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Intraarticular Ligament Degeneration Is Interrelated with Cartilage and Bone Destruction in Osteoarthritis. Cells 2019; 8:cells8090990. [PMID: 31462003 PMCID: PMC6769780 DOI: 10.3390/cells8090990] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/18/2019] [Accepted: 08/20/2019] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) induces inflammation and degeneration of all joint components including cartilage, joint capsule, bone and bone marrow, and ligaments. Particularly intraarticular ligaments, which connect the articulating bones such as the anterior cruciate ligament (ACL) and meniscotibial ligaments, fixing the fibrocartilaginous menisci to the tibial bone, are prone to the inflamed joint milieu in OA. However, the pathogenesis of ligament degeneration on the cellular level, most likely triggered by OA associated inflammation, remains poorly understood. Hence, this review sheds light into the intimate interrelation between ligament degeneration, synovitis, joint cartilage degradation, and dysbalanced subchondral bone remodeling. Various features of ligament degeneration accompanying joint cartilage degradation have been reported including chondroid metaplasia, cyst formation, heterotopic ossification, and mucoid and fatty degenerations. The entheses of ligaments, fixing ligaments to the subchondral bone, possibly influence the localization of subchondral bone lesions. The transforming growth factor (TGF)β/bone morphogenetic (BMP) pathway could present a link between degeneration of the osteochondral unit and ligaments with misrouted stem cell differentiation as one likely reason for ligament degeneration, but less studied pathways such as complement activation could also contribute to inflammation. Facilitation of OA progression by changed biomechanics of degenerated ligaments should be addressed in more detail in the future.
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Ruschke K, Meier C, Ullah M, Krebs AC, Silberreis K, Kohl B, Knaus P, Jagielski M, Arens S, Schulze-Tanzil G. Bone morphogenetic protein 2/SMAD signalling in human ligamentocytes of degenerated and aged anterior cruciate ligaments. Osteoarthritis Cartilage 2016; 24:1816-1825. [PMID: 27208419 DOI: 10.1016/j.joca.2016.05.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 04/27/2016] [Accepted: 05/11/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Anterior cruciate ligament (ACL) degeneration leads to knee instability and favors osteoarthritis (OA) progression. During ageing the growth factor sensitivity of ligaments changes but nothing is known about BMP2-signalling and -sensitivity in degenerated ACLs. This study addressed the question whether a dysregulated BMP2 signalling might contribute to age- and OA-dependent ACL degeneration. METHOD ACL samples from patients with/without OA of different ages (<60 and ≥60 years, males, females) were graded histopathologically (n = 45). After stimulation of cultured ACL fibroblasts with 5 nM BMP2 for different time points, phosphorylation of SMAD1/5/8 and gene expression of crucial BMP2 signalling proteins, ligamentogenic and chondrogenic transcription factors, scleraxis (SCX) and SOX9, were analyzed. RESULTS ACL samples displayed different grades of degeneration, often associated with synovitis and calcium deposits. Degeneration correlated significantly with synovitis. ACL fibroblasts expressed BMP type I receptors ALK3 and ALK6 and the BMP type II receptor BMPRII. Donors could be divided into "responders" and "non responders" since their BMP2 mediated SMAD1/5/8 phosphorylation level differed. Basal ID1 expression was lower in cells derived from OA compared with non-OA patients and BMP2 led to an ID1 induction in both. Irrespective of BMP2 stimulation, the donor age significantly influenced the expression profile of BMP6 and SCX but not BMP signalling. The BMP2-mediated SMAD6 expression differed between OA and healthy ACL fibroblasts. CONCLUSION Our data indicate that the expression level of BMP2/SMAD target genes such as ID1 and SMAD6 was reduced in ACL fibroblasts derived from OA compared with non OA patients.
