Knee Rheumatoid Arthritis With Lateral Tibial Plateau and Tibial Stress Fractures Managed With One-Stage Knee Joint Replacement

Total knee arthroplasty with long tibial stem for tibial stress fractures with knee osteoarthritis: Two birds with one stone

PURPOSE

The treatment and outcome of tibial stress fractures concomitant with knee osteoarthritis (OA) are complicated. The aim of this study was to evaluate the functional and radiological outcome of total knee arthroplasty with long tibial stem as a treatment for patients having knee OA and tibial stress fracture.

METHODS

Patients who were diagnosed to have proximal tibia stress fracture along with knee OA at our institution between June 2013 and November 2018 were included in our study. All patients underwent total knee arthroplasty with long tibial stem. Preoperative and postoperative functional assessments were done according to range of movement of the knee joint, knee society score and knee injury and OA outcome score. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.

RESULTS

Twelve patients were included in the study. All patients were found to have stress fractures in the proximal half of tibia and extra-arthrosis. Four patients had non-union/delayed union, and 8 patients had acute fractures. The average preoperative range of movement was 88.1°, which improved to 116.3° at 3 months following surgery. It was found that the fracture has healed in all cases. Mean knee society score improved from 32.9 preoperatively to 89.3 at 1 year follow-up. Knee injury and OA outcome score improved from a mean score of 28.3 preoperatively to 81.1 at 1 year follow-up.

CONCLUSION

Stress fractures can occur in the proximal tibia in patients with knee OA. Total knee arthroplasty with tibial stem provides a suitable solution for both conditions. Additional plating or bone graft is unlikely to be required.

MicroRNA-1592 in the Bone Marrow Mesenchymal Stem Cell-Derived Exosomes Inhibits the Glioma Development In Vivo and In Vitro

This study evaluated the role of miRNA-1592 (miR-1592) carried by exosomes that originated from bone marrow mesenchymal stem cell (BMSC) in glioma. BMSCs were cultured and identified, followed by being co-cultured with glioma cells to measure cell invasion, metastasis, and apoptosis by transwell assay and flow cytometry, cell proliferation by MTT, PI3K/AKT signal protein expression by western blot. BMSC-originated exosomes with different concentrations were used as a treatment strategy for established tumor models. The tumor volume was measured and tumor tissues were harvested for immunohistochemistry and immunoblot analysis. After co-culture with BMSC-originated exosomes, glioma cells showed an up-regulated transcription of miR-1592, along with inhibited phosphorylation and activation of PI3K/AKT signal pathway. Moreover, glioma cells exhibited reduced migration and invasiveness In Vitro, which was accompanied by diminished levels of proteins involved in cellular invasiveness. Simultaneously, co-culture with BMSC-originated exosomes can restrain glioma cell proliferation via facilitating cell apoptosis In Vivo and In Vitro. In conclusion, exosome-encapsulated microRNA-1592 from BMSCs can suppress the In Vivo and In Vitro development of glioma through interfering with PI3K/AKT signaling pathway.

MiR-449b-5p Regulates the Proliferation and Migration of Cervical Cancer Cells by Targeting Forkhead Box Protein P1 (FOXP1)

This study intends to assess miR-449b-5p’s effect on cervical cancer (CC) cells and its mechanism. After transfection of miR-449b-5p mimics, inhibitor, si-Foxp1 and negative control, CC cell viability was analyzed by MTT along with analysis of migration and invasion by transwell and scratch test, and Foxp1 protein level by Western blot. CC cells presented a significantly higher miR-449b-5p level and lower Foxp1 level in relative to normal cervical cells. miR-449b-5p mimic transfection significantly promoted CC cell viability, migration and invasion and decreased Foxp1 expression. However, all the above changes were significantly reversed after treatment with si-Foxp1. In conclusion, miR-449b-5p level is elevated in CC cells and its overexpression promotes the biological behaviors of CC cells possibly through targeting Foxp1, indicating that it might be a new target for the treatment of CC.

MicroRNA-3100 from Bone Marrow Mesenchymal Stem Cells (BMSCs) Exosomes Alleviates Autoimmune Arthritis in Mice via Regulating Forkhead Box P3 Acetylase

To study the effect and mechanism of microRNA-3100 from exosome of BMSCs on autoimmune arthritis in mice. CIA mice model was established and treated with BMSCs exosomes or DMSO. The expression of Foxp3 was detected by PCR and Western blot. The Treg/Th17 population of T cells and the expression of related inflammatory factors were analyzed by flow cytometry. BMSCs trans-fected with MicroRNA-3100 inhibitor or MicroRNA-3100 was used to treat CIA mice through intravenous injection. The levels of Foxp3 and its acetylation, Treg/Th17 differentiation and inflammatory factors were detected, and the synovial tissues of mice were collected for analysis of its inflammatory infiltration. RA rats exhibited down-regulated Treg population and increased Th17 population in PBMC and SF, accompanied by reduced Foxp3 and acetylated Foxp3 expression, suppressed Tip60 expression in SF, in relative to normal control. However, exosomes of BMSCs administration recovered the changes. Further result showed that exosomes from BMSCs was enriched for miR-3100. miR-3100 inhibitor exposed CD4+ T cell exhibited reduced Tip60 and acetylated-Foxp3 expression, decreased Tregs population and increased Th17 cell population, vice versa as the miR-3100 mimics does. In addition, Tip60 inhibitors NU905 exerted the same effect as miR-3100 inhibitor transfection dose. Finally, miR-3100 overexpression could significantly reduce inflammation and immune cell infiltration, correct the dysfunction between Th17 and Tregs, recovered Tip60 and acetylation Foxp3 expression. MiRNA-3100 is enriched in exosomes of BMSCs, and can up-regulatethe expression of Foxp3, acetylated Foxp3 and Tip60 level, improving the imbalance of Treg/Th17 ratio, and improve autoimmune arthritis in mice.