The pathogenesis of osteochondrosis--a hypothesis

Gene expression profiling of articular cartilage reveals functional pathways and networks of candidate genes for osteochondrosis in pigs

Osteochondrosis (OC) is a joint disorder that frequently causes leg weakness in growing pigs, resulting in welfare problems and economic losses. We aimed to detect molecular pathways relevant to the emergence of the disease and to identify candidate genes for the liability to the disorder. Therefore, we compared microarray-based expression patterns of articular cartilage with (n=11) and without (n=11) histologically diagnosed OC lesions obtained from discordant sib-pairs. A total of 1,564 genes were found with different transcript abundance [differentially expressed (DE) genes] at q≤0.05. To further identify candidate genes, we integrated data from quantitative trait loci (QTL) and genome-wide association (GWA) studies with the expression analysis. We detected 317 DE genes within the QTL confidence intervals, of which 26 DE genes also overlapped GWA regions. Ingenuity Pathway Analysis suggests a pathogenic role of immune response, angiogenesis, and synthesis of extracellular matrix pathways for OC. These processes could facilitate the emergence of defects. But they may also promote the degradation of articular cartilage and the worsening of the disease. A functional network was derived that comprised genes with functional and positional clues of their role in bone and cartilage metabolisms and development, including extracellular matrix genes (e.g., LOX, OGN, and ASPN), angiogenesis genes (e.g., ANGPTL4 and PDGFA), and immune response genes (e.g., ICAM1, AZGP1, C1QB, C1QC, PDE4B, and CDA). The study identified molecular processes linked to OC and several genes with positional, genetic-statistical, and functional evidence for their role in the emergence of articular cartilage lesions and the liability to OC.

Microscopic localization of active gelatinases in equine osteochondritis dissecans (OCD) cartilage

OBJECTIVE

To investigate the relationship between matrix metalloproteinase (MMP) activity and osteochondritis dissecans (OCD) in the equine joint.

METHODS

Equine articular cartilage was obtained from normal (N = 8) and osteochondrotic (OCD) (N = 6) femoropatellar joints from horses at necropsy. The activity of gelatinase MMPs was determined in sections of cartilage by in situ gelatin zymography.

RESULTS

Gelatinase activity was markedly increased in articular cartilage obtained from OCD samples and was particularly prominent in the deep cartilage zone. Activity was only seen in the pericellular area of chondrocytes. In addition, in OCD cartilage there were vertical lines of activity, starting from the deep zone and radiating towards the articular surface. In contrast, normal cartilage showed only a very small amount of gelatinolytic activity, which was not restricted to specific cartilage zones. Gelatin zymography of culture supernatants from isolated chondrocytes demonstrated increased production of MMP-2 and MMP-9 from OCD chondrocytes.

CONCLUSIONS

Sections of articular cartilage from OCD lesions revealed MMP activity, especially in the deep zone adjacent to the calcified subchondral bone. This MMP activity could account for the loss of cartilage integrity in the deep cartilage zone and the vertical lines of activity could represent areas of mechanical weakness, likely to result in fissures and the release of cartilage fragments into the joint space.

Influence of dietary calcium and phosphorus content in a fixed ratio on growth and development in Great Danes

OBJECTIVE

To study the musculoskeletal development of Great Dane puppies fed various dietary concentrations of calcium (Ca) and phosphorus (P) in fixed ratio by use of dual energy x-ray absorptiometry (DEXA), determination of serum insulin-like growth factor 1 and parathyroid hormone concentrations, radiography, and blood chemistry analysis results.

ANIMALS

32 purebred Great Dane puppies from 4 litters.

PROCEDURE

At weaning, puppies were assigned randomly to 1 of 3 diets. Blood was collected for biochemical analyses and hormone assays, and radiography and DEXA were performed through 18 months of age. Changes in body weight, bone mineral content, fat tissue weight, lean mass, result of serum biochemical analyses, hormonal concentrations, and radius lengths were analyzed through 18 months of age.

