qiming Fan
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Tingting Tang
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - An Qin
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
| | - Kerong Dai
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
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Ross RD, Hamilton JL, Wilson BM, Sumner DR, Virdi AS. Pharmacologic augmentation of implant fixation in osteopenic bone. Curr Osteoporos Rep 2014; 12:55-64. [PMID: 24293098 DOI: 10.1007/s11914-013-0182-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Osteoporosis presents a challenge for successful implant fixation due to an impaired healing response. Preclinical studies have consistently reported reduced osseointegration capability in trabecular bone. Although clinical studies of implant success in dentistry have not found a negative effect due to osteoporosis, low bone mass is a significant risk factor for implant migration in orthopedics. Pharmacologic treatment options that limit bone resorption or upregulate formation have been studied preclinically. While, both treatment options improve implant fixation, direct comparisons to-date have found anti-catabolic more effective than anabolic treatments for establishing implant fixation, but combination approaches are better than either treatment alone. Clinically, anti-catabolic treatments, particularly bisphosphonates have been shown to increase the longevity of implants, while limited clinical evidence on the effects of anabolic treatment exists. Preclinical experiments are needed to determine the effects of osteoporosis and subsequent treatment on the long-term maintenance of fixation and recovery after bone loss.
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Affiliation(s)
- R D Ross
- Anatomy and Cell Biology, Rush University Medical Center, 600 S. Paulina Street, Suite # AcFc 507, Chicago, IL, 60612, USA
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25
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Anti-oxidation treatment of ultra high molecular weight polyethylene components to decrease periprosthetic osteolysis: evaluation of osteolytic and osteogenic properties of wear debris particles in a murine calvaria model. Curr Rheumatol Rep 2013; 15:325. [PMID: 23532463 PMCID: PMC3636428 DOI: 10.1007/s11926-013-0325-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Wear debris-induced osteolysis remains the greatest limitation of long-term success for total joint replacements with ultra-high molecular weight polyethylene (UHMWPE) bearings. To address oxidative degradation post-gamma irradiation, manufacturers are investigating the incorporation of antioxidants into PE resins. Similarly, larger molecular weight monomers have been developed to increase crosslinking and decrease wear debris, and ultimately osteolysis. However, the effects of modifying monomer size, crosslink density, and antioxidant incorporation on UHMWPE particle-induced osteoclastic bone resorption and coupled osteoblastic bone formation have never been tested. Here, we review the field of antioxidant-containing UHMWPE, and present an illustrative pilot study evaluating the osteolytic and osteogenic potential of wear debris generated from three chemically distinct particles (MARATHON®, XLK, and AOX™) as determined by a novel 3D micro-CT algorithm designed for the murine calvaria model. The results demonstrate an approach by which the potential osteoprotective effects of antioxidants in UHMWPE can be evaluated.
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26
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Kong L, Yang C, Yu L, Smith W, Zhu S, Zhu J, Zhu Q. Pyrroloquinoline quinine inhibits RANKL-mediated expression of NFATc1 in part via suppression of c-Fos in mouse bone marrow cells and inhibits wear particle-induced osteolysis in mice. PLoS One 2013; 8:e61013. [PMID: 23613773 PMCID: PMC3630230 DOI: 10.1371/journal.pone.0061013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 03/05/2013] [Indexed: 12/04/2022] Open
Abstract
The effects of pyrroloquinoline quinine (PQQ) on RANKL-induced osteoclast differentiation and on wear particle-induced osteolysis were examined in this study. PQQ inhibited RANKL-mediated osteoclast differentiation in bone marrow macrophages (BMMs) in a dose-dependent manner without any evidence of cytotoxicity. The mRNA expression of c-Fos, NFATc1, and TRAP in RANKL-treated BMMs was inhibited by PQQ treatment. Moreover, RANKL-induced c-Fos and NFATc1 protein expression was suppressed by PQQ. PQQ additionally inhibited the bone resorptive activity of differentiated osteoclasts. Further a UHMWPE-induced murine calvaria erosion model study was performed to assess the effects of PQQ on wear particle-induced osteolysis in vivo. Mice treated with PQQ demonstrated marked attenuation of bone erosion based on Micro-CT and histologic analysis of calvaria. These results collectively suggested that PQQ demonstrated inhibitory effects on osteoclast differentiation in vitro and may suppress wear particle-induced osteolysis in vivo, indicating that PQQ may therefore serve as a useful drug in the prevention of bone loss.
