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Zhou E, Wu J, Zhou X, Yin Y. Systemic inflammatory biomarkers are novel predictors of all-cause and cardiovascular mortality in individuals with osteoarthritis: a prospective cohort study using data from the NHANES. BMC Public Health 2024; 24:1586. [PMID: 38872115 PMCID: PMC11170786 DOI: 10.1186/s12889-024-19105-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 06/11/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Chronic inflammation may contribute to increased mortality risk in individuals with osteoarthritis (OA), but research on the prognostic value of inflammatory biomarkers is limited. We aimed to evaluate the associations of the systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) with all-cause and cardiovascular mortality among US adults with OA. METHODS This cohort study included 3545 adults with OA aged ≥ 20 years from the National Health and Nutrition Examination Survey 1999-2020. The SII and SIRI were calculated using complete blood cell count data. Participants were categorized as having a higher or lower SII and SIRI using cutoff points derived by the maximally selected rank statistics method. Cox proportional hazards models, Fine-Gray competing risk regression models and time-dependent receiver operating characteristic (ROC) analysis were used to evaluate the associations between the SII/SIRI and mortality in OA patients. RESULTS Over a median follow-up of 5.08 (3.42-9.92) years, 636 (17.94%) deaths occurred, including 149 (4.20%) cardiovascular deaths. According to multivariable-adjusted models involving demographic, socioeconomic, and health factors, OA patients with a higher SII had a twofold greater risk of all-cause mortality than patients with a lower SII (HR 2.01; 95% CI: 1.50-2.68). Similarly, a higher SIRI was associated with an 86% increased risk of all-cause mortality relative to a lower SIRI (HR 1.86; 95% CI: 1.46-2.38). Similar to the trend found with all-cause mortality, patients with an elevated SII and SIRI had a 88% and 67% increased risk of cardiovascular mortality, respectively, compared to patients with a lower SII (HR 1.88; 95% CI: 1.16-3.03) and SIRI (HR 1.67; 95% CI: 1.14-2.44). Time-dependent ROC curves showed that both the SII and SIRI have moderate and valid performance in predicting short- and long-term mortality in patients with OA. CONCLUSIONS Higher SII and SIRI values were associated with greater all-cause and cardiovascular mortality among US adults with OA.
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Affiliation(s)
- Erye Zhou
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Soochow University, No.188 Shizi St, Suzhou , Jiangsu, 215006, China
| | - Jian Wu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Soochow University, No.188 Shizi St, Suzhou , Jiangsu, 215006, China
| | - Xin Zhou
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Soochow University, No.188 Shizi St, Suzhou , Jiangsu, 215006, China
| | - Yufeng Yin
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Soochow University, No.188 Shizi St, Suzhou , Jiangsu, 215006, China.
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Qin J, Zhang J, Wu JJ, Ru X, Zhong QL, Zhao JM, Lan NH. Identification of autophagy-related genes in osteoarthritis articular cartilage and their roles in immune infiltration. Front Immunol 2023; 14:1263988. [PMID: 38090564 PMCID: PMC10711085 DOI: 10.3389/fimmu.2023.1263988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
Background Autophagy plays a critical role in the progression of osteoarthritis (OA), mainly by regulating inflammatory and immune responses. However, the underlying mechanisms remain unclear. This study aimed to investigate the potential relevance of autophagy-related genes (ARGs) associated with infiltrating immune cells in OA. Methods GSE114007, GSE169077, and ARGs were obtained from the Gene Expression Omnibus (GEO) database and the Human Autophagy database. R software was used to identify the differentially expressed autophagy-related genes (DEARGs) in OA. Functional enrichment and protein-protein interaction (PPI) analyses were performed to explore the role of DEARGs in OA cartilage, and then Cytoscape was utilized to screen hub ARGs. Single-sample gene set enrichment analysis (ssGSEA) was used to conduct immune infiltration analysis and evaluate the potential correlation of key ARGs and immune cell infiltration. Then, the expression levels of hub ARGs in OA were further verified by the GSE169077 and qRT-PCR. Finally, Western blotting and immunohistochemistry were used to validate the final hub ARGs. Results A total of 24 downregulated genes and five upregulated genes were identified, and these genes were enriched in autophagy, mitophagy, and inflammation-related pathways. The intersection results identified nine hub genes, namely, CDKN1A, DDIT3, FOS, VEGFA, RELA, MAP1LC3B, MYC, HSPA5, and HSPA8. GSE169077 and qRT-PCR validation results showed that only four genes, CDKN1A, DDT3, MAP1LC3B, and MYC, were consistent with the bioinformatics analysis results. Western blotting and immunohistochemical (IHC) showed that the expression of these four genes was significantly downregulated in the OA group, which is consistent with the qPCR results. Immune infiltration correlation analysis indicated that DDIT3 was negatively correlated with immature dendritic cells in OA, and FOS was positively correlated with eosinophils. Conclusion CDKN1A, DDIT3, MAP1LC3B, and MYC were identified as ARGs that were closely associated with immune infiltration in OA cartilage. Among them, DDIT3 showed a strong negative correlation with immature dendritic cells. This study found that the interaction between ARGs and immune cell infiltration may play a crucial role in the pathogenesis of OA; however, the specific interaction mechanism needs further research to be clarified. This study provides new insights to further understand the molecular mechanisms of immunity involved in the process of OA by autophagy.
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Affiliation(s)
- Jun Qin
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Clinical Medical Research Center for Orthopedic Disease, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Department of Medical Cosmetology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jin Zhang
- Department of Orthopaedics Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jian-Jun Wu
- Department of Orthopedics, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, China
| | - Xiao Ru
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Clinical Medical Research Center for Orthopedic Disease, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qiu-Ling Zhong
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Clinical Medical Research Center for Orthopedic Disease, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jin-Min Zhao
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Clinical Medical Research Center for Orthopedic Disease, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Department of Orthopaedics Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Research Centre for Regenerative Medicine, Department of Orthopedics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ni-Han Lan
- Guangxi Engineering Center in Biomedical Materials for Tissue and Organ Regeneration, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Clinical Medical Research Center for Orthopedic Disease, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Hayashi D, Roemer FW, Jarraya M, Guermazi A. Update on recent developments in imaging of inflammation in osteoarthritis: a narrative review. Skeletal Radiol 2023; 52:2057-2067. [PMID: 36542129 DOI: 10.1007/s00256-022-04267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Synovitis is an important component of the osteoarthritis (OA) disease process, particularly regarding the "inflammatory phenotype" of OA. Imaging plays an important role in the assessment of synovitis in OA with MRI and ultrasound being the most deployed imaging modalities. Contrast-enhanced (CE) MRI, particularly dynamic CEMRI (DCEMRI) is the ideal method for synovitis assessment, but for several reasons CEMRI is not commonly performed for OA imaging in general. Effusion-synovitis and Hoffa-synovitis are commonly used as surrogate markers of synovitis on non-contrast-enhanced (NCE) MRI and have been used in many epidemiological observational studies of knee OA. Several semiquantitative MRI scoring systems are available for the evaluation of synovitis in knee OA. Synovitis can be a target tissue for disease-modifying OA drug (DMOAD) clinical trials. Both MRI and ultrasound may be used to determine the eligibility and assess the therapeutic efficacy of DMOAD approaches. Ultrasound is mostly used for evaluation of synovitis in hand OA, while MRI is typically used for larger joints, namely knees and hips. The role of other modalities such as CT (including dual-energy CT) and nuclear medicine imaging (such as positron-emission tomography (PET) and its hybrid imaging) is limited in the context of synovitis assessment in OA. Despite research efforts to develop NCEMRI-based synovitis evaluation methods, these typically underestimate the severity of synovitis compared to CEMRI, and thus more research is needed before we can rely only on NCEMRI.
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Affiliation(s)
- Daichi Hayashi
- Department of Radiology, Stony Brook University Renaissance School of Medicine, HSc Level 4, Room 120, Stony Brook, NY, 11794, USA.
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, West Roxbury, Boston, MA, USA
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Qiu G, Zhong S, Xie J, Feng H, Sun S, Gao C, Xu X, Kang B, Xu H, Zhao C, Ran L, Xinyu A, Xu B, Meng X, Meng L, Zhang X, Xiao L. Expanded CD1c +CD163 + DC3 Population in Synovial Tissues Is Associated with Disease Progression of Osteoarthritis. J Immunol Res 2022; 2022:9634073. [PMID: 35958878 PMCID: PMC9359855 DOI: 10.1155/2022/9634073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/15/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022] Open
Abstract
The mechanisms underlying osteoarthritis (OA) have recently been hypothesized to involve a dysfunctional immune system. In this study, we collected synovium, synovial fluid (SF), and peripheral blood from 21 patients. Mononuclear cells were characterized using FCM. H&E staining and mIHC histological assessment of synovium were performed. Cytokine levels in the SF were measured using ELISA. We observed similar frequencies of immune cells in the synovium and SF, which were enriched in DCs. Notably, CD1c+CD163+ DC3s were expanded in the synovium and SF. Furthermore, we found that DC3s were primarily located within the ectopic lymphoid-like structure (ELLS) in close proximity to CD8+ T cells. Finally, the level of TNF-α and IL12p70 in the SF correlated with the severity of OA. These data suggest that OA is an immune system-related disease and that DC3s may play an active role in OA progression by promoting ELLS formation and inflammatory responses.
