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Zhou J, Ren R, Zhan Y, Song N, Zhu S, Jiang N. Comparing microstructural and micromechanical deformation of the TMJ disc in two anterior disc displacement models. J Oral Rehabil 2024; 51:2390-2397. [PMID: 39152540 DOI: 10.1111/joor.13821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/26/2024] [Accepted: 07/17/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVE Anterior disc displacement (ADD) has been used to establish temporomandibular joint disorder (TMD) models. Based on whether preserve of the retrodiscal attachment, the modelling methodologies include ADD with dissecting the retrodiscal attachment (ADDwd) and ADD without dissecting the retrodiscal attachment (ADDwod). This article aims to determine which model better matches the micromechanical and microstructural progression of TMD. METHODS Through meticulous microscopic observations, the microstructure and micromechanical deformation of the TMJ discs in ADDwd and ADDwod rabbit models were compared at 2 and 20 weeks. RESULT Scanning electron microscopy and transmission electron microscopy showed that collagen fibres became slenderized and straightened, collagen fibrils lost diameter and arrangement in the ADDwd group at 2 weeks. Meanwhile, nanoindentation and atomic electron microscopy showed that the micro- and nano- mechanical properties decreased dramatically. However, the ADDwod group exhibited no significant microstructure and micromechanical deformations at 2 weeks. Dissection of the retrodiscal attachment contribute in the acceleration of disease progression at the early stage, the devastating discal phenotype remained fundamentally the same within the two models at 20 weeks. CONCLUSION ADDwod models, induced stable and persistent disc deformation, therefore, can better match the progression of TMD. While ADDwd models can be considered for experiments which aim to obtain advanced phenotype in a short time.
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Affiliation(s)
- Jiahao Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan University, Chengdu, Sichuan, China
| | - Rong Ren
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan University, Chengdu, Sichuan, China
| | - Yanjing Zhan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan University, Chengdu, Sichuan, China
| | - Ning Song
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan University, Chengdu, Sichuan, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan University, Chengdu, Sichuan, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan University, Chengdu, Sichuan, China
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Hamada M, Eskelinen ASA, Florea C, Mikkonen S, Nieminen P, Grodzinsky AJ, Tanska P, Korhonen RK. Loss of collagen content is localized near cartilage lesions on the day of injurious loading and intensified on day 12. J Orthop Res 2024. [PMID: 39312444 DOI: 10.1002/jor.25975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 07/19/2024] [Accepted: 09/01/2024] [Indexed: 09/25/2024]
Abstract
Joint injury can lead to articular cartilage damage, excessive inflammation, and post-traumatic osteoarthritis (PTOA). Collagen is an essential component for cartilage function, yet current literature has limited understanding of how biochemical and biomechanical factors contribute to collagen loss in injured cartilage. Our aim was to investigate spatially dependent changes in collagen content and collagen integrity of injured cartilage, with an explant model of early-stage PTOA. We subjected calf knee cartilage explants to combinations of injurious loading (INJ), interleukin-1α-challenge (IL) and physiological cyclic loading (CL). Using Fourier transform infrared microspectroscopy, collagen content (Amide I band) and collagen integrity (Amide II/1338 cm-1 ratio) were estimated on days 0 and 12 post-injury. We found that INJ led to lower collagen content near lesions compared to intact regions on day 0 (p < 0.001). On day 12, near-lesion collagen content was lower compared to day 0 (p < 0.05). Additionally, on day 12, INJ, IL, and INJ + IL groups exhibited lower collagen content along most of tissue depth compared to free-swelling control group (p < 0.05). CL groups showed higher collagen content along most of tissue depth compared to corresponding groups without CL (p < 0.05). Immunohistochemical analysis revealed higher MMP-1 and MMP-3 staining intensities localized within cell lacunae in INJ group compared to CTRL group on day 0. Our results suggest that INJ causes rapid loss of collagen content near lesions, which is intensified on day 12. Additionally, CL could mitigate the loss of collagen content at intact regions after 12 days.
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Affiliation(s)
- Moustafa Hamada
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Atte S A Eskelinen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Cristina Florea
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Santtu Mikkonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Petteri Nieminen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Alan J Grodzinsky
- Departments of Biological Engineering, Electrical Engineering and Computer Science, and Mechanical Engineering, Massachusetts Institute of Technology, Massachusetts Avenue, Cambridge, Massachusetts, USA
| | - Petri Tanska
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
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3
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Gao Q, Jiang Y, Zhou D, Li G, Han Y, Yang J, Xu K, Jing Y, Bai L, Geng Z, Zhang H, Zhou G, Zhu M, Ji N, Han R, Zhang Y, Li Z, Wang C, Hu Y, Shen H, Wang G, Shi Z, Han Q, Chen X, Su J. Advanced glycation end products mediate biomineralization disorder in diabetic bone disease. Cell Rep Med 2024; 5:101694. [PMID: 39173634 DOI: 10.1016/j.xcrm.2024.101694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 06/04/2024] [Accepted: 07/26/2024] [Indexed: 08/24/2024]
Abstract
Patients with diabetes often experience fragile fractures despite normal or higher bone mineral density (BMD), a phenomenon termed the diabetic bone paradox (DBP). The pathogenesis and therapeutics opinions for diabetic bone disease (DBD) are not fully explored. In this study, we utilize two preclinical diabetic models, the leptin receptor-deficient db/db mice (DB) mouse model and the streptozotocin-induced diabetes (STZ) mouse model. These models demonstrate higher BMD and lower mechanical strength, mirroring clinical observations in diabetic patients. Advanced glycation end products (AGEs) accumulate in diabetic bones, causing higher non-enzymatic crosslinking within collagen fibrils. This inhibits intrafibrillar mineralization and leads to disordered mineral deposition on collagen fibrils, ultimately reducing bone strength. Guanidines, inhibiting AGE formation, significantly improve the microstructure and biomechanical strength of diabetic bone and enhance bone fracture healing. Therefore, targeting AGEs may offer a strategy to regulate bone mineralization and microstructure, potentially preventing the onset of DBD.
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Affiliation(s)
- Qianmin Gao
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Yingying Jiang
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China.
| | - Dongyang Zhou
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Guangfeng Li
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Yafei Han
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Jingzhi Yang
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Ke Xu
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Yingying Jing
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Long Bai
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Zhen Geng
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Hao Zhang
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China; Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China
| | - Guangyin Zhou
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Mengru Zhu
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Ning Ji
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Ruina Han
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China
| | - Yuanwei Zhang
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China
| | - Zuhao Li
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China
| | - Chuandong Wang
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China
| | - Yan Hu
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China
| | - Hao Shen
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China
| | - Guangchao Wang
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China
| | - Zhongmin Shi
- Department of Orthopedics, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, P.R. China
| | - Qinglin Han
- Orthopaedic Department, The Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China.
| | - Xiao Chen
- Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China.
| | - Jiacan Su
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, P.R. China; Organoid Research Center, Shanghai University, Shanghai 200444, P.R. China; National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai 200444, P.R. China; Department of Orthopedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, P.R. China.
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Lai A, Tamea C, Shou J, Okafor A, Sparks J, Dodd R, Lambert N, Woods C, Schulte O, Kovar S, Barrett T. Retrospective Evaluation of Cryopreserved Human Umbilical Cord Tissue Allografts in the Supplementation of Cartilage Defects Associated with Hip Osteoarthritis. J Clin Med 2024; 13:4040. [PMID: 39064079 PMCID: PMC11277460 DOI: 10.3390/jcm13144040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Osteoarthritis is a chronic disorder that affects the synovial joints by the progressive loss of articular cartilage. In the hip, the largest weight-bearing joint, the deterioration of articular cartilage and acetabular labrum can cause pain, diminishing the quality of life for patients. This study presents changes in reported pain scales from patients who received Wharton's jelly applications to cartilage deterioration in the hip from the observational retrospective repository at Regenative Labs. Methods: Sixty-nine patients were selected based on inclusion criteria with patient-reported pain scales, including the Numeric Pain Rating Scale and the Western Ontario and McMaster University Osteoarthritis Index, collected at the initial application, 30, and 90-day follow-up visits. Thirteen patients received a second allograft application and had additional follow-up visits at 120 and 180 days. Results: Five of the six scales used showed a statistically significant improvement in average scores across the cohort. The greatest improvements were observed in the NPRS with a 31.36% improvement after 90 days and a 44.64% improvement for patients with two applications after 180 days. The minimal clinically important difference (MCID) was also calculated to determine the perceived value of care for each patient with 44.9% of patients exceeding the MCID and 78.3% reporting at least one level of improvement. Conclusions: The positive outcomes for the patients in this cohort suggest WJ to be a promising alternative care option for patients with structural tissue degeneration in the hip refractory to the current standard of care.
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Affiliation(s)
- Albert Lai
- Desert Physical Medicine and Pain Management, Indio, CA 92201, USA; (A.L.); (R.D.)
| | - Conrad Tamea
- Orthopedic Associates of Tampa Bay, Tampa, FL 33603, USA;
| | - John Shou
- Department of Pharmacology, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Anthony Okafor
- Mathematics & Statistics, University of West Florida, Pensacola, FL 32514, USA; (A.O.); (J.S.)
| | - Jay Sparks
- Mathematics & Statistics, University of West Florida, Pensacola, FL 32514, USA; (A.O.); (J.S.)
| | - Renee Dodd
- Desert Physical Medicine and Pain Management, Indio, CA 92201, USA; (A.L.); (R.D.)
| | - Naomi Lambert
- Regenative Labs, Pensacola, FL 32501, USA; (C.W.); (O.S.); (S.K.); (T.B.)
| | - Crislyn Woods
- Regenative Labs, Pensacola, FL 32501, USA; (C.W.); (O.S.); (S.K.); (T.B.)
| | - Orion Schulte
- Regenative Labs, Pensacola, FL 32501, USA; (C.W.); (O.S.); (S.K.); (T.B.)
| | - Sarah Kovar
- Regenative Labs, Pensacola, FL 32501, USA; (C.W.); (O.S.); (S.K.); (T.B.)
| | - Tyler Barrett
- Regenative Labs, Pensacola, FL 32501, USA; (C.W.); (O.S.); (S.K.); (T.B.)
