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Raymond HE, Barbera JP, Shah KC, Zubizarreta N, Huang HH, Poeran J, Chen DD, Moucha CS, Hayden BL. Risk of Infection After Total Knee or Hip Arthroplasty After Receipt of Multiple Corticosteroid or Hyaluronic Acid Injections. J Am Acad Orthop Surg 2023; 31:e868-e875. [PMID: 37603685 DOI: 10.5435/jaaos-d-22-01177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/05/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Few studies have assessed the relationship between the quantity of preoperative corticosteroid injections (CSIs) or hyaluronic acid injections (HAIs) and postoperative infection risk after total knee or hip arthroplasty (TKA, THA). We aimed to (1) determine whether the number of injections administered before TKA/THA procedures is associated with postoperative infections and (2) establish whether infection risk varies by injection type. METHODS This retrospective cohort study included 230,487 THAs and 371,511 TKAs from the 2017 to 2018 Medicare Limited Data Set. The quantity of CSI or HAI, defined as receiving either CSI or HAI ≤2 years before TKA/THA, was identified and categorized as 0, 1, 2, or >2. The primary outcome was 90-day postoperative infection. Multivariable regression models measured the association between the number of injections and 90-day postoperative infection. Odds ratios and 95% confidence intervals were reported. RESULTS The percentage of THA patients receiving 1, 2, and >2 preoperative CSIs was 6.1%, 1.6%, and 0.8%, respectively. Receiving >2 CSIs within 2 years before THA was associated with higher odds of 90-day postoperative infection (odds ratios = 1.74, 95% CI = 1.11 to 2.74, P = 0.02). The percentage of TKA patients receiving 1, 2, and >2 CSIs was 3.0%, 1.2%, and 1.1%, respectively. For HAIs in TKA patients, percentage receiving injections was 98.3%, 0.6%, 0.2%, and 0.9%, respectively. Quantity of CSIs or HAIs administered was not associated with postoperative infection among TKA patients. CONCLUSION Patients receiving >2 injections before THA had higher odds of 90-day postoperative infection. This finding was not observed in TKA patients. These results suggest that the use of >2 injections within 2 years of THA should be avoided.
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Affiliation(s)
- Hayley E Raymond
- From the Department of Orthopaedic Surgery, Mount Sinai Health System, New York, NY
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2
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Yang X, Li L, Ren X, Nie L. Do preoperative intra-articular injections of corticosteroids or hyaluronic acid increase the risk of infection after total knee arthroplasty? A meta-analysis. Bone Joint Res 2022; 11:171-179. [PMID: 35311571 PMCID: PMC8962854 DOI: 10.1302/2046-3758.113.bjr-2021-0350.r1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims There is conflicting evidence on the safety of intra-articular injections of hyaluronic acid (HA) or corticosteroids (CSs) before total knee arthroplasty (TKA). We performed a meta-analysis of the relationship between intra-articular injections and subsequent infection rates after TKA. Methods We searched PubMed, EMBASE, and the Cochrane Library for cohort studies that assessed the effect of preoperative injection of drugs into the joint cavity on the infection rate after TKA. The outcomes analyzed included the total infection rate, as well as those for different preoperative injection time periods and different drugs. Results Eight studies, including 73,880 in the injection group and 126,187 in the control group, met the inclusion criteria. The injection group had a significantly higher postoperative infection rate than the control group (risk ratio (RR) 1.16; 95% confidence interval (CI) 1.07 to 1.27; p < 0.001; I2 = 32%). For patients who received injections up to three months preoperatively, the postoperative infection risk was significantly higher than that in the control group (RR 1.26; 95% CI 1.18 to 1.35; p<0.001; I2 = 0%). There was no significant difference in the infection rates between the four-to-six-month injection and control groups (RR 1.12; 95% CI 0.93 to 1.35; p = 0.240; I2 = 75%) or between the seven-to-12-month injection and control groups (RR 1.02; 95% CI 0.94 to 1.12; p = 0.600; I2 = 0%). Conclusion Current evidence suggests that intra-articular injections of CSs or HA before TKA increase the risk of postoperative infection. Injections administered more than three months before TKA do not significantly increase the risk of infection. Cite this article: Bone Joint Res 2022;11(3):171–179.