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Affiliation(s)
- Guowei Qiu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Sheng Zhong
- Department of Orthopedics, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Arthritis Institute of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200052, China
| | - Jun Xie
- Department of Orthopedics, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Arthritis Institute of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200052, China
| | - Hui Feng
- Department of Orthopedics, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Arthritis Institute of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200052, China
| | - Songtao Sun
- Department of Orthopedics, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Arthritis Institute of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200052, China
| | - Chenxin Gao
- Department of Orthopedics, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Arthritis Institute of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200052, China
| | - Xirui Xu
- Department of Orthopedics, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Arthritis Institute of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200052, China
| | - Bingxin Kang
- Department of Rehabilitation, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Hui Xu
- Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Chi Zhao
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Ran
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - A. Xinyu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bo Xu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaohui Meng
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lu Meng
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences/University of Chinese Academy of Sciences, Shanghai, China
| | - Xiaoming Zhang
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences/University of Chinese Academy of Sciences, Shanghai, China
| | - Lianbo Xiao
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Orthopedics, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Arthritis Institute of Integrated Traditional Chinese and Western Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200052, China
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Wang J, Fan Q, Yu T, Zhang Y. Identifying the hub genes and immune cell infiltration in synovial tissue between osteoarthritic and rheumatoid arthritic patients by bioinformatic approach. Curr Pharm Des 2021; 28:497-509. [PMID: 34736376 DOI: 10.2174/1381612827666211104154459] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Osteoarthritis (OA) and rheumatoid arthritis (RA) are two common diseases that result in limb disability and a decrease in quality of life. The major symptoms of OA and RA are pain, swelling, stiffness, and malformation of joints, and each disease also has unique characteristics. OBJECTIVE To compare the pathological mechanisms of OA and RA via weighted correlation network analysis (WGCNA) and immune infiltration analysis and find potential diagnostic and pharmaceutical targets for the treatment of OA and RA. METHODS The gene expression profiles of ten OA and ten RA synovial tissue samples were downloaded from the Gene Expression Omnibus (GEO) database (GSE55235). After obtaining differentially expressed genes (DEGs) via GEO2R, WGCNA was conducted using an R package, and modules and genes that were highly correlated with OA and RA were identified. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and protein-protein interaction (PPI) network analyses were also conducted. Hub genes were identified using the Search Tool for the Retrieval of Interacting Genes (STRING) and Cytoscape software. Immune infiltration analysis was conducted using the Perl program and CIBERSORT software. RESULTS Two hundred ninety-nine DEGs, 24 modules, 16 GO enrichment terms, 6 KEGG pathway enrichment terms, 10 hub genes (CXCL9, CXCL10, CXCR4, CD27, CD69, CD3D, IL7R, STAT1, RGS1, and ISG20), and 8 kinds of different infiltrating immune cells (plasma cells, CD8 T cells, activated memory CD4 T cells, T helper follicular cells, M1 macrophages, Tregs, resting mast cells, and neutrophils) were found to be involved in the different pathological mechanisms of OA and RA. CONCLUSION Inflammation-associated genes were the top differentially expressed hub genes between OA and RA, and their expression was downregulated in OA. Genes associated with lipid metabolism may have upregulated expression in OA. In addition, immune cells that participate in the adaptive immune response play an important role in RA. OA mainly involves immune cells that are associated with the innate immune response.
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Affiliation(s)
- Junjie Wang
- Qingdao University, Qingdao, Shandong 266000. China
| | - Qin Fan
- Qingdao University, Qingdao, Shandong 266000. China
| | - Tengbo Yu
- Qingdao University, Qingdao, Shandong 266000. China
| | - Yingze Zhang
- Qingdao University, Qingdao, Shandong 266000. China
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Huang RZ, Zheng J, Liu FL, Li QL, Huang WH, Zhang DM, Wu QC. A Novel Autophagy-Related Marker for Improved Differential Diagnosis of Rheumatoid Arthritis and Osteoarthritis. Front Genet 2021; 12:743560. [PMID: 34712268 PMCID: PMC8546229 DOI: 10.3389/fgene.2021.743560] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Rheumatoid arthritis (RA) and osteoarthritis (OA) are two most common rheumatic diseases in the world. Although there are standard methods for the diagnosis of both RA and OA, the differentials in some cases are poor. With deepening research, the role of autophagy in maintaining cell homeostasis and thus enabling cells adapt to external environments has become increasingly prominent. Both RA and OA, two diseases with inherent differences in pathogenesis, gradually show differences in autophagy levels. Our study therefore aims to further understand differences in pathogenesis of RA and OA through in-depth studies of autophagy in RA and OA. We also define appropriate autophagy-related markers as recognition indicators. Differences in autophagy levels between RA and OA were found based on analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) and single-sample gene set enrichment (ssGSEA). These differences were mainly caused by 134 differentially expressed genes (DEGs). In two autophagy-related genes, CXCR4 and SERPINA1, there existed significant statistical difference between RA and OA. An autophagy related index (ARI) was thus successfully constructed based on CXCR4 and SERPINA by binary logistic regression of the generalized linear regression (GLR) algorithm. Pearson analysis indicated that the expression of CXCR4, SERPINA1, and ARI were closely correlated with autophagy scores and immune infiltration. Moreover, ARI showed high disease identification through receiver operating characteristic (ROC) analysis (AUCtesting cohort = 0.956, AUCtraining cohort = 0.867). These results were then verified in GSE12021 independent cohort. In conclusion, ARI associated with autophagy and immune infiltration was successfully constructed for accurately identifying OA and RA. The index, thus, has great potential in clinical applications.
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Affiliation(s)
- Rong-zhi Huang
- Traumatic Orthopaedic Hand Surgery, The First People’s Hospital of Qinzhou, Qinzhou, China
| | - Jie Zheng
- Traumatic Orthopaedic Hand Surgery, The First People’s Hospital of Qinzhou, Qinzhou, China
- First Clinical Medical School, Guangxi Medical University, Nanning, China
| | - Feng-ling Liu
- Traumatic Orthopaedic Hand Surgery, The First People’s Hospital of Qinzhou, Qinzhou, China
- First Clinical Medical School, Guangxi Medical University, Nanning, China
| | - Qing-ling Li
- Traumatic Orthopaedic Hand Surgery, The First People’s Hospital of Qinzhou, Qinzhou, China
- First Clinical Medical School, Guangxi Medical University, Nanning, China
| | - Wen-hui Huang
- Traumatic Orthopaedic Hand Surgery, The First People’s Hospital of Qinzhou, Qinzhou, China
- First Clinical Medical School, Guangxi Medical University, Nanning, China
| | - Dan-meng Zhang
- Traumatic Orthopaedic Hand Surgery, The First People’s Hospital of Qinzhou, Qinzhou, China
- First Clinical Medical School, Guangxi Medical University, Nanning, China
| | - Qiang-chu Wu
- Traumatic Orthopaedic Hand Surgery, The First People’s Hospital of Qinzhou, Qinzhou, China
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Pentosan polysulfate sodium prevents functional decline in chikungunya infected mice by modulating growth factor signalling and lymphocyte activation. PLoS One 2021; 16:e0255125. [PMID: 34492036 PMCID: PMC8423248 DOI: 10.1371/journal.pone.0255125] [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: 04/01/2021] [Accepted: 07/09/2021] [Indexed: 11/19/2022] Open
Abstract
Chikungunya virus (CHIKV) is an arthropod-borne virus that causes large outbreaks world-wide leaving millions of people with severe and debilitating arthritis. Interestingly, clinical presentation of CHIKV arthritides have many overlapping features with rheumatoid arthritis including cellular and cytokine pathways that lead to disease development and progression. Currently, there are no specific treatments or vaccines available to treat CHIKV infections therefore advocating the need for the development of novel therapeutic strategies to treat CHIKV rheumatic disease. Herein, we provide an in-depth analysis of an efficacious new treatment for CHIKV arthritis with a semi-synthetic sulphated polysaccharide, Pentosan Polysulfate Sodium (PPS). Mice treated with PPS showed significant functional improvement as measured by grip strength and a reduction in hind limb foot swelling. Histological analysis of the affected joint showed local inflammation was reduced as seen by a decreased number of infiltrating immune cells. Additionally, joint cartilage was protected as demonstrated by increased proteoglycan staining. Using a multiplex-immunoassay system, we also showed that at peak disease, PPS treatment led to a systemic reduction of the chemokines CXCL1, CCL2 (MCP-1), CCL7 (MCP-3) and CCL12 (MCP-5) which may be associated with the reduction in cellular infiltrates. Further characterisation of the local effect of PPS in its action to reduce joint and muscle inflammation was performed using NanoString™ technology. Results showed that PPS altered the local expression of key functional genes characterised for their involvement in growth factor signalling and lymphocyte activation. Overall, this study shows that PPS is a promising treatment for alphaviral arthritis by reducing inflammation and protecting joint integrity.
