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Ko JY, Wang FS, Lian WS, Yang FS, Chen JW, Huang PH, Liao CY, Kuo SJ. Dickkopf-1 (DKK1) blockade mitigates osteogenesis imperfecta (OI) related bone disease. Mol Med 2024; 30:66. [PMID: 38773377 PMCID: PMC11106911 DOI: 10.1186/s10020-024-00838-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 05/14/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND The current treatment of osteogenesis imperfecta (OI) is imperfect. Our study thus delves into the potential of using Dickkopf-1 antisense (DKK1-AS) to treat OI. METHODS We analysed serum DKK1 levels and their correlation with lumbar spine and hip T-scores in OI patients. Comparative analyses were conducted involving bone marrow stromal cells (BMSCs) and bone tissues from wild-type mice, untreated OI mice, and OI mice treated with DKK1-ASor DKK1-sense (DKK1-S). RESULTS Significant inverse correlations were noted between serum DKK1 levels and lumbar spine (correlation coefficient = - 0.679, p = 0.043) as well as hip T-scores (correlation coefficient = - 0.689, p = 0.042) in OI patients. DKK1-AS improved bone mineral density (p = 0.002), trabecular bone volume/total volume fraction (p < 0.001), trabecular separation (p = 0.010), trabecular thickness (p = 0.001), trabecular number (p < 0.001), and cortical thickness (p < 0.001) in OI mice. DKK1-AS enhanced the transcription of collagen 1α1, osteocalcin, runx2, and osterix in BMSC from OI mice (all p < 0.001), resulting in a higher von Kossa-stained matrix area (p < 0.001) in ex vivo osteogenesis assays. DKK1-AS also reduced osteoclast numbers (p < 0.001), increased β-catenin and T-cell factor 4 immunostaining reactivity (both p < 0.001), enhanced mineral apposition rate and bone formation rate per bone surface (both p < 0.001), and decreased osteoclast area (p < 0.001) in OI mice. DKK1-AS upregulated osteoprotegerin and downregulated nuclear factor-kappa B ligand transcription (both p < 0.001). Bone tissues from OI mice treated with DKK1-AS exhibited significantly higher breaking force compared to untreated OI mice (p < 0.001). CONCLUSIONS Our study elucidates that DKK1-AS has the capability to enhance bone mechanical properties, restore the transcription of osteogenic genes, promote osteogenesis, and inhibit osteoclastogenesis in OI mice.
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Affiliation(s)
- Jih-Yang Ko
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
- Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
| | - Feng-Sheng Wang
- Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
| | - Wei-Shiung Lian
- Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
| | - Fu-Shine Yang
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
| | - Jeng-Wei Chen
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
| | - Po-Hua Huang
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
| | - Chin-Yi Liao
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, 833401, Taiwan
| | - Shu-Jui Kuo
- School of Medicine, China Medical University, Taichung City, 404328, Taiwan.
- Department of Orthopedic Surgery, China Medical University Hospital, Taichung City, 404327, Taiwan.
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Denys A, Norman A, Perrien DS, Suva LJ, Simon L, McDaniel LS, Ferguson T, Pedersen K, Welsh D, Molina PE, Ronis MJJ. Impact of Alcohol on Bone Health in People Living With HIV: Integrating Clinical Data From Serum Bone Markers With Morphometric Analysis in a Non-Human Primate Model. JBMR Plus 2023; 7:e10703. [PMID: 36699637 PMCID: PMC9850440 DOI: 10.1002/jbm4.10703] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/30/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022] Open
Abstract
People living with HIV (PLWH) represent a vulnerable population to adverse musculoskeletal outcomes due to HIV infection, antiretroviral therapy (ART), and at-risk alcohol use. Developing measures to prevent skeletal degeneration in this group requires a grasp of the relationship between alcohol use and low bone mass in both the PLWH population and its constituents as defined by sex, age, and race. We examined the association of alcohol use with serum biochemical markers of bone health in a diverse cohort of PLWH enrolled in the New Orleans Alcohol Use in HIV (NOAH) study. To explore the effects of alcohol on bone in the context of HIV and ART and the role of estrogen, we conducted a parallel, translational study using simian immunodeficiency virus (SIV)+/ART+ female rhesus macaques divided into four groups: vehicle (Veh)/Sham; chronic binge alcohol (CBA)/Sham; Veh/ovariectomy (OVX); and CBA/OVX. Clinical data showed that both osteocalcin (Ocn) and procollagen type I N-propeptide (PINP) levels were inversely associated with multiple measures of alcohol consumption. Age (>50 years) significantly increased susceptibility to alcohol-associated suppression of bone formation in both female and male PLWH, with postmenopausal status appearing as an additional risk factor in females. Serum sclerostin (Scl) levels correlated positively with measures of alcohol use and negatively with Ocn. Micro-CT analysis of the macaque tibias revealed that although both CBA and OVX independently decreased trabecular number and bone mineral density, only OVX decreased trabecular bone volume fraction and impacted cortical geometry. The clinical data implicate circulating Scl in the pathogenesis of alcohol-induced osteopenia and suggest that bone morphology can be significantly altered in the absence of net change in osteoblast function as measured by serum markers. Inclusion of sophisticated tools to evaluate skeletal strength in clinical populations will be essential to understand the impact of alcohol-induced changes in bone microarchitecture. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Alexandra Denys
- Department of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Allison Norman
- Department of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Daniel S Perrien
- Division of Clinical Pharmacology in the Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Larry J Suva
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTXUSA
| | - Liz Simon
- Comprehensive Alcohol Research CenterLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Lee S McDaniel
- Comprehensive Alcohol Research CenterLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Tekeda Ferguson
- Comprehensive Alcohol Research CenterLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Kim Pedersen
- Department of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - David Welsh
- Comprehensive Alcohol Research CenterLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Patricia E Molina
- Comprehensive Alcohol Research CenterLouisiana State University Health Sciences CenterNew OrleansLAUSA
- Department of PhysiologyLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Martin JJ Ronis
- Department of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew OrleansLAUSA
- Comprehensive Alcohol Research CenterLouisiana State University Health Sciences CenterNew OrleansLAUSA
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The Antagonism of Neuropeptide Y Type I Receptor (Y1R) Reserves the Viability of Bone Marrow Stromal Cells in the Milieu of Osteonecrosis of Femoral Head (ONFH). Biomedicines 2022; 10:biomedicines10112942. [PMID: 36428510 PMCID: PMC9687204 DOI: 10.3390/biomedicines10112942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022] Open
Abstract
Neuropeptide Y (NPY)-Y1 receptor (Y1R) signaling is known to negatively affect bone anabolism. Our study aimed at investigating the impact of NPY-Y1R signaling in the pathogenesis of glucocorticoid-related osteonecrosis of the femoral head (ONFH). Femoral heads were retrieved from 20 patients with and without ONFH, respectively. The bone marrow stromal cells (BMSCs) from ONFH femoral heads were treated with Y1R agonists and antagonists for subsequent analysis. We showed that the local NPY expression level was lower in ONFH heads. The Y1R agonists and antagonists disturb and facilitate the survival of BMSCs. The transcription of stromal derived factor-1 (SDF-1) was enhanced by Y1R antagonists. Our study showed that the local NPY expression level was lower in ONFH heads. Y1R antagonists facilitate the survival of BMSCs and stimulate the transcription of SDF-1 by BMSCs. These findings shed light on the role of NPY-Y1R signaling in the pathogenesis of ONFH.
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[Progress of pathogenesis and genetics of alcohol-induced osteonecrosis of femoral head]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:1420-1427. [PMID: 36382462 PMCID: PMC9681594 DOI: 10.7507/1002-1892.202206072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To review the research progress of pathogenesis and genetics of alcohol-induced osteonecrosis of the femoral head (AIONFH). METHODS The relevant domestic and foreign literature in recent years was extensively reviewed. The pathogenesis, the relationship between gene polymorphism and susceptibility, the related factors of disease progression, and the potential therapeutic targets of AIONFH were summarized. RESULTS AIONFH is a refractory orthopedic disease caused by excessive drinking, seriously affecting the daily life of patients due to its high disability rate. The pathogenesis of AIONFH includes lipid metabolism disorder, endothelial dysfunction, bone homeostasis imbalance, and et al. Gene polymorphism and non-coding RNA are also involved. The hematological and molecular changes involved in AIONFH may be used as early diagnostic markers and potential therapeutic targets of the disease. CONCLUSION The pathogenesis of AIONFH has not been fully elucidated. Research based on genetics, including gene polymorphism and non-coding RNA, combined with next-generation sequencing technology, may provide directions for future research on the mechanism and discovery of potential therapeutic targets.
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Vlashi R, Zhang X, Wu M, Chen G. Wnt signaling: essential roles in osteoblast differentiation, bone metabolism and therapeutic implications for bone and skeletal disorders. Genes Dis 2022. [DOI: 10.1016/j.gendis.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Assessment of Systemic and Maxillary Bone Loss in Cancer Patients with Endo-Periodontal Lesions Using Dkk-1 Biomarker and Dental Radiological Examinations. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105235] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of our study was to correlate systemic bone loss by evaluating human Dickkopf-related protein 1 (Dkk-1) biomarker compared to horizontal bone loss as well as the presence and size of periapical lesions assessed by dental X-ray (ortopantomography—OPT) and cone beam computed tomography (CBCT) in patients with cancer in the ears, nose and throat (ENT) region vs. healthy controls. The study included 63 subjects divided into a study group of 33 cancer patients with ENT cancer (larynx/oropharynx/sinuses) and a control group of 30 healthy individuals. Blood samples were collected from both groups to assess Dkk-1 level using a sandwich enzyme immunoassay. The dental radiological examination consisted of a panoramic X-ray and a CBCT in order to appraise the horizontal bone loss, the presence and size of the periapical lesions in 2D vs. 3D images. The panoramic X-ray showed that in the control group, the maximum bone loss reached 13.2 mm, with an average of 4.930 ± 3.258 mm, while in the study group, the maximum horizontal bone loss was 11.3 mm, with an average of 5.191 ± 2.109 mm. The CBCT 3D investigation, when compared to the OPT, showed increased values for horizontal bone loss, both in the control group and in the study group; in the control group, the maximum bone loss reached 14.10 mm, with an average of 5.736 ± 3.471 mm, and in the study group, the maximum value was 12.40 mm, and the average was again slightly higher (6.152 ± 2.519 mm). The mean value for Dkk-1 in cancer patients was 1.209 ± 0.110 ng/mL, significantly lower than the value observed in healthy patients (1.712 ± 0.100 ng/mL). CBCT revealed higher values for the investigated parameters when compared to panoramic X-rays. Taking into account the preliminary nature of our study, we observed a significant correlation between the level of bone loss recorded by the Dkk-1 biomarker and radiological dental examination in patients with ENT cancer when compared to the control group.
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Martínez-Gil N, Ugartondo N, Grinberg D, Balcells S. Wnt Pathway Extracellular Components and Their Essential Roles in Bone Homeostasis. Genes (Basel) 2022; 13:genes13010138. [PMID: 35052478 PMCID: PMC8775112 DOI: 10.3390/genes13010138] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 12/11/2022] Open
Abstract
The Wnt pathway is involved in several processes essential for bone development and homeostasis. For proper functioning, the Wnt pathway is tightly regulated by numerous extracellular elements that act by both activating and inhibiting the pathway at different moments. This review aims to describe, summarize and update the findings regarding the extracellular modulators of the Wnt pathway, including co-receptors, ligands and inhibitors, in relation to bone homeostasis, with an emphasis on the animal models generated, the diseases associated with each gene and the bone processes in which each member is involved. The precise knowledge of all these elements will help us to identify possible targets that can be used as a therapeutic target for the treatment of bone diseases such as osteoporosis.
