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Rasmussen S, Petersen KK, Aboo C, Andersen JS, Skjoldemose E, Jørgensen NK, Stensballe A, Arendt-Nielsen L. Intra-articular injection of gold micro-particles with hyaluronic acid for painful knee osteoarthritis. BMC Musculoskelet Disord 2024; 25:211. [PMID: 38475764 PMCID: PMC10935980 DOI: 10.1186/s12891-024-07321-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Recently, in an open pilot study, we found up to two years, a potential pain-relieving effect of intra-articular gold micro-particles using the patient's synovial fluid for patients with knee osteoarthritis (KOA). During the study the excluded group of patients, due to multisite pain, co-morbidities, and other exclusion criteria., received intra-articular gold micro-particles using hyaluronic acid,. We aimed to identify if pre-treatment characteristics influence the global outcome two years after intra-articular treatment for painful KOA with gold microparticles using hyaluronic acid. METHODS Using hyaluronic acid as the carrier, 136 patients with KOA received intraarticular injections with 20 mg gold microparticles (72.000 particles, 20-40 μm in diameter). In the analysis, we included the Global Rating of Change Scale, Pain Detect Questionnaire (PDQ), Body Mass Index (BMI), and Kellgren & Lawrence score at the inclusion, Western Ontario, and McMaster Universities Osteoarthritis Index (WOMAC) sub-scores for pain, stiffness, and function at inclusion and two years. RESULTS On the Global Rating Change Scale, 69.1% of patients reported a positive effect, 28.7% no effect, and 2.2% worse. PDQ and the three WOMAC subscores all improved at two years of follow-up. PDQ ≥ 13 (P = 0.028), BMI (P = 0.022) and Kellgren & Lawrence grade 4 (P = 0.028) at inclusion reduced the effect with a minor odds ratio compared to the baseline effect of treatment (P = 0.025). WOMAC subscores at inclusion did not influence the outcome (P > 0.5). CONCLUSIONS Severe osteoarthritis, obesity, and neuropathic pain, reduced the effect of intra-articular gold microparticles for knee OA. TRIAL REGISTRATION The study followed the principles of the Declaration of Helsinki and was approved by the local ethics committee of the North Denmark Region by 27/07/2016 (N-20,160,045). The regional data protection agency approved the project by 06/07/2016 (2008-58-0028, ID 2016 - 116) and registered in ClinicalTrial.Gov by 04/01/2018 (NCT03389906).
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Affiliation(s)
- Sten Rasmussen
- Department of Clinical Medicine, Aalborg University, 249 Selma Lagerløfs Vej, Gistrup, 9260, Denmark.
- Department of Orthopedic Surgery, Sport and Arthroscopy, Aalborg University Hospital, Aalborg, Denmark.
| | - Kristian Kjaer Petersen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Christopher Aboo
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Emilie Skjoldemose
- Department of Clinical Medicine, Aalborg University, 249 Selma Lagerløfs Vej, Gistrup, 9260, Denmark
| | - Nia Kristine Jørgensen
- Department of Clinical Medicine, Aalborg University, 249 Selma Lagerløfs Vej, Gistrup, 9260, Denmark
| | - Allan Stensballe
- Department of Clinical Medicine, Aalborg University, 249 Selma Lagerløfs Vej, Gistrup, 9260, Denmark
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Gastroenterology & Hepatology, Mech-Sense, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
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Danscher G, Rasmussen S. nanoGold and µGold inhibit autoimmune inflammation: a review. Histochem Cell Biol 2023; 159:225-232. [PMID: 36864314 PMCID: PMC10006034 DOI: 10.1007/s00418-023-02182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 03/04/2023]
Abstract
The newest data on metallic gold have placed the noble metal central in the fight for the safe treatment of autoimmune inflammation. There are two different ways to use gold for the treatment of inflammation: gold microparticles > 20 µm and gold nanoparticles. The injection of gold microparticles (µGold) is a purely local therapy. µGold particles stay put where injected, and gold ions released from them are relatively few and taken up by cells within a sphere of only a few millimeters in diameter from their origin particles. The macrophage-induced release of gold ions may continue for years. Injection of gold nanoparticles (nanoGold), on the other hand, is spread throughout the whole body, and the bio-released gold ions, therefore, affect multitudes of cells all over the body, as when using gold-containing drugs such as Myocrisin. Since macrophages and other phagocytotic cells take up and transport nanoGold and remove it after a short period, repeated treatment is necessary. This review describes the details of the cellular mechanisms that lead to the bio-release of gold ions in µGold and nanoGold.