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Affiliation(s)
- Lingbo Kong
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Chongfei Yang
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Lifeng Yu
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Wanli Smith
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, United States of America
| | - Shu Zhu
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Jinyu Zhu
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Qingsheng Zhu
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
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Huang JB, Ding Y, Huang DS, Zeng WK, Guan ZP, Zhang ML. RNA Interference Targeting p110β Reduces Tumor Necrosis Factor-Alpha Production in Cellular Response to Wear Particles In vitro and Osteolysis In vivo. Inflammation 2013; 36:1041-54. [DOI: 10.1007/s10753-013-9636-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yu X, Zhao X, Wu T, Zhou Z, Gao Y, Wang X, Zhang CQ. Inhibiting wear particles-induced osteolysis with naringin. INTERNATIONAL ORTHOPAEDICS 2012; 37:137-43. [PMID: 23111634 DOI: 10.1007/s00264-012-1668-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 09/16/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The purpose of this study was to determine the effects of naringin on osteoclastogenesis and osteolysis both in vitro and in vivo. METHODS In this research osteoclasts were generated from mouse bone marrow monocytes with the receptor activator of NF-КB ligand and the macrophage colony stimulating factor. Naringin, at a concentration of 1, 10, 50, and 100 μg/mL, was respectively added to the medium. Seven days later, the osteoclasts were determined through tartrate-resistant acid phosphatase (TRAP) staining. Mature osteoclasts were isolated from newborn rabbits and cultured for three days on bone slices. Naringin at a concentration of 1, 10, 50, and 100 μg/mL was respectively added to the medium. The resorption bone slices were quantified, and the area was calculated after toluidine blue and Mayer-hematoxylin staining. Polymethyl methacrylate (PMMA) particles were implanted on the calvariae of C57BL/J6 mice. Naringin, at a dose of 50 μg/kg and 100 μg/kg, was respectively given intraperitoneally for seven. Seven days later, the calvariae were removed and processed for pathological analysis. RESULTS The result indicated that naringin treatment effectively inhibited in vitro osteoclastogenesis and inhibited mature osteoclasts. In vivo data indicated that naringin strongly inhibited PMMA-induced osteolysis. CONCLUSION Naringin can effectively inhibit osteoclastogenesis and suppress wear particles-induced osteolysis and might be useful in the treatment or prevention of wear particles-induced osteolysis and aseptic loosening for its effect on osteoclast generation and function.
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Affiliation(s)
- Xiaowei Yu
- Department of Orthopaedics, Shanghai Jiaotong University, Shanghai, China
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29
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Combination gene therapy targeting on interleukin-1β and RANKL for wear debris-induced aseptic loosening. Gene Ther 2012; 20:128-35. [PMID: 22318091 PMCID: PMC3349796 DOI: 10.1038/gt.2012.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study investigated the efficacy of a combination gene therapy to repress interleukin-1 (IL-1) and receptor activator of nuclear factor NF-kappa B ligand (RANKL) for the treatment of particulate debris-induced aseptic loosening, and tried to explore the molecular mechanism of the exogenous gene modifications on osteoclastogenesis. RAW cells activated by titanium particles were transduced with DFG-IL-1Ra (retroviral vector encoding IL-1 receptor antagonist) and AAV-OPG (adeno-associated viral vectors-osteoprotegerin) individually or in combination for 4 weeks. Pro-inflammatory cytokines in culture media were determined by enzyme-linked immunosorbent assay, and gene expressions of RANK, IL-1β, c-Fos, TRAF6, JNK1 and CPK were examined using real-time PCR. An established knee-implant-failure mouse model was employed to evaluate the efficacy of the in vivo double-gene therapy. The surgical implantation of a titanium alloy pin into the proximal tibia was followed by monthly challenge with titanium debris. Peri-implant gene transfers of IL-1Ra and OPG (respectively or in combination) were given 3 weeks after surgery. The combination of OPG and IL-1Ra gene transfer exhibited strong synergetic effects in blockage of inflammation and osteoclastogenesis at 8 weeks after gene modification. The combination therapy reversed peri-implant bone resorption and restored implant stability when compared with either single gene transduction. Real-time PCR data indicated that the action of IL-1Ra gene therapy may be mediated via the JNK1 pathway, while the reduction of osteoclastogenesis by OPG gene modification may be regulated by c-Fos expression. In addition, both gene modifications resulted in significant diminishment of TRAF6 expression.