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Affiliation(s)
- K Ruschke
- Freie Universität Berlin, Institute of Chemistry and Biochemistry, Berlin, Germany
| | - C Meier
- Charité-Universitätsmedizin Berlin, Department of Orthopaedic, Trauma and Reconstructive Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - M Ullah
- Charité-Universitätsmedizin Berlin, Department of Orthopaedic, Trauma and Reconstructive Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - A-C Krebs
- Freie Universität Berlin, Institute of Chemistry and Biochemistry, Berlin, Germany; Charité-Universitätsmedizin Berlin, Department of Orthopaedic, Trauma and Reconstructive Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - K Silberreis
- Charité-Universitätsmedizin Berlin, Department of Orthopaedic, Trauma and Reconstructive Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - B Kohl
- Charité-Universitätsmedizin Berlin, Department of Orthopaedic, Trauma and Reconstructive Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - P Knaus
- Freie Universität Berlin, Institute of Chemistry and Biochemistry, Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M Jagielski
- Charité-Universitätsmedizin Berlin, Department of Orthopaedic, Trauma and Reconstructive Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - S Arens
- Charité-Universitätsmedizin Berlin, Department of Orthopaedic, Trauma and Reconstructive Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - G Schulze-Tanzil
- Charité-Universitätsmedizin Berlin, Department of Orthopaedic, Trauma and Reconstructive Surgery, Campus Benjamin Franklin, Berlin, Germany; Institute of Anatomy, Paracelsus Medical University, Salzburg and Nuremberg, Nuremberg, Germany.
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Kriegsmann M, Randau TM, Gravius S, Lisenko K, Altmann C, Arens N, Kriegsmann J. Expression of miR-146a, miR-155, and miR-223 in formalin-fixed paraffin-embedded synovial tissues of patients with rheumatoid arthritis and osteoarthritis. Virchows Arch 2016; 469:93-100. [DOI: 10.1007/s00428-016-1939-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/24/2016] [Accepted: 04/04/2016] [Indexed: 12/18/2022]
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Orth P, Peifer C, Goebel L, Cucchiarini M, Madry H. Comprehensive analysis of translational osteochondral repair: Focus on the histological assessment. ACTA ACUST UNITED AC 2015; 50:19-36. [PMID: 26515165 DOI: 10.1016/j.proghi.2015.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/07/2015] [Accepted: 10/07/2015] [Indexed: 12/15/2022]
Abstract
Articular cartilage guarantees for an optimal functioning of diarthrodial joints by providing a gliding surface for smooth articulation, weight distribution, and shock absorbing while the subchondral bone plays a crucial role in its biomechanical and nutritive support. Both tissues together form the osteochondral unit. The structural assessment of the osteochondral unit is now considered the key standard procedure for evaluating articular cartilage repair in translational animal models. The aim of this review is to give a detailed overview of the different methods for a comprehensive evaluation of osteochondral repair. The main focus is on the histological assessment as the gold standard, together with immunohistochemistry, and polarized light microscopy. Additionally, standards of macroscopic, non-destructive imaging such as high resolution MRI and micro-CT, biochemical, and molecular biological evaluations are addressed. Potential pitfalls of analysis are outlined. A second focus is to suggest recommendations for osteochondral evaluation.
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Affiliation(s)
- Patrick Orth
- Center of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Kirrberger Strasse 100, Building 37, D-66421 Homburg/Saar, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Strasse 100, Building 37, D-66421 Homburg/Saar, Germany.
| | - Carolin Peifer
- Center of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Kirrberger Strasse 100, Building 37, D-66421 Homburg/Saar, Germany.
| | - Lars Goebel
- Center of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Kirrberger Strasse 100, Building 37, D-66421 Homburg/Saar, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Strasse 100, Building 37, D-66421 Homburg/Saar, Germany.
| | - Magali Cucchiarini
- Center of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Kirrberger Strasse 100, Building 37, D-66421 Homburg/Saar, Germany.
| | - Henning Madry
- Center of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Kirrberger Strasse 100, Building 37, D-66421 Homburg/Saar, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Strasse 100, Building 37, D-66421 Homburg/Saar, Germany.
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Illgner U, Krenn V, Bause L. [Purulent gonarthritis resulting from H1N1 viral pneumonia]. Z Rheumatol 2012; 71:142-6. [PMID: 22307198 DOI: 10.1007/s00393-011-0945-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
No articles on orthopedic complications of pneumonia due to influenza A H1N1 virus have yet been published. A 44-year-old male patient was hospitalized due to the suspicion of an infected knee. During arthroscopy beta-hemolytic Streptococcus group A and Acinetobacter were found and the histopathological diagnosis of an infectious bacterial synovialitis was made. Despite resistance-oriented antibiotic treatment the patient's general condition worsened. Influenza A H1N1 virus was detected in a nasal sample and was successfully treated with Tamiflu®. If fever and elevated infection markers persist a search for the focus has to be performed including unlikely diseases such as influenza A H1N1 virus.
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Affiliation(s)
- U Illgner
- Klinik für Rheumaorthopädie, St. Josef Stift Sendenhorst, Sendenhorst, Deutschland.
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