RESULTS

Bone mineral content of puppies correlated positively with Ca and P content of the diets fed. Significant differences between groups in bone mineral content, lean mass, and body fat were apparent early. The disparity among groups increased until 6 months of age and then declined until body composition was no longer different at 12 months of age. Accretion rates for skeletal mineral content, fat, and lean tissue differed from each other and by diet group.

CONCLUSIONS AND CLINICAL RELEVANCE

Ca and P concentrations in the diet of young Great Dane puppies are rapidly reflected in the bone mineral content of the puppies until 5 to 6 months of age, after which hormonal regulation adjusts absorption and excretion of these minerals. Appropriate Ca and P concentrations in diets are important in young puppies < 6 months of age.

Conclusions regarding the influence of exercise on the development of the equine musculoskeletal system with special reference to osteochondrosis

This paper summarises and interrelates the findings of a large-scale multidisciplinary investigation to assess the influence of exercise on the development of the equine musculoskeletal system in general and of osteochondrosis in particular, up to age 5 months. Forty-three foals, genetically predisposed to develop OC, were divided into 3 exercise groups: box-rest, box-rest with training and free pasture exercise. At 5 months, all foals were weaned and 8 foals per group were subjected to euthanasia for postmortem examination. The remaining 19 foals were placed together and subjected to euthanasia at age 11 months. Foals were clinically and radiographically monitored during life, muscle and tendon biopsies were taken and gait analysed kinematically. After euthanasia, all major musculoskeletal tissue components (bone, articular cartilage, tendon and muscle) were analysed extensively using a wide variety of techniques. Radiographic monitoring of the stifle and hock joints and postmortem analysis of all diarthrodial joints led to the conclusion that osteochondrosis is a dynamic and very common process in which lesions cannot only develop, but may regress spontaneously during the 'windows of susceptibility' of the various joints, making the clinically diagnosed forms of osteochondrosis into the tip of an iceberg. Closure of the 'window of susceptibility' may be determined by the metabolic status of the chondrocyte which was shown to be inferior in older lesions. Exercise had no influence on the number of lesions, but was related to the distribution of lesions within the joint. There was some evidence that growth rate may be one of the most important intrinsic factors that determine the occurrence of OC. Lack of exercise (box-rest) generally delayed the development of the tissues that make up the equine musculoskeletal system. This was evident in bone mineral density (BMD) at various sites, chemical composition of tendon and of articular cartilage, and in the development of gait. In most cases, this delay was compensated for when box confinement was lifted after 5 months. However, there were indications that this was not true for some collagen characteristics of articular cartilage where the withholding of exercise at early age may therefore have a lifelong effect. The training protocol used (rather high-intensity exercise superimposed on a basic box-rest regimen) appeared to have long lasting negative effects, affecting chondrocyte viability long after the training protocol had ended. A same tendency was seen in bone (decrease in BMD) and tendons (decreases in proteoglycan and hyaluronic acid content). It is concluded that, during the first months postpartum, the equine musculoskeletal system passes through a very dynamic period of growth-related development and intense alteration. In this period, the system is vulnerable to adverse influences that may result in developmental orthopaedic disease. However, regenerative capacity is still high, also in those tissues that are notorious for their lack of repair capacity in the mature individual, such as articular cartilage and tendon. Exercise seems to be an important factor in the determination of the final make-up (and hence biomechanical strength) of these tissues and, therefore, is a potentially powerful tool for the enhancement of injury resistance.

Hormones, growth factors and other plasma variables in relation to osteochondrosis

Osteochondrosis (OC) is a multifactorial disorder with endocrinological dysfunction and mineral imbalance having a role in pathogenesis. The present study focused on a possible relationship between insulin-like growth factor I (IGF-I), insulin-like growth factor II (IGF-II), parathyroid hormone (PTH), 1,25-dihydroxy-vitamin D (1,25(OH)2D), cortisol, copper, zinc, calcium, ionised calcium, magnesium and phosphorus and 5 different postmortem and radiographical osteochondrosis scores of hock and stifle joints in foals age 0-11 months. Osteochondrosis-positive foals showed a significantly lower IGF-I activity than osteochondrosis-negative foals. PTH, 1,25(OH)2D, cortisol, copper, zinc and calcium also showed significant differences between osteochondrosis-positive and osteochondrosis-negative foals.