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30
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Liu S, Virdi AS, Sena K, Hughes WF, Sumner DR. Bone turnover markers correlate with implant fixation in a rat model using LPS-doped particles to induced implant loosening. J Biomed Mater Res A 2012; 100:918-28. [PMID: 22275163 DOI: 10.1002/jbm.a.34029] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 11/18/2011] [Indexed: 01/20/2023]
Abstract
Revision surgery for particle-induced implant loosening in total joint replacement is expected to increase dramatically over the next few decades. This study was designed to investigate if local tissue and serum markers of bone remodeling reflect implant fixation following administration of lipopolysaccharide (LPS)-doped polyethylene (PE) particles in a rat model. Twenty-four rats received bilateral implantation of intramedullary titanium rods in the distal femur, followed by weekly bilateral intra-articular injection of either LPS-doped PE particles (n = 12) or vehicle that contained no particles (n = 12) for 12 weeks. The group in which the particles were injected had increased serum C-terminal telopeptide of type I collagen (CTX-I), decreased serum osteocalcin (OC), increased peri-implant eroded surface, decreased peri-implant bone volume, and decreased mechanical pull-out strength compared to the controls. Implant fixation strength was positively correlated with peri-implant bone volume and serum OC and inversely correlated with serum CTX-I, while energy to yield was positively correlated with serum OC and inversely correlated with the number of tartrate-resistant acid phosphatase positive cells at the interface and the amount of peri-implant eroded surface. There was no effect on trabecular bone volume at a remote site. Thus, the particle-induced impaired fixation in this rat model was directly associated with local and serum markers of elevated bone resorption and depressed bone formation, supporting the rationale of exploring both anticatabolic and anabolic strategies to treat and prevent particle-related implant osteolysis and loosening, and indicating that serum markers may prove useful in tracking implant fixation.
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Affiliation(s)
- Shuo Liu
- Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, Illinois 60612, USA
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31
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Zhao J, Shen G, Liu C, Wang S, Zhang W, Zhang X, Zhang X, Ye D, Wei J, Zhang Z, Jiang X. Enhanced healing of rat calvarial defects with sulfated chitosan-coated calcium-deficient hydroxyapatite/bone morphogenetic protein 2 scaffolds. Tissue Eng Part A 2011; 18:185-97. [PMID: 21830854 DOI: 10.1089/ten.tea.2011.0297] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Calcium phosphate cements (CPCs), which are widely used in bone regeneration, possess good biocompatibility and osteoconductivity and have been demonstrated to be candidate carriers for bone growth factors. However, limited release of growth factors from CPCs and slow degradation of the materials are not desirable for certain clinical applications. Previous studies have shown that calcium-deficient hydroxyapatite (CDHA) from CPCs presents more rapid degradation rate than CPCs. In this study, a hybrid growth factor delivery system was prepared by using bone morphogenetic protein 2 (BMP-2) loaded CDHA porous scaffold with sulfated chitosan (SCS) coating for improved release profile. We tested the BMP-2 release characteristic of CDHA/BMP-2/SCS composite in vitro and its ability to repair rat calvarial bone defects. A higher percentage of BMP-2 was released when sulfated chitosan coating was present compared with CDHA/BMP-2 group. Eight weeks postoperation, the repaired crania were evaluated by microcomputed tomography, sequential fluorescent labeling, histological analysis, and immunohistochemistry. CDHA/BMP-2/SCS group promoted the most extensive new bone formation than CDHA/BMP-2 and CDHA groups. Our observations suggest that sulfated chitosan coating could enhance the release profile of CDHA/BMP-2 composite in vitro and promote new bone formation in vivo. The hybrid CDHA/BMP-2/SCS system is a promising growth factor delivery strategy for bone regeneration.