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Affiliation(s)
- Xurong Yang
- Jiangle County General Hospital, Sanming, China
| | - Li Li
- Jiangle County General Hospital, Sanming, China
| | - Xiaonan Ren
- Department of Rehabilitation, Mawei District Hospital, Fuzhou, China
| | - Lixiong Nie
- Jiangle County General Hospital, Sanming, China
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3
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Sheets K, Overbey J, Ksajikian A, Bovid K, Kenter K, Li Y. The pathophysiology and treatment of musculoskeletal fibrosis. J Cell Biochem 2022; 123:843-851. [DOI: 10.1002/jcb.30217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 12/19/2022]
Affiliation(s)
- Kelsey Sheets
- Department of Orthopaedic Surgery, Homer Stryker MD School of Medicine Western Michigan University Kalamazoo Michigan USA
| | - Juliana Overbey
- BioMedical Engineering, Department of Orthopaedic Surgery, WMed, Homer Stryker MD School of Medicine Western Michigan University Kalamazoo Michigan USA
| | - Andre Ksajikian
- BioMedical Engineering, Department of Orthopaedic Surgery, WMed, Homer Stryker MD School of Medicine Western Michigan University Kalamazoo Michigan USA
| | - Karen Bovid
- Department of Orthopaedic Surgery, Homer Stryker MD School of Medicine Western Michigan University Kalamazoo Michigan USA
| | - Keith Kenter
- Department of Orthopaedic Surgery, Homer Stryker MD School of Medicine Western Michigan University Kalamazoo Michigan USA
| | - Yong Li
- Department of Orthopaedic Surgery, Homer Stryker MD School of Medicine Western Michigan University Kalamazoo Michigan USA
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Yang Z, Li W, Song C, Leng H. CTGF as a multifunctional molecule for cartilage and a potential drug for osteoarthritis. Front Endocrinol (Lausanne) 2022; 13:1040526. [PMID: 36325449 PMCID: PMC9618584 DOI: 10.3389/fendo.2022.1040526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/29/2022] [Indexed: 11/19/2022] Open
Abstract
CTGF is a multifunctional protein and plays different roles in different cells and under different conditions. Pamrevlumab, a monoclonal antibody against CTGF, is an FDA approved drug for idiopathic pulmonary fibrosis (IPF) and Duchenne muscular dystrophy (DMD). Recent studies have shown that CTGF antibodies may potentially serve as a new drug for osteoarthritis (OA). Expression of CTGF is significantly higher in OA joints than in healthy counterparts. Increasing attention has been attracted due to its interesting roles in joint homeostasis. Joint homeostasis relies on normal cellular functions and cell-cell interactions. CTGF is essential for physiological activities of chondrocytes. Abnormal CTGF expression may cause cartilage degeneration. In this review, the physiological functions of CTGF in chondrocytes and related mechanisms are summarized. Changes in the related signaling pathways due to abnormal CTGF are discussed, which are contributing factors to inflammation, cartilage degeneration and synovial fibrosis in OA. The possibility of CTGF as a potential therapeutic target for OA treatment are reviewed.
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Affiliation(s)
- Zihuan Yang
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
| | - Weishi Li
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China
| | - Chunli Song
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Spinal Disease Research, Beijing Municipal Science & Technology Commission, Beijing, China
| | - Huijie Leng
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- *Correspondence: Huijie Leng,
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CCN proteins in the musculoskeletal system: current understanding and challenges in physiology and pathology. J Cell Commun Signal 2021; 15:545-566. [PMID: 34228239 PMCID: PMC8642527 DOI: 10.1007/s12079-021-00631-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/14/2021] [Indexed: 02/07/2023] Open
Abstract
The acronym for the CCN family was recently revised to represent “cellular communication network”. These six, small, cysteine-enriched and evolutionarily conserved proteins are secreted matricellular proteins, that convey and modulate intercellular communication by interacting with structural proteins, signalling factors and cell surface receptors. Their role in the development and physiology of musculoskeletal system, constituted by connective tissues where cells are interspersed in the cellular matrix, has been broadly studied. Previous research has highlighted a crucial balance of CCN proteins in mesenchymal stem cell commitment and a pivotal role for CCN1, CCN2 and their alter ego CCN3 in chondrogenesis and osteogenesis; CCN4 plays a minor role and the role of CCN5 and CCN6 is still unclear. CCN proteins also participate in osteoclastogenesis and myogenesis. In adult life, CCN proteins serve as mechanosensory proteins in the musculoskeletal system providing a steady response to environmental stimuli and participating in fracture healing. Substantial evidence also supports the involvement of CCN proteins in inflammatory pathologies, such as osteoarthritis and rheumatoid arthritis, as well as in cancers affecting the musculoskeletal system and bone metastasis. These matricellular proteins indeed show involvement in inflammation and cancer, thus representing intriguing therapeutic targets. This review discusses the current understanding of CCN proteins in the musculoskeletal system as well as the controversies and challenges associated with their multiple and complex roles, and it aims to link the dispersed knowledge in an effort to stimulate and guide readers to an area that the writers consider to have significant impact and relevant potentialities.
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The pathogenic role of connective tissue growth factor in osteoarthritis. Biosci Rep 2019; 39:BSR20191374. [PMID: 31262970 PMCID: PMC6639465 DOI: 10.1042/bsr20191374] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 02/07/2023] Open
Abstract
Osteoarthritis (OA) is the most common form of arthritis, and connective tissue growth factor (CTGF) is found to be up-regulated in adjacent areas of cartilage surface damage. CTGF is present in osteophytes of late stage OA. In the present study, we have reviewed association of CTGF in the development and progression of OA and the potential effects of CTGF as a therapeutic agent for the treatment of OA. We have reviewed the recent articles on CTGF and OA in databases like PubMed, google scholar, and SCOPUS and collected the information for the articles. CTGF is usually up-regulated in synovial fluid of OA that stimulates the production of inflammatory cytokines. CTGF also activates nuclear factor-κB, increases the production of chemokines and cytokines, and up-regulates matrix metalloproteinases-3 (MMP-3) that in turn leads to the reduction in proteoglycan contents in joint cartilage. Consequently, cartilage homeostasis is imbalanced that might contribute to the pathogenesis of OA by developing synovial inflammation and cartilage degradation. CTGF might serve as a useful biomarker for the prognosis and treatment of OA, and recent studies have taken attempt to use CTGF as therapeutic target of OA. However, more investigations with clinical trials are necessary to validate the possibility of use of CTGF as a biomarker in OA diagnosis and therapeutic target for OA treatment.