Studies on growth cartilage in the horse and their application to aetiopathogenesis of dyschondroplasia (osteochondrosis)

The importance of osteochondrosis (dyschondroplasia) to the horse industry has been well documented since it was first recorded 50 years ago. The condition is known to be multifactorial in origin, arising from focal failure of endochondral ossification at predilection sites in articular/epiphyseal growth cartilage, but specific information on its aetiopathogenesis is sparse. This paper reviews the current knowledge of growth cartilage metabolism and the process of normal endochondral ossification in the horse. It highlights the localization of various protein products of chondrocytes and the differences in the zones of articular cartilage. In the early focal lesions (referred to as dyschondroplasia) there are alterations in the chondrocytes, extracellular matrix and some of the local protein products. The most obvious feature is an alteration in matrix metabolism which may be responsible for triggering a range of other factors leading to the development of a retained core of cartilage and a primary lesion of dyschondroplasia. Based on available evidence, a preliminary hypothesis for pathogenesis is presented. This suggests that there are a number of factors capable of initiating the condition. One of these involves high circulating insulin levels from high energy feeding which may affect chondrocyte maturation leading to altered matrix metabolism and faulty mineralization resulting in the formation of cartilage cores which characterize the condition. Further research to test this hypothesis is needed before there can be a rational basis for prophylaxis.

Nutrition and osteochondrosis

Developmental orthopedic disease is a group of musculoskeletal disorders that occur in growing animals (most commonly fast growing, large breed dogs). Osteochondritis dissecans and canine hip dysplasia are the overwhelming majority of the diagnoses in those musculoskeletal problems with a possible nutritional-related etiology. Nutritional management alone will not completely control osteochondrosis or any of the developmental bone diseases. However, osteochondrosis and other developmental orthopedic diseases can be influenced during growth by feeding technique and nutrient profile. Dietary deficiencies are of minimal concern in this age of commercial foods specifically prepared for young, growing dogs. The potential for harm is in overnutrition from excess consumption and over supplementation.

The pathophysiology of osteochondrosis

Osteochondrosis is a disorder of epiphyseal cartilage about which there is considerable confusion in the literature. We believe that this is due to the fact that osteochondrosis has been studied in the chronic stage when the lesions are morphologically complicated and the initial causative insult is impossible to determine. The etiology of osteochondrosis appears to be multifactorial, with trauma, hereditary factors and rapid growth, nutritional factors, and ischemia all having a role in its pathogenesis. Although predilection sites are variable among species, the morphology of the early lesions is strikingly similar, strongly suggesting that the pathogenesis of osteochondrosis is the same, regardless of the species affected. Based on recent studies in pigs and horses, and supported by observations in dogs and cattle, we believe that local ischemia secondary to defects in cartilage canal blood supply is a key factor in the initiation of lesions of osteochondrosis and explains many of the features of this disease. Local ischemia to the epiphyseal cartilage of the articular-epiphyseal cartilage complex leads to the formation of highly vulnerable zones of necrotic epiphyseal cartilage which later cause a delay in endochondral ossification, with extension of necrotic cartilage into the subchondral bone. Trauma, whether major or minor, to the overlying articular cartilage leads to cartilage cleft formation, clinical signs of pain and lameness, and other chronic sequelae. Studies aimed at further elucidating the pathogenesis of osteochondrosis should attempt to determine the cause of the vascular defect and whether or not it may be modified by experimental manipulations.