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Affiliation(s)
- Jun Zhao
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, School of Dental Medicine, Shanghai Jiao Tong University, Shanghai, China
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Yang C, Niu S, Yu L, Zhu S, Zhu J, Zhu Q. The aqueous extract of Angelica sinensis, a popular Chinese herb, inhibits wear debris-induced inflammatory osteolysis in mice. J Surg Res 2011; 176:476-83. [PMID: 21962805 DOI: 10.1016/j.jss.2011.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 08/10/2011] [Accepted: 08/15/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND More and more studies have shown Angelica sinensis' (AS) therapeutic action on chronic inflammatory diseases in recent years. We investigated effects of aqueous extract of AS on inflammatory cytokines release and wear debris particles-induced osteolysis. MATERIALS AND METHODS Ultra high molecular weight polyethylene (UHMWPE) particles were used to induce inflammation in RAW264.7 cell and C57BL/J6 mice. AS extract was obtained through a series of purification steps, and divided into high dose group and low dose group during the research of cell culture, tissue culture, and animal treatment. After 72 h culture with optimal particles, supernatants were collected for cytokine analysis. Calvaria were harvested from the mice model after 10 d treatment with the AS extract. Six calvaria of each group were cultured into medium for 72 h for analyzing cytokine generated in vivo. Histologic analyses and micro-computed tomography (micro-CT) scan were used to determine osteoclastogenesis and inflammatory bone resorption. RESULTS Concentration of tumor necrosis-alpha (TNF-α) and interleukin-1beta (IL-1β) was significantly attenuated by AS extract both in vitro and in vivo. The osteolysis area and the osteoclast numbers were decreased from 0.406 ± 0.0799 to 0.117 ± 0.0103 mm(2), and from 22.7 ± 5.0 to 11.3 ± 1.8, respectively (P < 0.01). Compared with the control group, the protection effects of AS extract was further confirmed with data of the more accurate 3-dimension micro-CT reconstruction. CONCLUSIONS This study suggests a potential resolution of inhibiting wear debris particles-induced inflammatory bone resorption, as well as a possible way of inhibiting aseptic loosening after joint replacement surgery.
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Affiliation(s)
- Chongfei Yang
- Institute of Orthopedic Surgery, Xijing Hostpital, The Fourth Military Medical University, Xi'an, China
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Li J, Zhou Q, Wood RW, Kuzin I, Bottaro A, Ritchlin CT, Xing L, Schwarz EM. CD23(+)/CD21(hi) B-cell translocation and ipsilateral lymph node collapse is associated with asymmetric arthritic flare in TNF-Tg mice. Arthritis Res Ther 2011; 13:R138. [PMID: 21884592 PMCID: PMC3239381 DOI: 10.1186/ar3452] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 07/26/2011] [Accepted: 08/31/2011] [Indexed: 12/21/2022] Open
Abstract
Introduction Rheumatoid arthritis (RA) is a chronic autoimmune disease with episodic flares in affected joints. However, how arthritic flare occurs only in select joints during a systemic autoimmune disease remains an enigma. To better understand these observations, we developed longitudinal imaging outcomes of synovitis and lymphatic flow in mouse models of RA, and identified that asymmetric knee flare is associated with ipsilateral popliteal lymph node (PLN) collapse and the translocation of CD23+/CD21hi B-cells (B-in) into the paracortical sinus space of the node. In order to understand the relationship between this B-in translocation and lymph drainage from flaring joints, we tested the hypothesis that asymmetric tumor necrosis factor (TNF)-induced knee arthritis is associated with ipsilateral PLN and iliac lymph node (ILN) collapse, B-in translocation, and decreased afferent lymphatic flow. Methods TNF transgenic (Tg) mice with asymmetric knee arthritis were identified by contrast-enhanced (CE) magnetic resonance imaging (MRI), and