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Immunofluorescence Analysis of NF-kB and iNOS Expression in Different Cell Populations during Early and Advanced Knee Osteoarthritis. Int J Mol Sci 2021; 22:ijms22126461. [PMID: 34208719 PMCID: PMC8233870 DOI: 10.3390/ijms22126461] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 01/15/2023] Open
Abstract
Synovitis of the knee synovium is proven to be a precursor of knee osteoarthritis (OA), leading to a radiologically advanced stage of the disease. This study was conducted to elucidate the expression pattern of different inflammatory factors—NF-kB, iNOS, and MMP-9 in a subpopulation of synovial cells. Thirty synovial membrane intra-operative biopsies of patients (ten controls, ten with early OA, and ten with advanced OA, according to the Kellgren–Lawrence radiological score) were immunohistochemically stained for NF-kB, iNOS, and MMP9, and for different cell markers for macrophages, fibroblasts, leukocytes, lymphocytes, blood vessel endothelial cells, and blood vessel smooth muscle cells. The total number of CD68+/NF-kB+ cells/mm2 in the intima of early OA patients (median = 2359) was significantly higher compared to the total number of vimentin+/Nf-kB+ cells/mm2 (median = 1321) and LCA+/NF-kB+ cells/mm2 (median = 64) (p < 0.001 and p < 0.0001, respectively). The total number of LCA+/NF-kB+ cells/mm2 in the subintima of advanced OA patients (median = 2123) was significantly higher compared to the total number of vimentin+/NF-kB+ cells/mm2 (median = 14) and CD68+/NF-kB+ cells/mm2 (median = 29) (p < 0.0001). The total number of CD68+/iNOS+ cells/mm2 in the intima of both early and advanced OA patients was significantly higher compared to the total number of vimentin+/iNOS+ cells/mm2 and LCA+/iNOS+ cells/mm2 (p < 0.0001 and p < 0.001, respectively). The total number of CD68+/MMP-9+ cells/mm2 in the intima of both early and advanced OA patients was significantly higher compared to the total number of vimentin+/MMP-9+ cells/mm2 and CD5+/MMP-9+ cells/mm2 (p < 0.0001). Macrophages may have a leading role in OA progression through the NF-kB production of inflammatory factors (iNOS and MMP-9) in the intima, except in advanced OA, where leukocytes could have a dominant role through NF-kB production in subintima. The blocking of macrophageal and leukocyte NF-kB expression is a possible therapeutic target as a disease modifying drug.
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Watson Levings RS, Broome TA, Smith AD, Rice BL, Gibbs EP, Myara DA, Hyddmark EV, Nasri E, Zarezadeh A, Levings PP, Lu Y, White ME, Dacanay EA, Foremny GB, Evans CH, Morton AJ, Winter M, Dark MJ, Nickerson DM, Colahan PT, Ghivizzani SC. Gene Therapy for Osteoarthritis: Pharmacokinetics of Intra-Articular Self-Complementary Adeno-Associated Virus Interleukin-1 Receptor Antagonist Delivery in an Equine Model. HUM GENE THER CL DEV 2019; 29:90-100. [PMID: 29869540 DOI: 10.1089/humc.2017.142] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Toward the treatment of osteoarthritis (OA), the authors have been investigating self-complementary adeno-associated virus (scAAV) for intra-articular delivery of therapeutic gene products. As OA frequently affects weight-bearing joints, pharmacokinetic studies of scAAV gene delivery were performed in the joints of the equine forelimb to identify parameters relevant to clinical translation in humans. Using interleukin-1 receptor antagonist (IL-1Ra) as a secreted therapeutic reporter, scAAV vector plasmids containing codon-optimized cDNA for equine IL-1Ra (eqIL-1Ra) were generated, which produced eqIL-1Ra at levels 30- to 50-fold higher than the native sequence. The most efficient cDNA was packaged in AAV2.5 capsid, and following characterization in vitro, the virus was injected into the carpal and metacarpophalangeal joints of horses over a 100-fold dose range. A putative ceiling dose of 5 × 1012 viral genomes was identified that elevated the steady-state eqIL-1Ra in the synovial fluids of injected joints by >40-fold over endogenous levels and was sustained for at least 6 months. No adverse effects were seen, and eqIL-1Ra in serum and urine remained at background levels throughout. Using the 5 × 1012 viral genome dose of scAAV, and green fluorescent protein as a cytologic marker, the local and systemic distribution of vector and transduced cells following intra-articular injection scAAV.GFP were compared in healthy equine joints and in those with late-stage, naturally occurring OA. In both cases, 99.7% of the vector remained within the injected joint. Strikingly, the pathologies characteristic of OA (synovitis, osteophyte formation, and cartilage erosion) were associated with a substantial increase in transgenic expression relative to tissues in healthy joints. This was most notable in regions of articular cartilage with visible damage, where foci of brilliantly fluorescent chondrocytes were observed. Overall, these data suggest that AAV-mediated gene transfer can provide relatively safe, sustained protein drug delivery to joints of human proportions.
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Affiliation(s)
| | - Ted A Broome
- 2 Department of Large Animal Clinical Sciences, University of Florida , Gainesville, Florida
| | - Andrew D Smith
- 2 Department of Large Animal Clinical Sciences, University of Florida , Gainesville, Florida
| | - Brett L Rice
- 2 Department of Large Animal Clinical Sciences, University of Florida , Gainesville, Florida
| | - Eric P Gibbs
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - David A Myara
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - E Viktoria Hyddmark
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Elham Nasri
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Ali Zarezadeh
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Padraic P Levings
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Yuan Lu
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Margaret E White
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - E Anthony Dacanay
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Gregory B Foremny
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Christopher H Evans
- 3 Rehabilitation Medicine Research Center, Mayo Clinic , Rochester, Minnesota
| | - Alison J Morton
- 2 Department of Large Animal Clinical Sciences, University of Florida , Gainesville, Florida
| | - Mathew Winter
- 4 Department of Small Animal Clinical Sciences, University of Florida , Gainesville, Florida
| | - Michael J Dark
- 5 Department of Infectious Diseases and Pathology, University of Florida , Gainesville, Florida
| | - David M Nickerson
- 6 Department of Statistics and Actuarial Science, University of Central Florida , Orlando, Florida
| | - Patrick T Colahan
- 2 Department of Large Animal Clinical Sciences, University of Florida , Gainesville, Florida
| | - Steven C Ghivizzani
- 1 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
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10
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Rosshirt N, Hagmann S, Tripel E, Gotterbarm T, Kirsch J, Zeifang F, Lorenz HM, Tretter T, Moradi B. A predominant Th1 polarization is present in synovial fluid of end-stage osteoarthritic knee joints: analysis of peripheral blood, synovial fluid and synovial membrane. Clin Exp Immunol 2018; 195:395-406. [PMID: 30368774 DOI: 10.1111/cei.13230] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 01/16/2023] Open
Abstract
Thorough understanding of the complex pathophysiology of osteoarthritis (OA) is necessary in order to open new avenues for treatment. The aim of this study was to characterize the CD4+ T cell population and evaluate their activation and polarization status in OA joints. Fifty-five patients with end-stage knee OA (Kellgren-Lawrence grades III-IV) who underwent surgery for total knee arthroplasty (TKA) were enrolled into this study. Matched samples of synovial membrane (SM), synovial fluid (SF) and peripheral blood (PB) were analysed for CD3+ CD4+ CD8- T cell subsets [T helper type 1 (Th1), Th2, Th17, regulatory T cells] and activation status (CD25, CD69, CD45RO, CD45RA, CD62L) by flow cytometry. Subset-specific cytokines were analysed by cytometric bead array (CBA). SM and SF samples showed a distinct infiltration pattern of CD4+ T cells. In comparison to PB, a higher amount of joint-derived T cells was polarized into CD3+ CD4+ CD8- T cell subsets, with the most significant increase for proinflammatory Th1 cells in SF. CBA analysis revealed significantly increased immunomodulating cytokines [interferon (IFN)-γ, interleukin (IL)-2 and IL-10] in SF compared to PB. Whereas in PB only a small proportion of CD4+ T cells were activated, the majority of joint-derived CD4+ T cells can be characterized as activated effector memory cells (CD69+ CD45RO+ CD62L- ). End-stage OA knees are characterized by an increased CD4+ T cell polarization towards activated Th1 cells and cytokine secretion compared to PB. This local inflammation may contribute to disease aggravation and eventually perpetuate the disease process.
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Affiliation(s)
- N Rosshirt
- Clinic for Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Germany
| | - S Hagmann
- Clinic for Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Germany
| | - E Tripel
- Clinic for Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Germany
| | - T Gotterbarm
- Clinic for Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Germany
| | - J Kirsch
- Clinic for Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Germany
| | - F Zeifang
- Clinic for Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Germany
| | - H-M Lorenz
- Department of Internal Medicine V, Division of Rheumatology, University Hospital Heidelberg, Germany
| | - T Tretter
- Department of Internal Medicine V, Division of Rheumatology, University Hospital Heidelberg, Germany
| | - B Moradi
- Clinic for Orthopaedic and Trauma Surgery, University Hospital Heidelberg, Germany
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11
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Kimura MY, Hayashizaki K, Tokoyoda K, Takamura S, Motohashi S, Nakayama T. Crucial role for CD69 in allergic inflammatory responses: CD69-Myl9 system in the pathogenesis of airway inflammation. Immunol Rev 2018; 278:87-100. [PMID: 28658550 DOI: 10.1111/imr.12559] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CD69 has been known as an early activation marker of lymphocytes; whereas, recent studies demonstrate that CD69 also has critical functions in immune responses. Early studies using human samples revealed the involvement of CD69 in various inflammatory diseases including asthma. Moreover, murine disease models using Cd69-/- mice and/or anti-CD69 antibody (Ab) treatment have revealed crucial roles for CD69 in inflammatory responses. However, it had not been clear how the CD69 molecule contributes to the pathogenesis of inflammatory diseases. We recently elucidated a novel mechanism, in which the interaction between CD69 and its ligands, myosin light chain 9, 12a and 12b (Myl9/12) play a critical role in the recruitment of activated T cells into the inflammatory lung. In this review, we first summarize CD69 function based on its structure and then introduce the evidence for the involvement of CD69 in human diseases and murine disease models. Then, we will describe how we discovered CD69 ligands, Myl9 and Myl12, and how the CD69-Myl9 system regulates airway inflammation. Finally, we will discuss possible therapeutic usages of the blocking Ab to the CD69-Myl9 system.