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5
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Macdonald JK, Mehta AS, Drake RR, Angel PM. Molecular analysis of the extracellular microenvironment: from form to function. FEBS Lett 2024; 598:602-620. [PMID: 38509768 PMCID: PMC11049795 DOI: 10.1002/1873-3468.14852] [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: 11/29/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
The extracellular matrix (ECM) proteome represents an important component of the tissue microenvironment that controls chemical flux and induces cell signaling through encoded structure. The analysis of the ECM represents an analytical challenge through high levels of post-translational modifications, protease-resistant structures, and crosslinked, insoluble proteins. This review provides a comprehensive overview of the analytical challenges involved in addressing the complexities of spatially profiling the extracellular matrix proteome. A synopsis of the process of synthesizing the ECM structure, detailing inherent chemical complexity, is included to present the scope of the analytical challenge. Current chromatographic and spatial techniques addressing these challenges are detailed. Capabilities for multimodal multiplexing with cellular populations are discussed with a perspective on developing a holistic view of disease processes that includes both the cellular and extracellular microenvironment.
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Affiliation(s)
- Jade K Macdonald
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC
| | - Anand S Mehta
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC
| | - Richard R Drake
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC
| | - Peggi M. Angel
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, Charleston, SC
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6
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Pérez-Díaz MA, Martínez-Colin EJ, González-Torres M, Ortega-Sánchez C, Sánchez-Sánchez R, Delgado-Meza J, Machado-Bistraín F, Martínez-López V, Giraldo D, Márquez-Gutiérrez ÉA, Jiménez-Ávalos JA, García-Carvajal ZY, Melgarejo-Ramírez Y. Chondrogenic Potential of Human Adipose-Derived Mesenchymal Stromal Cells in Steam Sterilized Gelatin/Chitosan/Polyvinyl Alcohol Hydrogels. Polymers (Basel) 2023; 15:3938. [PMID: 37835986 PMCID: PMC10574893 DOI: 10.3390/polym15193938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
Cross-linked polymer blends from natural compounds, namely gelatin (Gel), chitosan (CS), and synthetic poly (vinyl alcohol) (PVA), have received increasing scrutiny because of their versatility, biocompatibility, and ease of use for tissue engineering. Previously, Gel/CS/PVA [1:1:1] hydrogel produced via the freeze-drying process presented enhanced mechanical properties. This study aimed to investigate the biocompatibility and chondrogenic potential of a steam-sterilized Gel/CS/PVA hydrogel using differentiation of human adipose-derived mesenchymal stromal cells (AD-hMSC) and cartilage marker expression. AD-hMSC displayed fibroblast-like morphology, 90% viability, and 69% proliferative potential. Mesenchymal profiles CD73 (98.3%), CD90 (98.6%), CD105 (97.0%), CD34 (1.11%), CD45 (0.27%), HLA-DR (0.24%); as well as multilineage potential, were confirmed. Chondrogenic differentiation of AD-hMSC in monolayer revealed the formation of cartilaginous nodules composed of glycosaminoglycans after 21 days. Compared to nonstimulated cells, hMSC-derived chondrocytes shifted the expression of CD49a from 2.82% to 40.6%, CD49e from 51.4% to 92.2%, CD54 from 9.66 to 37.2%, and CD151 from 45.1% to 75.8%. When cultured onto Gel/CS/PVA hydrogel during chondrogenic stimulation, AD-hMSC changed to polygonal morphology, and chondrogenic nodules increased by day 15, six days earlier than monolayer-differentiated cells. SEM analysis showed that hMSC-derived chondrocytes adhered to the surface with extended filopodia and abundant ECM formation. Chondrogenic nodules were positive for aggrecan and type II collagen, two of the most abundant components in cartilage. This study supports the biocompatibility of AD-hMSC onto steam-sterilized GE/CS/PVA hydrogels and its improved potential for chondrocyte differentiation. Hydrogel properties were not altered after steam sterilization, which is relevant for biosafety and biomedical purposes.
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Affiliation(s)
- Mario Alberto Pérez-Díaz
- Laboratorio de Biotecnología, Unidad de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico; (M.A.P.-D.); (M.G.-T.); (C.O.-S.); (J.D.-M.); (F.M.-B.)
| | - Erick Jesús Martínez-Colin
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados, Ciudad de México 07360, Mexico
| | - Maykel González-Torres
- Laboratorio de Biotecnología, Unidad de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico; (M.A.P.-D.); (M.G.-T.); (C.O.-S.); (J.D.-M.); (F.M.-B.)
| | - Carmina Ortega-Sánchez
- Laboratorio de Biotecnología, Unidad de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico; (M.A.P.-D.); (M.G.-T.); (C.O.-S.); (J.D.-M.); (F.M.-B.)
| | - Roberto Sánchez-Sánchez
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación LGII, Ciudad de México 14389, Mexico; (R.S.-S.)
| | - Josselin Delgado-Meza
- Laboratorio de Biotecnología, Unidad de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico; (M.A.P.-D.); (M.G.-T.); (C.O.-S.); (J.D.-M.); (F.M.-B.)
| | - Fernando Machado-Bistraín
- Laboratorio de Biotecnología, Unidad de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico; (M.A.P.-D.); (M.G.-T.); (C.O.-S.); (J.D.-M.); (F.M.-B.)
| | - Valentín Martínez-López
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación LGII, Ciudad de México 14389, Mexico; (R.S.-S.)
| | - David Giraldo
- Department of Cell and Tissue Biology, School of Medicine, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico;
| | - Érik Agustín Márquez-Gutiérrez
- Cirugía Plástica y Reconstructiva, Centro Nacional de Investigación y Atención de Quemados, Instituto Nacional de Rehabilitación LGII, Ciudad de México 14389, Mexico;
| | - Jorge Armando Jiménez-Ávalos
- Unidad de Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, A.C. (CIATEJ), Guadalajara 44270, Mexico;
| | - Zaira Yunuen García-Carvajal
- Unidad de Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, A.C. (CIATEJ), Guadalajara 44270, Mexico;
| | - Yaaziel Melgarejo-Ramírez
- Laboratorio de Biotecnología, Unidad de Gerociencias, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico; (M.A.P.-D.); (M.G.-T.); (C.O.-S.); (J.D.-M.); (F.M.-B.)
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7
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Hao L, Mao H. Magnetically anisotropic hydrogels for tissue engineering. Biomater Sci 2023; 11:6384-6402. [PMID: 37552036 DOI: 10.1039/d3bm00744h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Many soft tissues of the human body possess hierarchically anisotropic structures, exhibiting orientation-specific mechanical properties and biological functionality. Hydrogels have been proposed as promising scaffold materials for tissue engineering applications due to their water-rich composition, excellent biocompatibility, and tunable physico-chemical properties. However, conventional hydrogels with homogeneous structures often exhibit isotropic properties that differ from those of biological tissues, limiting their further application. Recently, magnetically anisotropic hydrogels containing long-range ordered magneto-structures have attracted widespread interest owing to their highly controllable assembly strategy, rapid magnetic responsiveness and remote spatiotemporal regulation. In this review, we summarize the latest progress of magnetically anisotropic hydrogels for tissue engineering. The fabrication strategy of magnetically anisotropic hydrogels from magnetic nanofillers with different dimensions is systemically introduced. Then, the effects of magnetically anisotropic cues on the physicochemical properties of hydrogels and the cellular biological behavior are discussed. And the applications of magnetically anisotropic hydrogels in the engineering of different tissues are emphasized. Finally, the current challenges and the future perspectives for magnetically anisotropic hydrogels are presented.
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Affiliation(s)
- Lili Hao
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Nanjing Tech University, Nanjing 211816, China.
| | - Hongli Mao
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Nanjing Tech University, Nanjing 211816, China.
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8
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Köck H, Striegl B, Kraus A, Zborilova M, Christiansen S, Schäfer N, Grässel S, Hornberger H. In Vitro Analysis of Human Cartilage Infiltrated by Hydrogels and Hydrogel-Encapsulated Chondrocytes. Bioengineering (Basel) 2023; 10:767. [PMID: 37508794 PMCID: PMC10376441 DOI: 10.3390/bioengineering10070767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/31/2023] [Accepted: 06/10/2023] [Indexed: 07/30/2023] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disease causing loss of articular cartilage and structural damage in all joint tissues. Given the limited regenerative capacity of articular cartilage, methods to support the native structural properties of articular cartilage are highly anticipated. The aim of this study was to infiltrate zwitterionic monomer solutions into human OA-cartilage explants to replace lost proteoglycans. The study included polymerization and deposition of methacryloyloxyethyl-phosphorylcholine- and a novel sulfobetaine-methacrylate-based monomer solution within ex vivo human OA-cartilage explants and the encapsulation of isolated chondrocytes within hydrogels and the corresponding effects on chondrocyte viability. The results demonstrated that zwitterionic cartilage-hydrogel networks are formed by infiltration. In general, cytotoxic effects of the monomer solutions were observed, as was a time-dependent infiltration behavior into the tissue accompanied by increasing cell death and penetration depth. The successful deposition of zwitterionic hydrogels within OA cartilage identifies the infiltration method as a potential future therapeutic option for the repair/replacement of OA-cartilage extracellular suprastructure. Due to the toxic effects of the monomer solutions, the focus should be on sealing the OA-cartilage surface, instead of complete infiltration. An alternative treatment option for focal cartilage defects could be the usage of monomer solutions, especially the novel generated sulfobetaine-methacrylate-based monomer solution, as bionic for cell-based 3D bioprintable hydrogels.