PLN were phenotyped as "expanding" or "collapsed" using LNcap threshold = 30 (Arbitrary Unit (AU)). Inflammatory-erosive arthritis was confirmed by histology. Afferent lymphatic flow to PLN and ILN was quantified by near infrared imaging of injected indocyanine green (NIR-ICG). The B-in population in PLN and ILN was assessed by immunohistochemistry (IHC) and flow cytometry. Linear regression analyses of ipsilateral knee synovial volume and afferent lymphatic flow to PLN and ILN were performed. Results Afferent lymph flow to collapsed nodes was significantly lower (P < 0.05) than flow to expanding nodes by NIR-ICG imaging, and this occurred ipsilaterally. While both collapsed and expanding PLN and ILN had a significant increase (P < 0.05) of B-in compared to wild type (WT) and pre-arthritic TNF-Tg nodes, B-in of expanding lymph nodes (LN) resided in follicular areas while B-in of collapsed LN were present within LYVE-1+ lymphatic vessels. A significant correlation (P < 0.002) was noted in afferent lymphatic flow between ipsilateral PLN and ILN during knee synovitis. Conclusions Asymmetric knee arthritis in TNF-Tg mice occurs simultaneously with ipsilateral PLN and ILN collapse. This is likely due to translocation of the expanded B-in population to the lumen of the lymphatic vessels, resulting in a dramatic decrease in afferent lymphatic flow. PLN collapse phenotype can serve as a new biomarker of knee flare.
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Affiliation(s)
- Jie Li
- Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, USA
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Yang F, Wu W, Cao L, Huang Y, Zhu Z, Tang T, Dai K. Pathways of macrophage apoptosis within the interface membrane in aseptic loosening of prostheses. Biomaterials 2011; 32:9159-67. [PMID: 21872327 DOI: 10.1016/j.biomaterials.2011.08.039] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Accepted: 08/14/2011] [Indexed: 11/25/2022]
Abstract
Aseptic loosening is a major cause of failure of total hip arthroplasty (THA). Macrophage apoptosis in interface membrane has been proved to play an important role in the pathogenesis of aseptic loosening. The purpose of current study was to identify the apoptotic mechanism of macrophages in the interface membrane of aseptic loosening. We collected periprosthetic interface membrane from 23 patients undergoing the revision operations for aseptic loosening of hip joint prostheses. To serve as the control group, samples of capsule were collected from 18 patients undergoing the primary hip arthroplasties for osteoarthritis (OA). The ultrastructure of interface membrane was examined by transmission electron microscopy (TEM), and in situ apoptotic macrophage identification was performed by TUNEL staining. Furthermore, using immunohistochemical methods we investigated the expression of some apoptosis-related markers such as inducible nitric oxide synthase (iNOS), peroxynitrite (ONOO(-)), cleaved caspase-3/4/8/9, cytochrome c, glucose regulated protein 78 (GRP78), and growth arrest and DNA damage-inducible gene 153 (GADD153) in macrophages. These markers were regarded as apoptotic inducers or specific indicators of different apoptotic pathways such as death receptor pathway, mitochondrial pathway and endoplasmic reticulum (ER) stress pathway. TEM showed that a great deal of wear debris was phagocytosed by macrophages, which displayed morphological changes characteristic of apoptosis. The results of TUNEL staining demonstrated that there were more apoptotic macrophages in interface membrane. The expression levels of iNOS, ONOO(-), cleaved caspase-3/4/8/9, cytochrome c, GRP78 and GADD153 in macrophages in interface membrane were significantly higher than those in the control samples (p < 0.05). Our results suggest that death receptor pathway, mitochondria/cytochrosome c caspase-dependent pathway and ER stress pathway are involved in the process of macrophage apoptosis. A therapeutic target to modulate the apoptotic pathways in macrophages may be a strategy to prevent and treat aseptic loosening.