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7
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Richardson SS, Schairer WW, Sculco TP, Sculco PK. Comparison of Infection Risk with Corticosteroid or Hyaluronic Acid Injection Prior to Total Knee Arthroplasty. J Bone Joint Surg Am 2019; 101:112-118. [PMID: 30653040 DOI: 10.2106/jbjs.18.00454] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Recent studies have shown that intra-articular injections ≤3 months before total knee arthroplasty increase the risk of periprosthetic joint infection. We are aware of no previous study that has differentiated the risk of periprosthetic joint infection on the basis of the type of medication injected. In addition, we are aware of no prior study that has evaluated whether hyaluronic acid injections increase the risk of infection after total knee arthroplasty. In this study, we utilized pharmaceutical data to compare patients who received preoperative corticosteroid or hyaluronic acid injections and to determine whether a specific injection type increased the risk of periprosthetic joint infection. METHODS Patients undergoing unilateral primary total knee arthroplasty were selected from a nationwide private insurer database. Ipsilateral preoperative injections were identified and were grouped by medication codes for corticosteroid or hyaluronic acid. Patients who had received both types of injections ≤1 year before total knee arthroplasty were excluded. The outcome of interest was periprosthetic joint infection that occurred ≤6 months following the total knee arthroplasty. The risk of periprosthetic joint infection was compared between groups (no injection, corticosteroid, hyaluronic acid) and between patients who received single or multiple injections. Statistical comparisons were performed using logistic regression controlling for age, sex, and comorbidities. RESULTS A total of 58,337 patients underwent total knee arthroplasty during the study period; 3,249 patients (5.6%) received hyaluronic acid and 16,656 patients (28.6%) received corticosteroid ≤1 year before total knee arthroplasty. The overall infection rate was 2.74% in the no-injection group. Multivariable logistic regression showed independent periprosthetic joint infection risk for both corticosteroid (odds ratio [OR], 1.21; p = 0.014) and hyaluronic acid (OR, 1.55; p = 0.029) given ≤3 months before total knee arthroplasty. There was no increased risk with injections >3 months prior to total knee arthroplasty. Direct comparison of corticosteroid and hyaluronic acid showed no significant difference (p > 0.05) between medications or between single and multiple injections. CONCLUSIONS Preoperative corticosteroid or hyaluronic acid injection ≤3 months before total knee arthroplasty increased the risk of periprosthetic joint infection. There was no difference in infection risk between medications or between multiple and single injections. On the basis of these data, we recommend avoiding both injection types in the 3 months prior to total knee arthroplasty. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Lu CH, Lin CH, Li KJ, Shen CY, Wu CH, Kuo YM, Lin TS, Yu CL, Hsieh SC. Intermediate Molecular Mass Hyaluronan and CD44 Receptor Interactions Enhance Neutrophil Phagocytosis and IL-8 Production via p38- and ERK1/2-MAPK Signalling Pathways. Inflammation 2018; 40:1782-1793. [PMID: 28730511 DOI: 10.1007/s10753-017-0622-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
CD44 is a common leukocyte adhesion molecule expressed on the surface of various cells. Hyaluronan (HA), the natural ligand of CD44, is a simple repeated disaccharide with variable molecular mass that is widely distributed on cell surfaces and the connective tissue matrix. The binding of small molecular mass HA (SMM-HA, MW < 80 kDa) to CD44 on immune-related cells elicits cell proliferation, differentiation, and cytokine production. However, the effects and molecular basis of intermediate molecular mass HA (IMM-HA, MW ≈ 500 kDa)-CD44 interactions on polymorphonuclear neutrophil (PMN) functions have not been elucidated. We hypothesised that IMM-HA would potentiate immune functions as well as SMM-HA. In the present study, we demonstrated IMM-HA and CD44 interactions enhanced normal PMN phagocytosis and IL-8 production compared to those with LPS or anti-CD45 treatment via F-actin cytoskeleton polymerization and subsequent ERK1/2- and p38-MAPK phosphorylation. Antibody-based inhibition of CD44 did not affect PMN function; however, F-actin aggregation was induced without MAPK phosphorylation. Enhanced PMN function via IMM-HA was determined to be CD44-dependent since this effect was abolished in DMSO-induced CD44(-) PMN-like cells obtained from HL-60 cells. In conclusion, we demonstrated that IMM-HA and CD44 interactions on PMNs potently elicit F-actin cytoskeleton polymerization and p38- and ERK1/2-MAPK phosphorylation to enhance PMN function.