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Affiliation(s)
- Hannah Köck
- Biomaterials Laboratory, Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule (OTH), 93053 Regensburg, Germany
- Department of Orthopaedic Surgery, Experimental Orthopaedics, Centre for Medical Biotechnology (ZMB/Biopark 1), University of Regensburg, 93053 Regensburg, Germany
- Regensburg Center of Biomedical Engineering (RCBE), Ostbayerische Technische Hochschule (OTH) and University of Regensburg, 93053 Regensburg, Germany
| | - Birgit Striegl
- Regensburg Center of Biomedical Engineering (RCBE), Ostbayerische Technische Hochschule (OTH) and University of Regensburg, 93053 Regensburg, Germany
| | - Annalena Kraus
- Institute for Nanotechnology and Correlative Microscopy eV INAM, 91301 Forchheim, Germany
| | - Magdalena Zborilova
- Department of Orthopaedic Surgery, University of Regensburg, 93053 Regensburg, Germany
| | - Silke Christiansen
- Institute for Nanotechnology and Correlative Microscopy eV INAM, 91301 Forchheim, Germany
| | - Nicole Schäfer
- Department of Orthopaedic Surgery, Experimental Orthopaedics, Centre for Medical Biotechnology (ZMB/Biopark 1), University of Regensburg, 93053 Regensburg, Germany
| | - Susanne Grässel
- Department of Orthopaedic Surgery, Experimental Orthopaedics, Centre for Medical Biotechnology (ZMB/Biopark 1), University of Regensburg, 93053 Regensburg, Germany
- Department of Orthopaedic Surgery, University of Regensburg, 93053 Regensburg, Germany
| | - Helga Hornberger
- Biomaterials Laboratory, Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule (OTH), 93053 Regensburg, Germany
- Regensburg Center of Biomedical Engineering (RCBE), Ostbayerische Technische Hochschule (OTH) and University of Regensburg, 93053 Regensburg, Germany
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9
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Girão-Carmona VCC, Bezerra MM, Porto FMAX, Pinto ACMD, de Melo Nunes R, Alves AMCV, Campello CC, de Melo Leite ACR, de Castro Brito GA, da Rocha FAC. Quantitative evaluation of very early cartilage damage in experimental osteoarthritis using scanning electron microscopy. Adv Rheumatol 2022; 62:42. [PMID: 36371322 DOI: 10.1186/s42358-022-00277-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe parametric changes observed using scanning electron microscopy (SEM) in very early stages in posttraumatic osteoarthritis (OA) models in mice. METHODS Mice (5/group) had their knees subjected to anterior cruciate ligament transection (ACLT), ACLT plus meniscectomy (MNCT) or sham surgery, sacrificed after 3, 7 or 14 days, had the articular cartilage evaluated under optical microscopy using Osteoarthritis Research Society International (OARSI) parameters as well as cartilage thickness, roughness, and a damage index using SEM. RESULTS Alterations of the cartilage under optical microscopy were not significantly relevant among groups. SEM analysis revealed reduction of femoral and tibial cartilage thickness in ACLT and MNCT groups at 7 and 14 days, with increased cartilage roughness in MNCT group as early as 3 days postsurgery, being sustained up to 14 days. Articular damage index was significantly higher at 14 days post surgery in ACLT and MNCT vs control groups. CONCLUSION This is the first demonstration of very early quantitative changes in the cartilage of mice subjected to posttraumatic experimental OA using SEM, revealing increased roughness and thickness as early as 3 days post surgery. These changes may be used as early surrogates for later joint damage in experimental OA.
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Affiliation(s)
- Virgínia Cláudia Carneiro Girão-Carmona
- Faculdade de Medicina da Universidade Federal do Ceará, Postgraduate Program in Morphological Sciences, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | | | - Fernanda Maria Aragão Ximenes Porto
- Faculdade de Medicina da Universidade Federal do Ceará, Postgraduate Program in Morphological Sciences, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | | | - Rodolfo de Melo Nunes
- Postgraduate Program in Medical Sciences, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Anelise Maria Costa Vasconcelos Alves
- Faculdade de Medicina da Universidade Federal do Ceará, Postgraduate Program in Medical Microbiology, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Claudio Cabral Campello
- Faculdade de Medicina Veterinária of the Universidade Estadual do Ceará, Fortaleza, Ceará, Brazil
| | | | - Gerly Anne de Castro Brito
- Faculdade de Medicina da Universidade Federal do Ceará, Postgraduate Program in Morphological Sciences, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
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10
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Chen Z, Khuu N, Xu F, Kheiri S, Yakavets I, Rakhshani F, Morozova S, Kumacheva E. Printing Structurally Anisotropic Biocompatible Fibrillar Hydrogel for Guided Cell Alignment. Gels 2022; 8:685. [PMID: 36354593 PMCID: PMC9689575 DOI: 10.3390/gels8110685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 08/13/2023] Open
Abstract
Many fibrous biological tissues exhibit structural anisotropy due to the alignment of fibers in the extracellular matrix. To study the impact of such anisotropy on cell proliferation, orientation, and mobility, it is important to recapitulate and achieve control over the structure of man-made hydrogel scaffolds for cell culture. Here, we report a chemically crosslinked fibrous hydrogel due to the reaction between aldehyde-modified cellulose nanofibers and gelatin. We explored two ways to induce structural anisotropy in this gel by extruding the hydrogel precursor through two different printheads. The cellulose nanofibers in the hydrogel ink underwent shear-induced alignment during extrusion and retained it in the chemically crosslinked hydrogel. The degree of anisotropy was controlled by the ink composition and extrusion flow rate. The structural anisotropy of the hydrogel extruded through a nozzle affected the orientation of human dermal fibroblasts that were either seeded on the hydrogel surface or encapsulated in the extruded hydrogel. The reported straightforward approach to constructing fibrillar hydrogel scaffolds with structural anisotropy can be used in studies of the biological impact of tissue anisotropy.
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Affiliation(s)
- Zhengkun Chen
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada
| | - Nancy Khuu
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada
| | - Fei Xu
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada
| | - Sina Kheiri
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada
| | - Ilya Yakavets
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada
| | - Faeze Rakhshani
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada
| | - Sofia Morozova
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada
- N.E. Bauman Moscow State Technical University, 5/1 2nd Baumanskaya Street, 105005 Moscow, Russia
| | - Eugenia Kumacheva
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON M5S 3E5, Canada
- The Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
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11
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Raju V, Koorata PK. Influence of material heterogeneity on the mechanical response of articulated cartilages in a knee joint. Proc Inst Mech Eng H 2022; 236:1340-1348. [DOI: 10.1177/09544119221116263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Structurally, the articular cartilages are heterogeneous owing to nonuniform distribution and orientation of its constituents. The oversimplification of this soft tissue as a homogeneous material is generally considered in the simulation domain to estimate contact pressure along with other physical responses. Hence, there is a need for investigating knee cartilages for their actual response to external stimuli. In this article, impact of material and geometrical heterogeneity of the cartilage is resolved using well known material models. The findings are compared with conventional homogeneous models. The results indicate vital differences in contact pressure distribution and tissue deformation. Further, this study paves way for standardizing material models to extract maximum information possible for investigating knee mechanics with variable geometry and case specific parameters.
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Affiliation(s)
- Vaishakh Raju
- Applied Solid Mechanics Laboratory, Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Karnataka, India
| | - Poornesh Kumar Koorata
- Applied Solid Mechanics Laboratory, Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal, Karnataka, India
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12
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Tschaikowsky M, Brander S, Barth V, Thomann R, Rolauffs B, Balzer BN, Hugel T. The articular cartilage surface is impaired by a loss of thick collagen fibers and formation of type I collagen in early osteoarthritis. Acta Biomater 2022; 146:274-283. [PMID: 35487427 DOI: 10.1016/j.actbio.2022.04.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/03/2022] [Accepted: 04/21/2022] [Indexed: 12/14/2022]
Abstract
Osteoarthritis (OA) is a joint disease affecting millions of patients worldwide. During OA onset and progression, the articular cartilage is destroyed, but the underlying complex mechanisms remain unclear. Here, we uncover changes in the thickness of collagen fibers and their composition at the onset of OA. For articular cartilage explants from knee joints of OA patients, we find that type I collagen-rich fibrocartilage-like tissue was formed in macroscopically intact cartilage, distant from OA lesions. Importantly, the number of thick fibers (>100 nm) has decreased early in the disease, followed by complete absence of thick fibers in advanced OA. We have obtained these results by a combination of high-resolution atomic force microscopy imaging under near-native conditions, immunofluorescence, scanning electron microscopy and a fluorescence-based classification of the superficial chondrocyte spatial organization. Taken together, our data suggests that the loss of tissue functionality in early OA cartilage is caused by a reduction of thick type II collagen fibers, likely due to the formation of type I collagen-rich fibrocartilage, followed by the development of focal defects in later OA stages. We anticipate that such an integrative characterization will be very beneficial for an in-depth understanding of other native biological tissues and the development of sustainable biomaterials. STATEMENT OF SIGNIFICANCE: In early osteoarthritis (OA) the cartilage appears macroscopically intact. However, this study demonstrates that the collagen network already changes in early OA by collagen fiber thinning and the formation of fibrocartilage-like tissue. Both nanoscopic deficiencies already occur in macroscopically intact regions of the human knee joint and are likely connected to processes that result in a weakened extracellular matrix. This study enhances the understanding of earliest progressive cartilage degeneration in the absence of external damage. The results suggest a determination of the mean collagen fiber thickness as a new target for the detection of early OA and a regulation of type I collagen synthesis as a new path for OA treatment.