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Affiliation(s)
- Motoko Y Kimura
- Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koji Hayashizaki
- Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koji Tokoyoda
- Department of Osteoimmunology, German Rheumatism Research Centre (DRFZ) Berlin, Berlin, Germany
| | - Shiki Takamura
- Department of Immunology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Shinichiro Motohashi
- Department of Medical Immunology Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshinori Nakayama
- Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
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12
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Pan L, Zhang Y, Chen N, Yang L. Icariin Regulates Cellular Functions and Gene Expression of Osteoarthritis Patient-Derived Human Fibroblast-Like Synoviocytes. Int J Mol Sci 2017; 18:ijms18122656. [PMID: 29292760 PMCID: PMC5751258 DOI: 10.3390/ijms18122656] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/28/2017] [Accepted: 12/04/2017] [Indexed: 01/07/2023] Open
Abstract
Synovial inflammation plays an important role in the pathogenesis and progress of osteoarthritis (OA). There is an urgent need to find safe and effective drugs that can reduce the inflammation and regulate the pathogenesis of cytokines of the OA disease. Here, we investigated the effect of icariin, the major pharmacological active component of herb Epimedium on human osteoarthritis fibroblast-like synoviocytes (OA–FLSs). The OA–FLSs were isolated from patients with osteoarthritis and cultured in vitro with different concentrations of icariin. Then, cell viability, proliferation, and migration were investigated; MMP14, GRP78, and IL-1β gene expression levels were detected via qRT-PCR. Icariin showed low cytotoxicity to OA–FLSs at a concentration of under 10 μM and decreased the proliferation of the cells at concentrations of 1 and 10 μM. Icariin inhibited cell migration with concentrations ranging from 0.1 to 1 μM. Also, the expression of three cytokines for the pathogenesis of OA which include IL-1β, MMP14 and GRP78 was decreased by the various concentrations of icariin. These preliminary results imply that icariin might be an effective compound for the treatment of OA disease.
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Affiliation(s)
- Lianhong Pan
- Department of Basic Medicine, Chongqing Three Gorges Medical College, Chongqing 404000, China.
| | - Yonghui Zhang
- Department of Basic Medicine, Chongqing Three Gorges Medical College, Chongqing 404000, China.
| | - Na Chen
- Digital Medicine Institute, Biomedical Engineering College, Third Military Medical University, Chongqing 400038, China.
| | - Li Yang
- National Innovation and Attracting Talents "111" Base, Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China.
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13
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Ostojic M, Soljic V, Vukojevic K, Dapic T. Immunohistochemical characterization of early and advanced knee osteoarthritis by NF-κB and iNOS expression. J Orthop Res 2017; 35:1990-1997. [PMID: 27958655 DOI: 10.1002/jor.23504] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 12/05/2016] [Indexed: 02/04/2023]
Abstract
This study was performed to determine the differences in grade of synovitis and expression of NF-κB and iNOS in knee synovial membrane between early and advanced stage of osteoarthritis (OA). Thirty synovial membrane intra-operative biopsies of patients (ten controls, ten with early and ten with advanced OA according to Kellgren-Lawrence radiological score) were immunohistochemically (NF-κB and iNOS) and hystologically (Krenn synovitis score) analyzed and correlated to WOMAC clinical score and pain duration. Krenn synovitis score of patients with radiologically early OA was significantly higher than in patients with advanced OA (p < 0.001). NF-κB expression in both synovial intima (p < 0.001) and subintima (p < 0.001) was also higher in early OA. iNOS expression in subintima was significantly higher in early than in advanced OA (p < 0.001), while in intima iNOS showed no statistical difference between groups (p = 0.07). The lymphocytic nodules, located in synovial subintima, were significantly higher in advanced OA when compared to early OA (p = 0.006) and the control group (p < 0.001). These results suggest that in early OA, there is a localized inflammation of the synovial membrane with high expression of NF-κB and iNOS. In advanced OA, number of expressed factors is reduced, with the exception of intima cells that highly express iNOS, reflecting the ongoing localized inflammatory process of lower degree. In advanced OA, the density of the resident cells is reduced and lymphocytic nodules appear, confirming the important role of adaptive immunity in later OA stage. Clinical significance of this study is better understanding possibilities of preventive measures for synovitis and OA advancement. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1990-1997, 2017.
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Affiliation(s)
- Marko Ostojic
- Department of Orthopaedics and Traumatology, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,Department of Anatomy, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Violeta Soljic
- Department of Histology and Embryology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.,Department of Pathology, Cytology and Forensic Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Katarina Vukojevic
- Department of Histology and Embryology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina.,Department of Anatomy, Histology and Embryology School of Medicine, University of Split, Split, Croatia
| | - Tomislav Dapic
- Department of Orthopaedics, University Hospital Zagreb, Zagreb, Croatia
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14
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Jeffries MA, Donica M, Baker LW, Stevenson ME, Annan AC, Beth Humphrey M, James JA, Sawalha AH. Genome-Wide DNA Methylation Study Identifies Significant Epigenomic Changes in Osteoarthritic Subchondral Bone and Similarity to Overlying Cartilage. Arthritis Rheumatol 2017; 68:1403-14. [PMID: 26713865 DOI: 10.1002/art.39555] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/10/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To perform a genome-wide DNA methylation study to identify differential DNA methylation patterns in subchondral bone underlying eroded and intact cartilage from patients with hip osteoarthritis (OA) and to compare these with DNA methylation patterns in overlying cartilage. METHODS Genome-wide DNA methylation profiling using Illumina HumanMethylation 450 arrays was performed on eroded and intact cartilage and subchondral bone from within the same joint of 12 patients undergoing hip arthroplasty. Genes with differentially methylated CpG sites were analyzed to identify shared pathways, upstream regulators, and overrepresented gene ontologies, and these patterns were compared with those of the overlying cartilage. Histopathology was graded by modified Mankin score and assessed for correlation with DNA methylation. RESULTS We identified 7,316 differentially methylated CpG sites in subchondral bone underlying eroded cartilage, most of which (∼75%) were hypomethylated, and 1,397 sites in overlying eroded cartilage, 126 of which were shared. Samples clustered into 3 groups with distinct histopathologic scores. We observed differential DNA methylation of genes including the RNA interference-processing gene AGO2, the growth factor TGFB3, the OA suppressor NFATC1, and the epigenetic effector HDAC4. Among known susceptibility genes in OA, 32 were differentially methylated in subchondral bone, 8 were differentially methylated in cartilage, and 5 were shared. Upstream regulator analysis using differentially methylated genes in OA subchondral bone showed a strong transforming growth factor β1 signature (P = 1 × 10(-40) ) and a tumor necrosis factor family signature (P = 3.2 × 10(-28) ), among others. CONCLUSION Our data suggest the presence of an epigenetic phenotype associated with eroded OA subchondral bone that is similar to that of overlying eroded OA cartilage.
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Affiliation(s)
- Matlock A Jeffries
- University of Oklahoma Health Sciences Center and Oklahoma Medical Research Foundation, Oklahoma City
| | | | | | | | - Anand C Annan
- University of Oklahoma Health Sciences Center, Oklahoma City
| | - Mary Beth Humphrey
- MPH: University of Oklahoma Medical Research Center and Veterans Affairs Medical Center, Oklahoma City
| | - Judith A James
- University of Oklahoma Health Sciences Center and Oklahoma Medical Research Foundation, Oklahoma City
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15
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Li YS, Luo W, Zhu SA, Lei GH. T Cells in Osteoarthritis: Alterations and Beyond. Front Immunol 2017; 8:356. [PMID: 28424692 PMCID: PMC5371609 DOI: 10.3389/fimmu.2017.00356] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 03/13/2017] [Indexed: 12/16/2022] Open
Abstract
Although osteoarthritis (OA) has been traditionally regarded as a non-inflammatory disease, reports increasingly suggest that it is inflammatory, at least in certain patients. OA patients often exhibit inflammatory infiltration of synovial membranes by macrophages, T cells, mast cells, B cells, plasma cells, natural killer cells, dendritic cells, granulocytes, etc. Although previous reviews have summarized the knowledge of inflammation in the pathogenesis of OA, as far as we know, no report review our current understanding about T cells, especially, each T cell subtype, in the biology of OA. This review highlights the current understanding of the role of T cells in the pathogenesis of OA, with attention to Th1 cells, Th2 cells, Th9 cells, Th17 cells, Th22 cells, regulatory T cells, follicular helper T cells, cytotoxic T cells, T memory cells, and even unconventional T cells (e.g., γδ T cells and cluster of differentiation 1 restricted T cells). The findings highlight the importance of T cells to the development and progression of OA and suggest new therapeutic approaches for OA patients based on the manipulation of T-cell responses.