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Affiliation(s)
- Cheng-Hsun Lu
- Institute of Clinical Medicine, National Taiwan University College of Medicine, No. 7 Chung-San South Road, Taipei, 10002, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital-Yunlin Branch, No. 95 Xuefu Rd, Huwei Township, Yunlin County, 632, Taiwan
| | - Chia-Huei Lin
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Chung-San South Road, Taipei, 10002, Taiwan
| | - Ko-Jen Li
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Chung-San South Road, Taipei, 10002, Taiwan
| | - Chieh-Yu Shen
- Institute of Clinical Medicine, National Taiwan University College of Medicine, No. 7 Chung-San South Road, Taipei, 10002, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Chung-San South Road, Taipei, 10002, Taiwan
| | - Cheng-Han Wu
- Institute of Clinical Medicine, National Taiwan University College of Medicine, No. 7 Chung-San South Road, Taipei, 10002, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Chung-San South Road, Taipei, 10002, Taiwan
| | - Yu-Min Kuo
- Institute of Clinical Medicine, National Taiwan University College of Medicine, No. 7 Chung-San South Road, Taipei, 10002, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Chung-San South Road, Taipei, 10002, Taiwan
| | - Ting-Syuan Lin
- Department of Internal Medicine, National Taiwan University Hospital-Yunlin Branch, No. 95 Xuefu Rd, Huwei Township, Yunlin County, 632, Taiwan
| | - Chia-Li Yu
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Chung-San South Road, Taipei, 10002, Taiwan.,Institute of Molecular Medicine, National Taiwan University College of Medicine, No. 7 Chung-San South Road, Taipei, 10002, Taiwan
| | - Song-Chou Hsieh
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7, Chung-San South Road, Taipei, 10002, Taiwan.
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Majors AK, Chakravarti R, Ruple LM, Leahy R, Stuehr DJ, Lauer M, Erzurum SC, Janocha A, Aronica MA. Nitric oxide alters hyaluronan deposition by airway smooth muscle cells. PLoS One 2018; 13:e0200074. [PMID: 29966020 PMCID: PMC6028120 DOI: 10.1371/journal.pone.0200074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 06/19/2018] [Indexed: 12/04/2022] Open
Abstract
Asthma is a chronic inflammatory disease that is known to cause changes in the extracellular matrix, including changes in hyaluronan (HA) deposition. However, little is known about the factors that modulate its deposition or the potential consequences. Asthmatics with high levels of exhaled nitric oxide (NO) are characterized by greater airway reactivity and greater evidence of airway inflammation. Based on these data and our previous work we hypothesized that excessive NO promotes the pathologic production of HA by airway smooth muscle cells (SMCs). Exposure of cultured SMCs to various NO donors results in the accumulation of HA in the form of unique, cable-like structures. HA accumulates rapidly after exposure to NO and can be seen as early as one hour after NO treatment. The cable-like HA in NO-treated SMC cultures supports the binding of leukocytes. In addition, NO produced by murine macrophages (RAW cells) and airway epithelial cells also induces SMCs to produce HA cables when grown in co-culture. The modulation of HA by NO appears to be independent of soluble guanylate cyclase. Taken together, NO-induced production of leukocyte-binding HA by SMCs provides a new potential mechanism for the non-resolving airway inflammation in asthma and suggests a key role of non-immune cells in driving the chronic inflammation of the submucosa. Modulation of NO, HA and the consequent immune cell interactions may serve as potential therapeutic targets in asthma.
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Affiliation(s)
- Alana K. Majors
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Ritu Chakravarti
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Lisa M. Ruple
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Rachel Leahy
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Dennis J. Stuehr
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Mark Lauer
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Serpil C. Erzurum
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
- Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Allison Janocha
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Mark A. Aronica
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
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10
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Olivotto E, Merli G, Assirelli E, Cavallo C, Belluzzi E, Ramonda R, Favero M, Filardo G, Roffi A, Kon E, Grigolo B. Cultures of a human synovial cell line to evaluate platelet-rich plasma and hyaluronic acid effects. J Tissue Eng Regen Med 2018; 12:1835-1842. [PMID: 29770602 DOI: 10.1002/term.2704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 04/16/2018] [Accepted: 05/03/2018] [Indexed: 12/26/2022]
Abstract
Synovial inflammation plays an important role in osteoarthritis (OA) pathogenesis. Different biological compounds have been tested mainly on chondrocytes, to treat early stages of OA. However, because OA has been recently defined as "an organ" pathology, investigation on synoviocytes is also needed. Therefore, the aim of the present study was to validate a human fibroblast-like synoviocytes cell line (K4IM) to test the effects of platelet-rich plasma (PRP) and hyaluronan (HA) on anabolic and catabolic gene expression and on HA secretion from cell cultures. In order to determine the effect of PRP and HA, K4IM cells were maintained in culture with or without TNF-α stimulation. In the presence of PRP, unstimulated K4IM cells presented the same expression of IL1B, IL6, CXCL8, VEGF, TIMP1, and hyaluronic synthase isoform HAS3 as primary human synoviocytes, while HA addition did not change their expression pattern, which was similar to control cells. Stimulated cells expressed significantly higher values of IL1B, CXCL8, and VEGF compared with unstimulated ones. PRP did not show any modification, except for VEGF, while HA addition modulated IL1B expression. PRP did not modulate HA release of both stimulated and unstimulated cells. Our study showed the possibility to use K4IM synoviocytes as an in vitro model to test biological compounds useful for the treatment of early OA. Primary cells reflect the phenotype of cells in vivo, but limited recovery from biopsies and restricted lifespan makes experimental manipulation challenging. Therefore, despite cell lines present some limitations, they could be used as an alternative for preliminary experiments.