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13
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Niestrawska JA, Pukaluk A, Babu AR, Holzapfel GA. Differences in Collagen Fiber Diameter and Waviness between Healthy and Aneurysmal Abdominal Aortas. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2022; 28:1-15. [PMID: 35545876 DOI: 10.1017/s1431927622000629] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Collagen plays a key role in the strength of aortic walls, so studying micro-structural changes during disease development is critical to better understand collagen reorganization. Second-harmonic generation microscopy is used to obtain images of human aortic collagen in both healthy and diseased states. Methods are being developed in order to efficiently determine the waviness, that is, tortuosity and amplitude, as well as the diameter, orientation, and dispersion of collagen fibers, and bundles in healthy and aneurysmal tissues. The results show layer-specific differences in the collagen of healthy tissues, which decrease in samples of aneurysmal aortic walls. In healthy tissues, the thick collagen bundles of the adventitia are characterized by greater waviness, both in the tortuosity and in the amplitude, compared to the relatively thin and straighter collagen fibers of the media. In contrast, most aneurysmal tissues tend to have a more uniform structure of the aortic wall with no significant difference in collagen diameter between the luminal and abluminal layers. An increase in collagen tortuosity compared to the healthy media is also observed in the aneurysmal luminal layer. The data set provided can help improve related material and multiscale models of aortic walls and aneurysm formation.
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Affiliation(s)
- Justyna A Niestrawska
- Institute of Biomechanics, Graz University of Technology, Stremayrgasse 16, 8010Graz, Austria
| | - Anna Pukaluk
- Institute of Biomechanics, Graz University of Technology, Stremayrgasse 16, 8010Graz, Austria
| | - Anju R Babu
- Institute of Biomechanics, Graz University of Technology, Stremayrgasse 16, 8010Graz, Austria
| | - Gerhard A Holzapfel
- Institute of Biomechanics, Graz University of Technology, Stremayrgasse 16, 8010Graz, Austria
- Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), 7491Trondheim, Norway
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14
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Shao H, Yang J, Ma Y, Su X, Tang G, Jiang J, Du J, Liu J. Evaluation of cartilage degeneration using multiparametric quantitative ultrashort echo time-based MRI: an ex vivo study. Quant Imaging Med Surg 2022; 12:1738-1749. [PMID: 35284286 PMCID: PMC8899946 DOI: 10.21037/qims-21-550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/10/2021] [Indexed: 01/26/2024]
Abstract
BACKGROUND The quantitative MR techniques developed rapidly, vary MR-biomarkers have shown the ability to assess the quality of articular cartilage. This study aimed to investigate the diagnostic efficacy of multi-parametric quantitative ultrashort echo time (UTE)-based MRI for evaluating human cartilage degeneration. METHODS Twenty fresh anterolateral femoral condyle samples were obtained from 20 patients (age, 58.8±6.6 years; 6 females) who underwent total knee arthroplasty due to primary osteoarthritis (OA). The samples were imaged using UTE-based magnetization transfer (UTE-MT), UTE-based adiabatic T1ρ (UTE-AdiabT1ρ), UTE-based T2* (UTE-T2*), and CubeQuant-T2 sequences. Cartilage degeneration was classified based on the OA Research Society International grade and polarized light microscopy (PLM) collagen organization score. Spearman's correlation analysis was used to determine the relationships between quantitative MRI biomarkers [UTE-MT ratio (UTE-MTR), UTE-AdiabT1ρ, UTE-T2*, and CubeQuant-T2], OA Research Society International grade, and PLM collagen organization score. The diagnostic efficacy of each MRI biomarker for the detection of mild cartilage degeneration was assessed using the area under the receiver operating characteristic (ROC) curve (AUC). RESULTS Of the quantitative MRI biomarkers, UTE-MTR had the strongest correlation with both OA Research Society International grade (r=-0.709, P<0.001) and PLM collagen organization score (r=0.579, P<0.001). The UTE-MTR and UTE-AdiabT1ρ values showed significant differences between the normal group and the mild degeneration group (P=0.047 and 0.015, respectively), while UTE-T2* and CubeQuant-T2 did not. The UTE-MTR values were 15.90%±1.06% and 14.59%±1.35% for normal and mildly degenerated cartilage, respectively. The UTE-AdiabT1ρ values were 40.19±2.87 and 42.6±2.26 ms for normal and mildly degenerated cartilage, respectively. ROC analysis showed that UTE-MTR (AUC =0.805, P=0.001, sensitivity =73.7%, specificity =89.5%) had the highest diagnostic efficacy for mild cartilage degeneration, while UTE-AdiabT1ρ (AUC =0.727, P=0.017) and CubeQuant-T2 (AUC =0.712, P=0.026) showed lower diagnostic efficacy. CONCLUSIONS Quantitative UTE-MT and UTE-AdiabT1ρ biomarkers may potentially be used in the evaluation of early cartilage degeneration.
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Affiliation(s)
- Hongda Shao
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiawei Yang
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Xiaolian Su
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guangyu Tang
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Junjie Jiang
- Department of Orthopedics, People’s Hospital of Jingjiang, Jingjiang, China
- Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jiang Du
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Jianjun Liu
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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15
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Khuu N, Kheiri S, Kumacheva E. Structurally anisotropic hydrogels for tissue engineering. TRENDS IN CHEMISTRY 2021. [DOI: 10.1016/j.trechm.2021.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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16
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Mantripragada V, Gao W, Piuzzi N, Hoemann C, Muschler G, Midura R. Comparative Assessment of Primary Osteoarthritis Progression Using Conventional Histopathology, Polarized Light Microscopy, and Immunohistochemistry. Cartilage 2021; 13:1494S-1510S. [PMID: 32659115 PMCID: PMC8808935 DOI: 10.1177/1947603520938455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Evaluation of collagen orientation and arrangement in articular cartilage can improve our understanding of primary osteoarthritis (OA) progression and targeted therapies. Our goal was to determine if polarized light microscopy (PLM) for collagen organization is useful in identifying early primary OA features in comparison to current standard histopathological methods. DESIGN Osteochondral specimens from 90 total knee arthroplasty patients with relatively preserved lateral femoral condyle were scored using (1) histological-histochemical grading system (HHGS); (2) Osteoarthritis Research Society International (OARSI); (3) PLM-Changoor system for repair cartilage, scores ranging between 0 (totally disorganized cartilage) and 5 (healthy adult cartilage); and (4) new PLM system for primary OA cartilage with superficial zone PLM (PLM-SZ) and deep zone PLM (PLM-DZ) scores, each ranging between 0 (healthy adult SZ and DZ collagen organization) and 4 (total loss of collagen organization). Serial sections were stained for collagen I and II antibodies. Spearman correlation coefficients (rs) were determined. RESULTS The associations between: (1) PLM-Changoor and HHGS or OARSI were weak (rs = -0.36) or moderate (rs = -0.56); (2) PLM-SZ and HHGS or OARSI were moderate (rs = 0.46 or rs = 0.53); and (3) PLM-DZ and HHGS or OARSI were poor (rs = 0.31 or rs = 0.21), respectively. Specimens exhibiting early and mild OA (HHGS < 5 and OARSI < 8.6) had PLM-SZ and PLM-DZ scores between 0 and 4 and between 0 and 3, respectively, and indicated new histopathological features not currently considered by HHGS/OARSI. CONCLUSIONS PLM was effective at identifying early SZ and DZ collagen alterations that were not evident in the traditional scoring systems. Incorporating PLM scores and/or additional HHGS/OARSI features can help improve characterization of early primary OA cartilage.
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Affiliation(s)
- V.P. Mantripragada
- Department of Biomedical Engineering,
Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA,V.P. Mantripragada, Department of Biomedical
Engineering, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH
44195, USA.
| | - W. Gao
- Department of Biomedical Engineering,
Cornell University, Ithaca, NY, USA
| | - N.S. Piuzzi
- Department of Biomedical Engineering,
Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA,Department of Orthopedic Surgery,
Cleveland Clinic, Cleveland, OH, USA
| | - C.D. Hoemann
- Department of Bioengineering, George
Mason University, Manassas, VA, USA
| | - G.F. Muschler
- Department of Biomedical Engineering,
Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA,Department of Orthopedic Surgery,
Cleveland Clinic, Cleveland, OH, USA
| | - R.J. Midura
- Department of Biomedical Engineering,
Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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17
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Szarek P, Lilledahl MB, Emery NC, Lewis CG, Pierce DM. The zonal evolution of collagen-network morphology quantified in early osteoarthritic grades of human cartilage. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100086. [DOI: 10.1016/j.ocarto.2020.100086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022] Open
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18
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Bielajew BJ, Hu JC, Athanasiou KA. Collagen: quantification, biomechanics, and role of minor subtypes in cartilage. NATURE REVIEWS. MATERIALS 2020; 5:730-747. [PMID: 33996147 PMCID: PMC8114887 DOI: 10.1038/s41578-020-0213-1] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 05/02/2023]
Abstract
Collagen is a ubiquitous biomaterial in vertebrate animals. Although each of its 28 subtypes contributes to the functions of many different tissues in the body, most studies on collagen or collagenous tissues have focussed on only one or two subtypes. With recent developments in analytical chemistry, especially mass spectrometry, significant advances have been made toward quantifying the different collagen subtypes in various tissues; however, high-throughput and low-cost methods for collagen subtype quantification do not yet exist. In this Review, we introduce the roles of collagen subtypes and crosslinks, and describe modern assays that enable a deep understanding of tissue physiology and disease states. Using cartilage as a model tissue, we describe the roles of major and minor collagen subtypes in detail; discuss known and unknown structure-function relationships; and show how tissue engineers may harness the functional characteristics of collagen to engineer robust neotissues.