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Affiliation(s)
- Yu-Sheng Li
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, China.,Department of Orthopaedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Wei Luo
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, China
| | - Shou-An Zhu
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, China
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16
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Post-Traumatic Osteoarthritis in Mice Following Mechanical Injury to the Synovial Joint. Sci Rep 2017; 7:45223. [PMID: 28345597 PMCID: PMC5366938 DOI: 10.1038/srep45223] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/20/2017] [Indexed: 01/14/2023] Open
Abstract
We investigated the spectrum of lesions characteristic of post-traumatic osteoarthritis (PTOA) across the knee joint in response to mechanical injury. We hypothesized that alteration in knee joint stability in mice reproduces molecular and structural features of PTOA that would suggest potential therapeutic targets in humans. The right knees of eight-week old male mice from two recombinant inbred lines (LGXSM-6 and LGXSM-33) were subjected to axial tibial compression. Three separate loading magnitudes were applied: 6N, 9N, and 12N. Left knees served as non-loaded controls. Mice were sacrificed at 5, 9, 14, 28, and 56 days post-loading and whole knee joint changes were assessed by histology, immunostaining, micro-CT, and magnetic resonance imaging. We observed that tibial compression disrupted joint stability by rupturing the anterior cruciate ligament (except for 6N) and instigated a cascade of temporal and topographical features of PTOA. These features included cartilage extracellular matrix loss without proteoglycan replacement, chondrocyte apoptosis at day 5, synovitis present at day 14, osteophytes, ectopic calcification, and meniscus pathology. These findings provide a plausible model and a whole-joint approach for how joint injury in humans leads to PTOA. Chondrocyte apoptosis, synovitis, and ectopic calcification appear to be targets for potential therapeutic intervention.
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17
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Duan X, Rai MF, Holguin N, Silva MJ, Patra D, Liao W, Sandell LJ. Early changes in the knee of healer and non-healer mice following non-invasive mechanical injury. J Orthop Res 2017; 35:524-536. [PMID: 27591401 PMCID: PMC5718184 DOI: 10.1002/jor.23413] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/20/2016] [Indexed: 02/04/2023]
Abstract
In this study, we examined early time-dependent changes in articular cartilage and synovium in response to tibial compression and sought the plausible origin of cells that respond to compression in the healer (LGXSM-6) and non-healer (LGXSM-33) recombinant inbred mouse strains. The right knee of 13-week old male mice was subjected to tibial compression using 9N axial loading. The contralateral left knee served as a control. Knees were harvested at 5, 9, and 14 days post-injury. Histological changes in cartilage and synovium, immunofluorescence pattern of CD44, aggrecan, type-II collagen, cartilage oligomeric matrix protein and the aggrecan neo-epitope NITEGE, and cell apoptosis (by TUNEL) were examined. We used a double nucleoside analog cell-labeling strategy to trace cells responsive to injury. We showed that tibial compression resulted in rupture of anterior cruciate ligament, cartilage matrix loss and chondrocyte apoptosis at the injury site. LGXSM-33 showed higher synovitis and ectopic synovial chondrogenesis than LGXSM-6 with no differences for articular cartilage lesions. With loading, an altered pattern of CD44 and NITEGE was observed: cells in the impacted area underwent apoptosis, cells closely surrounding the injured area expressed CD44, and cells in the intact area expressed NITEGE. Cells responding to injury were found in the synovium, subchondral bone marrow and the Groove of Ranvier. Taken together, we found no strain differences in chondrocytes in the early response to injury. However, the synovial response was greater in LGXSM-33 indicating that, at early time points, there is a genetic difference in synovial cell reaction to injury. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:524-536, 2017.
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Affiliation(s)
- Xin Duan
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine at Barnes-Jewish Hospital, 425 S. Euclid Ave. MS 8233, St. Louis, Missouri 63110
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Muhammad Farooq Rai
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine at Barnes-Jewish Hospital, 425 S. Euclid Ave. MS 8233, St. Louis, Missouri 63110
| | - Nilsson Holguin
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine at Barnes-Jewish Hospital, 425 S. Euclid Ave. MS 8233, St. Louis, Missouri 63110
- Department of Biomedical Engineering, Washington University in St. Louis at Engineering and Applied Sciences, Whitaker Hall, MS 1097, St. Louis, Missouri 63130
| | - Matthew J. Silva
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine at Barnes-Jewish Hospital, 425 S. Euclid Ave. MS 8233, St. Louis, Missouri 63110
- Department of Biomedical Engineering, Washington University in St. Louis at Engineering and Applied Sciences, Whitaker Hall, MS 1097, St. Louis, Missouri 63130
| | - Debabrata Patra
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine at Barnes-Jewish Hospital, 425 S. Euclid Ave. MS 8233, St. Louis, Missouri 63110
| | - Weiming Liao
- First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Linda J. Sandell
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine at Barnes-Jewish Hospital, 425 S. Euclid Ave. MS 8233, St. Louis, Missouri 63110
- Department of Biomedical Engineering, Washington University in St. Louis at Engineering and Applied Sciences, Whitaker Hall, MS 1097, St. Louis, Missouri 63130
- Department of Cell Biology and Physiology, Washington University School of Medicine at Barnes-Jewish Hospital, 425 S. Euclid Ave. MS 8233, St. Louis, Missouri 63110
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18
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Klein-Wieringa IR, de Lange-Brokaar BJE, Yusuf E, Andersen SN, Kwekkeboom JC, Kroon HM, van Osch GJVM, Zuurmond AM, Stojanovic-Susulic V, Nelissen RGHH, Toes REM, Kloppenburg M, Ioan-Facsinay A. Inflammatory Cells in Patients with Endstage Knee Osteoarthritis: A Comparison between the Synovium and the Infrapatellar Fat Pad. J Rheumatol 2016; 43:771-8. [PMID: 26980579 DOI: 10.3899/jrheum.151068] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To get a better understanding of inflammatory pathways active in the osteoarthritic (OA) joint, we characterized and compared inflammatory cells in the synovium and the infrapatellar fat pad (IFP) of patients with knee OA. METHODS Infiltrating immune cells were characterized by flow cytometry in 76 patients with knee OA (mean age 63.3, 52% women, median body mass index 28.9) from whom synovial tissue (n = 40) and IFP (n = 68) samples were obtained. Pain was assessed by the visual analog scale (VAS; 0-100 mm). Spearman rank correlations and linear regression analyses adjusted for sex and age were performed. RESULTS Macrophages and T cells, followed by mast cells, were the most predominant immune cells in the synovium and IFP, and were equally abundant in these tissues. Macrophages and T cells secreted mostly proinflammatory cytokines even without additional stimulation, indicating their activated state. Accordingly, most CD4+ T cells had a memory phenotype and contained a significant population of cells expressing activation markers (CD25+, CD69+). Interestingly, the percent of CD69+ T cells was higher in synovial than IFP CD4+ T cells. Preliminary analyses indicated that the number of synovial CD4+ T cells were associated with VAS pain (β 0.51, 95% CI 0.09-1.02, p = 0.02). CONCLUSION Our data suggest that the immune cell composition of the synovium and the IFP is similar, and includes activated cells that could contribute to inflammation through secretion of proinflammatory cytokines. Moreover, preliminary analyses indicate that synovial CD4+ T cells might associate with pain in patients with endstage OA of the knee.
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Affiliation(s)
- Inge R Klein-Wieringa
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Badelog J E de Lange-Brokaar
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Erlangga Yusuf
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Stefan N Andersen
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Joanneke C Kwekkeboom
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Herman M Kroon
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Gerjo J V M van Osch
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Anne-Marie Zuurmond
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Vedrana Stojanovic-Susulic
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Rob G H H Nelissen
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - René E M Toes
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Margreet Kloppenburg
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre
| | - Andreea Ioan-Facsinay
- From the Department of Rheumatology, Leiden University Medical Centre; Department of Radiology, Department of Orthopedics, and Department of Clinical Epidemiology, Leiden University Medical Center; TNO, Leiden; Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Janssen Pharmaceutical Companies of Johnson & Johnson, Spring House, Pennsylvania, USA.I.R. Klein-Wieringa*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; B.J. de Lange-Brokaar*, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; E. Yusuf, MD, PhD, Department of Rheumatology, Leiden University Medical Centre; S.N. Andersen, Ing, Department of Rheumatology, Leiden University Medical Centre; J.C. Kwekkeboom, Ing, Department of Rheumatology, Leiden University Medical Centre; H.M. Kroon, PhD, Department of Radiology, Leiden University Medical Center; G.J. van Osch, PhD, Professor, Department of Orthopedics and Otorhinolaryngology, Erasmus MC, University Medical Center; A.M. Zuurmond, PhD, TNO; V. Stojanovic-Susulic, PhD, Janssen Pharmaceutical Companies of Johnson & Johnson; R.G. Nelissen, MD, PhD, Professor, Department of Orthopedics, Leiden University Medical Center; R.E. Toes, PhD, Professor, Department of Rheumatology, Leiden University Medical Centre; M. Kloppenburg, MD, PhD, Professor, Department of Rheumatology, and Department of Clinical Epidemiology, Leiden University Medical Centre; A. Ioan-Facsinay, PhD, Assistant Professor, Department of Rheumatology, Leiden University Medical Centre.