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Zhang SY, Wang F, Zeng XJ, Huang Z, Dong KF. Astragalus polysaccharide ameliorates steroid-induced osteonecrosis of femoral head through miR-206/HIF-1α/BNIP3 axis. Kaohsiung J Med Sci 2021; 37:1089-1100. [PMID: 34338434 DOI: 10.1002/kjm2.12426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 01/17/2023] Open
Abstract
Declining autophagy and rising apoptosis are the main factors driving the development of steroid-induced osteonecrosis of the femoral head (SONFH). Here, we showed that astragalus polysaccharide (APS) improved femoral head necrosis via regulation of cell autophagy and apoptosis through microRNA (miR)-206/hypoxia inducible factor-1 (HIF-1α)/BCL2 interacting protein 3 (BNIP3) axis. The expression of miR-206, HIF-1α, and BNIP3 in SONFH specimens and cell model were measured using qPCR. SONFH cell model was treated with APS. Cell autophagy was evaluated using LC3-immunofluorescence assays. Flow cytometry was conducted to assess cell apoptosis. Apoptosis-related proteins and autophagy-related proteins were determined using western blot. Besides, dual-luciferase reporter assay was employed to investigate the relationship between miR-206 and HIF-1α. Here we showed that miR-206 expression was upregulated in SONFH tissues and cell model. APS promoted autophagy and inhibited apoptosis in SONFH cell model via downregulating miR-206. What is more, HIF-1α was the target of miR-206. Knockdown of HIF-1α reversed the recovery effect of miR-206 inhibitor on SONFH cell model. Furthermore, BNIP3 was the target of HIF-1α. HIF-1α overexpression promoted autophagy and inhibited apoptosis, and knockdown of BNIP3 abolished the recovery effect of HIF-1α overexpression in SONFH cell model. These results provided evidence that APS reduced miR-206 expression, and the downregulated miR-206 increased BNIP3 expression by targeting HIF-1α to promote autophagy and inhibit bone cell apoptosis. Our research proved that APS effectively improved SONFH by regulating cell autophagy and apoptosis.
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Affiliation(s)
- Shen-Yao Zhang
- Department of Orthopedics, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Fan Wang
- Department of Orthopedics, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Xiang-Jing Zeng
- Department of Orthopedics, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Zhen Huang
- Department of Orthopedics, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Ke-Fang Dong
- Department of Orthopedics, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
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Wang H, Yang F, Cao Z, Luo Y, Liu J, Yang Z, Xia H, Li F, Mao Z, Yang W. Clinical acupuncture therapy for femur head necrosis: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e26400. [PMID: 34160424 PMCID: PMC8238343 DOI: 10.1097/md.0000000000026400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 06/03/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Femur Head Necrosis (FHN) is a common clinical joint orthopedic-related disease, and its incidence is increasing year by year. Symptoms include dull pain and dull pain in the affected hip joint or its surrounding joints. More severely, it can lead to limited joint movement and inability to walk autonomously. Surgical treatment has many sequelae. The high cost makes it unaffordable for patients, and the side effects of drug treatment are unknown. A large number of clinical studies have shown that acupuncture is effective in treating femoral head necrosis. Therefore, this systematic review aims to explore the safety and effectiveness of acupuncture in the treatment of femoral head necrosis. METHODS We will conduct a comprehensive literature search in Medline, PubMed, Cochrane Database of Systematic Reviews, Embase, Chinese Biomedical Literatures Database (CBM), China National Knowledge Infrastructure (CNKI), Wang FangDatabase (WF), Chinese Scientific Journal Database (VIP) from inception to May 2021 without any language restriction. In addition, we will retrieve the unpublished studies and the references of initially included literature manually. The two reviewers will identify studies, extract data, and assess the quality independently. The outcomes of interest include: total effective rate; the total nasal symptom score; Hip function (Hip Harris joint score, WOMAC hip score, hip joint Lequesne index score, Merle D 'Aubigne and hip joint Postel score); Adverse events. Randomized clinical trials will be collected, methodological quality will be evaluated using the Cochrane risk-of-bias assessment tool, and the level of evidence will be rated using the Grading of Recommendations, Assessment, Development and Evaluation approach. Meta-analysis will be performed using RevMan 5.4.0 software. The heterogeneity test will be conducted between the studies, P < .1 and I2 > 50% are the thresholds for the tests. We will utilize the fixed effects model or the random effects model according to the size of heterogeneity. RESULTS The meta-analysis program will systematically evaluate the efficacy and safety of acupuncture in the treatment of FHN patients. CONCLUSION This study will investigate whether acupuncture can be used as one of the non-surgical and non-pharmacological therapies for the prevention or treatment of FHN. TRIAL REGISTRATION NUMBER INPLASY202150035.
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Affiliation(s)
- Hongyu Wang
- Jiangxi University of Traditional Chinese Medicine
| | - Fengyun Yang
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Zhiwen Cao
- Jiangxi University of Traditional Chinese Medicine
| | - Yunfeng Luo
- Jiangxi University of Traditional Chinese Medicine
| | | | - Zhijun Yang
- Jiangxi University of Traditional Chinese Medicine
| | - Hanting Xia
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Fuwei Li
- Jiangxi University of Traditional Chinese Medicine
| | | | - Wenlong Yang
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Song D, Wu ZS, Xu Q, Wang K, Xu MT, Ha CZ, Zhang C, Wang DW. LRRC17 regulates the bone metabolism of human bone marrow mesenchymal stem cells from patients with idiopathic necrosis of femoral head through Wnt signaling pathways: A preliminary report. Exp Ther Med 2021; 22:666. [PMID: 33986831 PMCID: PMC8112125 DOI: 10.3892/etm.2021.10098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/19/2021] [Indexed: 11/06/2022] Open
Abstract
Idiopathic necrosis of the femoral head (INFH) is a common disease with unknown cause. Its successful treatment relies on the repair of the necrotic bone. The application of autologous mesenchymal stem cells (MSCs) has shown great promise in saving the patients from undergoing total hip arthroplasty. Leucine-rich repeat-containing 17 (LRRC17) is less expressed in patients with femoral head necrosis and LRRC17 can inhibit bone degradation. However, it remains unknown whether LRRC17 plays a role in the pathogenesis of INFH. The present study aimed to investigate the potential role and mechanism of LRRC17 in the pathogenesis and treatment of INFH. It was found that despite the similar cell morphology and MSC surface marker expressions of human bone marrow MSCs (BMSCs) isolated from patients with INFH (INFH-hBMSC) and femoral neck fracture (FNF) (FNF-hBMSC), INFH-hBMSC had higher percentage of apoptosis (P<0.05), as well as lower osteogenic potential and higher adipogenic potential (both P<0.05). However, there was no difference in cell proliferation between FNF-hBMSC and INFH-hBMSC (P>0.05). It was also confirmed that the expression of LRRC17 was lower in the bone tissue and hBMSCs from patients with INFH compared with patients with FNF (P<0.05). Overexpression of LRRC17 promoted osteogenesis and inhibited the adipogenesis in hBMSCs, accompanied with the increase of Wnt3a and β-catenin expressions, and the decrease of Wnt5a and receptor activator of nuclear factor κ-B ligand (Rankl) expressions (all, P<0.05). Furthermore, knockout of LRRC17 in hBMSCs inhibited the expression levels of osteogenic and promoted adipogenic markers, while decreasing Wnt3a and β-catenin expressions, and increasing Wnt5a and Rankl expressions (all, P<0.05). The present preliminary study suggested that imbalanced bone metabolism may be involved in the pathogenesis of INFH. The modulation of the LRRC17 gene may delay or even restore the balance of osteogenic and adipogenic differentiation in autologous BMSCs derived from patients with INFH, providing a new target for the treatment of INFH.
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Affiliation(s)
- Da Song
- Department of Orthopedics, Liaocheng People's Hospital, Cheeloo College of Medicine, Shandong University, Liaocheng, Shandong 252000, P.R. China.,Department of Orthopedics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Zhen-Song Wu
- Department of Joint Surgery, Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277100, P.R. China
| | - Qi Xu
- Department of Orthopedics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Kai Wang
- Department of Orthopedics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Ming-Tao Xu
- Department of Orthopedics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Cheng-Zhi Ha
- Department of Orthopedics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Chao Zhang
- Department of Orthopedics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Da-Wei Wang
- Department of Orthopedics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
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Srikanth MP, Feldman RA. Elevated Dkk1 Mediates Downregulation of the Canonical Wnt Pathway and Lysosomal Loss in an iPSC Model of Neuronopathic Gaucher Disease. Biomolecules 2020; 10:E1630. [PMID: 33287247 PMCID: PMC7761665 DOI: 10.3390/biom10121630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
Gaucher Disease (GD), which is the most common lysosomal storage disorder, is caused by bi-allelic mutations in GBA1-a gene that encodes the lysosomal hydrolase β-glucocerebrosidase (GCase). The neuronopathic forms of GD (nGD) are characterized by severe neurological abnormalities that arise during gestation or early in infancy. Using GD-induced pluripotent stem cell (iPSC)-derived neuronal progenitor cells (NPCs), we have previously reported that neuronal cells have neurodevelopmental defects associated with the downregulation of canonical Wnt signaling. In this study, we report that GD NPCs display elevated levels of Dkk1, which is a secreted Wnt antagonist that prevents receptor activation. Dkk1 upregulation in mutant NPCs resulted in an increased degradation of β-catenin, and there was a concomitant reduction in lysosomal numbers. Consistent with these results, incubation of the mutant NPCs with recombinant Wnt3a (rWnt3a) was able to outcompete the excess Dkk1, increasing β-catenin levels and rescuing lysosomal numbers. Furthermore, the incubation of WT NPCs with recombinant Dkk1 (rDkk1) phenocopied the mutant phenotype, recapitulating the decrease in β-catenin levels and lysosomal depletion seen in nGD NPCs. This study provides evidence that downregulation of the Wnt/β-catenin pathway in nGD neuronal cells involves the upregulation of Dkk1. As Dkk1 is an extracellular Wnt antagonist, our results suggest that the deleterious effects of Wnt/β-catenin downregulation in nGD may be ameliorated by the prevention of Dkk1 binding to the Wnt co-receptor LRP6, pointing to Dkk1 as a potential therapeutic target for GBA1-associated neurodegeneration.
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Affiliation(s)
| | - Ricardo A. Feldman
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD 21201, USA;
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12
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Tan L, Song X, Ren Y, Wang M, Guo C, Guo D, Gu Y, Li Y, Cao Z, Deng Y. Anti-inflammatory effects of cordycepin: A review. Phytother Res 2020; 35:1284-1297. [PMID: 33090621 DOI: 10.1002/ptr.6890] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/25/2020] [Accepted: 09/13/2020] [Indexed: 01/08/2023]
Abstract
Cordycepin is the major bioactive component extracted from Cordyceps militaris. In recent years, cordycepin has received increasing attention owing to its multiple pharmacological activities. This study reviews recent researches on the anti-inflammatory effects and the related activities of cordycepin. The results from our review indicate that cordycepin exerts protective effects against inflammatory injury for many diseases including acute lung injury (ALI), asthma, rheumatoid arthritis, Parkinson's disease (PD), hepatitis, atherosclerosis, and atopic dermatitis. Cordycepin regulates the NF-κB, RIP2/Caspase-1, Akt/GSK-3β/p70S6K, TGF-β/Smads, and Nrf2/HO-1 signaling pathways among others. Several studies focusing on cordycepin derivatives were reviewed and found to down metabolic velocity of cordycepin and increase its bioavailability. Moreover, cordycepin enhanced immunity, inhibited the proliferation of viral RNA, and suppressed cytokine storms, thereby suggesting its potential to treat COVID-19 and other viral infections. From the collected and reviewed information, this article provides the theoretical basis for the clinical applications of cordycepin and discusses the path for future studies focusing on expanding the medicinal use of cordycepin. Taken together, cordycepin and its analogs show great potential as the next new class of anti-inflammatory agents.
