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Kciuk M, Garg A, Rohilla M, Chaudhary R, Dhankhar S, Dhiman S, Bansal S, Saini M, Singh TG, Chauhan S, Mujwar S, Gielecińska A, Kontek R. Therapeutic Potential of Plant-Derived Compounds and Plant Extracts in Rheumatoid Arthritis-Comprehensive Review. Antioxidants (Basel) 2024; 13:775. [PMID: 39061843 PMCID: PMC11274232 DOI: 10.3390/antiox13070775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/22/2024] [Accepted: 06/23/2024] [Indexed: 07/28/2024] Open
Abstract
Rheumatoid arthritis (RA) is a persistent autoimmune disorder that is characterized by joint inflammation, discomfort, and impairment. Despite the existence of several therapeutic approaches, their effectiveness is often restricted and may be linked to unfavorable side effects. Consequently, there has been growing interest in investigating naturally derived compounds as plausible therapeutic agents for RA disease. The objective of this review is to summarize the existing preclinical and clinical evidence regarding the efficacy of naturally extracted compounds and plant extracts in the treatment of RA, focusing on their anti-inflammatory, anti-oxidative, and immunomodulatory properties. Some of the problems with using natural chemicals are the uneven quality of commercially available preparations and the poor bioavailability of these compounds. Future investigations should focus on improving the formulations, conducting thorough clinical trials, and exploring different techniques to fully utilize the intrinsic potential of naturally derived chemicals in treating RA.
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Affiliation(s)
- Mateusz Kciuk
- Department of Molecular Biotechnology and Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Banacha St. 12/16, 90-237 Lodz, Poland
| | - Anjali Garg
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
- Swami Devi Dyal College of Pharmacy, Golpura Barwala, Panchkula 134118, Haryana, India
| | - Manni Rohilla
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
- Swami Vivekanand College of Pharmacy, Ram Nagar, Banur 140601, Punjab, India
| | - Rishabh Chaudhary
- M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala 133206, Haryana, India
| | - Sanchit Dhankhar
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Sachin Dhiman
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Seema Bansal
- M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala 133206, Haryana, India
| | - Monika Saini
- Swami Vivekanand College of Pharmacy, Ram Nagar, Banur 140601, Punjab, India
- M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala 133206, Haryana, India
| | - Thakur Gurjeet Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Samrat Chauhan
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Somdutt Mujwar
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Adrianna Gielecińska
- Department of Molecular Biotechnology and Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Banacha St. 12/16, 90-237 Lodz, Poland
- Doctoral School of Exact and Natural Sciences, University of Lodz, Banacha Street 12/16, 90-237 Lodz, Poland
| | - Renata Kontek
- Department of Molecular Biotechnology and Genetics, Faculty of Biology and Environmental Protection, University of Lodz, Banacha St. 12/16, 90-237 Lodz, Poland
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Rajankunte Mahadeshwara M, Al-Jawad M, Hall RM, Pandit H, El-Gendy R, Bryant M. How Do Cartilage Lubrication Mechanisms Fail in Osteoarthritis? A Comprehensive Review. Bioengineering (Basel) 2024; 11:541. [PMID: 38927777 PMCID: PMC11200606 DOI: 10.3390/bioengineering11060541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/02/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Cartilage degeneration is a characteristic of osteoarthritis (OA), which is often observed in aging populations. This degeneration is due to the breakdown of articular cartilage (AC) mechanical and tribological properties primarily attributed to lubrication failure. Understanding the reasons behind these failures and identifying potential solutions could have significant economic and societal implications, ultimately enhancing quality of life. This review provides an overview of developments in the field of AC, focusing on its mechanical and tribological properties. The emphasis is on the role of lubrication in degraded AC, offering insights into its structure and function relationship. Further, it explores the fundamental connection between AC mechano-tribological properties and the advancement of its degradation and puts forth recommendations for strategies to boost its lubrication efficiency.