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Affiliation(s)
- E Olivotto
- RAMSES Laboratory, Research and Innovation Technology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - G Merli
- Nano-Biotechnology Laboratory-NaBi, Research and Innovation Technology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - E Assirelli
- Laboratory of Immunorheumatology and Tissue Regeneration, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - C Cavallo
- RAMSES Laboratory, Research and Innovation Technology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - E Belluzzi
- Rheumatology Unit, University Hospital of Padova, Padova, Italy
| | - R Ramonda
- Rheumatology Unit, University Hospital of Padova, Padova, Italy
| | - M Favero
- RAMSES Laboratory, Research and Innovation Technology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.,Rheumatology Unit, University Hospital of Padova, Padova, Italy
| | - G Filardo
- Nano-Biotechnology Laboratory-NaBi, Research and Innovation Technology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Roffi
- Nano-Biotechnology Laboratory-NaBi, Research and Innovation Technology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - E Kon
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Humanitas Clinical and Research Center, Milan, Italy
| | - B Grigolo
- RAMSES Laboratory, Research and Innovation Technology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.,Laboratory of Immunorheumatology and Tissue Regeneration, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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11
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Tanaka T, Furumatsu T, Miyazawa S, Fujii M, Inoue H, Kodama Y, Ozaki T. Hyaluronan stimulates chondrogenic gene expression in human meniscus cells. Connect Tissue Res 2017; 58:520-530. [PMID: 27898233 DOI: 10.1080/03008207.2016.1264944] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Purpose/Aim of the Study: Inner meniscus cells have a chondrocytic phenotype, whereas outer meniscus cells have a fibroblastic phenotype. In this study, we examined the effect of hyaluronan on chondrocytic gene expression in human meniscus cells. MATERIALS AND METHODS Human meniscus cells were prepared from macroscopically intact lateral meniscus. Inner and outer meniscus cells were obtained from the inner and outer halves of the meniscus. The cells were stimulated with hyaluronan diluted in Dulbecco's modified Eagle's medium without serum to the desired concentration (0, 10, 100, and 1000 μg/mL) for 2-7 days. Cellular proliferation, migration, and polymerase chain reaction analyses were performed for the inner and outer cells separately. Meniscal samples perforated by a 2 mm diameter punch were maintained for 3 weeks in hyaluronan-supplemented medium and evaluated by histological analyses. RESULTS Hyaluronan increased the proliferation and migration of both meniscus cell types. Moreover, cellular counts at the surface of both meniscal tissue perforations were increased by hyaluronan treatments. In addition, hyaluronan stimulated α1(II) collagen expression in inner meniscus cells. Accumulation of type II collagen at the perforated surface of both meniscal samples was induced by hyaluronan treatment. Hyaluronan did not induce type I collagen accumulation around the injured site of the meniscus. CONCLUSION Hyaluronan stimulated the proliferation and migration of meniscus cells. Our results suggest that hyaluronan may promote the healing potential of meniscus cells in damaged meniscal tissues.
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Affiliation(s)
- Takaaki Tanaka
- a Department of Orthopaedic Surgery , Okayama University Graduate School , Okayama , Japan
| | - Takayuki Furumatsu
- a Department of Orthopaedic Surgery , Okayama University Graduate School , Okayama , Japan
| | - Shinichi Miyazawa
- a Department of Orthopaedic Surgery , Okayama University Graduate School , Okayama , Japan
| | - Masataka Fujii
- a Department of Orthopaedic Surgery , Okayama University Graduate School , Okayama , Japan
| | - Hiroto Inoue
- a Department of Orthopaedic Surgery , Okayama University Graduate School , Okayama , Japan
| | - Yuya Kodama
- a Department of Orthopaedic Surgery , Okayama University Graduate School , Okayama , Japan
| | - Toshifumi Ozaki
- a Department of Orthopaedic Surgery , Okayama University Graduate School , Okayama , Japan
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12
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Guo Y, Lu X, Wang H. Downregulation of miR-18a induces CTGF and promotes proliferation and migration of sodium hyaluronate treated human corneal epithelial cells. Gene 2016; 591:129-136. [PMID: 27390086 DOI: 10.1016/j.gene.2016.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 05/12/2016] [Accepted: 07/03/2016] [Indexed: 01/18/2023]
Abstract
Properly controlled corneal epithelial wound healing is critical for health of cornea, which involves cell proliferation, migration, anchoring and differentiation. Sodium hyaluronate (SH) has been proven to exert beneficial pharmacological effect on corneal wound healing, though the underlying mechanism remained open to investigation. MicroRNAs (miRNAs) are small single-stranded RNAs that could bind to 3'UTR of mRNAs of target genes. The multi-target regulation of miRNAs may favor treatment of corneal wound given the complicated processes implicated in the healing process, which has inspired initiatives to develop miRNA therapy in corneal wound healing. In this light, we used miRNAs profiling to detect whether miRNAs are also implicated in the mechanism underlying the stimulatory effect of SH on corneal epithelial wound healing. We found miR-18a was most susceptible to SH treatment, the target prediction of which were enriched in a bunch of pathways implicated in corneal wound healing. Connective tissue growth factor (CTGF) was found to be overrepresented in most significant enriched pathways and was experimentally confirmed as a bona fide target of miR-18a, which modulated cell migration and proliferation of human corneal epithelial cells.