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Affiliation(s)
- Lu Tan
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| | - Xiaominting Song
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| | - Yali Ren
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| | - Miao Wang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| | - Chuanjie Guo
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| | - Dale Guo
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| | - Yucheng Gu
- Syngenta Jealott's Hill International Research Centre, Berkshire, UK
| | - Yuzhi Li
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| | - Zhixing Cao
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
| | - Yun Deng
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine; Key Laboratory of Standardization for Chinese Herbal Medicine, Ministry of Education; National Key Laboratory Breeding Base of Systematic Research, Development and Utilization of Chinese Medicine Resources, Chengdu, China
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13
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de Sousa Ferreira VC, Lopes AP, Alves NM, Sousa FRN, Pereira KMA, Gondim DV, Girão VCC, Leitão RFC, Goes P. Bisphosphonate-related osteonecrosis induced change in alveolar bone architecture in rats with participation of Wnt signaling. Clin Oral Investig 2020; 25:673-682. [PMID: 32897500 DOI: 10.1007/s00784-020-03551-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/25/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This work aimed to study the role of inflammation in medication-related osteonecrosis of the jaw (MRONJ) in rats with focus on Wnt signaling. METHODS A total of 36 female Wistar rats (12 weeks ± 200 g) were divided into 2 groups (n = 6) in 3 experiments: saline (SAL) and zoledronic acid (ZOL). For MRONJ induction, rats received 0.1 mg/kg of ZOL (ip) 3×/week for 9 weeks. Animals from the SAL group received 0.1 mg/kg of 0.9% SAL, ip 3×/week for 9 weeks. On the 8th week, 3 left upper molars were extracted, and on the 11th week, they were euthanized. Maxillae were evaluated by macroscopic and histopathological analyses; scanning electron microscopy (SEM); immunohistochemistry for DKK-1, Wnt 10b, and caspase-3; and Raman spectrometry. Gingiva was also collected for TNF-α e IL-1β quantification. RESULTS Bone necrosis was confirmed by healing impairment, reduced number of viable osteocytes, increased caspase-3 immunoexpression, and increased number of empty lacunae (p < 0.05). ZOL enhanced inflammation and increased gingival levels of IL-1β and TNF-α (p < 0.05). Irregular indentations were seen on bone after ZOL administration. Bone necrosis was marked by reduced amount of total and type I collagen. ZOL reduced the mineral/matrix ratio and increased carbonate/phosphate ratio. It was observed a significant reduction on Wnt10b and beta-catenin immunolabeling in the bone tissue of ZOL group. CONCLUSION In summary, MRONJ model caused bone necrosis due to intense inflammation. Wnt signaling seems to play an important role in this process. CLINICAL RELEVANCE New therapeutic strategies focusing on Wnt pathway can provide an interesting approach for future treatments.
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Affiliation(s)
- Vanessa Costa de Sousa Ferreira
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil.,Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Amanda Pimentel Lopes
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil.,Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Nicholas Militão Alves
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil.,Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Karuza Maria Alves Pereira
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil.,Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Delane Viana Gondim
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil.,Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | | | - Paula Goes
- Nucleus of Study and Research in Pain, Inflammation and Osteoimmunology (NEPDIO), Medical School, Federal University of Ceará, Fortaleza, CE, Brazil. .,Department of Pathology and Legal Medicine, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil. .,Departamento de Patologia e Medicina Legal, Faculdade de Medicina, Universidade Federal do Ceará, Rua Monsenhor Furtado, s/n 60441-750. Rodolfo Teófilo, Fortaleza, CE, Brazil.
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14
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Chen CY, Du W, Rao SS, Tan YJ, Hu XK, Luo MJ, Ou QF, Wu PF, Qing LM, Cao ZM, Yin H, Yue T, Zhan CH, Huang J, Zhang Y, Liu YW, Wang ZX, Liu ZZ, Cao J, Liu JH, Hong CG, He ZH, Yang JX, Tang SY, Tang JY, Xie H. Extracellular vesicles from human urine-derived stem cells inhibit glucocorticoid-induced osteonecrosis of the femoral head by transporting and releasing pro-angiogenic DMBT1 and anti-apoptotic TIMP1. Acta Biomater 2020; 111:208-220. [PMID: 32447063 DOI: 10.1016/j.actbio.2020.05.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 01/08/2023]
Abstract
Osteonecrosis of the femoral head (ONFH) frequently occurs after glucocorticoid (GC) treatment. Extracellular vesicles (EVs) are important nano-sized paracrine mediators of intercellular crosstalk. This study aimed to determine whether EVs from human urine-derived stem cells (USC-EVs) could protect against GC-induced ONFH and focused on the impacts of USC-EVs on angiogenesis and apoptosis to explore the mechanism by which USC-EVs attenuated GC-induced ONFH. The results in vivo showed that the intravenous administration of USC-EVs at the early stage of GC exposure could rescue angiogenesis impairment, reduce apoptosis of trabecular bone and marrow cells, prevent trabecular bone destruction and improve bone microarchitecture in the femoral heads of rats. In vitro, USC-EVs reversed the GC-induced suppression of endothelial angiogenesis and activation of apoptosis. Deleted in malignant brain tumors 1 (DMBT1) and tissue inhibitor of metalloproteinases 1 (TIMP1) proteins were enriched in USC-EVs and essential for the USC-EVs-induced pro-angiogenic and anti-apoptotic effects in GC-treated cells, respectively. Knockdown of TIMP1 attenuated the protective effects of USC-EVs against GC-induced ONFH. Our study suggests that USC-EVs are a promising nano-sized agent for the prevention of GC-induced ONFH by delivering pro-angiogenic DMBT1 and anti-apoptotic TIMP1. STATEMENT OF SIGNIFICANCE: This study demonstrates that the intravenous injection of extracellular vesicles from human urine-derived stem cells (USC-EVs) at the early stage of glucocorticoid (GC) exposure efficiently protects the rats from the GC-induced osteonecrosis of the femoral head (ONFH). Moreover, this study identifies that the promotion of angiogenesis and inhibition of apoptosis by transferring pro-angiogenic DMBT1 and anti-apoptotic TIMP1 proteins contribute importantly to the USC-EVs-induced protective effects against GC-induced ONFH. This study suggests the promising prospect of USC-EVs as a new nano-sized agent for protecting against GC-induced ONFH, and the potential of DMBT1 and TIMP1 as the molecular targets for further augmenting the protective function of USC-EVs.
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Affiliation(s)
- Chun-Yuan Chen
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Wei Du
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Shan-Shan Rao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Xiangya Nursing School, Central South University, Changsha, Hunan 410013, China
| | - Yi-Juan Tan
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Xiong-Ke Hu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Ming-Jie Luo
- Xiangya Nursing School, Central South University, Changsha, Hunan 410013, China
| | - Qi-Feng Ou
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Pan-Feng Wu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Li-Ming Qing
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zhe-Ming Cao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Hao Yin
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Tao Yue
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Chao-Hong Zhan
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jie Huang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Yan Zhang
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Yi-Wei Liu
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zhen-Xing Wang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zheng-Zhao Liu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jia Cao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jiang-Hua Liu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Chun-Gu Hong
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Ze-Hui He
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jun-Xiao Yang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Si-Yuan Tang
- Xiangya Nursing School, Central South University, Changsha, Hunan 410013, China
| | - Ju-Yu Tang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
| | - Hui Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Hunan Key Laboratory of Organ Injury, Aging and Regenerative Medicine, Changsha, Hunan 410008, China; Hunan Key Laboratory of Bone Joint Degeneration and Injury, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Key Laboratory of Biological Nanotechnology of National Health Commission, Changsha, Hunan 410008, China.
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15
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Shu P, Sun DL, Shu ZX, Tian S, Pan Q, Wen CJ, Xi JY, Ye SN. Therapeutic Applications of Genes and Gene-Engineered Mesenchymal Stem Cells for Femoral Head Necrosis. Hum Gene Ther 2020; 31:286-296. [PMID: 32013585 DOI: 10.1089/hum.2019.306] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Osteonecrosis of the femoral head (ONFH) is a common and disabling joint disease. Although there is no clear consensus on the complex pathogenic mechanism of ONFH, trauma, abuse of glucocorticoids, and alcoholism are implicated in its etiology. The therapeutic strategies are still limited, and the clinical outcomes are not satisfactory. Mesenchymal stem cells (MSCs) have been shown to exert a positive impact on ONFH in preclinical experiments and clinical trials. The beneficial properties of MSCs are due, at least in part, to their ability to home to the injured tissue, secretion of paracrine signaling molecules, and multipotentiality. Nevertheless, the regenerative capacity of transplanted cells is impaired by the hostile environment of necrotic tissue in vivo, limiting their clinical efficacy. Recently, genetic engineering has been introduced as an attractive strategy to improve the regenerative properties of MSCs in the treatment of early-stage ONFH. This review summarizes the function of several genes used in the engineering of MSCs for the treatment of ONFH. Further, current challenges and future perspectives of genetic manipulation of MSCs are discussed. The notion of genetically engineered MSCs functioning as a "factory" that can produce a significant amount of multipotent and patient-specific therapeutic product is emphasized.
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Affiliation(s)
- Peng Shu
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Deng Long Sun
- Department of Physiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; and
| | - Zi Xing Shu
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuo Tian
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Pan
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cen Jin Wen
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiao Ya Xi
- Department of Physiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; and
| | - Shu Nan Ye
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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16
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Ying J, Wang P, Ding Q, Shen J, O'Keefe RJ, Chen D, Tong P, Jin H. Peripheral Blood Stem Cell Therapy Does Not Improve Outcomes of Femoral Head Osteonecrosis With Cap-Shaped Separated Cartilage Defect. J Orthop Res 2020; 38:269-276. [PMID: 31520480 DOI: 10.1002/jor.24471] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/03/2019] [Indexed: 02/04/2023]
Abstract
A combination treatment with porous tantalum rod implantation and intra-arterial infusion of peripheral blood stem cells (PBSCs) provides a promise for treating early and intermediate stages of osteonecrosis of the femoral head (ONFH). However, its clinical indications and application restrictions remain unclear. This study aims to determine the clinical, histological, and radiological outcomes of a combination treatment using mechanical support and a targeted intra-arterial infusion of PBSCs for painful ONFH with a cap-shaped separation (CSS) cartilage defect. Compared with the standard pain management (control group), this combination treatment did not improve the Harris Hip Score (HHS) at 36 months. Micro-CT and histologic analyses showed severe focal destruction in all CSS-ONFH femoral heads in both the combination and control groups. Femoral heads showed a higher percentage of bone lesions in the combination treatment group than in the control group. There was no significant difference in osteoclast number in the subchondral bone areas between the two groups. A high level of expression of inflammatory cytokines, including tumor necrosis factor-α and interleukin-1β, was detected in blood vessels around the subchondral bone in both groups. The RANKL/OPG (receptor activator of the nuclear factor-kB ligand/osteoprotegerin) ratio was also similar between the control and combination treatment groups. Our results indicate that this combination treatment is not an effective method for the treatment of patients with painful CSS-ONFH. Moreover, this combination treatment did not inhibit inflammatory osteoclastogenesis in patients with more advanced disease. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:269-276, 2020.