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Affiliation(s)
- Manoj Rajankunte Mahadeshwara
- Institute of Functional Surfaces, Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
- Department of Oral Biology, Faculty of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (M.A.-J.); (R.E.-G.)
| | - Maisoon Al-Jawad
- Department of Oral Biology, Faculty of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (M.A.-J.); (R.E.-G.)
| | - Richard M. Hall
- School of Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Hemant Pandit
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA, UK;
| | - Reem El-Gendy
- Department of Oral Biology, Faculty of Dentistry, University of Leeds, Leeds LS2 9JT, UK; (M.A.-J.); (R.E.-G.)
- Department of Oral Pathology, Faculty of Dentistry, Suez Canal University, Ismailia 3, Ismailia Governorate 8366004, Egypt
| | - Michael Bryant
- Institute of Functional Surfaces, Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK
- School of Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham B15 2TT, UK;
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3
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Pastrama M, van Hees R, Stavenuiter I, Petterson NJ, Ito K, Lopata R, van Donkelaar CC. Characterization of intra-tissue strain fields in articular cartilage explants during post-loading recovery using high frequency ultrasound. J Biomech 2022; 145:111370. [PMID: 36375264 DOI: 10.1016/j.jbiomech.2022.111370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/02/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
This study aims to demonstrate the potential of ultrasound elastography as a research tool for non-destructive imaging of intra-tissue strain fields and tissue quality assessment in cartilage explants. Osteochondral plugs from bovine patellae were loaded up to 10, 40, or 70 N using a hemi-spherical indenter. The load was kept constant for 15 min, after which samples were unloaded and ultrasound imaging of strain recovery over time was performed in the indented area for 1 h. Tissue strains were determined using speckle tracking and accumulated to LaGrangian strains in the indentation direction. For all samples, strain maps showed a heterogeneous strain field, with the highest values in the superficial cartilage under the indenter tip at the bottom of the indent and decreasing values in the deeper cartilage. Strains were higher at higher load levels and tissue recovery over time was faster after indentation at 10 N than at 40 N and 70 N. At lower compression levels most displacement occurred near the surface with little deformation in the deep layers, while at higher levels strains increased more evenly in all cartilage zones. Ultrasound elastography is a promising method for high resolution imaging of intra-tissue strain fields and evaluation of cartilage quality in tissue explants in a laboratory setting. In the future, it may become a clinical diagnostic tool used to identify the extent of cartilage damage around visible defects.
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Affiliation(s)
- Maria Pastrama
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Roy van Hees
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Isabel Stavenuiter
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Niels J Petterson
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Richard Lopata
- Cardiovascular Biomechanics, Photoacoustics & Ultrasound Laboratory Eindhoven (PULS/e), Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands
| | - Corrinus C van Donkelaar
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands.
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Li G, Zhang Z, Liu Y. Genetically predicted tea intake increases the risk of osteoarthritis: A Mendelian randomization study. Front Genet 2022; 13:1004392. [PMID: 36267411 PMCID: PMC9576864 DOI: 10.3389/fgene.2022.1004392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background: This study aimed to clarify the relationship between tea consumption and osteoarthritis (OA). Methods: Common single-nucleotide polymorphisms (SNPs) from the Open Genome-wide Association Studies database were obtained. Summary statistics on OA were retrieved from the second dataset that enrolled 50,508 participants (10,083 OA cases) of European ancestry. The causal association between tea intake and OA was tested using two-sample Mendelian randomization (MR) analysis. Results: Tea consumption has adverse effects on OA. (inverse-variance weighted method: OR = 1.19, 95% CI = 1.08–1.30; weighted median method: OR = 1.22, 95% CI = 1.07–1.40). The MR–Egger regression intercept (MR intercept = −0.002; p = 0.73) showed no evidence of directional pleiotropy. Moreover, no evidence of underlying heterogeneity in MR analysis was found according to Cochran’s Q test and funnel and forest analyses. Conclusion: A genetically predicted high daily tea intake can increase the risk of OA.