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Affiliation(s)
- Yingzhuo Guo
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China; Department of Ophthalmology& Optometry, Hunan Provincial People's Hospital, Changsha 410005, Hunan Province,China
| | - Xiaohe Lu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China.
| | - Hua Wang
- Department of Ophthalmology& Optometry, Hunan Provincial People's Hospital, Changsha 410005, Hunan Province,China
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Zhao S, Sun Y, Li X, Wang J, Yan L, Chen H, Wang D, Dai J, He J. Reduction of intraarticular adhesion of knee by local application of rapamycin in rabbits via inhibition of fibroblast proliferation and collagen synthesis. J Orthop Surg Res 2016; 11:45. [PMID: 27094512 PMCID: PMC4837638 DOI: 10.1186/s13018-016-0375-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 03/24/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The formation of intraarticular adhesion is a common complication after total knee arthroplasty or anterior cruciate ligament reconstruction. Previously, little research was reported regarding whether the local application of rapamycin (RAPA) could reduce intraarticular adhesion following knee surgery. In our present study, we determined the therapeutic effect of RAPA by local application on the reduction of intraarticular adhesion following knee surgery in rabbits. METHODS In this study, we built the model of knee surgery according to a previous study. The decorticated areas of the cortical bone were exposed and covered with cotton pads soaked with different concentrations of RAPA or physiological saline for 10 min. All of the rabbits were euthanized 4 weeks after the surgery. Macroscopic evaluation of the hydroxyproline content, the histological morphological analysis and collagen density and fibroblast density were used to evaluate the effect of RAPA on reducing intraarticular adhesion. RESULTS The results shown that RAPA could significantly inhibit the proliferation of fibroblasts and reduce collagen synthesis; in the rabbit model of knee surgery, there were weak scar tissues around the decorticated areas in the 0.2 mg/ml RAPA group; moderate scar tissues were found in the 0.1 mg/ml RAPA group. However, severe fibrous adhesions were found in the 0.05 mg/ml RAPA group and the control group. The hydroxyproline content and the fibroblast density in the 0.2 mg/ml and 0.1 mg/ml RAPA groups were significantly less than those of the control group. CONCLUSIONS We concluded that the local application of RAPA could reduce intraarticular adhesion after knee surgery in the rabbit model; this effect was mediated by inhibition of fibroblast proliferation and collagen synthesis, which may provide a new method for reducing intraarticular adhesion after clinical knee surgery.
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Affiliation(s)
- Shuai Zhao
- Department of Orthopedics, Xiangya Second Hospital, Central South University, Changsha, Hunan, 410012, China.,Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China.,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China
| | - Yu Sun
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China.,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China
| | - Xiaolei Li
- Department of Orthopedics, Xiangya Second Hospital, Central South University, Changsha, Hunan, 410012, China.,Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China.,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China
| | - Jingcheng Wang
- Department of Orthopedics, Xiangya Second Hospital, Central South University, Changsha, Hunan, 410012, China. .,Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China. .,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China.
| | - Lianqi Yan
- Department of Orthopedics, Xiangya Second Hospital, Central South University, Changsha, Hunan, 410012, China. .,Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China. .,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China.
| | - Hui Chen
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China.,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China
| | - Daxin Wang
- Department of Orthopedics, Xiangya Second Hospital, Central South University, Changsha, Hunan, 410012, China.,Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China.,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China
| | - Jihang Dai
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China.,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China
| | - Jun He
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Nantong West Road 98, Yangzhou, Jiangsu, 225001, China.,Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001, China
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Zorzi C, Rigotti S, Screpis D, Giordan N, Piovan G. A new hydrogel for the conservative treatment of meniscal lesions: a randomized controlled study. JOINTS 2016; 3:136-45. [PMID: 26889470 DOI: 10.11138/jts/2015.3.3.136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE this study aimed to investigate the efficacy of intra-articular (IA) administration of a hydrogel formulation obtained from a hyaluronic acid (HA) derivative (HYADD4(®)) in the management of meniscal tears and in meniscal tear repair. METHODS fifty subjects with degenerative meniscal tears were enrolled into this single-site, observer-blind, parallel-group study. Clinical evaluations were performed at baseline and after 14, 30 and 60 days. Clinical outcomes included: pain reduction (Visual Analog Scale), improvement of knee functionality (WOMAC questionnaire), reduction in length and depth of the meniscal lesion (MRI-confirmed) and SF-36 questionnaire scores. Local tolerability and safety were also investigated. RESULTS a significant reduction in VAS pain (p< 0.001) in favor of HYADD4(®) was recorded at day 14 and maintained at all the follow-up assessments. Data on knee functionality were in line with the VAS pain assessment results. A significant reduction in length and depth of the meniscal lesion, assessed using MRI, was found in the HYADD4(®) group compared to the control group (p<0.001). CONCLUSIONS the results of this study may indicate a new treatment option in the conservative management of patients complaining of pain due to meniscal tears. The MRI data suggest that the hydrogel formulation of HA used in this study may also play a role in the healing process of the lesion. LEVEL OF EVIDENCE Level I, prospective randomized clinical trial.