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Affiliation(s)
- Jun Ying
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310053, China.,Department of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310053, China.,Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri
| | - Pinger Wang
- Department of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310053, China
| | - Quanwei Ding
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310053, China.,Department of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310053, China
| | - Jie Shen
- Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri
| | - Regis J O'Keefe
- Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri
| | - Di Chen
- Department of Biochemistry, Rush University Medical Center, Chicago, Illinois, 60612
| | - Peijian Tong
- Department of Orthopaedic Surgery, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006, Zhejiang Province, China
| | - Hongting Jin
- Department of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 310053, China
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17
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Wu RW, Lian WS, Kuo CW, Chen YS, Ko JY, Wang FS. S100 Calcium Binding Protein A9 Represses Angiogenic Activity and Aggravates Osteonecrosis of the Femoral Head. Int J Mol Sci 2019; 20:ijms20225786. [PMID: 31752076 PMCID: PMC6887714 DOI: 10.3390/ijms20225786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 12/13/2022] Open
Abstract
Ischemic damage aggravation of femoral head collapse is a prominent pathologic feature of osteonecrosis of the femoral head (ONFH). In this regard, S100 calcium binding protein A9 (S100A9) is known to deteriorate joint integrity, however, little is understood about which role S100A9 may play in ONFH. In this study, a proteomics analysis has revealed a decrease in the serum S100A9 level in patients with ONFH upon hyperbaric oxygen therapy. Serum S100A9 levels, along with serum vascular endothelial growth factor (VEGF), soluble vascular cell adhesion molecule-1 (sVCAM-1), interleukin-6 (IL-6), and tartrate-resistant acid phosphatase 5b levels were increased in patients with ONFH, whereas serum osteocalcin levels were decreased as compared to healthy controls. Serum S100A9 levels were increased with the Ficat and Arlet stages of ONFH and correlated with the patients with a history of being on glucocorticoid medication and alcohol consumption. Osteonecrotic tissue showed hypovasculature histopathology together with weak immunostaining for vessel marker CD31 and von Willrbrand factor (vWF) as compared to femoral head fracture specimens. Thrombosed vessels, fibrotic tissue, osteocytes, and inflammatory cells displayed strong S100A9 immunoreactivity in osteonecrotic lesion. In vitro, ONFH serum and S100A9 inhibited the tube formation of vessel endothelial cells and vessel outgrowth of rat aortic rings, whereas the antibody blockade of S100A9 improved angiogenic activities. Taken together, increased S100A9 levels are relevant to the development of ONFH. S100A9 appears to provoke avascular damage, ultimately accelerating femoral head deterioration through reducing angiogenesis. This study provides insight into the molecular mechanism underlying the development of ONFH. Here, analysis also highlights that serum S100A9 is a sensitive biochemical indicator of ONFH.
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Affiliation(s)
- Re-Wen Wu
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (R.-W.W.); (J.-Y.K.)
- Department of Medicine; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Wei-Shiung Lian
- Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (W.-S.L.); (C.-W.K.); (Y.-S.C.)
- Core Laboratory for Phenomics & Diagnostics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Chung-Wen Kuo
- Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (W.-S.L.); (C.-W.K.); (Y.-S.C.)
- Core Laboratory for Phenomics & Diagnostics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Yu-Shan Chen
- Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (W.-S.L.); (C.-W.K.); (Y.-S.C.)
- Core Laboratory for Phenomics & Diagnostics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Jih-Yang Ko
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (R.-W.W.); (J.-Y.K.)
| | - Feng-Sheng Wang
- Department of Medicine; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (W.-S.L.); (C.-W.K.); (Y.-S.C.)
- Core Laboratory for Phenomics & Diagnostics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- Correspondence:
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18
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Nie Z, Chen S, Peng H. Glucocorticoid induces osteonecrosis of the femoral head in rats through GSK3β-mediated osteoblast apoptosis. Biochem Biophys Res Commun 2019; 511:693-699. [PMID: 30827503 DOI: 10.1016/j.bbrc.2019.02.118] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 02/21/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE One of the important causes of glucocorticoids (GCs)-induced osteonecrosis of the femoral head (ONFH) is osteoblast apoptosis. Glycogen synthase kinase 3β (GSK3β) has been reported to be related to dexamethasone (Dex)-induced osteoblast apoptosis. This study aimed to determine whether GSK3β plays role in GC-induced ONFH and investigate the underlying mechanism. METHODS 18 male Sprague-Dawley rats were divided into 3 groups. Rats from ONFH group underwent lipopolysaccharide and methylprednisolone injection. Lithium chloride (LiCl, a GSK3β inhibitor) group were fed with LiCl solution. The control group were untreated. Osteonecrosis, apoptosis and bone loss were evaluated by HE staining, TUNEL staining and micro-CT respectively. Protein expressions were examined by western blotting. In addition, primary osteoblast cells were transfected by GSK3β-siRNA and related signaling pathway and proteins were examined. RESULTS ONFH group showed a relative high percentage of empty lacunae and apoptotic cells, whilst LiCl treatment markedly decreased the percentage. LiCl treatment decreased GC-induced bone loss. Immunoblot analysis for GSK3β showed decreased level of Ser9-phosphorylated GSK3β in ONFH group compared with control group. Knockdown of GSK3β by siRNA in primary osteoblast cells attenuated DEX-induced apoptosis and loss of mitochondrial transmembrane potential (Δψm). GSK3β knockdown also reversed the release of cytochrome C (Cyt C) from mitochondria to the cytosol. GSK3β decreased apoptosis-related protein expression both in vitro and in vivo. CONCLUSION Our findings suggest that GC induces ONFH in rats through GSK3β-mediated osteoblast apoptosis, with involvement of mitochondrial apoptotic pathway.
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Affiliation(s)
- Zhigang Nie
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Sen Chen
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hao Peng
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
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19
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Wu F, Jiao J, Liu F, Yang Y, Zhang S, Fang Z, Dai Z, Sun Z. Hypermethylation of Frizzled1 is associated with Wnt/β-catenin signaling inactivation in mesenchymal stem cells of patients with steroid-associated osteonecrosis. Exp Mol Med 2019; 51:1-9. [PMID: 30808872 PMCID: PMC6391470 DOI: 10.1038/s12276-019-0220-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/07/2018] [Accepted: 12/06/2018] [Indexed: 12/27/2022] Open
Abstract
The Wnt/β-catenin signaling pathway is associated with the pathogenesis of steroid-induced osteonecrosis. Our investigation studied whether aberrant CpG island hypermethylation of the FZD1 gene was present in patients with osteonecrosis of the femoral head (ONFH), which results in Wnt/β-catenin signaling inactivation and subsequent cell dysfunction. Bone marrow was collected from the proximal femurs of patients with steroid-associated ONFH (n = 21) and patients with new femoral neck fractures (n = 22), and then mesenchymal stem cells (MSCs) were isolated. We investigated cell viability, the transcription and translation levels of Wnt/β-catenin signaling-related genes, the extent of methylation at CpG islands of the FZD1 promoter, and the osteogenic and adipogenic differentiation abilities of MSCs from the control group and from the ONFH group treated with or without 5′-Aza-dC. According to the results, MSCs from the ONFH group showed a reduced proliferation ability, low transcription and translation levels of FZD1, inhibition of the Wnt/β-catenin signaling pathway, weakened osteogenesis and enhanced adipogenesis ability. Aberrant CpG island hypermethylation of FZD1 was observed in the ONFH group. Treatment with 5’-Aza-dC resulted in de novo FZD1 expression, reactivation of the Wnt/β-catenin signaling pathway and promotion of osteogenesis. Taken together, our study not only provides novel insights into the regulation of the Wnt/β-catenin signaling pathway in this disease but also reveals potential for the use of demethylating agents for the treatment of GC-associated ONFH. Studies of genetic and molecular signaling processes in the bone disease osteonecrosis, when it is associated with steroid use, reveal insights into disease development and suggest new approaches for treatment. Steroid drugs increase the risk of osteonecrosis, in which bone tissue dies due to insufficient blood supply, but the mechanism of this effect is unclear. Researchers in China, led by Zhibo Sun at Wuhan University, investigated a link between the aberrant addition of methyl groups (CH3) to the DNA of a specific gene and the onset of the disease. They identified an important molecular signaling pathway in cultured bone marrow cells from patients that is inhibited by the gene methylation. Treating these cells with a drug that inhibits methylation led to reactivation of the gene and the associated signalling pathway that promotes healthy bone formation.
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Affiliation(s)
- Fei Wu
- Department of Orthopedics, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Jing Jiao
- Department of Orthopedics, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feng Liu
- Department of Orthopedics, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Yue Yang
- Department of Orthopedics, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Shanfeng Zhang
- Department of Orthopedics, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhenhua Fang
- Department of Orthopedics, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhipeng Dai
- Department of Orthopedics, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Zhibo Sun
- Department of Orthopedics, Renmin Hospital, Wuhan University, Wuhan, Hubei, China. .,Department of Orthopedics, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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20
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Dickkopf-1: Current knowledge and related diseases. Life Sci 2018; 209:249-254. [PMID: 30102902 DOI: 10.1016/j.lfs.2018.08.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/02/2018] [Accepted: 08/07/2018] [Indexed: 02/07/2023]
Abstract
Dickkopf-1(DKK-1) has been identified as a secretory protein that can inhibit the Wnt signaling transduction pathway. It is well known that the Wnt signaling pathway plays an important role in embryogenesis, organogenesis and homeostasis. This signaling cascade is essential for many normal physiological processes such as cellular proliferation, tissue regeneration, embryonic development and many other systemic and local effects, and it can be regulated at different levels. Therefore, defects in the pathway may lead to some complicated effects. In addition, it has been demonstrated that defects in this pathway are closely linked to some diseases including cancer, rheumatism, bone disease, diabetes, and Alzheimer disease. Since DKK-1 is an antagonist of the Wnt pathway, it may be related to these diseases; in fact, many studies have identified this fact. This review will summarize the current knowledge of DKK-1 and DKK-1-mediated regulation of Wnt signaling in the development of these related diseases.
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21
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Luo P, Gao F, Han J, Sun W, Li Z. The role of autophagy in steroid necrosis of the femoral head: a comprehensive research review. INTERNATIONAL ORTHOPAEDICS 2018; 42:1747-1753. [PMID: 29797168 DOI: 10.1007/s00264-018-3994-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 05/17/2018] [Indexed: 12/25/2022]
Abstract
Steroid-induced osteonecrosis of the femoral head (ONFH) has the incidence of 9-40% in patients receiving long-term treatment and is mainly involved in the middle and young people. It is mostly bilateral, with a wide range of necrosis and high disability rate, which brings disaster for patients and families. The experimental study shows that autophagy participates in the pathological process of steroid ONFH and is closely related to apoptosis, and the interaction between autophagy and bone cells is related to the dose of hormones. Moreover, autophagy also affects the interaction between osteoblasts and osteoclasts in ONFH. In the present review, we have discussed the role of autophagy in the pathological process of the steroid-induced ONFH.