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Abbasi B, Pezeshki-Rad M, Akhavan R, Sahebari M. Association between clinical and sonographic synovitis in patients with painful knee osteoarthritis. Int J Rheum Dis 2016; 20:561-566. [PMID: 26915050 DOI: 10.1111/1756-185x.12834] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVE To evaluate the association between ultrasonographic findings of inflammation (effusion, synovitis) and clinical findings in patients with primary painful knee osteoarthritis. METHOD This cross-sectional study was performed on 142 patients with primary painful knee osteoarthritis (American College of Rheumatology criteria) in whom the visual analogue scale of pain was 30 or more. Clinical parameters were evaluated by a rheumatologist using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score while the ultrasonographic examination was performed by a musculoskeletal radiologist in our center. Knee joint synovitis and effusion were defined as synovial thickness ≥ 4 mm and depth of fluid in the suprapatellar recess ≥ 4 mm, respectively. RESULTS Sixty-eight (47.9%) patients demonstrated neither synovitis nor effusion, 37 (26.1%) had only effusion, 11 (7.7%) had only synovitis and 26 (18.3%) had both effusion and synovitis in the ultrasonographic examination. There was significant association between ultrasonographic knee arthritis (defined as presence of synovitis or effusion) and WOMAC pain sub-score, WOMAC physical function sub-score and WOMAC total score. No significant association was noted between sonographic signs of arthritis and WOMAC joint stiffness sub-score. We also found significant correlation between ultrasonographic synovitis and WOMAC pain sub-score (P < 0.001), WOMAC physical function sub-score (P < 0.001) and total WOMAC score (P < 0.001). CONCLUSION This study revealed a positive correlation between ultrasonographic synovitis and total WOMAC score, WOMAC pain and physical function sub-score. There was no association between sonographic signs of arthritis and WOMAC joint stiffness sub-score.
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Affiliation(s)
- Bita Abbasi
- Radiology Department, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Pezeshki-Rad
- Vascular and Interventional Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Akhavan
- Emergency Medicine Department, Edalatian Emergency Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Sahebari
- Rheuamtic Disease Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Thijssen E, van Caam A, van der Kraan PM. Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis. Rheumatology (Oxford) 2014; 54:588-600. [PMID: 25504962 DOI: 10.1093/rheumatology/keu464] [Citation(s) in RCA: 216] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OA is a degenerative joint disease characterized by articular cartilage degradation, osteophyte formation, synovitis, and subchondral bone sclerosis. One of OAs main risk factors is obesity. To date, it is not fully understood how obesity results in OA. Historically, this link was ascribed to excessive joint loading as a result of increased body weight. However, the association between obesity and OA in non-weight-bearing joints suggests a more complex aetiology for obesity-induced OA. In the present review, the link between obesity and OA is discussed. First, the historical view of altered joint loading leading to wear and tear of the joint is addressed. Subsequently, the effects of a disturbed lipid metabolism, low-grade inflammation, and adipokines on joint tissues are discussed and linked to OA. Taken together, inflamed adipose tissue and dyslipidaemia play pivotal roles in obesity-induced OA. It becomes increasingly clear that the link between obesity and OA transcends excessive loading.
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Affiliation(s)
- Eva Thijssen
- Experimental Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arjan van Caam
- Experimental Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter M van der Kraan
- Experimental Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
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21
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Balaganur V, Pathak NN, Lingaraju MC, More AS, Latief N, Kumari RR, Kumar D, Tandan SK. Chondroprotective and anti-inflammatory effects of S-methylisothiourea, an inducible nitric oxide synthase inhibitor in cartilage and synovial explants model of osteoarthritis. J Pharm Pharmacol 2014; 66:1021-31. [DOI: 10.1111/jphp.12228] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 01/12/2014] [Indexed: 11/26/2022]
Abstract
Abstract
Objectives
To study the chondroprotective and anti-inflammatory potential of inducible nitric oxide synthase (iNOS) inhibitor S-methylisothiourea (SMT) in in-vitro model.
Methods
Rabbit cartilage explants were stimulated with recombinant human interleukin 1β (rhIL-1β), and the chondroprotective and anti-inflammatory effects of SMT were investigated. Rat synovial explants were stimulated with LPS, and the anti-inflammatory effect of SMT on synovium was studied. To examine the role of SMT in synovial inflammation mediated cartilage damage, LPS stimulated synovial explants were cultured with dead cartilage with or without SMT for 72 h. The culture medium was analysed for sulfated glycosaminoglycans (GAGs) and hydroxyproline as measure of proteoglycans and collagen degradation, respectively.
Key findings
SMT significantly reduced GAGs, hydroxyproline, matrix metalloproteinase (MMP)-13, tumour necrosis factor alpha (TNF-α), prostaglindin E2 (PGE2) and nitrite release in stimulated rabbit cartilage media indicating chondroprotective and anti-inflammatory effects of SMT in osteoarthritis (OA). Stimulated synovial explants caused release of nitrite, PGE2, IL-1β and TNF-α in the medium which were significantly reduced by SMT indicating its anti-inflammatory action. SMT significantly reduced GAGs and hydroxyproline in medium and shown protective effect against synovium-mediated cartilage damage.
Conclusions
SMT inhibited cartilage degradation, synovial inflammation and synovium-mediated cartilage damage, suggesting that SMT may be an agent for pharmacological intervention in OA.
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Affiliation(s)
- Venkanna Balaganur
- Division of Pharmacology & Toxicology, Indian Veterinary Research Institute, Bareilly, UP, India
| | - Nitya Nand Pathak
- Division of Pharmacology & Toxicology, Indian Veterinary Research Institute, Bareilly, UP, India
| | | | - Amar Sunil More
- Division of Pharmacology & Toxicology, Indian Veterinary Research Institute, Bareilly, UP, India
| | - Najeeb Latief
- Division of Pharmacology & Toxicology, Indian Veterinary Research Institute, Bareilly, UP, India
| | - Rashmi Rekha Kumari
- Division of Pharmacology & Toxicology, Indian Veterinary Research Institute, Bareilly, UP, India
| | - Dinesh Kumar
- Division of Pharmacology & Toxicology, Indian Veterinary Research Institute, Bareilly, UP, India
| | - Surendra K Tandan
- Division of Pharmacology & Toxicology, Indian Veterinary Research Institute, Bareilly, UP, India
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The ADAM12 is upregulated in synovitis and postinflammatory fibrosis of the synovial membrane in patients with early radiographic osteoarthritis. Joint Bone Spine 2014; 81:51-6. [DOI: 10.1016/j.jbspin.2013.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 03/07/2013] [Indexed: 01/15/2023]
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González-Amaro R, Cortés JR, Sánchez-Madrid F, Martín P. Is CD69 an effective brake to control inflammatory diseases? Trends Mol Med 2013; 19:625-32. [PMID: 23954168 PMCID: PMC4171681 DOI: 10.1016/j.molmed.2013.07.006] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 07/02/2013] [Accepted: 07/18/2013] [Indexed: 12/28/2022]
Abstract
Early studies described CD69 as a leukocyte activation marker, and suggested its involvement in the activation of different leukocyte subsets as well as in the pathogenesis of chronic inflammation. However, recent investigations have showed that CD69 knockout mice exhibit an enhanced or reduced susceptibility to different experimental models of inflammatory diseases, including those mediated by T helper 17 (Th17) lymphocytes. In this regard, the expression of CD69, both in Th17 lymphocytes and by a subset of regulatory T cells, has an important role in the control of the immune response and the inflammatory phenomenon. Therefore, different evidence indicates that CD69 exerts a complex immunoregulatory role in humans, and that it could be considered as a target molecule for the therapy of immune-mediated diseases.
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Affiliation(s)
| | - Jose R. Cortés
- Department of Vascular Biology and Inflammation, Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain, 28029
| | - Francisco Sánchez-Madrid
- Department of Vascular Biology and Inflammation, Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain, 28029
- Servicio de Inmunología, Hospital de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain, 28006
| | - Pilar Martín
- Department of Vascular Biology and Inflammation, Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain, 28029
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Balbaloglu O, Korkmaz M, Yolcu S, Karaaslan F, Beceren NGÇ. Evaluation of mean platelet volume (MPV) levels in patients with synovitis associated with knee osteoarthritis. Platelets 2013; 25:81-5. [DOI: 10.3109/09537104.2013.776162] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Synovial inflammation, immune cells and their cytokines in osteoarthritis: a review. Osteoarthritis Cartilage 2012; 20:1484-99. [PMID: 22960092 DOI: 10.1016/j.joca.2012.08.027] [Citation(s) in RCA: 478] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 07/21/2012] [Accepted: 08/30/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Although osteoarthritis (OA) is considered a non-inflammatory condition, it is widely accepted that synovial inflammation is a feature of OA. However, the role of immune cells and their cytokines in OA is largely unknown. This narrative systematic review summarizes the knowledge of inflammatory properties, immune cells and their cytokines in synovial tissues (STs) of OA patients. DESIGN Broad literature search in different databases was performed which resulted in 100 articles. RESULTS Of 100 articles 33 solely investigated inflammation in OA ST with or without comparison with normal samples; the remaining primarily focussed on rheumatoid arthritis (RA) ST. Studies investigating different severity stages or cellular source of cytokines were sparse. OA ST displayed mild/moderate grade inflammation when investigated by means of haematoxylin and eosin (H&E) staining. Most frequently found cells types were macrophages, T cells and mast cells (MCs). Overall the number of cells was lower than in RA, although the number of MCs was as high as or sometimes even higher than in RA ST. Cytokines related to T cell or macrophage function were found in OA ST. Their expression was overall higher than in normal ST, but lower than in RA ST. Their cellular source remains largely unknown in OA ST. CONCLUSION Inflammation is common in OA ST and characterized by immune cell infiltration and cytokine secretion. This inflammation seems quantitatively and qualitatively different from inflammation in RA. Further research is needed to clarify the role of inflammation, immune cells and their cytokines in the pathogenesis of OA.