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Affiliation(s)
- Fei Yang
- Shanghai Key Laboratory of Orthopaedic Implant, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, PR China
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In vivo imaging of particle-induced inflammation and osteolysis in the calvariae of NFκB/luciferase transgenic mice. J Biomed Biotechnol 2010; 2011. [PMID: 20936177 PMCID: PMC2946593 DOI: 10.1155/2011/727063] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 08/29/2010] [Indexed: 11/17/2022] Open
Abstract
Wear debris causes biological response which can result in periprosthetic osteolysis after total joint replacement surgery. Nuclear factor-kappa B (NFκB), a representative transcription factor involved in inflammation, is believed to play an important role in this event by regulating the production of proinflammatory mediators and osteoclastogenesis. In this study, we sought to determine whether activation of NFκB in response to stimulation by particles could be visualized by in vivo imaging. We loaded polyethylene (PE) particles onto the calvaria of NFκB/luciferase transgenic mouse, and detected luminescence generated by activation of NFκB. On day 7 after loading, the level of luminescence was maximal. Levels of luminescence were significantly correlated with the levels of luciferase activity, proinflammatory mediator mRNAs, and bone resorption parameters. This system, which enabled us to evaluate particle-induced inflammation and osteolysis without sacrificing mice, constitutes a useful tool for evaluating the efficacy of prophylaxis or treatments for particle-induced osteolysis.
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Papuga MO, Proulx ST, Kwok E, You Z, Rubery PT, Dougherty PE, Hilton MJ, Awad HA, Schwarz EM. Chronic axial compression of the mouse tail segment induces MRI bone marrow edema changes that correlate with increased marrow vasculature and cellularity. J Orthop Res 2010; 28:1220-8. [PMID: 20187115 PMCID: PMC2891234 DOI: 10.1002/jor.21103] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Magnetic resonance imaging (MRI) of bone marrow edema (BME) has been found to be helpful in the diagnosis of back pain attributed to degenerative disk disease (DDD) and spondyloarthropathy (SA), but its interpretation is limited by a lack of knowledge of its nature and natural history. We assessed effects of compressive forces to mouse tail segments of WT and TNF-Tg mice with SA, via contrast enhanced-MRI and histology. Normalized marrow contrast enhancement (NMCE) of uninstrumented WT vertebrae significantly decrease, threefold (p < 0.01) from 8 to 12 weeks of age, while the NMCE of TNF-Tg vertebrae remained elevated. Compressive loading (6x body weight) increased NMCE twofold (p < 0.02) within 2 weeks in WT tails, which was equal to 6x loaded TNF-Tg tails within 4 weeks. Histology confirmed degenerative changes and that load-induced NMCE corresponded to increased vascular sinus tissue (35 +/- 3% vs. 19 +/- 3%; p < 0.01) and cellularity (4,235 +/- 886 vs.1,468 +/- 320 cells/mm(2); p < 0.01) for the loaded versus unloaded WT, respectively. However, micro-computed tomography (CT) analyses failed to detect significant load-induced changes to bone. While the bone marrow of loaded WT and TNF-Tg vertebrae were similar, histology demonstrated mild cellular infiltrate and increased osteoclastic resorption in the WT tails versus severe inflammatory-erosive arthritis in TNF-Tg joints. Significant (p < 0.05) decreases in cortical and trabecular bone volume in uninstrumented TNF-Tg versus WT vertebrae were confirmed by micro-CT. Thus, chronic load-induced DDD causes BME signals in vertebrae similar to those observed from SA, and both DDD and SA signals correlate with a conversion from yellow to red marrow, with increased vascularity.