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Affiliation(s)
- Pan Luo
- Department of Orthopedic Surgery, China-Japan Friendship Institute of Clinical Medicine, Peking Union Medical College, Beijing, 100029, China
| | - Fuqiang Gao
- Department of Orthopedic Surgery, China-Japan Friendship Institute of Clinical Medicine, Peking Union Medical College, Beijing, 100029, China. .,Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, Peking Union Medical College, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100029, China. .,Department of Orthopedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, 100029, China.
| | - Jun Han
- Department of Orthopedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, 100029, China
| | - Wei Sun
- Department of Orthopedic Surgery, China-Japan Friendship Institute of Clinical Medicine, Peking Union Medical College, Beijing, 100029, China. .,Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, Peking Union Medical College, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100029, China. .,Department of Orthopedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, 100029, China.
| | - Zirong Li
- Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, Peking Union Medical College, National Health and Family Planning Commission of the People's Republic of China, Beijing, 100029, China
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22
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Kong D, Guan Q, Li G, Xin W, Qi X, Guo Y, Zhao J, Xu J, Sun S, Gao L. Expression of FSHR in chondrocytes and the effect of FSH on chondrocytes. Biochem Biophys Res Commun 2017; 495:587-593. [PMID: 29133260 DOI: 10.1016/j.bbrc.2017.11.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 11/07/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Chondrocytes express many kinds of hormone receptors. The function of Follicle stimulating hormone (FSH) in the ovary is mediated by FSH receptor (FSHR). FSH receptor (FSHR) is found in many non-ovarian tissues, however it has been unclear if chondrocytes express FSHR. The purpose of this study is to determine it. METHODS Mouse primary chondrocytes and human articular cartilage tissues were examined. The expression and sequence of FSHR mRNA by reverse transcription polymerase chain reaction (RT-PCR) and sequenced, respectively, and its protein expression was tested using western blotting and location was observed under immunofluorescence microscopy. Ovarian tissue was as a positive control. After FSH stimulated mouse chondrocytes, intracellular cAMP levels were assessed by ELISA, and gene expression relative to Mouse WNT Signaling Pathway was tested by RT2 Profiler PCR Arrays. RESULTS FSHR was detected at the transcriptional level and confirmed to have the same sequence as that of ovary-derived mRNA of FSHR. FSHR proteins presented at the same line as the positive proteins of ovary, in mouse chondrocytes and human cartilage tissue, respectively. FSHR proteins were located at the cell membrane. Intracellular cAMP contents were significantly elevated up to 7-fold in mouse chondrocytes by forskolin (100 mM) (P < 0.001); however, different doses of FSH did not change the cAMP contents in mouse primary chondrocytes. RT2 Profiler PCR Arrays demonstrated that FSH could cause changes in gene expression among the 84 preordained genes, such as Fosl1, Rhou, and Dkk1, in mouse chondrocytes relative to the control. CONCLUSION Mouse chondrocytes and human articular cartilage express functional FSHR. Moreover, FSH can act on chondrocytes and cause genetic changes.
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Affiliation(s)
- Dehuan Kong
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China; Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong province, China; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong province, China; Department of Geriatrics, Taian City Central Hospital, Taian, Shandong province, China.
| | - Qingbo Guan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China; Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong province, China; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong province, China.
| | - Guandong Li
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China.
| | - Wei Xin
- Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China.
| | - Xiaoyi Qi
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China; Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong province, China; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong province, China.
| | - Yanjing Guo
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China; Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong province, China; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong province, China.
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China; Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong province, China; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong province, China.
| | - Jin Xu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China; Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong province, China; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong province, China.
| | - Shui Sun
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China.
| | - Ling Gao
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong province, China; Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong province, China; Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong province, China.
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23
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Huang L, Wang Y, Jiang Y, Wu Y, Hu C, Ouyang H. High levels of GSK-3β signalling reduce osteogenic differentiation of stem cells in osteonecrosis of femoral head. J Biochem 2017; 163:243-251. [DOI: 10.1093/jb/mvx076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 09/18/2017] [Indexed: 02/04/2023] Open
Affiliation(s)
- Lu Huang
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jie Fang Road, Hangzhou 310009, PR China
| | - Ying Wang
- Department of Radiation Oncology, Zhejiang Provincial People’s Hospital, #158 Shang Tang Road, Hangzhou 310014, PR China
| | - Yangzi Jiang
- Center for Stem Cell and Tissue Engineering, Department of Sports Medicine, School of Medicine, Zhejiang University, #866 Yu Hang Tang Road, Hangzhou 310058, PR China
| | - Yan Wu
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jie Fang Road, Hangzhou 310009, PR China
| | - Changchang Hu
- Center for Stem Cell and Tissue Engineering, Department of Sports Medicine, School of Medicine, Zhejiang University, #866 Yu Hang Tang Road, Hangzhou 310058, PR China
| | - Hongwei Ouyang
- Center for Stem Cell and Tissue Engineering, Department of Sports Medicine, School of Medicine, Zhejiang University, #866 Yu Hang Tang Road, Hangzhou 310058, PR China
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24
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Chen YX, Zhu DY, Yin JH, Yin WJ, Zhang YL, Ding H, Yu XW, Mei J, Gao YS, Zhang CQ. The protective effect of PFTα on alcohol-induced osteonecrosis of the femoral head. Oncotarget 2017; 8:100691-100707. [PMID: 29246013 PMCID: PMC5725055 DOI: 10.18632/oncotarget.19160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/29/2017] [Indexed: 12/11/2022] Open
Abstract
Epidemiologic studies have shown alcohol plays a pivotal role in the development of osteonecrosis of the femoral head (ONFH). The aim of this study was to explore the underlying mechanism of alcohol-induced ONFH and the protective effect of pifithrin-α (PFTα). In vitro, we found ethanol treatment significantly activated p53, suppressed Wnt/β-catenin signaling and inhibited osteogenic-related proteins. Furthermore, by separating the cytoplasmic and nuclear proteins, we found ethanol inhibited osteogenesis by impairing the accumulation of β-catenin in both the cytoplasm and nucleus in human bone mesenchymal stem cells (hBMSCs), which resulted from activating glycogen synthase kinase-3β (GSK-3β). Therefore, PFTα, a p53 inhibitor, was introduced in this study to block the ethanol-triggered activation of p53 in hBMSCs and alcohol-induced ONFH in a rat model. In vivo, we established alcohol-induced ONFH in rats and investigated the protective effect of PFTα. Hematoxylin & eosin (H&E) staining combined with TdT-mediated dUTP nick end labeling (TUNEL), cleaved caspase-3 immunohistochemical staining, and micro-CT images revealed substantial ONFH in the alcohol-administered rats, whereas significantly less osteonecrosis developed in the rats injected with PFTα. Osteogenic-related proteins, including osteocalcin, osteopontin and collagen I, were significantly decreased in the alcohol-administered rats, whereas these results were reversed in the PFTα-injected rats. Fluorochrome labeling similarly showed that alcohol significantly reduced the osteogenic activity in the rat femoral head, which was blocked by the injection of PFTα. In conclusion, PFTα had an antagonistic effect against the effects of ethanol on hBMSCs and could be a clinical strategy to prevent the development of alcohol-induced ONFH.
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Affiliation(s)
- Yi-Xuan Chen
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Dao-Yu Zhu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Jun-Hui Yin
- Institute of Microsurgery on Extremities, Shanghai 200233, China
| | - Wen-Jing Yin
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yue-Lei Zhang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Hao Ding
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Xiao-Wei Yu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Jiong Mei
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - You-Shui Gao
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Chang-Qing Zhang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Institute of Microsurgery on Extremities, Shanghai 200233, China
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25
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Zhao J, Ma XL, Ma JX, Sun L, Lu B, Wang Y, Xing GS, Wang Y, Dong BC, Xu LY, Kuang MJ, Fu L, Bai HH, Ma Y, Jin WL. TET3 Mediates Alterations in the Epigenetic Marker 5hmC and Akt pathway in Steroid-Associated Osteonecrosis. J Bone Miner Res 2017; 32:319-332. [PMID: 27627619 DOI: 10.1002/jbmr.2992] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/01/2016] [Accepted: 09/09/2016] [Indexed: 01/10/2023]
Abstract
Steroid-associated osteonecrosis (SAON) is one of the common complications of clinical glucocorticoid (GC) administration, with osteocyte apoptosis appearing as the primary histopathological lesion. However, the precise mechanism underlying SAON remains unknown. Epigenetic modification may be a major cause of SAON. Recently, cumulative research revealed that Ten-Eleven Translocation (TET) proteins can catalyze the conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) and then alter the epigenetic state of DNA. Here, we report that TET3-5hmC was upregulated in the femoral head tissues of SAON patients and MLO-Y4 cells with dexamethasone (Dex) treatment. Knockdown of TET3 in MLO-Y4 cells decreased 5hmC enrichment and rescued Dex-induced apoptosis. Meanwhile, the local intramedullary injection of TET3 siRNA in Sprague-Dawley rats abrogated GC-induced osteocyte apoptosis, histopathological changes, abnormal MRI signals, and bone microstructure declines in the femoral head in vivo. Moreover, a hydroxymethylated DNA immunoprecipitation (hMeDIP)-chip analysis of Dex-treated osteocytes revealed 456 different 5hmC-enriched genes. The Akt pathway was found to mediate the functional effect of Dex-induced dynamic 5hmC change; this was further verified in clinical samples. The loss of TET3 in MLO-Y4 cells abrogated Dex-induced Akt signaling pathway inhibition. Therefore, our data for the first time identify the effect of TET3-5hmC on the Akt pathway and the necessity of this signaling cascade in SAON, identifying a new potential therapeutic target. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Jie Zhao
- Tianjin Medical University General Hospital, Tianjin, China.,Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Xin-Long Ma
- Tianjin Medical University General Hospital, Tianjin, China.,Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Jian-Xiong Ma
- Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Lei Sun
- Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Bin Lu
- Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Ying Wang
- Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Guo-Sheng Xing
- Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Yan Wang
- Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Ben-Chao Dong
- Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Li-Yan Xu
- Tianjin Medical University General Hospital, Tianjin, China.,Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Ming-Jie Kuang
- Tianjin Medical University General Hospital, Tianjin, China.,Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Lin Fu
- Tianjin Medical University General Hospital, Tianjin, China.,Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Hao-Hao Bai
- Institute of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Yue Ma
- Department of Instrument Science and Engineering, Key Lab. for Thin Film and Microfabrication Technology of Ministry of Education, School of Electronic Information and Electronic Engineering, Shanghai Jiao Tong University, Shanghai, China.,National Centers for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei-Lin Jin
- Department of Instrument Science and Engineering, Key Lab. for Thin Film and Microfabrication Technology of Ministry of Education, School of Electronic Information and Electronic Engineering, Shanghai Jiao Tong University, Shanghai, China.,National Centers for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
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26
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Mont MA, Cherian JJ, Sierra RJ, Jones LC, Lieberman JR. Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today? A Ten-Year Update. J Bone Joint Surg Am 2015; 97:1604-27. [PMID: 26446969 DOI: 10.2106/jbjs.o.00071] [Citation(s) in RCA: 308] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Although multiple theories have been proposed, no one pathophysiologic mechanism has been identified as the etiology for the development of osteonecrosis of the femoral head. However, the basic mechanism involves impaired circulation to a specific area that ultimately becomes necrotic.➤ A variety of nonoperative treatment regimens have been evaluated for the treatment of precollapse disease, with varying success. Prospective, multicenter, randomized trials are needed to evaluate the efficacy of these regimens in altering the natural history of the disease.➤ Joint-preserving procedures are indicated in the treatment of precollapse disease, with several studies showing successful outcomes at mid-term and long-term follow-up.➤ Studies of total joint arthroplasty, once femoral head collapse is present, have described excellent outcomes at greater than ten years of follow-up, which is a major advance and has led to a paradigm shift in treating these patients.➤ The results of hemiresurfacing and total resurfacing arthroplasty have been suboptimal, and these procedures have restricted indications in patients with osteonecrosis of the femoral head.