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Eskelinen ASA, Florea C, Tanska P, Hung HK, Frank EH, Mikkonen S, Nieminen P, Julkunen P, Grodzinsky AJ, Korhonen RK. Cyclic loading regime considered beneficial does not protect injured and interleukin-1-inflamed cartilage from post-traumatic osteoarthritis. J Biomech 2022; 141:111181. [DOI: 10.1016/j.jbiomech.2022.111181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022]
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Sauerland K, Wolf A, Schudok M, Steinmeyer J. A novel model of a biomechanically induced osteoarthritis-like cartilage for pharmacological in vitro studies. J Cell Mol Med 2021; 25:11221-11231. [PMID: 34766430 PMCID: PMC8650028 DOI: 10.1111/jcmm.17044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/28/2021] [Accepted: 10/26/2021] [Indexed: 11/27/2022] Open
Abstract
Excessive pressure or overload induces and aggravates osteoarthritic changes in articular cartilage, but the underlying biomechanical forces are largely ignored in existing pharmacological in vitro models that are used to investigate drugs against osteoarthritis (OA). Here, we introduce a novel in vitro model to perform pathophysiological and pharmacological investigations, in which cartilage explants are subjected to intermittent cyclic pressure, and characterize its ability to mimic OA‐like tissue reactivity. Mechanical loading time‐dependently increased the biosynthesis, content and retention of fibronectin (Fn), whereas collagen metabolism remained unchanged. This protocol upregulated the production and release of proteoglycans (PGs). The release of PGs from explants was significantly inhibited by a matrix metalloproteinase (MMP) inhibitor, suggesting the involvement of such proteinases in the destruction of the model tissue, similar to what is observed in human OA cartilage. In conclusion, the metabolic alterations in our new biomechanical in vitro model are similar to those of early human OA cartilage, and our pharmacological prevalidation with an MMP‐inhibitor supports its value for further in vitro drug studies.
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Affiliation(s)
- Katrin Sauerland
- Institute for Pharmacology and Toxicology, University of Bonn, Bonn, Germany
| | - Amela Wolf
- Institute for Pharmacology and Toxicology, University of Bonn, Bonn, Germany
| | - Manfred Schudok
- R&D, Drug Metabolism & Pharmacokinetics, Sanofi-Aventis Deutschand GmbH, Frankfurt, Germany
| | - Juergen Steinmeyer
- Institute for Pharmacology and Toxicology, University of Bonn, Bonn, Germany.,Laboratory for Experimental Orthopaedics, Department of Orthopaedics, University of Giessen, Giessen, Germany
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The mechanical influence of bone spicules in the osteochondral junction: A finite element modelling study. Biomech Model Mechanobiol 2021; 20:2335-2351. [PMID: 34468916 DOI: 10.1007/s10237-021-01510-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/13/2021] [Indexed: 10/20/2022]
Abstract
While much has been done to study how cartilage responds to mechanical loading, as well as modelling such responses, arguably less has been accomplished around the mechanics of the cartilage-bone junction. Previously, it has been reported that the presence of bony spicules invading the zone of calcified cartilage, preceded the formation of new subchondral bone and the advancing of the cement line (Thambyah and Broom in Osteoarthr Cartil 17:456-463, 2009). In this study, the morphology and frequency of bone spicules in the cartilage-bone interface of osteochondral beams subjected to three-point bending were modelled, and the results are discussed within the context of biomechanical theories on bone formation. It was found that the stress and strain magnitudes, and their distribution were sensitive to the presence and number of spicules. Spicule numbers and shape were shown to affect the strain energy density (SED) distribution in the areas of the cement line adjacent to spicules. Stresses, strains and SED analyses thus provided evidence that the mechanical environment with the addition of spicules promotes bone formation in the cartilage-bone junction.
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Samvelyan HJ, Hughes D, Stevens C, Staines KA. Models of Osteoarthritis: Relevance and New Insights. Calcif Tissue Int 2021; 109:243-256. [PMID: 32062692 PMCID: PMC8403120 DOI: 10.1007/s00223-020-00670-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/05/2020] [Indexed: 12/31/2022]
Abstract
Osteoarthritis (OA) is a progressive and disabling musculoskeletal disease affecting millions of people and resulting in major healthcare costs worldwide. It is the most common form of arthritis, characterised by degradation of the articular cartilage, formation of osteophytes, subchondral sclerosis, synovial inflammation and ultimate loss of joint function. Understanding the pathogenesis of OA and its multifactorial aetiology will lead to the development of effective treatments, which are currently lacking. Two-dimensional (2D) in vitro tissue models of OA allow affordable, high-throughput analysis and stringent control over specific variables. However, they are linear in fashion and are not representative of physiological conditions. Recent in vitro studies have adopted three-dimensional (3D) tissue models of OA, which retain the advantages of 2D models and are able to mimic physiological conditions, thereby allowing investigation of additional variables including interactions between the cells and their surrounding extracellular matrix. Numerous spontaneous and induced animal models are used to reproduce the onset and monitor the progression of OA based on the aetiology under investigation. This therefore allows elucidation of the pathogenesis of OA and will ultimately enable the development of novel and specific therapeutic interventions. This review summarises the current understanding of in vitro and in vivo OA models in the context of disease pathophysiology, classification and relevance, thus providing new insights and directions for OA research.