Equine dyschondroplasia (osteochondrosis)--histological findings and type VI collagen localization

This study describes (1) the histological appearance of dyschondroplasia, the primary lesion of osteochondrosis, in articular cartilage of the horse and (2) the localization of type VI collagen which is an important constituent of the extracellular matrix (ECM). Dyschondroplastic cartilage was identified on the basis of the presence of cartilage cores (i.e., cartilage extending into the subchondral bone) and confirmed with subsequent histological examination. Full-thickness cartilage samples from 57 horses were collected and paraffin embedded. Histological examination was used to examine the normal architecture of equine growth cartilage and to determine the presence of various pathological changes in dyschondroplastic lesions. Immunolocalization was used to identify type VI collagen in normal and dyschondroplastic lesions. The abnormalities observed in the dyschondroplastic cartilage fell into two groups. In Group A (n = 18) the lesions were associated with a disruption in the normal sequential transition of the chondrocytes through proliferation and maturation resulting in an accumulation of large numbers of small, rounded chondrocytes. A decrease in type VI collagen immunoreactivity compared with normal animals was detected except around chondrocyte clusters. Group B lesions (n = 9) were characterized by an alteration in the staining pattern of the mineralized cartilage and underlying bone. In these lesions type VI collagen immunoreactivity was increased. In both groups the presence of retained blood vessels, chondrocyte clusters, chondronecrosis and fissure formation was detected. These two histologically-distinct groups suggest that equine dyschondroplasia may be comprised of different pathological entities and that it is associated with alterations in the pattern of distribution of an ECM protein.

Nutritional management of osteoarthritis

Nutrition can influence developmental orthopedic diseases and the inflammatory process of arthritis. Developmental skeletal disease is a group of skeletal abnormalities that primarily affect fast-growing, large-breed dogs. Nutrient excesses (calcium and energy) and rapid growth (overfeeding and excess energy) are known risk factors. Inflammation can be directly or indirectly affected by nutritional influences. A direct effect can be achieved by modulating the immune response and inflammatory process with fatty acids. Weight control can indirectly influence the degenerative joint disease process by reducing the stresses on the joint.

Pathological and radiological investigations on osteochondrosis in pigs, associated with leg weakness

Two-hundred and seventy-eight Danish Landrace boars were examined radiologically and pathologically for osteochondrosis and other joint lesions on the left legs at slaughter (95 kg). The joint changes were scored on a scale from 1 (normal) to 5 (very severe changes/osteochondritis dissecans). The correlations between radiological and pathological scores were highly significant in the humeral condyles (r = 0.66, P < 0.001), the distal ulna growth plate (r = 0.51, P < 0.001), the femoral condyles (r = 0.33, P < 0.001) and hock (distal tibia (r = 0.17, P < 0.01) and the medial trochlear ridge of the talus (r = 0.17, P < 0.01), indicating that radiographical examination is a useful method for diagnosing osteochondrosis in live pigs. Thickening of cartilage was strongly associated with subchondrial lesions in the three predilection sites: the humeral condyle, the femoral condyles and the distal ulna growth plate. Osteochondritis dissecans (OCD) in the humeral condyles was significantly associated with subchondral lesions (OR = 1.86; P < 0.001), but not with cartilage thickness when analysed simultaneously. There were no associations between lesions in the distal ulna growth plate, the humeral condyles, the femoral condyles or the anconeal process. There was no significant correlation between OCD in the humeral condyles and the anconeal process. Osteochondrosis could therefore not be stated to be a generalized disorder. Regression coefficients between joint changes and leg weakness symptoms judged before slaughter were very small and showed no clear trends. OCD in the humeral condyles was, however, significantly associated with 'legs turned out on fore (OR = 2.48; P < 0.001) and hind (OR = 1.62; P < 0.05) legs', and OCD in the anconeal process with 'stiff movement in front' (OR = 2.01; P < 0.05). Osteochondrosis is thus comparable with a threshold trait, where the threshold is the development of an OCD in an osteochondrosis injured joint.