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Goldring MB. Chondrogenesis, chondrocyte differentiation, and articular cartilage metabolism in health and osteoarthritis. Ther Adv Musculoskelet Dis 2012; 4:269-85. [PMID: 22859926 PMCID: PMC3403254 DOI: 10.1177/1759720x12448454] [Citation(s) in RCA: 294] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Chondrogenesis occurs as a result of mesenchymal cell condensation and chondroprogenitor cell differentiation. Following chondrogenesis, the chondrocytes remain as resting cells to form the articular cartilage or undergo proliferation, terminal differentiation to chondrocyte hypertrophy, and apoptosis in a process termed endochondral ossification, whereby the hypertrophic cartilage is replaced by bone. Human adult articular cartilage is a complex tissue of matrix proteins that varies from superficial to deep layers and from loaded to unloaded zones. A major challenge to efforts to repair cartilage by stem cell-based and other tissue-engineering strategies is the inability of the resident chondrocytes to lay down a new matrix with the same properties as it had when it was formed during development. Thus, understanding and comparing the mechanisms of cartilage remodeling during development, osteoarthritis (OA), and aging may lead to more effective strategies for preventing cartilage damage and promoting repair. The pivotal proteinase that marks OA progression is matrix metalloproteinase 13 (MMP-13), the major type II collagen-degrading collagenase, which is regulated by both stress and inflammatory signals. We and other investigators have found that there are common mediators of these processes in human OA cartilage. We also observe temporal and spatial expression of these mediators in early through late stages of OA in mouse models and are analyzing the consequences of knockout or transgenic overexpression of critical genes. Since the chondrocytes in adult human cartilage are normally quiescent and maintain the matrix in a low turnover state, understanding how they undergo phenotypic modulation and promote matrix destruction and abnormal repair in OA may to lead to identification of critical targets for therapy to block cartilage damage and promote effective cartilage repair.
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Affiliation(s)
- Mary B Goldring
- Hospital for Special Surgery, Caspary Research Building, 5th Floor, 535 East 70th Street, New York, NY 10021, USA
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Abstract
Osteoarthritis (OA) is a chronic, debilitating joint disease characterized by degenerative changes to the bones, cartilage, menisci, ligaments, and synovial tissue. Imaging modalities such as radiography, magnetic resonance imaging (MRI), optical coherence tomography (OCT), and ultrasound (US) permit visualization of these structures and can evaluate disease onset and progression. Radiography is primarily useful for the assessment of bony structures, while OCT is used for evaluation of articular cartilage and US for ligaments and the synovium. MRI permits visualization of all intraarticular structures and pathologies, though US or OCT may be preferential in some circumstances. As OA is a disease of the whole joint, a combination of imaging techniques may be necessary in order to gain the most comprehensive picture of the disease state. This article is part of a Special Issue entitled "Osteoarthritis".
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Koorts AM, Levay PF, Hall AN, van der Merwe CF, Becker PJ, Frantzen DJM, Viljoen M. Expression of the H- and L-subunits of ferritin in bone marrow macrophages of patients with osteoarthritis. Exp Biol Med (Maywood) 2012; 237:688-93. [PMID: 22688823 DOI: 10.1258/ebm.2012.011278] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Osteoarthritis is a disease characterized by an increase in the production of reactive oxygen species (ROS) in afflicted joints. Excess iron, due to its role in the production of ROS and crystal deposition in the joints, is implicated in the disease progression of osteoarthritis. Ferritin is a major regulator of the bioavailability of iron, and its functions are determined largely by the combination of H- and L-subunits present in its outer protein shell. The purpose of the study was to investigate the expression of the H- and L-subunits of ferritin in bone marrow macrophages of osteoarthritis patients. The cytokine profiles were assessed as cytokines play an important role in the expression of the ferritin subunits. The H-subunit of ferritin in the bone marrow macrophages was significantly higher (P value = 0.035) in the osteoarthritis patients compared with the controls (107.84; 69.25-167.94 counts/μm(2); n = 7 versus 71.07; 58.56-86.26 counts/μm(2); n = 19). A marginally significant increase (P value = 0.059) was shown for the expression of the L-subunit in the osteoarthritis patients compared with the controls (133.03; 104.04-170.10 counts/μm(2); n = 7 versus 104.23; 91.53-118.70 counts/μm(2); n = 19). The osteoarthritis and control groups had comparable C-reactive protein, as well as proinflammatory and anti-inflammatory cytokine concentrations. The major exception was for transforming growth factor-β (TGF-β), which was higher (P value = 0.014) in the plasma of the osteoarthritis patients (16.69; 13.09-21.28 ng/mL; n = 7 versus 8.60; 6.34-11.67 ng/mL; n = 19). Up-regulation of the ferritin subunits decreases the levels of bioavailable iron and provides protection against the unwarranted production of ROS and crystal deposition. A role for TGF-β in the up-regulation of the expression of the H-subunit, and possibly the L-subunit, of ferritin is postulated in osteoarthritis.
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Affiliation(s)
- Alida Maria Koorts
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia, Pretoria 0007, South Africa.
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Imaging of synovitis in osteoarthritis: current status and outlook. Semin Arthritis Rheum 2011; 41:116-30. [PMID: 21295331 DOI: 10.1016/j.semarthrit.2010.12.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 10/01/2010] [Accepted: 12/15/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This review article provides an overview of the current state of imaging of synovitis in osteoarthritis (OA), looking at recent advances and controversies and focusing particularly on the application of ultrasound and magnetic resonance imaging (MRI) in the assessment of the hand and knee joint. Computed tomography and nuclear medicine including positron emission tomography are also briefly discussed. METHODS PubMed and MEDLINE search for articles published up to 2010, using the keywords synovitis, osteoarthritis, rheumatoid arthritis, pathogenesis, imaging, radiography, computed tomography, nuclear medicine, magnetic resonance imaging, ultrasound, and pain. RESULTS Synovitis is defined as inflammation of the synovial membrane. Modern imaging techniques have demonstrated that synovial pathology is common in the early and late stages of OA and may be associated with pain. The current standard for OA imaging in clinical practice is conventional radiography but it does not allow direct visualization of synovitis. MRI without contrast administration, although widely used in clinical studies, cannot assess synovitis directly. Contrast-enhanced MRI and ultrasound, however, both allow direct visualization of synovitis including early inflammatory changes. They are regularly used to image synovitis in rheumatoid arthritis and increasingly in OA. CONCLUSIONS Synovitis is increasingly recognized as an important feature of the pathophysiology of OA, although there is conflicting evidence with respect to its association with disease severity and clinical parameters. Contrast-enhanced MRI and ultrasound are the most important methods for assessing synovitis associated with OA.
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Abstract
Joint tissues are exquisitely sensitive to their mechanical environment, and mechanical loading may be the most important external factor regulating the development and long-term maintenance of joint tissues. Moderate mechanical loading maintains the integrity of articular cartilage; however, both disuse and overuse can result in cartilage degradation. The irreversible destruction of cartilage is the hallmark of osteoarthritis and rheumatoid arthritis. In these instances of cartilage breakdown, inflammatory cytokines such as interleukin-1 beta and tumor necrosis factor-alpha stimulate the production of matrix metalloproteinases (MMPs) and aggrecanases (ADAMTSs), enzymes that can degrade components of the cartilage extracellular matrix. In order to prevent cartilage destruction, tremendous effort has been expended to design inhibitors of MMP/ADAMTS activity and/or synthesis. To date, however, no effective clinical inhibitors exist. Accumulating evidence suggests that physiologic joint loading helps maintain cartilage integrity; however, the mechanisms by which these mechanical stimuli regulate joint homeostasis are still being elucidated. Identifying mechanosensitive chondroprotective pathways may reveal novel targets or therapeutic strategies in preventing cartilage destruction in joint disease.
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Affiliation(s)
- Hui B Sun
- Leni and Peter W. May Department of Orthopedics, Mount Sinai School of Medicine, New York, New York, USA.