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Affiliation(s)
- Benjamin J. Bielajew
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617, USA
| | - Jerry C. Hu
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617, USA
| | - Kyriacos A. Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92617, USA
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19
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Kajabi AW, Casula V, Ojanen S, Finnilä MA, Herzog W, Saarakkala S, Korhonen RK, Nissi MJ, Nieminen MT. Multiparametric MR imaging reveals early cartilage degeneration at 2 and 8 weeks after ACL transection in a rabbit model. J Orthop Res 2020; 38:1974-1986. [PMID: 32129515 DOI: 10.1002/jor.24644] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/20/2020] [Accepted: 02/29/2020] [Indexed: 02/04/2023]
Abstract
In this study, the rabbit model with anterior cruciate ligament transection (ACLT) was used to investigate early degenerative changes in cartilage using multiparametric quantitative magnetic resonance imaging (qMRI). ACLT was surgically induced in the knees of skeletally mature New Zealand White rabbits (n = 14). ACL transected and contralateral knee compartments-medial femur, lateral femur, medial tibia, and lateral tibia-were harvested 2 (n = 8) and 8 weeks (n = 6) postsurgery. Twelve age-matched nonoperated rabbits served as control. qMRI was conducted at 9.4 T and included relaxation times T1 , T2 , continuous-wave T1ρ (CWT1ρ ), adiabatic T1ρ (AdT1ρ ), adiabatic T2ρ (AdT2ρ ), and relaxation along a fictitious field (TRAFF ). For reference, quantitative histology and biomechanical measurements were carried out. Posttraumatic changes were primarily noted in the superficial half of the cartilage. Prolonged T1 , T2 , CWT1ρ , and AdT1ρ were observed in the lateral femur 2 and 8 weeks post-ACLT, compared with the corresponding control and contralateral groups (P < .05). Collagen orientation was significantly altered in the lateral femur at 2 weeks post-ACLT compared with the corresponding control group. In the medial femur, all the studied relaxation time parameters, except TRAFF , were increased 8 weeks post-ACLT, as compared with the corresponding contralateral and control groups (P < .05). Similarly, significant proteoglycan loss was observed in the medial femur at 8 weeks following surgery (P < .05). Multiparametric MRI demonstrated early degenerative changes primarily in the superficial cartilage with T1 , T2 , CWT1ρ , and AdT1ρ sensitive to cartilage changes at 2 weeks after surgery.
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Affiliation(s)
- Abdul Wahed Kajabi
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Victor Casula
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Simo Ojanen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko A Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Walter Herzog
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko J Nissi
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Miika T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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20
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Vyas C, Mishbak H, Cooper G, Peach C, Pereira RF, Bartolo P. Biological perspectives and current biofabrication strategies in osteochondral tissue engineering. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s40898-020-00008-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractArticular cartilage and the underlying subchondral bone are crucial in human movement and when damaged through disease or trauma impacts severely on quality of life. Cartilage has a limited regenerative capacity due to its avascular composition and current therapeutic interventions have limited efficacy. With a rapidly ageing population globally, the numbers of patients requiring therapy for osteochondral disorders is rising, leading to increasing pressures on healthcare systems. Research into novel therapies using tissue engineering has become a priority. However, rational design of biomimetic and clinically effective tissue constructs requires basic understanding of osteochondral biological composition, structure, and mechanical properties. Furthermore, consideration of material design, scaffold architecture, and biofabrication strategies, is needed to assist in the development of tissue engineering therapies enabling successful translation into the clinical arena. This review provides a starting point for any researcher investigating tissue engineering for osteochondral applications. An overview of biological properties of osteochondral tissue, current clinical practices, the role of tissue engineering and biofabrication, and key challenges associated with new treatments is provided. Developing precisely engineered tissue constructs with mechanical and phenotypic stability is the goal. Future work should focus on multi-stimulatory environments, long-term studies to determine phenotypic alterations and tissue formation, and the development of novel bioreactor systems that can more accurately resemble the in vivo environment.
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Guo JB, Liang T, Che YJ, Yang HL, Luo ZP. Structure and mechanical properties of high-weight-bearing and low-weight-bearing areas of hip cartilage at the micro- and nano-levels. BMC Musculoskelet Disord 2020; 21:425. [PMID: 32616028 PMCID: PMC7333404 DOI: 10.1186/s12891-020-03468-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 06/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Articular cartilage has a high-weight-bearing area and a low-weight-bearing area, the macroscopic elastic moduli of the two regions are different. Chondrocytes are affected by the applied force at the microscopic level. Currently, the modulus of the two areas at the micro and nano levels is unknown, and studies on the relationship between macro-, micro- and nano-scale elastic moduli are limited. Such information may be important for further understanding of cartilage mechanics. Moreover, the surface morphology, proteoglycan content, and micro and nano structure of the two areas, which influences the mechanical properties of cartilage should be discussed. METHODS Safranin-O/Fast Green staining was used to evaluate the surface morphology and semi-quantify proteoglycan content of porcine femoral head cartilage between the two weight-bearing areas. The unconfined compression test was used to determine the macro elastic modulus. Atomic force microscope was used to measure the micro and nano compressive elastic modulus as well as the nano structure. Scanning electron microscope was employed to evaluate the micro structure. RESULTS No significant differences in the fibrillation index were observed between two areas (P = 0.5512). The Safranin-O index of the high-weight-bearing area was significantly higher than that of the low-weight-bearing area (P = 0.0387). The compressive elastic modulus of the high-weight-bearing area at the macro and micro level was significantly higher than that of the low-weight-bearing area (P = 0.0411 for macro-scale, and P = 0.0001 for micro-scale), while no statistically significant differences were observed in the elastic modulus of collagen fibrils at the nano level (P = 0.8544). The density of the collagen fibers was significantly lower in the high-weight-bearing area (P = 0.0177). No significant differences were observed in the structure and diameter of the collagen fibers between the two areas (P = 0.7361). CONCLUSIONS A higher proteoglycan content correlated with a higher compressive elastic modulus of the high-weight-bearing area at the micro level than that of the low-weight-bearing area, which was consistent with the trend observed from the macroscopic compressive elastic modulus. The weight-bearing level was not associated with the elastic modulus of individual collagen fibers and the diameter at the nano level. The micro structure of cartilage may influence the macro- and micro-scale elastic modulus.
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Affiliation(s)
- Jiang-Bo Guo
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.,Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Ting Liang
- Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Yan-Jun Che
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.,Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Hui-Lin Yang
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.,Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Zong-Ping Luo
- Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.
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22
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Role of nanofibers on MSCs fate: Influence of fiber morphologies, compositions and external stimuli. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 107:110218. [DOI: 10.1016/j.msec.2019.110218] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 09/04/2019] [Accepted: 09/16/2019] [Indexed: 01/09/2023]
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23
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A biphasic visco-hyperelastic damage model for articular cartilage: application to micromechanical modelling of the osteoarthritis-induced degradation behaviour. Biomech Model Mechanobiol 2019; 19:1055-1077. [DOI: 10.1007/s10237-019-01270-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 11/22/2019] [Indexed: 01/10/2023]
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24
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Huynh RN, Pesante B, Nehmetallah G, Raub CB. Polarized reflectance from articular cartilage depends upon superficial zone collagen network microstructure. BIOMEDICAL OPTICS EXPRESS 2019; 10:5518-5534. [PMID: 31799028 PMCID: PMC6865123 DOI: 10.1364/boe.10.005518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 05/02/2023]
Abstract
Polarized reflectance from articular cartilage involves light scattering dependent on surface features, sub-surface optical properties, and collagen birefringence. To understand how surface roughness, zonal collagen microstructure, and chondrocyte organization contribute to polarized reflectance signals, experiments were conducted on bovine cartilage explants and osteochondral cores to compare polarized reflectance texture with split lines and relate these signals to cartilage zonal features and chondrocyte distribution. Texture parameter sensitivity to articular surface damage was determined from polarized reflectance maps and optimized to detect surface damage. Results indicate that polarized reflectance texture predominantly derives from the superficial zone collagen network, while the parameter average value also depends on surface roughness and total cartilage thickness.
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Affiliation(s)
- R. N. Huynh
- Department of Biomedical Engineering, The Catholic University of America, 620 Michigan Ave NE., Washington, DC 20064, USA
| | - B. Pesante
- Department of Biomedical Engineering, The Catholic University of America, 620 Michigan Ave NE., Washington, DC 20064, USA
| | - G. Nehmetallah
- Department of Electrical Engineering and Computer Science, The Catholic University of America, 620 Michigan Ave NE., Washington, DC 20064, USA
| | - C. B. Raub
- Department of Biomedical Engineering, The Catholic University of America, 620 Michigan Ave NE., Washington, DC 20064, USA
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25
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Oliveira AS, Seidi O, Ribeiro N, Colaço R, Serro AP. Tribomechanical Comparison between PVA Hydrogels Obtained Using Different Processing Conditions and Human Cartilage. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E3413. [PMID: 31635284 PMCID: PMC6829290 DOI: 10.3390/ma12203413] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023]
Abstract
Designing materials for cartilage replacement raises several challenges due to the complexity of the natural tissue and its unique tribomechanical properties. Poly(vinyl alcohol) (PVA) hydrogels have been explored for such purpose since they are biocompatible, present high chemical stability, and their properties may be tailored through different strategies. In this work, the influence of preparation conditions of PVA hydrogels on its morphology, water absorption capacity, thermotropic behavior, mechanical properties, and tribological performance was evaluated and compared with those of human cartilage (HC). The hydrogels were obtained by cast-drying (CD) and freeze-thawing (FT), in various conditions. It was found that the method of preparation of the PVA hydrogels critically affects their microstructure and performance. CD gels presented a denser structure, absorbed less water, were stiffer, dissipated less energy, and withstood higher loads than FT gels. Moreover, they led to friction coefficients against stainless steel comparable with those of HC. Overall, CD hydrogels had a closer performance to natural HC, when compared to FT ones.
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Affiliation(s)
- Andreia Sofia Oliveira
- Centro de Química Estrutural (CQE), Instituto Superior Técnico-Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal.
- Instituto de Engenharia Mecânica Instituto Superior Técnico (IDMEC)-Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal.
| | - Oumar Seidi
- Institut Supérieur des BioSciences (ISBS), École Supérieure d'Ingénieurs de Paris-Est Créteil, 71 Rue Saint-Simon, 94000 Créteil, France.
| | - Nuno Ribeiro
- Centro de Química Estrutural (CQE), Instituto Superior Técnico-Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal.