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Affiliation(s)
| | - David Hughes
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK
| | - Craig Stevens
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK
| | - Katherine Ann Staines
- School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK.
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Pichler KM, Weinmann D, Schmidt S, Kubista B, Lass R, Martelanz L, Alphonsus J, Windhager R, Gabius HJ, Toegel S. The Dysregulated Galectin Network Activates NF-κB to Induce Disease Markers and Matrix Degeneration in 3D Pellet Cultures of Osteoarthritic Chondrocytes. Calcif Tissue Int 2021; 108:377-390. [PMID: 33185768 PMCID: PMC7881967 DOI: 10.1007/s00223-020-00774-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022]
Abstract
This work aimed to study the dysregulated network of galectins in OA chondrocyte pellets, and to assess whether their recently discovered activity as molecular switches of functional biomarkers results in degradation of extracellular matrix in vitro. Scaffold-free 3D pellet cultures were established of human OA chondrocytes. Expression and secretion of galectin(Gal)-1, -3, and -8 were monitored relative to 2D cultures or clinical tissue sections by RT-qPCR, immunohistochemistry and ELISAs. Exposure of 2D and 3D cultures to an in vivo-like galectin mixture (Gal-1 and Gal-8: 5 µg/ml, Gal-3: 1 µg/ml) was followed by the assessment of pellet size, immunohistochemical matrix staining, and/or quantification of MMP-1, -3, and -13. Application of inhibitors of NF-κB activation probed into the potential of intervening with galectin-induced matrix degradation. Galectin profiling revealed maintained dysregulation of Gal-1, -3, and -8 in pellet cultures, resembling the OA situation in situ. The presence of the galectin mixture promoted marked reduction of pellet size and loss of collagen type II-rich extracellular matrix, accompanied by the upregulation of MMP-1, -3, and -13. Inhibition of p65-phosphorylation by caffeic acid phenethyl ester effectively alleviated the detrimental effects of galectins, resulting in downregulated MMP secretion, reduced matrix breakdown and augmented pellet size. This study suggests that the dysregulated galectin network in OA cartilage leads to extracellular matrix breakdown, and provides encouraging evidence of the feasible inhibition of galectin-triggered activities. OA chondrocyte pellets have the potential to serve as in vitro disease model for further studies on galectins in OA onset and progression.
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Affiliation(s)
- K M Pichler
- Department of Orthopedics and Trauma Surgery, Karl Chiari Lab for Orthopaedic Biology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - D Weinmann
- Department of Orthopedics and Trauma Surgery, Karl Chiari Lab for Orthopaedic Biology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - S Schmidt
- Institute of Physiological Chemistry, Faculty of Veterinary Medicine, Ludwig-Maximilians University Munich, Munich, Germany
| | - B Kubista
- Department of Orthopedics and Trauma Surgery, Division of Orthopedics, Medical University of Vienna, Vienna, Austria
| | - R Lass
- Department of Orthopedics and Trauma Surgery, Division of Orthopedics, Medical University of Vienna, Vienna, Austria
| | - L Martelanz
- Department of Orthopedics and Trauma Surgery, Karl Chiari Lab for Orthopaedic Biology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - J Alphonsus
- Department of Orthopedics and Trauma Surgery, Karl Chiari Lab for Orthopaedic Biology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - R Windhager
- Department of Orthopedics and Trauma Surgery, Karl Chiari Lab for Orthopaedic Biology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Department of Orthopedics and Trauma Surgery, Division of Orthopedics, Medical University of Vienna, Vienna, Austria
| | - H J Gabius
- Institute of Physiological Chemistry, Faculty of Veterinary Medicine, Ludwig-Maximilians University Munich, Munich, Germany
| | - S Toegel
- Department of Orthopedics and Trauma Surgery, Karl Chiari Lab for Orthopaedic Biology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria.