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Affiliation(s)
- Gorm Danscher
- Department of Biomedicine, Århus University, Århus, Denmark
| | - Sten Rasmussen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Nicholls D, Merchant-Walsh M, Dunne J, Cortellini NP, Adami C. Use of mechanical thresholds in a model of feline clinical acute pain and their correlation with the Glasgow Feline Composite Measure Pain Scale scores. J Feline Med Surg 2022; 24:517-523. [PMID: 34328358 PMCID: PMC11104254 DOI: 10.1177/1098612x211035051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the use of mechanical thresholds (MT), measured with the SMALGO (Small Animal ALGOmeter), and to determine whether there was a correlation between MT and Glasgow Feline Composite Measure Pain Scale (CMPS-Feline) scores in cats undergoing ovariohysterectomy. METHODS Client-owned cats undergoing flank ovariohysterectomy were recruited. Pain scores for the pre- and postoperative periods were obtained using the CMPS-Feline in each cat by two independent investigators (A and B). Following CMPS-Feline scoring, MT were measured with the SMALGO, in the surgical area, pre- and postoperatively, only by investigator A. Each cat served as its own control for the comparison of pre- and postoperative variables. Reliability statistics were used to assess the level of inter-observer agreement (A vs B) with respect to pre- and postoperative CMPS-Feline scores, while Spearman's correlation statistics were used to analyse the relationship between MT and CMPS-Feline scores. RESULTS Twenty-nine cats completed the study. Preoperative MT (340 g [range 108-691]) were significantly higher than postoperatively (233 g [range 19-549]; P = 0.001). CMPS-Feline scores were not found to differ significantly between the preoperative period (2 [range 0-7] for investigator A and 3.2 ± 2.3 for investigator B) and postoperative period (2 [range 0-10] for investigator A and 3 [range 0-8] for investigator B) for either investigator. Reliability statistics revealed that the level of inter-observer agreement with respect to CMPS-Feline was fair for the preoperative assessments but poor for the postoperative evaluations. There was no correlation between MT and CMPS-Feline scores. CONCLUSIONS AND RELEVANCE Although there was no correlation with CMPS-Feline scores performed at the same timepoint, MT increased postoperatively vs baseline. Assuming that, despite analgesia, susceptibility of the surgical area to mechanical stimulation would increase after surgery, this finding suggests that MT might be useful to assess feline surgical pain. The poor level of inter-observer agreement with respect to postoperative CMPS-Feline scores highlights the potential limitations of this scale.
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Affiliation(s)
- Daniel Nicholls
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK
| | | | | | | | - Chiara Adami
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Rasmussen S, Kjaer Petersen K, Kristiansen MK, Andersen JS, Aboo C, Thomsen ME, Skjoldemose E, Jørgensen NK, Stensballe A, Arendt-Nielsen L. Gold micro-particles for knee osteoarthritis. Eur J Pain 2022; 26:811-824. [PMID: 35076138 PMCID: PMC9307026 DOI: 10.1002/ejp.1909] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/29/2021] [Accepted: 01/08/2022] [Indexed: 11/22/2022]
Abstract
Background This exploratory study investigates if intra‐articular injected gold microparticles in knee osteoarthritis (KOA) reduce immunomodulatory‐based pain via proteomic changes in the synovial fluid (SF) and serum. Methods Thirty patients with moderate KOA were included. Intraarticular injections with 20 mg gold microparticles (72.000 particles, 20–40 µm in diameter) using the patient's synovial fluid (SF) as carrier were performed. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscores for pain, stiffness, and function were assessed at inclusion, 8 weeks and 2 years The PainDetect questionnaire, pain pressure threshold (PPT), temporal summation (TS), and conditioned pain modulation (CPM), and pain diary were assessed at inclusion and 8 weeks. Proteome analysis was performed on SF and blood samples before and after 8 weeks of treatment. Results A decrease in WOMAC scores (pain (p = 0.0001), stiffness (p = 0.0088), activity (p = 0.0001)), PainDetect (p = 0.0002) and increase in PPT (p = 0.001) and CPM (p = 0.021) and a decrease in TS (p = 0.03) were found after 8 weeks compared to inclusion assessments. At 2 years follow‐up compared to baseline there was a decrease in WOMAC scores (pain (p = 0.0001), stiffness (p = 0.007), activity (p = 0.0001)) and PainDetect (p = 0.0001). In SF, 28 different proteins were downregulated and 11 upregulated (p < 0.05) mainly associated immune response. Similarly, 31 proteins were downregulated and 1 upregulated in serum (p < 0.05) reflecting key immune response and anatomical structure development processes. No adverse effects related to the treatment were recorded. Conclusions Gold microparticles injected intra‐articular in KOA joints may provide pain relief and an inflammatory modulatory effect based on proteome changes found in SF and serum. A randomized, controlled, double‐blind study is needed to infer a conclusion. Significance This study indicates that intra‐articular gold may provide advantages in clinical practice for managing knee osteoarthritic pain. The use of intraarticular gold can add new knowledge to the treatment of inflammation and pain.
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Affiliation(s)
- Sten Rasmussen
- Department of Clinical Medicine, Aalborg University.,Department of Orthopedic Surgery, Sport and Arthroscopy, Aalborg University Hospital
| | - Kristian Kjaer Petersen
- Department of Health Science and Technology, Aalborg University.,Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | | | | | | | | | | | | | | | - Lars Arendt-Nielsen
- Department of Health Science and Technology, Aalborg University.,Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Medical Gastroenterology, Mech-Sense, Aalborg University Hospital
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Pellegrini DZ, Müller TR, Fonteque JH, de Souza LP, de Souza AF, Joaquim JGF. Equine acupuncture methods and applications: A review. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.12928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D. Z. Pellegrini
- Department of Veterinary Medicine Agroveterinary Sciences Center Santa Catarina State University (CAV/UDESC) Lages SC Brazil
| | - T. R. Müller
- Department of Veterinary Medicine Agroveterinary Sciences Center Santa Catarina State University (CAV/UDESC) Lages SC Brazil
| | - J. H. Fonteque
- Department of Veterinary Medicine Agroveterinary Sciences Center Santa Catarina State University (CAV/UDESC) Lages SC Brazil
| | - L. P. de Souza
- Department of Veterinary Medicine Agroveterinary Sciences Center Santa Catarina State University (CAV/UDESC) Lages SC Brazil
| | - A. F. de Souza
- Faculty of Veterinary Medicine and Animal Science University of São Paulo (FMVZ/USP) São Paulo SP Brazil
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