- Instituto de Engenharia Mecânica Instituto Superior Técnico (IDMEC)-Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal.
- Departamento de Ortopedia, Hospital Lusíadas Lisboa, R. Abílio Mendes 12, 1500-458 Lisboa, Portugal.
| | - Rogério Colaço
- Instituto de Engenharia Mecânica Instituto Superior Técnico (IDMEC)-Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal.
| | - Ana Paula Serro
- Centro de Química Estrutural (CQE), Instituto Superior Técnico-Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal.
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal.
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Maier F, Lewis CG, Pierce DM. Through-thickness patterns of shear strain evolve in early osteoarthritis. Osteoarthritis Cartilage 2019; 27:1382-1391. [PMID: 31121293 DOI: 10.1016/j.joca.2019.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 04/04/2019] [Accepted: 04/27/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Given the structural changes associated with the progression of Osteoarthritis (OA), we hypothesized that patterns of through-thickness, large-strain shear evolve with early-stage OA. We therefore aimed to determine whether and how patterns of shear strains change during early-stage OA to 1) gain insight into the progression of OA by quantifying changes in local deformations; 2) gauge the potential of patterns in shear strain to serve as image-based biomarkers of early-stage OA; and 3) provide high-resolution, through-thickness data for proposing, fitting, and validating constitutive models for cartilage. DESIGN We completed displacement-driven, large-strain shear tests (5, 10, 15%) on 44 specimens of variably advanced osteoarthritic human articular cartilage as determined by both Osteoarthritis Research Society International (OARSI) grade and PLM-CO score. We recorded the through-thickness deformations with a stereo-camera system and processed these data using digital image correlation (DIC) to determine full-thickness patterns of strains and relative zonal recruitments, i.e., the average shear strain in a through-thickness zone weighted by its relative thickness and normalized by the applied strain. RESULTS We observed three general shapes for the curves of averaged through-thickness, Green-Lagrange shear strains during progression of OA. We also observed that during the progression of OA only the deep zone is recruited differently under shear in a statistically significant way. CONCLUSIONS We propose that changes in through-thickness patterns of shear strain could provide sensitive biomarkers for early clinical detection of OA. The relative zonal recruitment of the deep zone decreases with progressing OA (OARSI grade) and microstructural remodeling (PLM-CO score), which do not consistently affect recruitment of the superficial and middle zones.
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Affiliation(s)
- F Maier
- University of Connecticut, Department of Mechanical Engineering, Storrs, CT, USA
| | - C G Lewis
- Hartford Healthcare, Bone & Joint Institute, Hartford, CT, USA
| | - D M Pierce
- University of Connecticut, Department of Mechanical Engineering, Storrs, CT, USA; University of Connecticut, Department of Biomedical Engineering, Storrs, CT, USA.
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27
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Lepage SIM, Robson N, Gilmore H, Davis O, Hooper A, St John S, Kamesan V, Gelis P, Carvajal D, Hurtig M, Koch TG. Beyond Cartilage Repair: The Role of the Osteochondral Unit in Joint Health and Disease. TISSUE ENGINEERING PART B-REVIEWS 2019; 25:114-125. [PMID: 30638141 PMCID: PMC6486663 DOI: 10.1089/ten.teb.2018.0122] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Once believed to be limited to articular cartilage, osteoarthritis is now considered to be an organ disease of the “whole joint.” Damage to the articular surface can lead to, be caused by, or occur in parallel with, damage to other tissues in the joint. The relationship between cartilage and the underlying subchondral bone has particular importance when assessing joint health and determining treatment strategies. The articular cartilage is anchored to the subchondral bone through an interface of calcified cartilage, which as a whole makes up the osteochondral unit. This unit functions primarily by transferring load-bearing weight over the joint to allow for normal joint articulation and movement. Unfortunately, irreversible damage and degeneration of the osteochondral unit can severely limit joint function. Our understanding of joint pain, the primary complaint of patients, is poorly understood and past efforts toward structural cartilage restoration have often not been associated with a reduction in pain. Continued research focusing on the contribution of subchondral bone and restoration of the entire osteochondral unit are therefore needed, with the hope that this will lead to curative, and not merely palliative, treatment options. The purpose of this narrative review is to investigate the role of the osteochondral unit in joint health and disease. Topics of discussion include the crosstalk between cartilage and bone, the efficacy of diagnostic procedures, the origins of joint pain, current and emerging treatment paradigms, and suitable preclinical animal models for safety and efficacy assessment of novel osteochondral therapies. The goal of the review is to facilitate an appreciation of the important role played by the subchondral bone in joint pain and why the osteochondral unit as a whole should be considered in many cases of joint restoration strategies.
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Affiliation(s)
- Sarah I M Lepage
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Naomi Robson
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Hillary Gilmore
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Ola Davis
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Allyssa Hooper
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Stephanie St John
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Vashine Kamesan
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Paul Gelis
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Diana Carvajal
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
| | - Mark Hurtig
- 2 Department of Clinical Studies, University of Guelph, Guelph, Canada
| | - Thomas G Koch
- 1 Department of Biomedical Sciences, University of Guelph, Guelph, Canada
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28
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Disrupted type II collagenolysis impairs angiogenesis, delays endochondral ossification and initiates aberrant ossification in mouse limbs. Matrix Biol 2019; 83:77-96. [PMID: 31381970 DOI: 10.1016/j.matbio.2019.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 12/20/2022]
Abstract
Cartilage remodelling and chondrocyte differentiation are tightly linked to angiogenesis during bone development and endochondral ossification. To investigate whether collagenase-mediated cleavage of the major cartilage collagen (collagen II) plays a role in this process, we generated a knockin mouse in which the mandatory collagenase cleavage site at PQG775↓776LAG, was mutated to PPG775↓776MPG (Col2a1Bailey). This approach blocked collagen II cleavage, and the production of putative collagen II matrikines derived from this site, without modifying matrix metalloproteinase expression or activity. We report here that this mouse (Bailey) is viable. It has a significantly expanded growth plate and exhibits delayed and abnormal angiogenic invasion into the growth plate. Deeper electron microscopy analyses revealed that, at around five weeks of age, a small number of blood vessel(s) penetrate into the growth plate, leading to its abrupt shrinking and the formation of a bony bridge. Our results from in vitro and ex vivo studies suggest that collagen II matrikines stimulate the normal branching of endothelial cells and promote blood vessel invasion at the chondro-osseous junction. The results further suggest that failed collagenolysis in Bailey leads to expansion of the hypertrophic zone and formation of a unique post-hypertrophic zone populated with chondrocytes that re-enter the cell cycle and proliferate. The biological rescue of this in vivo phenotype features the loss of a substantial portion of the growth plate through aberrant ossification, and narrowing of the remaining portion that leads to limb deformation. Together, these data suggest that collagen II matrikines stimulate angiogenesis in skeletal growth and development, revealing novel strategies for stimulating angiogenesis in other contexts such as fracture healing and surgical applications.
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29
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Maier F, Lewis CG, Pierce DM. The evolving large-strain shear responses of progressively osteoarthritic human cartilage. Osteoarthritis Cartilage 2019; 27:810-822. [PMID: 30660720 DOI: 10.1016/j.joca.2018.12.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/22/2018] [Accepted: 12/28/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The composition and structure of articular cartilage evolves during the development and progression of osteoarthritis (OA) resulting in changing mechanical responses. We aimed to assess the evolution of the intrinsic, large-strain mechanics of human articular cartilage-governed by collagen and proteoglycan and their interactions-during the progression of OA. DESIGN We completed quasi-static, large-strain shear tests on 64 specimens from ten donors undergoing total knee arthroplasty (TKA), and quantified the corresponding state of OA (OARSI grade), structural integrity (PLM score), and composition (glycosaminoglycan and collagen content). RESULTS We observed nonlinear stress-strain relationships with distinct hystereses for all magnitudes of applied strain where stiffnesses, nonlinearities, and hystereses all reduced as OA advanced. We found a reduction in energy dissipation density up to 80% in severely degenerated (OARSI grade 4, OA-4) vs normal (OA-1) cartilage, and more importantly, we found that even cartilage with a normal appearance in structure and composition (OA-1) dissipated 50% less energy than healthy (control) load-bearing cartilage (HL0). Changes in stresses and stiffnesses were in general less pronounced and did not allow us to distinguish between healthy load-bearing controls and very early-stage OA (OA-1), or to distinguish consistently among different levels of degeneration, i.e., OARSI grades. CONCLUSIONS Our results suggest that reductions in energy dissipation density can be detected by bulk-tissue testing, and that these reductions precede visible signs of degeneration. We highlight the potential of energy dissipation, as opposed to stress- or stiffness-based measures, as a marker to diagnose early-stage OA.
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Affiliation(s)
- F Maier
- University of Connecticut, Department of Mechanical Engineering, Storrs, CT, USA
| | - C G Lewis
- Hartford Healthcare, Bone & Joint Institute, Hartford, CT, USA
| | - D M Pierce
- University of Connecticut, Department of Mechanical Engineering, Storrs, CT, USA; University of Connecticut, Department of Biomedical Engineering, Storrs, CT, USA.
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30
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Tsang AS, Dart AJ, Biasutti SA, Jeffcott LB, Smith MM, Little CB. Effects of tendon injury on uninjured regional tendons in the distal limb: An in-vivo study using an ovine tendinopathy model. PLoS One 2019; 14:e0215830. [PMID: 31013317 PMCID: PMC6478347 DOI: 10.1371/journal.pone.0215830] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/09/2019] [Indexed: 12/11/2022] Open
Abstract
Following injury to a tendon little is known about potential for pathology to develop in other regional tendons from overloading or altered function. The aim of this study was to investigate the gene expression and histopathological changes that occur 1) within the deep digital flexor tendon (DDFT) after injury to the superficial digital flexor tendon (SDFT) and 2) within the flexor tendons (SDFT and DDFT) after injury to the extensor tendons. Merino wethers [Ovis aries] (n = 18) were divided into three equal groups and underwent either partial transection of the SDFT, complete transection of the extensor tendons or were left as non-operated controls. Tendons were harvested and sampled regionally for gene expression (real time PCR) and histologic analysis eight weeks after surgery. Transection of the SDFT resulted in increased expression of collagen III, versican, biglycan, lumican and MMP1 (P<0.026 for all genes) within the DDFT. There was no effect of transecting the extensor tendons on the expression of any gene tested in either the SDFT or the DDFT. The DDFT had elevated histopathology scores induced by transection of the SDFT, eight weeks previously. There were minimal histological differences in either the SDFT or DDFT after transection of the extensor tendons. Transection of the SDFT results in a mild, subclinical tendinopathy within the DDFT with potential implications on treatment and rehabilitation of SDFT injuries. Injury to the extensor tendons has minimal measured effect on the SDFT or DDFT.