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Affiliation(s)
- Michael A Mont
- Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215. E-mail address for M.A. Mont:
| | - Jeffrey J Cherian
- Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215. E-mail address for M.A. Mont:
| | - Rafael J Sierra
- Mayo Clinic, 200 First Street S.W., Gonda 14 South, Rochester, MN 55905
| | - Lynne C Jones
- Department of Orthopaedic Surgery, Johns Hopkins University, 601 North Caroline Street, JHOC 5245, Baltimore, MD 21287
| | - Jay R Lieberman
- Keck Medical Center of University of Southern California, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033
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27
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Identification of differentially expressed microRNAs involved in non-traumatic osteonecrosis through microRNA expression profiling. Gene 2015; 565:22-9. [DOI: 10.1016/j.gene.2015.03.072] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 01/27/2015] [Accepted: 03/10/2015] [Indexed: 12/19/2022]
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28
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Xie X, Pei F, Wang H, Tan Z, Yang Z, Kang P. Icariin: A promising osteoinductive compound for repairing bone defect and osteonecrosis. J Biomater Appl 2015; 30:290-9. [PMID: 25876888 DOI: 10.1177/0885328215581551] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Icariin (Ica), the main active component of Herba Epimedii, has been identified as an osteogenic and angiogenic phytomolecule. To develop a bioactive scaffold for enhancing bone repair, Ica was loaded into porous tricalcium phosphate (TCP) scaffolds, and the obtained porous Ica/TCP composites were investigated for treating osteonecrosis of the femoral head (ONFH) in a rabbit model. ONFH was histopathologically confirmed at two weeks after methylprednisolone acetate injection, and the rabbits were treated with porous Ica/TCP scaffolds (group A), porous TCP scaffolds (group B), and autogenous cancellous bone graft (group C). At 12 weeks, the amount of newly formed bone in group A increased significantly compared with that in group B (P = 0.003). The mean histological and radiological scores for repaired defects in group A were significantly higher than those in group B (P = 0.007, P = 0.029, respectively), but were lower than those in group C (P = 0.032, P = 0.046, respectively). In addition, the expression of vascular endothelial growth factor by immunohistochemical testing and real-time polymerase chain reaction in group A was significantly higher than that in group B (P = 0.002, P = 0.001, respectively), but was lower than that in group C (P = 0.034, P = 0.005, respectively). Therefore, Ica can be a promising osteogenic and angiogenic compound for repairing bone defects and preventing the collapse of the femoral head in ONFH.
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Affiliation(s)
- Xiaowei Xie
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Fuxing Pei
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Haoyang Wang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zhen Tan
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zhouyuan Yang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Pengde Kang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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29
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Kang P, Xie X, Tan Z, Yang J, Shen B, Zhou Z, Pei F. Repairing defect and preventing collapse of femoral head in a steroid-induced osteonecrotic of femoral head animal model using strontium-doped calcium polyphosphate combined BM-MNCs. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:80. [PMID: 25634136 DOI: 10.1007/s10856-015-5402-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 11/09/2014] [Indexed: 02/05/2023]
Abstract
We investigated the synergism between strontium-doped calcium polyphosphate (SCPP) and autologous bone marrow mononuclear cells (BM-MNCs) in treating osteonecrosis of the femoral head (ONFH). ONFH was confirmed histopathologically at 2 weeks after methylprednisolone acetate injection and the rabbits were treated with morselized autogenous cancellous compacted bone graft (group I), SCPP combined with BM-MNCs (group II), and calcium polyphosphate (group III), respectively. The amount of newly formed bone in group II increased dramatically by 4, 8, and 12 weeks and much more than that in group III (P<0.05). VEGF expression in group I was significantly higher than in group II (P=0.023), and its expression in group II was significantly higher than in group III (P=0.017). At 12 weeks, group II had articular cartilage collapse and group III had joint-space narrowing. The mean histological and radiological scores for repaired defects in group II were significantly higher than those in group III (P=0.000) but lower than those in group I (P=0.000). The implantation of a combination of SCPP and BM-MNCs enhances VEGF expression and promotes osteogenesis, which may improve angiogenesis and allow incorporation and remodeling into new trabecular bone without mechanical weakening.
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Affiliation(s)
- Pengde Kang
- Orthopaedic Department, West China Hospital, Sichuan University, Chengdu, 610041, China,
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Li Z, Zhao D, Wang B. ABCB1 gene polymorphisms and glucocorticoid-induced avascular necrosis of the femoral head susceptibility: a meta-analysis. Med Sci Monit 2014; 20:2811-6. [PMID: 25544111 PMCID: PMC4285923 DOI: 10.12659/msm.891286] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The results of studies on association between ABCB1 gene polymorphisms and glucocorticoid-induced avascular necrosis of the femoral head (GANFH) are controversial. This study aimed to assess the association of ABCB1 gene polymorphisms with the risk of GANFH by conducting a meta-analysis. MATERIAL AND METHODS The PubMed, Cochrane Library, and Embase databases were searched for papers that describe the association between ABCB1 polymorphisms and GANFH risk. Summary odds ratios and 95% confidence intervals (CI) were estimated based on a fixed-effects model or random-effects model, depending on the absence or presence of significant heterogeneity. RESULTS A total of 5 studies and 833 patients were included in the final analysis. Significant differences were found for rs1045642 polymorphism in the comparisons of CC vs. CT+TT (OR, 1.462; 95% CI, 1.066-2.007; P=0.019), and rs2032582 polymorphism in the comparisons of GG vs. G(TA)+(TA)(TA) (OR, 1.548; 95% CI,1.063-2.255; P=0.023). CONCLUSIONS The study demonstrated that the ABCB1 polymorphisms (rs1045642 and rs2032582) significantly reduced the risk of GANFH.
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Affiliation(s)
- Zhigang Li
- Department of Orthopaedics, Affiliated Zhongshan Hospital, Dalian University, Dalian, Liaoning, China (mainland)
| | - Dewei Zhao
- Department of Orthopaedics, Affiliated Zhongshan Hospital, Dalian University, Dalian, Liaoning, China (mainland)
| | - Benjie Wang
- Department of Orthopaedics, Affiliated Zhongshan Hospital, Dalian University, Dalian, Liaoning, China (mainland)
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Liu S, Tian W, Wang J, Cheng L, Jia J, Ma X. Two single-nucleotide polymorphisms in the DKK1 gene are associated with developmental dysplasia of the hip in the Chinese Han female population. Genet Test Mol Biomarkers 2014; 18:557-61. [PMID: 24926963 DOI: 10.1089/gtmb.2014.0044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS Developmental dysplasia of the hip (DDH) is a common congenital or acquired skeletal disease characterized by subluxation, dislocation, or dysplasia of the hip joint. This study aimed to explore the potential impact of Dickkopf-1 (DKK1) gene polymorphisms on embryonic hip joint development and the course of DDH. METHODS One hundred ninety-two unrelated Chinese Han female DDH patients and 191 unrelated, healthy, ethnically matched female controls were recruited and genotyped for two tag single-nucleotide polymorphisms (SNPs) of DKK1 using the Sequenom method. RESULTS One of the two DKK1 tag SNPs, rs11001560, was not shown to be significantly statistically different in allele frequency between DDH patients and control groups (χ(2)=0.898, df=1, p=0.343). However, a significant difference in genotype distribution was observed (χ(2)=21.987, df=2, p<0.0001). For SNP rs1569198, significant differences were observed in both allele frequency and genotype distribution between the DDH group and control group (χ(2)=31.484, df=1, p<0.0001 and χ(2)=30.323, df=2, p<0.0001). The A allele frequency of rs1569198 has a significant association to increased risk of DDH development (odds ratio [OR]=3.032, 95% confidence interval [95% CI]: 2.034-4.519). CONCLUSION In conclusion, the association between two tag SNPs of the DKK1 gene and DDH development reached statistical significance in our study population; the results of our genetic association analysis indicated that DKK1 may be a good candidate responsible for DDH development in the Chinese Han female population.
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Affiliation(s)
- Shengnan Liu
- 1 Graduate School of Peking Union Medical College , Beijing, China
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Dovjak P, Dorfer S, Föger-Samwald U, Kudlacek S, Marculescu R, Pietschmann P. Serum levels of sclerostin and dickkopf-1: effects of age, gender and fracture status. Gerontology 2014; 60:493-501. [PMID: 24943689 DOI: 10.1159/000358303] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 01/04/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Fragility fractures, especially hip fractures, are a very common complication of osteoporosis in elderly subjects. Sclerostin (SOST) and dickkopf-1 (DKK-1) are inhibitors of the canonical wnt signalling pathway and thus could be involved in the pathogenesis of age-related bone fragility. OBJECTIVE To investigate SOST and DKK-1 in a large group of geriatric patients with hip fractures and to relate the wnt inhibitors to age and gender. METHODS This was a cross-sectional study carried out in a department of acute geriatric care in a district hospital in Upper Austria and a hospital in Vienna, Austria. A total of 256 geriatric patients (172 women and 84 men) and 67 young control subjects were selected after exclusion. Medical history was obtained, a comprehensive geriatric assessment was performed and serum levels of SOST, DKK-1 and bone formation markers were analysed. RESULTS DKK-1 levels increased with age and in the presence of hip fractures. In contrast, SOST levels were lower in patients with hip fractures. When compared to women, men had higher SOST levels but lower DKK-1 levels. CONCLUSION Serum levels of the inhibitors of the canonical wnt signalling pathway reflect different biological events and are useful for the study of bone fragility in geriatric patients.
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Affiliation(s)
- Peter Dovjak
- Department of Geriatric Acute Care, Hospital of Gmunden, Gmunden, Austria
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Wang W, Wei J, Xu Z, Zhuo W, Zhang Y, Rong H, Cao X, Wang P. Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta-analysis. BMC Musculoskelet Disord 2014; 15:167. [PMID: 24885566 PMCID: PMC4047776 DOI: 10.1186/1471-2474-15-167] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 04/23/2014] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND A meta-analysis was performed to assess the association between healing rate, avascular necrosis (AVN) of femoral head and two reductions-open reduction internal fixation (ORIF) and closed reduction internal fixation (CRIF) for femoral neck fracture. METHODS A literature-based search was conducted to identify all relevant studies published before September 10, 2013. The odd ratio (OR) and 95% confidence interval (CI) were used for estimating the effects of the two reduction methods. Data were independently extracted by two investigators who reached a consensus on all of the items. The heterogeneity between studies was examined by χ2-based Q statistic. Egger's regression analysis was used to evaluate publication bias. Statistical analysis was performed by Stata 10.0 software. RESULTS We examined 14 publications. The results of the present meta-analysis showed that AVN of femoral head were significant associated with the two reductions (CRIF vs. ORIF, OR=1.746, 95% CI 1.159-2.628, p=0.008), while the healing rate were not (CRIF vs. ORIF, OR=0.853, 95% CI 0.573-1.270, p=0.433). CONCLUSION The present meta-analysis indicated the risk of AVN of femoral head was significant higher after CRIF fixation compared with ORIF, but no association between the healing rate and the two reductions for femoral neck fracture.