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Khella CM, Asgarian R, Horvath JM, Rolauffs B, Hart ML. An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications. Int J Mol Sci 2021; 22:1996. [PMID: 33671471 PMCID: PMC7922905 DOI: 10.3390/ijms22041996] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 12/15/2022] Open
Abstract
Understanding the causality of the post-traumatic osteoarthritis (PTOA) disease process of the knee joint is important for diagnosing early disease and developing new and effective preventions or treatments. The aim of this review was to provide detailed clinical data on inflammatory and other biomarkers obtained from patients after acute knee trauma in order to (i) present a timeline of events that occur in the acute, subacute, and chronic post-traumatic phases and in PTOA, and (ii) to identify key factors present in the synovial fluid, serum/plasma and urine, leading to PTOA of the knee in 23-50% of individuals who had acute knee trauma. In this context, we additionally discuss methods of simulating knee trauma and inflammation in in vivo, ex vivo articular cartilage explant and in vitro chondrocyte models, and answer whether these models are representative of the clinical inflammatory stages following knee trauma. Moreover, we compare the pro-inflammatory cytokine concentrations used in such models and demonstrate that, compared to concentrations in the synovial fluid after knee trauma, they are exceedingly high. We then used the Bradford Hill Framework to present evidence that TNF-α and IL-6 cytokines are causal factors, while IL-1β and IL-17 are credible factors in inducing knee PTOA disease progresssion. Lastly, we discuss beneficial infrastructure for future studies to dissect the role of local vs. systemic inflammation in PTOA progression with an emphasis on early disease.
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Affiliation(s)
| | | | | | | | - Melanie L. Hart
- G.E.R.N. Center for Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center—Albert-Ludwigs-University of Freiburg, 79085 Freiburg im Breisgau, Germany; (C.M.K.); (R.A.); (J.M.H.); (B.R.)
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11
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Blaker CL, Zaki S, Little CB, Clarke EC. Long-term Effect of a Single Subcritical Knee Injury: Increasing the Risk of Anterior Cruciate Ligament Rupture and Osteoarthritis. Am J Sports Med 2021; 49:391-403. [PMID: 33378213 DOI: 10.1177/0363546520977505] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Rupture of the anterior cruciate ligament (ACL) is a well-known risk factor for the development of posttraumatic osteoarthritis (PTOA), but patients with the "same injury" can have vastly different trajectories for the onset and progression of disease. Minor subcritical injuries preceding the critical injury event may drive this disparity through preexisting tissue pathologies and sensory changes. PURPOSE To investigate the role of subcritical injury on ACL rupture risk and PTOA through the evaluation of pain behaviors, joint mechanics, and tissue structural change in a mouse model of knee injury. STUDY DESIGN Controlled laboratory study. METHODS Ten-week-old male C57BL/6J mice were allocated to naïve control and subcritical knee injury groups. Injury was induced by a single mechanical compression to the right hindlimb, and mice were evaluated using joint histopathology, anteroposterior joint biomechanics, pain behaviors (mechanical allodynia and hindlimb weightbearing), and isolated ACL tensile testing to failure at 1, 2, 4, or 8 weeks after injury. RESULTS Subcritical knee injury produced focal osteochondral lesions in the patellofemoral and lateral tibiofemoral compartments with no resolution for the duration of the study (8 weeks). These lesions were characterized by focal loss of proteoglycan staining, cartilage structural change, chondrocyte pathology, microcracks, and osteocyte cell loss. Injury also resulted in the rapid onset of allodynia (at 1 week), which persisted over time and reduced ACL failure load (P = .006; mean ± SD, 7.91 ± 2.01 N vs 9.37 ± 1.01 N in naïve controls at 8 weeks after injury), accompanied by evidence of ACL remodeling at the femoral enthesis. CONCLUSION The present study in mice establishes a direct effect of a single subcritical knee injury on the development of specific joint tissue pathologies (osteochondral lesions and progressive weakening of the ACL) and allodynic sensitization. These findings demonstrate a predisposition for secondary critical injuries (eg, ACL rupture) and an increased risk of PTOA onset and progression (structurally and symptomatically). CLINICAL RELEVANCE Subcritical knee injuries are a common occurrence and, based on this study, can cause persistent sensory and structural change. These findings have important implications for the understanding of risk factors of ACL injury and subsequent PTOA, particularly with regard to prevention and management strategies following an often underreported event.