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Affiliation(s)
- Albert S. Tsang
- Research and Clinical Training Unit, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camden, Australia
- * E-mail:
| | - Andrew J. Dart
- Research and Clinical Training Unit, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camden, Australia
| | - Sara A. Biasutti
- Research and Clinical Training Unit, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camden, Australia
| | - Leo B. Jeffcott
- Research and Clinical Training Unit, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camden, Australia
| | - Margaret M. Smith
- Raymond Purves Bone and Joint Research Laboratories, The Kolling Institute, Sydney Medical School, University of Sydney, Sydney, Australia
- The Institute of Bone and Joint Research, Royal North Shore Hospital, Sydney, Australia
| | - Christopher B. Little
- Raymond Purves Bone and Joint Research Laboratories, The Kolling Institute, Sydney Medical School, University of Sydney, Sydney, Australia
- The Institute of Bone and Joint Research, Royal North Shore Hospital, Sydney, Australia
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31
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Ravanfar M, Yao G. Measurement of biaxial optical birefringence in articular cartilage. APPLIED OPTICS 2019; 58:2021-2027. [PMID: 30874069 DOI: 10.1364/ao.58.002021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/16/2019] [Indexed: 05/24/2023]
Abstract
Optical birefringence is a valuable parameter in evaluating collagen organization and assessing collagen degeneration in articular cartilage. A uniaxial birefringent model is implied when using existing methods such as polarized light microscopy in characterizing birefringence in cartilage. However, some studies suggest the existence of a sheet-like collagen organization in articular cartilage, which requires a biaxial birefringence model to describe. In this study, we applied a multi-incident birefringence measurement procedure to investigate the biaxial birefringence in articular cartilage. The results supported the existence of a small yet significant biaxial birefringence effect, which was in agreement with the expectation from a sheet-like collagen organization.
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32
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Elastic, Viscoelastic and Fibril-Reinforced Poroelastic Material Properties of Healthy and Osteoarthritic Human Tibial Cartilage. Ann Biomed Eng 2019; 47:953-966. [PMID: 30690688 PMCID: PMC8494710 DOI: 10.1007/s10439-019-02213-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 01/12/2019] [Indexed: 11/13/2022]
Abstract
Articular cartilage constituents (collagen, proteoglycans, fluid) are significantly altered during osteoarthritis (OA). A fibril-reinforced poroelastic (FRPE) material model can separate the contribution of each constituent on the mechanical response of cartilage. Yet, these properties and their OA related alterations are not known for human tibial cartilage. To answer this gap in the knowledge, we characterized the FRPE as well as elastic and viscoelastic properties of healthy and osteoarthritic human tibial cartilage. Tibial osteochondral explants (n = 27) harvested from 7 cadavers were mechanically tested in indentation followed by a quantification of elastic, viscoelastic and FRPE properties. Then they were histopathologically OARSI graded for the severity of OA. FRPE modeling revealed that non-fibrillar matrix modulus was higher in the healthy group compared to the early OA (p = 0.003) and advanced OA (p < 0.001) groups. The initial fibril network modulus was also higher in the healthy group compared to the early OA (p = 0.009) and advanced OA (p < 0.001) groups. The permeability correlated with the OARSI grade (p = 0.002, r = 0.56). For the first time, the FRPE properties were characterized for human tibial cartilage. This knowledge is crucial to improve the accuracy of computational knee joint models.
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33
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Spiesz EM, Thorpe CT, Thurner PJ, Screen HRC. Structure and collagen crimp patterns of functionally distinct equine tendons, revealed by quantitative polarised light microscopy (qPLM). Acta Biomater 2018; 70:281-292. [PMID: 29409868 PMCID: PMC5894809 DOI: 10.1016/j.actbio.2018.01.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 01/15/2023]
Abstract
Structure-function relationships in tendons are directly influenced by the arrangement of collagen fibres. However, the details of such arrangements in functionally distinct tendons remain obscure. This study demonstrates the use of quantitative polarised light microscopy (qPLM) to identify structural differences in two major tendon compartments at the mesoscale: fascicles and interfascicular matrix (IFM). It contrasts functionally distinct positional and energy storing tendons, and considers changes with age. Of particular note, the technique facilitates the analysis of crimp parameters, in which cutting direction artefact can be accounted for and eliminated, enabling the first detailed analysis of crimp parameters across functionally distinct tendons. IFM shows lower birefringence (0.0013 ± 0.0001 [−]), as compared to fascicles (0.0044 ± 0.0005 [−]), indicating that the volume fraction of fibres must be substantially lower in the IFM. Interestingly, no evidence of distinct fibre directional dispersions between equine energy storing superficial digital flexor tendons (SDFTs) and positional common digital extensor tendons (CDETs) were noted, suggesting either more subtle structural differences between tendon types or changes focused in the non-collagenous components. By contrast, collagen crimp characteristics are strongly tendon type specific, indicating crimp specialisation is crucial in the respective mechanical function. SDFTs showed much finer crimp (21.1 ± 5.5 µm) than positional CDETs (135.4 ± 20.1 µm). Further, tendon crimp was finer in injured tendon, as compared to its healthy equivalents. Crimp angle differed strongly between tendon types as well, with average of 6.5 ± 1.4° in SDFTs and 13.1 ± 2.0° in CDETs, highlighting a substantially tighter crimp in the SDFT, likely contributing to its effective recoil capacity. Statement of Significance This is the first study to quantify birefringence in fascicles and interfascicular matrix of functionally distinct energy storing and positional tendons. It adopts a novel method – quantitative polarised light microscopy (qPLM) to measure collagen crimp angle, avoiding artefacts related to the direction of histological sectioning, and provides the first direct comparison of crimp characteristics of functionally distinct tendons of various ages. A comparison of matched picrosirius red stained and unstained tendons sections identified non-homogenous staining effects, and leads us to recommend that only unstained sections are analysed in the quantitative manner. qPLM is successfully used to assess birefringence in soft tissue sections, offering a promising tool for investigating the structural arrangements of fibres in (soft) tissues and other composite materials.
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Affiliation(s)
- Ewa M Spiesz
- School of Engineering and Materials Science, Queen Mary University of London, Mile End Rd, London E1 4NS, United Kingdom; Department of Bionanoscience, Kavli Institute of Nanoscience, Delft University of Technology, Van der Maasweg 9, 2629 HZ Delft, The Netherlands.
| | - Chavaunne T Thorpe
- School of Engineering and Materials Science, Queen Mary University of London, Mile End Rd, London E1 4NS, United Kingdom; Comparative Biomedical Sciences, Royal Veterinary College, Royal College Street, London NW1 0TU, United Kingdom.
| | - Philipp J Thurner
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Getreidemarkt 9, A-1060 Vienna, Austria.
| | - Hazel R C Screen
- School of Engineering and Materials Science, Queen Mary University of London, Mile End Rd, London E1 4NS, United Kingdom.
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Mantripragada VP, Piuzzi NS, Zachos T, Obuchowski NA, Muschler GF, Midura RJ. Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation. Curr Res Transl Med 2017; 65:133-139. [PMID: 29132902 PMCID: PMC5731834 DOI: 10.1016/j.retram.2017.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The two main objectives of the study include (1) Test the hypothesis that the lateral femoral condyle (LFC) in patients with primary OA and varus knees undergoing total knee arthroplasty (TKA) can be used as a model to better characterize varying histological features of human OA, (2) Correlate characteristic OA features using the established histopathological scoring systems (HHGS and OARSI) to understand potential histopathological patterns of OA initiation. DESIGN Two osteochondral specimens (4×4×8mm) were collected from fifty patient's LFC at the time of TKA (total 100 specimens), who presented preserved lateral knee compartment with joint space width>2mm. Three independent readers graded the sections on three different occasions using HHGS and OARSI systems. The correlation between individual parameters of the two scoring systems and their inter- and intra-reader variability, reliability and reproducibility were estimated. RESULTS All samples in this cohort showed abnormal histopathological features. Total histopathological scores of the LFC ranged from HHGS median=4.6 (range=0 to 11), and OARSI median=5.2 (range=0 to 19.5). The four individual sub-items of HHGS scoring system (structure, cells, safraninO staining, tidemark) were weakly correlated, with the correlation between structure and cellularity being the strongest (r=0.40). Both the scoring systems had similar repeatability and reproducibility coefficients of<21%. CONCLUSIONS OA changes in the LFC are not confined to any one region, and maybe seen in different regions of cartilage, tidemark, subchondral bone, and/or the marrow space vascularity. These variations may point to the possibility of several potential patterns of initiation in OA.