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Affiliation(s)
- Claudio Zorzi
- Department of Orthopaedics, Sacro Cuore Hospital of Negrar, Negrar (VR), Italy
| | - Stefano Rigotti
- Department of Orthopaedics, Sacro Cuore Hospital of Negrar, Negrar (VR), Italy
| | - Daniele Screpis
- Department of Orthopaedics, Sacro Cuore Hospital of Negrar, Negrar (VR), Italy
| | - Nicola Giordan
- Department of Clinical Operations, Fidia Farmaceutici SpA, Abano Terme (PD), Italy
| | - Gianluca Piovan
- Department of Orthopaedics, Sacro Cuore Hospital of Negrar, Negrar (VR), Italy
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15
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Liu CC, Su LJ, Tsai WY, Sun HL, Lee HC, Wong CS. Hylan G-F 20 attenuates posttraumatic osteoarthritis progression: Association with upregulated expression of the circardian gene NPAS2. Life Sci 2015; 141:20-4. [PMID: 26388558 DOI: 10.1016/j.lfs.2015.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/13/2015] [Accepted: 09/15/2015] [Indexed: 11/19/2022]
Abstract
AIMS The study was to examine the effect of Hylan G-F 20 on the progression of posttraumatic osteoarthritis (PTOA) and the expression of the circadian genes neuronal PAS domain protein 2 (NPAS2) and period 2 (Per2). MAIN METHODS We used the anterior cruciate ligament transaction and medial menisectomy (ACLT+MMx) model in Wistar rats. The rats were divided into three groups, the sham-operated group, the Hylan G-F 20-treated group, and the saline-treated group. Rats which underwent ACLT + MMx surgery were injected intraarticularly with, respectively, Hylan G-F 20 or saline once a week for 3 consecutive weeks, starting 7days after surgery. The gross morphology and histopathology of the experimental knee joints were evaluated at the end of week 6. Expression of the NPAS2 and Per2 genes was measured by real-time PCR. KEY FINDINGS Hylan G-F 20 suppressed the articular cartilage destruction and synovitis compared to the saline-treated group. Compared to the sham-operated group, the Hylan G-F 20-treated group showed significantly upregulated expression of NPAS2 in cartilage (2.53±0.08-fold higher; p<0.05) and a non-significant increase in Per2 expression (2.35±1.26-fold higher p=0.28), while the saline-treated group showed significant downregulation of NPAS2 expression and a non-significant decrease in Per2 expression. SIGNIFICANCE Our data suggested that early intraarticular injection of Hylan G-F 20 attenuates the progression of PTOA and significantly upregulates NPAS2 expression. These findings provide a new direction for studying associations between the use of a pharmacological agent, the degenerative process, and circadian gene expression.
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Affiliation(s)
- Chih-Chung Liu
- Institute of Systems Biology and Bioinformatics, National Central University, Zhongli City, Taiwan; Department of Anesthesiology, Sijhih Cathay General Hospital, New Taipei City, Taiwan; Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Li-Jen Su
- Institute of Systems Biology and Bioinformatics, National Central University, Zhongli City, Taiwan
| | - Wei-Yuan Tsai
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Hsiao-Lun Sun
- Department of Anesthesiology, Sijhih Cathay General Hospital, New Taipei City, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei city, Taiwan
| | - Hoong-Chien Lee
- Institute of Systems Biology and Bioinformatics, National Central University, Zhongli City, Taiwan; Department of Physics, Chung Yuan Christian University, Zhongli, Taiwan.
| | - Chih-Shung Wong
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
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16
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Zhang P, Zhong ZH, Yu HT, Liu B. Exogenous expression of IL-1Ra and TGF-β1 promotes in vivo repair in experimental rabbit osteoarthritis. Scand J Rheumatol 2015; 44:404-11. [PMID: 26079860 DOI: 10.3109/03009742.2015.1009942] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Potential gene therapy application of single and co-expression of interleukin 1 (IL-1) receptor antagonist (IL-1Ra) and transforming growth factor-β1 (TGF-β1) to alter disease progression was investigated in an in-vivo rabbit model of osteoarthritis (OA). METHOD Sixteen young adult rabbits were randomly and equally divided into four groups: blank control group, IL-1Ra transfection group, TGF-β1 transfection group, and IL-1Ra/TGF-β1 double transfection group. Histological examinations were performed to monitor disease progression after haematoxylin and eosin (H&E) staining of articular cartilage. Immunohistochemistry was used to detect IL-1Ra and TGF-β1 in synovial membrane tissues. Exogenous IL-1Ra and TGF-β1 content was assessed in joint lavage fluid using an enzyme-linked immunosorbent assay (ELISA). RESULTS ELISA measurements from the joint lavage fluid showed high expressions of IL-1Ra and TGF-β1 in the single and double transfection groups. Remarkably, concomitant reductions in IL-1β and tumour necrosis factor alpha (TNF-α) levels were observed in these single and double transfection groups. Radioimmunoassay (RIA)-based detection showed that IL-1β and TNF-α levels in the gene transfection groups were significantly lower compared to the blank control group, in parallel experiments. Importantly, injection of IL-1Ra and TGF-β1 expressing cartilage cells into joints led to a significant inhibition of cartilage matrix degradation. Finally, IL-1Ra and TGF-β1 expression in tissues correlated with disease reversal in the experimental group, with improved tissue architecture and collagen deposition. CONCLUSIONS Our results reveal that both single- and double-gene transfection of IL-1Ra and TGF-β1 promote extensive repair of damaged cartilage, and double transfections showed better recovery than single transfections, suggesting that co-expression of IL-1Ra and TGF-β1 inhibits degeneration and improves repair of articular cartilage in OA.