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Affiliation(s)
- Carina L Blaker
- Murray Maxwell Biomechanics Laboratory, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia.,Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia
| | - Sanaa Zaki
- Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia.,Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, Australia
| | - Christopher B Little
- Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia
| | - Elizabeth C Clarke
- Murray Maxwell Biomechanics Laboratory, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, Australia
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12
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Trengove A, Di Bella C, O'Connor AJ. The Challenge of Cartilage Integration: Understanding a Major Barrier to Chondral Repair. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:114-128. [PMID: 33307976 DOI: 10.1089/ten.teb.2020.0244] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Articular cartilage defects caused by injury frequently lead to osteoarthritis, a painful and costly disease. Despite widely used surgical methods to treat articular cartilage defects and a plethora of research into regenerative strategies as treatments, long-term clinical outcomes are not satisfactory. Failure to integrate repair tissue with native cartilage is a recurring issue in surgical and tissue-engineered strategies, seeing eventual degradation of the regenerated or surrounding tissue. This review delves into the current understanding of why continuous and robust integration with native cartilage is so difficult to achieve. Both the intrinsic limitations of chondrocytes to remodel injured cartilage, and the significant challenges posed by a compromised biomechanical environment are described. Recent scaffold and cell-based techniques to repair cartilage are also discussed, and limitations of existing methods to evaluate integrative repair. In particular, the importance of evaluating the mechanical integrity of the interface between native and repair tissue is highlighted as a meaningful assessment of any strategy to repair this load-bearing tissue. Impact statement The failure to integrate grafts or biomaterials with native cartilage is a major barrier to cartilage repair. An in-depth understanding of the reasons cartilage integration remains a challenge is required to inform cartilage repair strategies. In particular, this review highlights that integration of cartilage repair strategies is frequently assessed in terms of the continuity of tissue, but not the mechanical integrity. Given the load-bearing nature of cartilage, evaluating integration in terms of interfacial strength is essential to assessing the potential success of cartilage repair methods.
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Affiliation(s)
- Anna Trengove
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia
| | - Claudia Di Bella
- Department of Surgery, St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia.,Department of Orthopedics, St. Vincent's Hospital Melbourne, Melbourne, Australia
| | - Andrea J O'Connor
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia
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Li Y, Feng R, Liu X, Wang G, Wang W, Lu Q, Huang W, Wu H, Cai X. A Post-Traumatic Osteoarthritic Model of Hip Following Fracture of Acetabulum in Rabbit: A Preliminary Study by Macroscopic and Radiographic Assessment. Orthop Surg 2021; 13:296-305. [PMID: 33398932 PMCID: PMC7862151 DOI: 10.1111/os.12882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/07/2020] [Accepted: 10/26/2020] [Indexed: 01/31/2023] Open
Abstract
Objective To develop a post‐traumatic osteoarthritic model of hip following fracture of acetabulum in rabbit for revealing biochemical mechanism of post‐traumatic osteoarthritis. Methods A total of 36 mature male New Zealand white rabbits were equally divided into sham group (n = 12), non‐ORIF group (n = 12), and open reduction and internal fixation (ORIF) group (n = 12). Except for the sham group, rabbits had survival surgeries to create acetabular fractures of dorsal wall for simulating dashboard impaction mechanism. The ORIF group received open reduction and internal fixation, while fractures in the non‐ORIF group were left as displaced but transverse fracture and dislocation was reduced. Besides intraoperative appearance and postoperative recovery, macroscopic and radiographic characteristics of the hips were recorded and assessed by a radiographic scoring scale at 3 weeks, 6 weeks, and 6 months, respectively. Results Out of 24 modeled acetabula, 21 (87.5%) were pure dorsal wall fractures as proposed and the remaining three were associated fractures (dorsal wall plus transverse fracture) accompanied by dorsal dislocation or not. All hips were stable, and no sciatic nerve injury was observed. One rabbit in the ORIF group died of deep infection 4 days after surgery. Rabbits in the sham and ORIF groups returned to normal gait in 2 weeks, but animals in the non‐ORIF group suffered from limping and restricted movement. As the