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Affiliation(s)
- Weiguo Wang
- Department of Orthopaedic Surgery, General Hospital of Jinan Military Command, 250031 Jinan, China
- Research on 2013 stage doctoral student of TCM Orthopaedics, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Junjie Wei
- Outpatient Department, General Hospital of Jinan Military Command, 250031 Jinan, China
| | - Zhanwang Xu
- Department of Orthopaedics, The First Affiliated Hospital of Shandong University of Traditional Chinese Medicine, NO.16369, Jingshi Road, 250014 Jinan, China
| | - Wenkun Zhuo
- Department of Orthopaedic Surgery, General Hospital of Jinan Military Command, 250031 Jinan, China
| | - Yuan Zhang
- Department of Orthopaedic Surgery, General Hospital of Jinan Military Command, 250031 Jinan, China
| | - Hui Rong
- Department of Orthopaedic Surgery, General Hospital of Jinan Military Command, 250031 Jinan, China
| | - Xuecheng Cao
- Department of Orthopaedic Surgery, General Hospital of Jinan Military Command, 250031 Jinan, China
| | - Pingshan Wang
- Department of Orthopaedic Surgery, General Hospital of Jinan Military Command, 250031 Jinan, China
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Mutijima E, De Maertelaer V, Deprez M, Malaise M, Hauzeur JP. The apoptosis of osteoblasts and osteocytes in femoral head osteonecrosis: its specificity and its distribution. Clin Rheumatol 2014; 33:1791-5. [PMID: 24733252 DOI: 10.1007/s10067-014-2607-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 03/30/2014] [Indexed: 11/26/2022]
Abstract
The pathogenesis of nontraumatic osteonecrosis (ON) remains unclear. Some studies have suggested that nontraumatic ON is attributed to increased osteocytic apoptosis. To test this hypothesis, a controlled study must compare the apoptosis of osteocytes and osteoblasts in cases of ON and osteoarthritis (OA). To assess either the localized or diffuse patterns of this increased osteocytic and osteoblastic apoptosis, we evaluated both the proximal and distal regions of necrotic areas. Femoral heads resected for total hip prosthesis were included for this study. Of these, 10 were ON cases-three were induced by corticosteroids, three by alcohol abuse, one resulted from trauma, one resulted from hyperlipemia, and two were idiopathic-10 were osteoarthritis cases, and 1 from a patient suffering from a subcapital fracture. The TUNEL reaction was used to detect the apoptosis in osteoblasts and osteocytes. A semi-quantitative evaluation was conducted, at both distal and proximal areas relative to the lesions, specifically in the area surrounding the necrotic region in the osteonecrosis cases, in the eburnated bone in the osteoarthritis cases, and in the subchondral bone fracture. The apoptosis of osteoblasts and osteocytes was statistically more frequent in the regions close to the necrotic areas in the ON group. No difference was found in the unpaired areas. In the ON group, no difference was found in terms of the etiological factors. During ON, the apoptosis of osteocytes and osteoblasts is increased proximally to the necrotic regions in the patients presenting with osteoarthritis and subcapital fractures. This increase was found not only in the corticosteroid-induced ON cases but also in the idiopathic and alcohol abuse- and trauma-induced ON cases.
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Affiliation(s)
- Eugène Mutijima
- Department of Pathology, CHU Sart Tilman, Sart Tilman, 4000, Liège, Belgium,
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Calori GM, Mazza E, Colombo M, Mazzola S, Mineo GV, Giannoudis PV. Treatment of AVN using the induction chamber technique and a biological-based approach: indications and clinical results. Injury 2014; 45:369-73. [PMID: 24119830 DOI: 10.1016/j.injury.2013.09.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2013] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the efficacy of core decompression (CD) technique combined with recombinant morphogenetic proteins, autologous mesenchymal stem cells (MSCs) and xenograft bone substitute into the necrotic lesion of the femoral head on clinical symptoms and on the progression of osteonecrosis of the femoral head. PATIENTS AND METHODS A total of 38 patients (40 hips) with early stage osteonecrosis of the femoral head were studied over a 4-year period. RESULTS CD technique combined with recombinant morphogenetic proteins, autologous MSCs and xenograft bone substitute was associated with a significant reduction in both pain and joint symptoms and reduced the incidence of fractural stages. At 36 months, 33 patients achieved clinical and radiographic healing. CONCLUSION This long-term follow-up study confirmed that CD technique combined with recombinant morphogenetic proteins, autologous MSCs and xenograft bone substitute may be an effective treatment for patients with early stage osteonecrosis of the femoral head.
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Affiliation(s)
- G M Calori
- Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy.
| | - E Mazza
- Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy
| | - M Colombo
- Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy
| | - S Mazzola
- Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy
| | - G V Mineo
- University Department of Orthopaedics, Orthopaedic Institute Gaetano Pini, University of Milan, Italy
| | - P V Giannoudis
- Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Leeds, UK
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Chee C, Sellahewa L, Pappachan JM. Inhaled corticosteroids and bone health. Open Respir Med J 2014; 8:85-92. [PMID: 25674178 PMCID: PMC4319192 DOI: 10.2174/1874306401408010085] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 10/21/2014] [Accepted: 10/21/2014] [Indexed: 02/08/2023] Open
Abstract
Inhaled corticosteroids (ICS) are the cornerstones in the management of bronchial asthma and some cases of chronic obstructive pulmonary disease. Although ICS are claimed to have low side effect profiles, at high doses they can cause systemic adverse effects including bone diseases such as osteopenia, osteoporosis and osteonecrosis. Corticosteroids have detrimental effects on function and survival of osteoblasts and osteocytes, and with the prolongation of osteoclast survival, induce metabolic bone disease. Glucocorticoid-induced osteoporosis (GIO) can be associated with major complications such as vertebral and neck of femur fractures. The American College of Rheumatology (ACR) published criteria in 2010 for the management of GIO. ACR recommends bisphosphonates along with calcium and vitamin D supplements as the first-line agents for GIO management. ACR recommendations can be applied to manage patients on ICS with a high risk of developing metabolic bone disease. This review outlines the mechanisms and management of ICS-induced bone disease.
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Affiliation(s)
- Carolyn Chee
- Department of Endocrinology, Nottingham University Hospitals, NG7 2UH, UK
| | - Luckni Sellahewa
- Department of Endocrinology, Royal Derby Hospital, Derby, DE22 3NE, UK
| | - Joseph M Pappachan
- Department of Endocrinology, Walsall Manor Hospital, West Midlands, WS2 9PS, UK
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Sun Z, Yang S, Ye S, Zhang Y, Xu W, Zhang B, Liu X, Mo F, Hua W. Aberrant CpG islands' hypermethylation of ABCB1 in mesenchymal stem cells of patients with steroid-associated osteonecrosis. J Rheumatol 2013; 40:1913-20. [PMID: 24037553 DOI: 10.3899/jrheum.130191] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Patients carrying an ABCB1 polymorphism have a higher risk of developing osteonecrosis of the femoral head (ONFH). We investigated whether aberrant dinucleotide CpG islands' hypermethylation of ABCB1 gene existed in mesenchymal stem cells (MSC) of patients with ONFH, which results in cell dysfunction. METHODS Bone marrow was collected from the proximal femur of patients with glucocorticoid (GC)-associated ONFH (n = 22) and patients with new femoral neck fractures (n = 25). MSC were isolated by density gradient centrifugation. We investigated cell viability, intracellular reactive oxygen species (ROS) level, mitochondrial membrane potential (MMP), the amount of P-glycoprotein (P-gp) and ABCB1 transcripts, and methylation at CpG islands of ABCB1 promoter from both the femoral neck fractures group and the GC-associated ONFH group treated with or without the DNA methyltransferase inhibitor, 5'-Aza-2-deoxycytidine (5'-Aza-dC). RESULTS We observed that MSC from GC-associated ONFH groups showed reduced proliferation ability, elevated ROS levels, and depressed MMP when compared with the other 2 groups. Low levels of P-gp and ABCB1 transcript, as well as ABCB1 gene hypermethylation, in patients with GC-associated ONFH were also noted. Treatment with 5'-Aza-dC rapidly restored ABCB1 expression. Analysis of general expression revealed that aberrant CpG islands' hypermethylation of ABCB1 caused sensitivity to GC and induced changes in the proliferation and oxidative stress of MSC under GC administration. CONCLUSION These data suggest that aberrant CpG islands' hypermethylation of ABCB1 gene may be responsible for individual differences in the development of GC-associated ONFH.
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Affiliation(s)
- Zhibo Sun
- From the Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Wang FS, Chung PC, Lin CL, Chen MW, Ke HJ, Chang YH, Chen YS, Wu SL, Ko JY. MicroRNA-29a Protects Against Glucocorticoid-Induced Bone Loss and Fragility in Rats by Orchestrating Bone Acquisition and Resorption. ACTA ACUST UNITED AC 2013; 65:1530-40. [DOI: 10.1002/art.37948] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 03/14/2013] [Indexed: 01/01/2023]
Affiliation(s)
- Feng-Sheng Wang
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Kaohsiung; Taiwan
| | - Pei-Chin Chung
- Kaohsiung Chang Gung Memorial Hospital; Kaohsiung; Taiwan
| | | | - Ming-Wen Chen
- Kaohsiung Chang Gung Memorial Hospital; Kaohsiung; Taiwan
| | - Huei-Jin Ke
- Kaohsiung Chang Gung Memorial Hospital; Kaohsiung; Taiwan
| | - Yu-Hsuan Chang
- Kaohsiung Chang Gung Memorial Hospital; Kaohsiung; Taiwan
| | - Yu-Shan Chen
- Kaohsiung Chang Gung Memorial Hospital; Kaohsiung; Taiwan
| | - Shin-Long Wu
- Kaohsiung Chang Gung Memorial Hospital; Kaohsiung; Taiwan
| | - Jih-Yang Ko
- Kaohsiung Chang Gung Memorial Hospital; Kaohsiung; Taiwan
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Weng LH, Ko JY, Wang CJ, Sun YC, Wang FS. Dkk-1 promotes angiogenic responses and cartilage matrix proteinase secretion in synovial fibroblasts from osteoarthritic joints. ACTA ACUST UNITED AC 2013; 64:3267-77. [PMID: 22736200 DOI: 10.1002/art.34602] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Synovial hypervascularity is a prominent pathologic feature in osteoarthritic (OA) joints. Wnt inhibitor Dkk-1 contributes to joint remodeling. We undertook this study to investigate whether Dkk-1 regulates cartilage destruction activities in OA synovial fibroblasts. METHODS Synovial tissues were harvested from knees of patients with OA and from injured knees of non-OA patients who underwent arthroscopy. Expression of Dkk-1, angiogenic factors (stromal cell-derived factor 1 and colony-stimulating factor 1), and cartilage proteinases (ADAMTS-5 and matrix metalloproteinase 3 [MMP-3]) as well as vascularity in synovium and synovial fluid were quantified using enzyme-linked immunosorbent assay, reverse transcription-polymerase chain reaction, and histomorphometry. Synovial fibroblasts were treated with interleukin-1β (IL-1β), anti-Dkk-1 antibody, and RNA interference to characterize their angiogenic activity. Rats with OA knees were administered Dkk-1 antisense oligonucleotide to verify synovial angiogenesis and cartilage integrity. RESULTS OA synovium exhibited increased vascularity and expression of angiogenic factors and proteinases in association with up-regulated Dkk-1 levels. Neutralizing Dkk-1 reduced the inhibitory effects of OA synovial fluid on aggrecan expression in chondrocyte cultures. IL-1β induction of Dkk-1 increased expression of hypoxia-inducible factor 1α (HIF-1α), angiogenic factors, ADAMTS-5, and MMP-3 in synovial fibroblasts and promoted angiogenesis in vascular endothelial cells. Knockdown of HIF-1α decreased Dkk-1 enhancement of angiogenic factor expression. Stabilization of glycogen synthase kinase 3β phosphorylated at Ser(9) , β-catenin, T cell factor 4, and ERK signaling attenuated Dkk-1 up-regulation of angiogenic factor and proteinase expression in synovial fibroblasts. In vivo, Dkk-1 interference reduced the expression of angiogenic factors and proteinases and ameliorated synovial vascularity and cartilage deterioration in knees of rats with OA. CONCLUSION Dkk-1 promoted angiogenic and cartilage degradation activities in synovial fibroblasts, which accelerated synovial angiogenesis and cartilage destruction. Dkk-1 blockade has therapeutic potential for reducing OA-induced synovitis and joint deterioration.