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Different distribution of CD4 and CD8 T cells in synovial membrane and peripheral blood of rheumatoid arthritis and osteoarthritis patients. Folia Histochem Cytobiol 2010; 47:627-32. [PMID: 20430731 DOI: 10.2478/v10042-009-0117-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rheumatoid arthritis (RA) and osteoarthritis (OA) are chronic diseases associated with morphological joint changes. Synovial membrane (SM) involvement was established for RA, but the data for OA are limited, because OA is usually regarded as noninflammatory disease. Changes in immune system in RA are not limited to joints, and the significant role of T cells of peripheral blood (PB) is not disputable. However, there is still an open debate about PB immunological profile in OA. Therefore, we decided to measure the distribution of CD4+ and CD8+ T cells, regarding CD28 expression, both in PB and SM of RA and OA patients, on the same day. Altogether, eleven RA patients, 11 OA patients and similar numbers of age-matched healthy controls were included into the study. Flow cytometry was used for T cells subpopulation distinguishing and quantification; monoclonal antibodies against CD3, CD4, CD8 and CD28 with different fluorochromes were used for stainings. The RA patients had significantly higher percentage of CD3+4+ cells in PB as compared to OA patients and relevant control group. Both within the CD4+ and CD8+ compartments, significantly lower percentages of cells bearing the CD28 marker were found in the PB of OA as compared to RA patients. The proportion of CD3+CD4+ cells in SM was dependent on age of OA patients, older OA patients had significantly higher value of their SM/blood ratio than RA patients. Older OA subjects were also characterized by higher values of the SM/blood ratio of both CD4+CD28+ and CD8+CD28+ subpopulations than RA or younger OA patients. In conclusion, in contrast to the traditional view of OA disease, our results give support to the hypothesis that OA may also (like RA) be a disease with a local immunological involvement.
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Attur M, Samuels J, Krasnokutsky S, Abramson SB. Targeting the synovial tissue for treating osteoarthritis (OA): where is the evidence? Best Pract Res Clin Rheumatol 2010; 24:71-9. [PMID: 20129201 DOI: 10.1016/j.berh.2009.08.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Osteoarthritis (OA) is often a progressive and disabling disease, which occurs in the setting of a variety of risk factors--such as advancing age, obesity and trauma--that collude to incite a cascade of pathophysiological events within joint tissues. An important emerging theme in OA is a broadening of focus from a disease of cartilage to one of the 'whole joint.' The synovium, bone and cartilage are each involved in pathological processes that lead to progressive joint degeneration. Additional themes that have emerged over the past decade are novel mechanisms of cartilage degradation and repair, the relationship between biomechanics and biochemical pathways, the importance of inflammation and the role of genetics. In this article, we review the molecular, clinical and imaging evidence that synovitis is not an 'incidental finding of OA', but plays a significant role in disease pathogenesis, and could therefore represent a target for future treatments.
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Affiliation(s)
- Mukundan Attur
- Division of Rheumatology, Department of Medicine and Pathology, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY 10003, USA
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Reynier F, Verjat T, Turrel F, Imbert PE, Marotte H, Mougin B, Miossec P. Increase in human endogenous retrovirus HERV-K (HML-2) viral load in active rheumatoid arthritis. Scand J Immunol 2009; 70:295-9. [PMID: 19703019 DOI: 10.1111/j.1365-3083.2009.02271.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To study the viral loads of human endogenous retrovirus HERV-K (HML-2) type 1 and type 2 in rheumatoid arthritis (RA), we measured the viral loads of HERV-K (HML-2) type 1 and type 2 using nucleic acid sequence-based amplification (NASBA) technology. We analyzed plasma samples from RA patients (n = 79) and healthy volunteers (HV, n = 46) and synovial fluid samples from RA (n = 10) and osteoarthritis (OA, n = 10) patients. HERV-K type 1 and type 2 viruses were detected and quantified for the majority of plasma and synovial fluid samples from RA patients. HERV-K type 1 and type 2 viral loads were significantly elevated in RA patients compared with HV in plasma (P < 0.0001) and from RA patients compared with OA patients in synovial fluid (type 1: P = 0.0007; type 2: P = 0.023). Moreover, an association was observed between the HERV-K type 1 viral load in plasma and the disease activity in RA patients (RA patients with low activity versus high activity P = 0.0129; RA patients with intermediate activity versus high activity P = 0.037). Our findings showed that HERV-K (HML-2) viral load can be detected in plasma samples from RA patients, with higher levels observed for those with active disease. There was an association of HERV-K type 1 levels with the disease activity.
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Affiliation(s)
- F Reynier
- Joint Unit Hospices Civils de Lyon - bioMérieux, and Department of Immunology and Rheumatology, Immunogenomics and inflammation research Unit EA 4130, University of Lyon, Lyon, France
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Abstract
Osteoarthritis is often a progressive and disabling disease, which occurs in the setting of a variety of risk factors--such as advancing age, obesity, and trauma--that conspire to incite a cascade of pathophysiologic events within joint tissues. An important emerging theme in osteoarthritis is a broadening of focus from a disease of cartilage to one of the 'whole joint'. The synovium, bone, and cartilage are each involved in pathologic processes that lead to progressive joint degeneration. Additional themes that have emerged over the past decade are novel mechanisms of cartilage degradation and repair, the relationship between biomechanics and biochemical pathways, the importance of inflammation, and the role played by genetics. In this review we summarize current scientific understanding of osteoarthritis and examine the pathobiologic mechanisms that contribute to progressive disease.
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Affiliation(s)
- Steven B Abramson
- Division of Rheumatology, NYU School of Medicine, NYU Hospital for Joint Diseases, New York, NY 10003, USA.
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Innate immune system activation in osteoarthritis: is osteoarthritis a chronic wound? Curr Opin Rheumatol 2008; 20:565-72. [PMID: 18698179 DOI: 10.1097/bor.0b013e32830aba34] [Citation(s) in RCA: 187] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW Synovial inflammation is increasingly recognized as an important pathophysiologic process in osteoarthritis, but the stimuli and downstream pathways activated are not well defined. Innate immune system activation, best documented in responses to pathogens, likely plays a role in induction of inflammatory mediators and the specific cellular infiltrate seen in osteoarthritis. Thus, the Toll-like receptors (TLRs) and their signaling pathways are of particular interest. These innate pattern-recognition receptors are activated not only by pathogens but by endogenous 'danger signals'. In this report, we review evidence that certain extracellular matrix components of joint tissues (hyaluronan and fibronectin) may act as TLR stimuli, and summarize recent literature implicating TLR activation in osteoarthritis. RECENT FINDINGS Convincing evidence exists that hyaluronan/TLR interactions drive responses to tissue injury. Evidence of a similar role for fibronectin is growing. TLRs are expressed and functional in the joint, and many proteases and cytokines that promote cartilage catabolism are dependent on nuclear factor-kappaB, a TLR-activated transcription factor. SUMMARY Activation of TLR pathways seems likely in osteoarthritis and may play a central role in disease development and progression. A model of osteoarthritis as a chronic wound, in which the innate immune response is triggered by molecular signals of tissue damage, is presented as a framework for future study of inflammation in this prevalent joint disease.
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Arranz A, Gutiérrez-Cañas I, Carrión M, Juarranz Y, Pablos JL, Martínez C, Gomariz RP. VIP reverses the expression profiling of TLR4-stimulated signaling pathway in rheumatoid arthritis synovial fibroblasts. Mol Immunol 2008; 45:3065-73. [PMID: 18452992 DOI: 10.1016/j.molimm.2008.03.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Revised: 03/11/2008] [Accepted: 03/15/2008] [Indexed: 12/29/2022]
Abstract
Since recent evidences point out the potential involvement of Toll-like receptors (TLRs) in the therapeutic effect of vasoactive intestinal peptide (VIP), the purpose of this study is to elucidate the role of VIP as a negative regulator of TLR-signaling. To this aim, we analyzed in fibroblast-like synoviocytes (FLS) from patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the expression profile of TLR-pathway related molecules, as well as the alterations induced by LPS stimulation in RA-FLS and the effect of VIP treatment. Cultured FLS were obtained from patients with RA or OA. RA-FLS were next stimulated with lipopolysaccharide (LPS) in presence or absence of VIP. The gene expression profiling of molecules involved in LPS-mediated TLR4-signaling was studied by cRNA microarray analysis. Twenty three molecules involved in TLR signaling resulted over-expressed at mRNA level in basal RA-FLS compared to OA-FLS. Moreover, in RA-FLS, 23 of the analyzed genes were found to be up-regulated by LPS stimulation whereas 30 were not affected. VIP down-regulated the LPS-induced RNA expression of molecules involved in TLR signaling pathway. Up-regulation of RNA expression of CD14, MD2, TRAM, TRIF, IRAK4, TAB2, TRAF6 and TBK1 was corroborated by RT-PCR as well as the VIP regulatory effect. Increased protein levels of TRAF6, TBK1 and pIRAK1 after exposure to LPS, and the inhibitory effect of VIP, were described by Western blotting. As functional consequences, it was observed the VIP-induced impaired production of IL-6 and RANTES/CCL5 after LPS stimulation. In conclusion, VIP acts as a negative modulator of the TLR4-signaling by overturning the production of several checkpoints molecules of the cascade and thus, widening its potential therapeutic effects.
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Affiliation(s)
- Alicia Arranz
- Departamento de Biología Celular, Facultad de Biología, Universidad Complutense de Madrid, 28040 Madrid, Spain
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