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Affiliation(s)
- M. Owen Papuga
- The Center for Musculoskeletal Research, University of Rochester, Rochester, NY,Department of Biomedical Engineering, University of Rochester, Rochester, NY,New York Chiropractic College, Seneca Falls, NY
| | - Steven T. Proulx
- The Center for Musculoskeletal Research, University of Rochester, Rochester, NY
| | - Edmund Kwok
- Department of Imaging Sciences, University of Rochester, Rochester, NY
| | - Zhigang You
- Department of Imaging Sciences, University of Rochester, Rochester, NY
| | - Paul T. Rubery
- The Center for Musculoskeletal Research, University of Rochester, Rochester, NY
| | | | - Matthew J. Hilton
- The Center for Musculoskeletal Research, University of Rochester, Rochester, NY
| | - Hani A. Awad
- The Center for Musculoskeletal Research, University of Rochester, Rochester, NY,Department of Biomedical Engineering, University of Rochester, Rochester, NY
| | - Edward M. Schwarz
- The Center for Musculoskeletal Research, University of Rochester, Rochester, NY,To whom correspondence should be addressed: Dr. Edward M. Schwarz, The Center for Musculoskeletal Research, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester NY 14642, Phone 585-275-3063, FAX 585-275-1121,
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Zhu FB, Cai XZ, Yan SG, Zhu HX, Li R. The effects of local and systemic alendronate delivery on wear debris-induced osteolysis in vivo. J Orthop Res 2010; 28:893-9. [PMID: 20058267 DOI: 10.1002/jor.21062] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We investigated the effects of locally and systemically administered alendronate on wear debris-induced osteolysis in vivo. Endotoxin-free titanium particles were injected into rabbit femurs, prior to insertion of a nonweight-bearing polymethylmethacrylate plug into the distal femur canal. Then the particles were repeatedly injected into the knee 2, 4, and 6 weeks after the implantation. Alendronate was incorporated at three different concentrations (0.1, 0.5, and 1.0 wt %) into bone cement for local delivery. For systemic delivery, alendronate was subcutaneously injected (1.0 mg/kg/week) 1 week after the implantation and then once a week until sacrifice. Eight weeks postoperatively, there was significant evidence of osteolysis surrounding the plug in the control group compared with markedly blocked osteolysis in the 0.5 wt % and the 1.0 wt % groups, and the systemic group. There was a concentration-dependent effect of alendronate-loaded bone cement on the improvement of peri-prosthetic bone stock. Notably, no significant differences were found between the 0.5 wt % and the systemic group in peri-prosthetic bone stock and implant fixation. Collectively, although the biological efficacy after the systemic delivery of alendronate was slightly higher than that in the local treatment groups, alendronate-loaded bone cement may be therapeutically effective in inhibiting titanium particle-induced osteolysis in vivo.
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Affiliation(s)
- Fang-Bing Zhu
- Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
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Iolascon G, Di Pietro G, Capaldo A, Gioia C, Gatto S, Gimigliano F. Periprosthetic bone density as outcome of therapeutic response. CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2010; 7:27-31. [PMID: 22461288 PMCID: PMC2898003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The bone surrounding a prosthetic implant normally experiences a progressive quantitative reduction as a result of stress shielding and wear debris production, that can lead to the aseptic loosening of the implant. Dual-energy X-ray absorptiometry (DXA), using software algorithms, can ensure a surrogate measure of load redistribution after the implant of the prosthetic components and can be a valid tool to evaluate the efficacy of pharmacological therapy to reduce the periprosthetic bone loss. In several animal and human studies DXA has been able to quantify antiresorptive action of bisphosphonates in the periprosthetic area.
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Affiliation(s)
- Giovanni Iolascon
- Department of Orthopaedics and Rehabilitation Medicine, Second University of Naples, Italy
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Abstract
Periprosthetic osteolysis is the most common cause of aseptic loosening in total joint arthroplasty. The role of inflammatory mediators such as prostaglandin E2 (PGE2) and osteoclast promoting factors including RANKL in the pathogenesis of osteolysis has been well characterized. However, the PGE2 receptor (EP1, EP2, or EP4), and cell type in which it is expressed, which is responsible for PGE2 induction of RANKL during wear debris-induced osteolysis, has yet to be elucidated. To address this, we used mice genetically deficient in these EP receptors to assess PGE2 and wear debris responses in vitro and in vivo. Wear debris-induced osteolysis and RANKL expression were observed at similar levels in WT, EP1(-/-), and EP2(-/-) mice, indicating that these receptors do not mediate PGE2 signals in this process. A conditional knockout approach was used to eliminate EP4 expression in FSP1(+) fibroblasts that are the predominant source of RANKL. In the absence of EP4, fibroblasts do not express RANKL after stimulation with particles or PGE2, nor do they exhibit high levels of osteoclasts and osteolysis. These results show that periprosthetic fibroblasts are important mediators of osteolysis through the expression of RANKL, which is induced after PGE2 signaling through the EP4 receptor.