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Affiliation(s)
- Lin-Hsiu Weng
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Ke HZ, Richards WG, Li X, Ominsky MS. Sclerostin and Dickkopf-1 as therapeutic targets in bone diseases. Endocr Rev 2012; 33:747-83. [PMID: 22723594 DOI: 10.1210/er.2011-1060] [Citation(s) in RCA: 295] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The processes of bone growth, modeling, and remodeling determine the structure, mass, and biomechanical properties of the skeleton. Dysregulated bone resorption or bone formation may lead to metabolic bone diseases. The Wnt pathway plays an important role in bone formation and regeneration, and expression of two Wnt pathway inhibitors, sclerostin and Dickkopf-1 (DKK1), appears to be associated with changes in bone mass. Inactivation of sclerostin leads to substantially increased bone mass in humans and in genetically manipulated animals. Studies in various animal models of bone disease have shown that inhibition of sclerostin using a monoclonal antibody (Scl-Ab) increases bone formation, density, and strength. Additional studies show that Scl-Ab improves bone healing in models of bone repair. Inhibition of DKK1 by monoclonal antibody (DKK1-Ab) stimulates bone formation in younger animals and to a lesser extent in adult animals and enhances fracture healing. Thus, sclerostin and DKK1 are emerging as the leading new targets for anabolic therapies to treat bone diseases such as osteoporosis and for bone repair. Clinical trials are ongoing to evaluate the effects of Scl-Ab and DKK1-Ab in humans for the treatment of bone loss and for bone repair.
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Affiliation(s)
- Hua Zhu Ke
- Metabolic Disorders Research, Amgen Inc., One Amgen Center Drive, MS 29-M-B, Thousand Oaks, California 91320, USA.
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Astrup E, Lekva T, Davì G, Otterdal K, Santilli F, Oie E, Halvorsen B, Damås JK, Raoult D, Vitale G, Olano JP, Ueland T, Aukrust P. A complex interaction between Rickettsia conorii and Dickkopf-1--potential role in immune evasion mechanisms in endothelial cells. PLoS One 2012; 7:e43638. [PMID: 23028464 PMCID: PMC3445570 DOI: 10.1371/journal.pone.0043638] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 07/24/2012] [Indexed: 01/08/2023] Open
Abstract
The pathophysiological hallmark of spotted fever group rickettsioses comprises vascular inflammation. Based on the emerging importance of the wingless (Wnt) pathways in inflammation and vascular biology, we hypothesized that Dickkopf-1 (DKK-1), as a major modulator of Wnt signaling, could be involved in the pathogenesis in rickettsial infections. Our major findings were: (i) While baseline concentration of DKK-1 in patients with R. conorii infection (n = 32) were not different from levels in controls (n = 24), DKK-1 rose significantly from presentation to first follow-up sample (median 7 days after baseline). (ii) In vitro experiments in human umbilical vein endothelial cells (HUVECs) showed that while heat-inactivated R. conorii enhanced the release of interleukin-6 (IL-6) and IL-8, it down-regulated the release of endothelial-derived DKK-1 in a time- and dose-dependent manner. (iii) Silencing of DKK-1 attenuated the release of IL-6, IL-8 and growth-related oncogene (GRO)α in R. conorii-exposed HUVECs, suggesting inflammatory effects of DKK-1. (iv) Silencing of DKK-1 attenuated the expression of tissue factor and enhanced the expression of thrombomodulin in R. conorii-exposed HUVECs suggesting pro-thrombotic effects of DKK-1. The capacity of R. conorii to down-regulate endothelial-derived DKK-1 and the ability of silencing DKK-1 to attenuate R. conorii-induced inflammation in endothelial cells could potentially reflect a novel mechanism by which R. conorii escapes the immune response at the site of infection.
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Affiliation(s)
- Elisabeth Astrup
- Institute of Clinical Medicine, Akershus University Hospital, Lørenskog, Norway.
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Dun Y, Li G, Yang Y, Xiong Z, Feng M, Wang M, Zhang Y, Xiang J, Ma R. Inhibition of the canonical Wnt pathway by Dickkopf-1 contributes to the neurodegeneration in 6-OHDA-lesioned rats. Neurosci Lett 2012; 525:83-8. [PMID: 22902902 DOI: 10.1016/j.neulet.2012.07.030] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 07/10/2012] [Accepted: 07/15/2012] [Indexed: 12/28/2022]
Abstract
Dickkopf-1 (Dkk1), an antagonist of the Wnt/β-catenin pathway, has been implicated in many neurodegenerative diseases. However, it's unknown whether Dkk1 is involved in the pathogenesis of Parkinson's disease. In this study, we discovered that Dkk1 was increased in 6-hydroxydopamin(6-OHDA)-lesioned rats. In the meanwhile, inhibition of the canonical Wnt signaling pathway, including the activation of glycogen synthase kinase-3β (GSK-3β) and decrease of β-catenin, was also found in 6-OHDA-lesioned rats. Treatment with rhDkk1 aggravated the dopaminergic neuron damage of the substantia nigra and the inhibition of the canonical Wnt signaling pathway in 6-OHDA-lesioned rats, while the above effects in these rats were abolished by pretreatment with LiCl, an inhibitor of GSK-3β, for consecutive 7 d. These data suggest that Dkk1 plays an important role in the etiology of PD models and it contributes to the neurodegeneration in 6-OHDA-lesioned rats via inhibition of the canonical Wnt pathway.
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Affiliation(s)
- Yaoyan Dun
- Department of Pharmacology, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China
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Abstract
Awareness of the need for prevention of glucocorticoid-induced fractures is growing, but glucocorticoid administration is often overlooked as the most common cause of nontraumatic osteonecrosis. Glucocorticoid-induced osteonecrosis develops in 9-40% of patients receiving long-term therapy although it may also occur with short-term exposure to high doses, after intra-articular injection, and without glucocorticoid-induced osteoporosis. The name, osteonecrosis, is misleading because the primary histopathological lesion is osteocyte apoptosis. Apoptotic osteocytes persist because they are anatomically unavailable for phagocytosis and, with glucocorticoid excess, decreased bone remodeling retards their replacement. Glucocorticoid-induced osteocyte apoptosis, a cumulative and unrepairable defect, uniquely disrupts the mechanosensory function of the osteocyte-lacunar-canalicular system and thus starts the inexorable sequence of events leading to collapse of the femoral head. Current evidence indicates that bisphosphonates may rapidly reduce pain, increase ambulation, and delay joint collapse in patients with osteonecrosis.
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Affiliation(s)
- Robert S Weinstein
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, Central Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, Little Rock, AR 72205-7199, USA.
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Dela Cruz F, Terry M, Matushansky I. A transgenic, mesodermal specific, Dkk1 mouse model recapitulates a spectrum of human congenital limb reduction defects. Differentiation 2012; 83:220-30. [PMID: 22406973 DOI: 10.1016/j.diff.2012.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 12/14/2011] [Accepted: 01/17/2012] [Indexed: 01/02/2023]
Abstract
Congenital limb reduction defects occurring in isolation of other developmental abnormalities continue to be an important medical problem in which little progress has been made. Herein we generated transgenic mice expressing Dkk1 in an appendicular mesodermal pattern. Prx1-Dkk1 mice recapitulate a full spectrum of human congenital limb reduction defects, without other developmental issues, and have normal life-spans. Importantly, a close examination of the inheritance pattern suggests that there is a significant degree of incomplete penetrance as progeny of phenotypically positive or phenotypically negative, but genotypically positive Prx1-Dkk1 mice, consistently give rise to both phenotypically positive mice and phenotypically normal-appearing mice. Thus, this heterogeneous phenotype is reproducible with each generation regardless of the phenotype of the parents. We further go on to identify that mesenchymal stem cells from Prx1-Dkk1 mice have limited proliferative ability, but normal differentiation potential, which may explain the mechanism for the limb reduction defects observed. We believe Prx1-Dkk1 mice may prove useful in the future to study the mechanisms underlying the development of congenital limb reduction defects.
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Affiliation(s)
- Filemon Dela Cruz
- Division of Pediatric Oncology, Department of Pediatrics, Columbia University Medical Center, 161 Fort Washington Ave, IP-7, New York, NY 10032, USA
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45
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Maurel DB, Boisseau N, Benhamou CL, Jaffre C. Alcohol and bone: review of dose effects and mechanisms. Osteoporos Int 2012; 23:1-16. [PMID: 21927919 DOI: 10.1007/s00198-011-1787-7] [Citation(s) in RCA: 202] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 08/19/2011] [Indexed: 12/14/2022]
Abstract
Alcohol is widely consumed across the world. It is consumed in both social and cultural settings. Until recently, two types of alcohol consumption were recognized: heavy chronic alcohol consumption or light consumption. Today, there is a new pattern of consumption among teenagers and young adults namely: binge drinking. Heavy alcohol consumption is detrimental to many organs and tissues, including bones, and is known to induce secondary osteoporosis. Some studies, however, have reported benefits from light alcohol consumption on bone parameters. To date, little is known regarding the effects of binge drinking on bone health. Here, we review the effects of three different means of alcohol consumption: light, heavy, and binge drinking. We also review the detailed literature on the different mechanisms by which alcohol intake may decrease bone mass and strength. The effects of alcohol on bone are thought to be both direct and indirect. The decrease in bone mass and strength following alcohol consumption is mainly due to a bone remodeling imbalance, with a predominant decrease in bone formation. Recent studies, however, have reported new mechanisms by which alcohol may act on bone remodeling, including osteocyte apoptosis, oxidative stress, and Wnt signalling pathway modulation. The roles of reduced total fat mass, increased lipid content in bone marrow, and a hypoleptinemia are also discussed.
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Affiliation(s)
- D B Maurel
- Unité INSERM U658, Caractérisation du Tissu Osseux par Imagerie, Techniques et Applications, CHR Orléans, 45000 Orléans, France.
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Gangji V, De Maertelaer V, Hauzeur JP. Autologous bone marrow cell implantation in the treatment of non-traumatic osteonecrosis of the femoral head: Five year follow-up of a prospective controlled study. Bone 2011; 49:1005-9. [PMID: 21821156 DOI: 10.1016/j.bone.2011.07.032] [Citation(s) in RCA: 218] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 07/18/2011] [Accepted: 07/20/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the efficacy of bone marrow cell implantation into the necrotic lesion of the femoral head on clinical symptoms and the progression of osteonecrosis of the femoral head in comparison with core decompression. METHODS We studied nineteen patients and twenty four hips with early stage osteonecrosis of the femoral head. The hips were allocated to either core decompression only or core decompression and implantation of bone marrow cells. Both patients and assessors were blind with respect to treatment group assignment. The primary outcomes were clinical symptoms and disease progression. RESULTS Bone marrow implantation afforded a significant reduction in pain and in joint symptoms and reduced the incidence of fractural stages. At 60 months, eight of the eleven hips in the control group had deteriorated to the fractural stage whereas only three of the thirteen hips in the bone marrow graft group had progressed to that stage. Survival analysis showed a significant difference in the time to failure between the two groups at 60 months. Patients had only minor side-effects after the treatments. CONCLUSIONS This long term follow-up study confirmed that implantation of autologous bone marrow cells in the necrotic lesion might be an effective treatment for patients with early stages of osteonecrosis of the femoral head.
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Affiliation(s)
- Valérie Gangji
- Department of Rheumatology and Physical Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium.
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