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Affiliation(s)
- P Zhang
- a Department of Orthopaedics, the Third Affiliated Hospital , Guangzhou Medical University , Guangzhou , P. R. China
| | - Z-H Zhong
- a Department of Orthopaedics, the Third Affiliated Hospital , Guangzhou Medical University , Guangzhou , P. R. China
| | - H-T Yu
- a Department of Orthopaedics, the Third Affiliated Hospital , Guangzhou Medical University , Guangzhou , P. R. China
| | - B Liu
- b Department of Orthopaedics, the Third Affiliated Hospital , Sun Yat-Sen University , Guangzhou , P. R. China
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Guo H, Fang W, Li Y, Ke J, Deng M, Meng Q, Li J, Long X. Up-regulation of proteoglycan 4 in temporomandibular osteoarthritic synovial cells by hyaluronic acid. J Oral Pathol Med 2014; 44:622-7. [PMID: 25366928 DOI: 10.1111/jop.12273] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Huilin Guo
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM); School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Wei Fang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM); School and Hospital of Stomatology; Wuhan University; Wuhan China
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Yingjie Li
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM); School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Jin Ke
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Mohong Deng
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Qinggong Meng
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Jian Li
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM); School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Xing Long
- Department of Oral and Maxillofacial Surgery; School and Hospital of Stomatology; Wuhan University; Wuhan China
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Chalmers PN, Ellman MB, Chahal J, Verma NN. Injection Therapy in the Management of Musculoskeletal Injuries of the Knee. OPER TECHN SPORT MED 2012. [DOI: 10.1053/j.otsm.2012.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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19
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Honsawek S, Yuktanandana P, Tanavalee A, Chirathaworn C, Anomasiri W, Udomsinprasert W, Saetan N, Suantawee T, Tantavisut S. Plasma and synovial fluid connective tissue growth factor levels are correlated with disease severity in patients with knee osteoarthritis. Biomarkers 2012; 17:303-8. [DOI: 10.3109/1354750x.2012.666676] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Chou LW, Wang J, Chang PL, Hsieh YL. Hyaluronan modulates accumulation of hypoxia-inducible factor-1 alpha, inducible nitric oxide synthase, and matrix metalloproteinase-3 in the synovium of rat adjuvant-induced arthritis model. Arthritis Res Ther 2011; 13:R90. [PMID: 21679445 PMCID: PMC3218905 DOI: 10.1186/ar3365] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 03/20/2011] [Accepted: 06/16/2011] [Indexed: 12/14/2022] Open
Abstract
Introduction Hypoxia is a feature of the inflamed synovium in rheumatoid arthritis (RA). Intra-articular injection of hyaluronan (HA) may be considered a potential way to treat RA. However, the exact molecular mechanism of HA on decreased cellular responses to hypoxic environment is unclear. The present study has been designed to use the adjuvant-induced arthritis model to examine the effects of HA on the changes of immunohistochemical expressions of hypoxia-inducible factor-1alpha (HIF-1alpha), inducible nitric oxide synthase (iNOS), and matrix metalloproteinase-3 (MMP3) in the synovial tissues at the early phase of arthritic inflammation. Methods Monoarthritis was induced in adult male Sprague-Dawley (250-300 g) via intraarticular injection of complete Freund's adjuvant (CFA) into the tibiotarsal joint. The CFA-induction arthritis animals were divided into three groups: treatment (intraarticular injection of HA), placebo (intraarticular injection of saline) and controls (no treatments). Functional evaluations of edema and pain behavior, histology, and HIF-1alpha, iNOS, and MMP3 immunohistochemistry were performed before, after the first injection, three injections, and on the follow-up injection of the treatments. Results Intra-articular injection of HA also significantly suppressed the mechanical allodynia (p < 0.001) and overexpressions of HIF-1alpha (p < 0.001), iNOS (p = 0.004) and MMP3 (p < 0.001) immunoreactivity in synovium. Conclusions This study demonstrated that early intervention of HA is an effective protection against accumulation of inflammation-induced HIF-1alpha, iNOS, and MMP3 to limit erosive damage in CFA-induced model of arthritis.
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Affiliation(s)
- Li-Wei Chou
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan 40202, Republic of China
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Iannitti T, Lodi D, Palmieri B. Intra-articular injections for the treatment of osteoarthritis: focus on the clinical use of hyaluronic acid. Drugs R D 2011; 11:13-27. [PMID: 21142290 PMCID: PMC3586124 DOI: 10.2165/11539760-000000000-00000] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Osteoarthritis (OA), also called degenerative joint disease, is the most frequently occurring chronic musculoskeletal disease, particularly affecting the aging population. The use of viscosupplementation, i.e. intra-articular (IA) hyaluronic acid (HA) drug therapy, to treat OA, is growing worldwide, due to important results obtained from several clinical trials, which reported IA HA-related improvements in functional activity and pain management. This review is an update of the IA use of this compound in the treatment of OA, with clinical evidence from the last few years being discussed and used to delineate new trends for the future.
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Affiliation(s)
- Tommaso Iannitti
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK.
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