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Landesberg R, Eisig S, Fennoy I, Siris E. Alternative indications for bisphosphonate therapy. J Oral Maxillofac Surg 2009; 67:27-34. [PMID: 19371812 DOI: 10.1016/j.joms.2008.12.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Accepted: 12/16/2008] [Indexed: 12/22/2022]
Abstract
Bisphosphonates are currently used in the treatment of osteoporosis (postmenopausal and steroid-induced), hypercalcemia of malignancy, Paget's disease of bone, multiple myeloma, and skeletally related events associated with metastatic bone disease in breast, prostate, lung, and other cancers. There are, however, numerous other conditions where a decrease in bone remodeling by bisphosphonates might aid in disease management. The focus of this review will be to discuss a select group of conditions for which bisphosphonate therapy may be efficacious. In this review we present several cases where bisphosphonates have been used as a primary or adjunctive treatment for giant cell lesions of the jaws. Use of bisphosphonate therapy for giant cell tumors of the appendicular skeleton, pediatric osteogenesis imperfecta, fibrous dysplasia, Gaucher's disease, and osteomyelitis will be discussed. Finally, we will review previous in vivo studies on the use of bisphosphonates to augment integration and to treat osteolysis surrounding failing orthopedic implants.
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Affiliation(s)
- Regina Landesberg
- Division of Oral and Maxillofacial Surgery, University of Connecticut Health Center, School of Dental Medicine, Farmington, CT 06032, USA.
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Atkins GJ, Welldon KJ, Holding CA, Haynes DR, Howie DW, Findlay DM. The induction of a catabolic phenotype in human primary osteoblasts and osteocytes by polyethylene particles. Biomaterials 2009; 30:3672-81. [PMID: 19349075 DOI: 10.1016/j.biomaterials.2009.03.035] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Accepted: 03/19/2009] [Indexed: 12/15/2022]
Abstract
Polyethylene (PE) wear particles are associated with the osteolysis seen in aseptic loosening that leads to orthopaedic implant failure. While cells of the monocyte/macrophage lineage are implicated, evidence is now emerging that osteoblastic cells may also be affected by PE. In this study we investigated the effect of PE particles on osteoblasts, using a novel in vitro cell culture system that was developed to juxtapose cells and PE particles, replicating the 3-dimensional (3D) environment near implants. This system allowed normal human bone-derived cells (NHBC) to undergo differentiation into a mature osteocyte-like phenotype over a 21-28-day culture period. PE particles induced an increase in mRNA expression of the osteocyte markers E11, DMP-1 and SOST/sclerostin. NHBC responded to PE particles by increasing the mRNA expression of several genes associated with osteoclast formation and activity (RANKL, IL-8 and M-CSF) and decreased the expression of the osteoclast antagonist, OPG. PE also appeared to induce a switch in the RUNX2 control of gene expression from that of promoting matrix production (type I collagen) to inducing the expression of pro-osteoclastogenic genes. These results suggest that PE particles switch mature osteoblastic cells from an anabolic to a more catabolic phenotype. This concept was further supported by the finding that PE-induced expression of RANKL mRNA in the mouse osteocyte cell line, MLO-Y4. Overall, our results suggest that PE particles directly induce a change in the phenotype of mature osteoblasts and osteocytes, consistent with the net loss of bone near orthopaedic implants.
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Affiliation(s)
- Gerald J Atkins
- Discipline of Orthopaedics and Trauma, The University of Adelaide, Adelaide, SA 5005, Australia.
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