time progressed, the hips in the non‐ORIF group experienced progressive and severe degeneration which exhibited dramatically malformed and hypertrophic joints at 6 months, but the ORIF group maintained much better morphological structure. Corresponding to morphological changes, the average radiographic scores of the non‐ORIF group increased from 1.25 at 3 weeks to 2.75 at 6 months and showed statistically significant difference when compared to the sham group at all three time points (P = 0.011, 0.011, 0.015, respectively, <0.0167). Although the scores of the ORIF group showed apparent improvements (increased from 0.67 at 3 weeks to 2.00 at 6 months), there was no significant difference between the two modeled groups at all three time points. Conclusion The fracture model with high consistency and reproducibility showed progressive post‐traumatic osteoarthritic changes which could be improved by open reduction and internal fixation surgery and provided an alternative selection for investigating potential pathogenesis and pathology of post‐traumatic osteoarthritis following fracture of acetabulum.
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Affiliation(s)
- Yanjin Li
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China.,Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China.,Department of Orthopedics, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Ruibing Feng
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China.,Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China
| | - Ximing Liu
- Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China
| | - Guodong Wang
- Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China
| | - Wei Wang
- Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China.,Department of Orthopedics, Hubei Province hospital of Traditional Chinese Medicine, Wuhan, China
| | - Qilin Lu
- Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China.,Department of Spine Surgery, Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, China
| | - Wei Huang
- Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China.,Department of Spine Surgery, Jingmen NO.2 People's Hospital, Jingmen, China
| | - Haiyang Wu
- Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China
| | - Xianhua Cai
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China.,Department of Orthopaedic Surgery, PLA Middle Military Command General Hospital, Wuhan, China
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Lin LJ, Ge YM, Tian Y, Liu N, Luo XH, Xue YT, Xue YZB, Wen CY, Tang B. Multi-scale mechanical investigation of articular cartilage suffered progressive pseudorheumatoid dysplasia. Clin Biomech (Bristol, Avon) 2020; 79:104947. [PMID: 31959394 DOI: 10.1016/j.clinbiomech.2019.12.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 11/16/2019] [Accepted: 12/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Progressive pseudorheumatoid dysplasia is a rare skeletal dysplasia mainly caused by abnormal autosomal recessive inheritance. Although the main function of cartilage is mechanical support and the characteristics of this disease is the degradation of AC, previous studies on it had been mainly focused on clinical and genetic aspects and the mechanical behavior of the cartilage affected by PPRD is still ambiguous. In this study, we investigate the mechanics and structure of the cartilage suffered disease at multi-scale, from individual chondrocytes to the bulk-scale tissue. METHODS Depth-sensing indenter were employed to investigate the mechanics of cartilage; we performed atomic force microscope nanoindentation to investigate the cell mechanics and scanning electron microscopy were used to explore the structure feature and chemical composition. FINDINGS The elastic modulus of chondrocytes harvested from cartilage suffered from progressive pseudorheumatoid dysplasia is significantly higher than from normal cartilage, same trend were also found in tissue level. Moreover, denser collagen meshwork and matrix calcification were also observed. INTERPRETATION The elastic modulus of cartilage should closely related to its denser structure and the calcification, and may potentially be an indicator for clinical diagnosis. The stiffening of chondrocytes during PPRD progression should play a rather important role in its pathogenesis.
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Affiliation(s)
- L J Lin
- Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Y M Ge
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Y Tian
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - N Liu
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - X H Luo
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Y T Xue
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Y Z B Xue
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - C Y Wen
- Interdisciplinary Division of Biomedical Engineering, Hong Kong Polytechnic University, HKUSAR, China
| | - B Tang
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China; Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China.
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