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Affiliation(s)
- V P Mantripragada
- Department of biomedical engineering, Lerner research institute, Cleveland clinic, 9500 Euclid avenue, OH 44195 Cleveland, USA.
| | - N S Piuzzi
- Department of biomedical engineering, Lerner research institute, Cleveland clinic, 9500 Euclid avenue, OH 44195 Cleveland, USA; Department of orthopedic surgery, Cleveland clinic, OH 44195 Cleveland, USA; Instituto Universitario del Hospital Italiano de Buenos Aires, Potosí 4234, C1199ACL Caba, Argentina
| | - T Zachos
- Department of orthopedic surgery, Cleveland clinic, OH 44195 Cleveland, USA
| | - N A Obuchowski
- Department of quantitative health science, Cleveland clinic, OH 44195 Cleveland, USA
| | - G F Muschler
- Department of biomedical engineering, Lerner research institute, Cleveland clinic, 9500 Euclid avenue, OH 44195 Cleveland, USA; Department of orthopedic surgery, Cleveland clinic, OH 44195 Cleveland, USA
| | - R J Midura
- Department of biomedical engineering, Lerner research institute, Cleveland clinic, 9500 Euclid avenue, OH 44195 Cleveland, USA
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Inamdar SR, Knight DP, Terrill NJ, Karunaratne A, Cacho-Nerin F, Knight MM, Gupta HS. The Secret Life of Collagen: Temporal Changes in Nanoscale Fibrillar Pre-Strain and Molecular Organization during Physiological Loading of Cartilage. ACS NANO 2017; 11:9728-9737. [PMID: 28800220 DOI: 10.1021/acsnano.7b00563] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Articular cartilage is a natural biomaterial whose structure at the micro- and nanoscale is critical for healthy joint function and where degeneration is associated with widespread disorders such as osteoarthritis. At the nanoscale, cartilage mechanical functionality is dependent on the collagen fibrils and hydrated proteoglycans that form the extracellular matrix. The dynamic response of these ultrastructural building blocks at the nanoscale, however, remains unclear. Here we measure time-resolved changes in collagen fibril strain, using small-angle X-ray diffraction during compression of bovine and human cartilage explants. We demonstrate the existence of a collagen fibril tensile pre-strain, estimated from the D-period at approximately 1-2%, due to osmotic swelling pressure from the proteoglycan. We reveal a rapid reduction and recovery of this pre-strain which occurs during stress relaxation, approximately 60 s after the onset of peak load. Furthermore, we show that this reduction in pre-strain is linked to disordering in the intrafibrillar molecular packing, alongside changes in the axial overlapping of tropocollagen molecules within the fibril. Tissue degradation in the form of selective proteoglycan removal disrupts both the collagen fibril pre-strain and the transient response during stress relaxation. This study bridges a fundamental gap in the knowledge describing time-dependent changes in collagen pre-strain and molecular organization that occur during physiological loading of articular cartilage. The ultrastructural details of this transient response are likely to transform our understanding of the role of collagen fibril nanomechanics in the biomechanics of cartilage and other hydrated soft tissues.
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Affiliation(s)
- Sheetal R Inamdar
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London , London E1 4NS, United Kingdom
| | - David P Knight
- Orthox Ltd. , 66 Innovation Drive, Milton Park, Abingdon OX14 4RQ, United Kingdom
| | - Nicholas J Terrill
- Harwell Science and Innovation Campus, Diamond Light Source , Harwell, Didcot OX11 0DE, United Kingdom
| | - Angelo Karunaratne
- Department of Bioengineering, Imperial College London , London SW7 2AZ, United Kingdom
| | - Fernando Cacho-Nerin
- Harwell Science and Innovation Campus, Diamond Light Source , Harwell, Didcot OX11 0DE, United Kingdom
| | - Martin M Knight
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London , London E1 4NS, United Kingdom
| | - Himadri S Gupta
- Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London , London E1 4NS, United Kingdom
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Nebelung S, Rath B, Tingart M, Kuhl C, Schrading S. [Chondral and osteochondral defects : Representation by imaging methods]. DER ORTHOPADE 2017; 46:894-906. [PMID: 28936540 DOI: 10.1007/s00132-017-3472-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Morphological imaging of cartilage at high resolution allows the differentiation of chondral and osteochondral lesions. Nowadays, magnetic resonance imaging is the principal diagnostic tool in the assessment of cartilage structure and composition. Conventional radiography, computed tomography, ultrasound or optical coherence tomography are adjunct diagnostic modalities in the assessment of cartilage pathologies. The present article discusses the up-to-date diagnostic practice of cartilage imaging in terms of its scientific basis and current clinical status, requirements, techniques and image interpretation. Innovations in the field such as functional MRI are discussed as well due to their mid- to long-term clinical perspective.
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Affiliation(s)
- S Nebelung
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - B Rath
- Klinik für Orthopädie, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - M Tingart
- Klinik für Orthopädie, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - C Kuhl
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - S Schrading
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
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Mahmoud EE, Tanaka Y, Kamei N, Harada Y, Ohdan H, Adachi N, Ochi M. Monitoring immune response after allogeneic transplantation of mesenchymal stem cells for osteochondral repair. J Tissue Eng Regen Med 2017; 12:e275-e286. [DOI: 10.1002/term.2413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 12/12/2016] [Accepted: 01/13/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Elhussein Elbadry Mahmoud
- Department of Orthopaedic Surgery, Integrated Health Sciences; Institute of Biomedical & Health Sciences, Hiroshima University; Hiroshima Japan
- Department of Surgery, Faculty of Veterinary Medicine; South Valley University; Qena Egypt
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences; Institute of Biomedical & Health Sciences, Hiroshima University; Hiroshima Japan
| | - Naosuke Kamei
- Department of Orthopaedic Surgery, Integrated Health Sciences; Institute of Biomedical & Health Sciences, Hiroshima University; Hiroshima Japan
- Medical Center for Translational and Clinical Research; Hiroshima University Hospital; Hiroshima Japan
| | - Yohei Harada
- Department of Orthopaedic Surgery, Integrated Health Sciences; Institute of Biomedical & Health Sciences, Hiroshima University; Hiroshima Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences; Institute of Biomedical & Health Sciences, Hiroshima University; Hiroshima Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Integrated Health Sciences; Institute of Biomedical & Health Sciences, Hiroshima University; Hiroshima Japan
| | - Mitsuo Ochi
- Department of Orthopaedic Surgery, Integrated Health Sciences; Institute of Biomedical & Health Sciences, Hiroshima University; Hiroshima Japan
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Jalili-Firoozinezhad S, Martin I, Scherberich A. Bimodal morphological analyses of native and engineered tissues. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 76:543-550. [DOI: 10.1016/j.msec.2017.03.140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/09/2017] [Accepted: 03/13/2017] [Indexed: 12/23/2022]
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Ferizi U, Ruiz A, Rossi I, Bencardino J, Raya JG. A robust diffusion tensor model for clinical applications of MRI to cartilage. Magn Reson Med 2017; 79:1157-1164. [PMID: 28556394 DOI: 10.1002/mrm.26702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 01/06/2023]
Abstract
PURPOSE Diffusion tensor imaging (DTI) of articular cartilage is a promising technique for the early diagnosis of osteoarthritis (OA). However, in vivo diffusion tensor (DT) measurements suffer from low signal-to-noise ratio (SNR) that can result in bias when estimating the six parameters of the full DT, thus reducing sensitivity. This study seeks to validate a simplified four-parameter DT model (zeppelin) for obtaining more robust and sensitive in vivo DTI biomarkers of cartilage. METHODS We use simulations in a substrate to mimic changes during OA; and analytic simulations of the DT drawn from a range of fractional anisotropies (FA) measured with high-quality DT data from ex vivo human cartilage. We also use in vivo data from the knees of a healthy subject and two OA patients with Kellgren-Lawrence (KL) grades 1 and 2. RESULTS For simulated in vivo cartilage SNR (∼25) and anisotropy levels, the estimated mean values of MD from the DT and zeppelin models were identical to the ground truth values. However, zeppelin's FA is more accurate in measuring water restriction. More specifically, the FA estimations of the DT model were additionally biased by between +2% and +48% with respect to zeppelin values. Additionally, both mean diffusivity (MD) and FA of the zeppelin had lower parameter variance compared to the full DT (F-test, P < 0.05). We observe the same trends from in vivo values of patient data. CONCLUSION The zeppelin is more robust than the full DT for cartilage diffusion anisotropy and SNR at levels typically encountered in clinical applications of articular cartilage. Magn Reson Med 79:1157-1164, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Uran Ferizi
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Amparo Ruiz
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Ignacio Rossi
- Centro de Diagnostico Dr. Enrique Rossi, Buenos Aires, Argentina
| | - Jenny Bencardino
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - José G Raya
- Department of Radiology, New York University School of Medicine, New York, New York, USA
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Klets O, Mononen ME, Tanska P, Nieminen MT, Korhonen RK, Saarakkala S. Comparison of different material models of articular cartilage in 3D computational modeling of the knee: Data from the Osteoarthritis Initiative (OAI). J Biomech 2016; 49:3891-3900. [PMID: 27825602 DOI: 10.1016/j.jbiomech.2016.10.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 10/15/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Abstract
The intricate properties of articular cartilage and the complexity of the loading environment are some of the key challenges in developing models for biomechanical analysis of the knee joint. Fibril-reinforced poroelastic (FRPE) material models have been reported to accurately capture characteristic responses of cartilage during dynamic and static loadings. However, high computational and time costs associated with such advanced models limit applicability of FRPE models when multiple subjects need to be analyzed. If choosing simpler material models, it is important to show that they can still produce truthful predictions. Therefore, the aim of this study was to compare depth-dependent maximum principal stresses and strains within articular cartilage in the 3D knee joint between FRPE material models and simpler isotropic elastic (IE), isotropic poroelastic (IPE) and transversely isotropic poroelastic (TIPE) material models during simulated gait cycle. When cartilage-cartilage contact pressures were matched between the models (15% allowed difference), maximum principal stresses in the IE, IPE and TIPE models were substantially lower than those in the FRPE model (by more than 50%, TIPE model being closest to the FRPE model), and stresses occurred only in compression in the IE model. Additional simulations were performed to find material parameters for the TIPE model (due to its anisotropic nature) that would yield maximum principal stresses similar to the FRPE model. The modified homogeneous TIPE model was in a better agreement with the homogeneous FRPE model, and the average and maximum differences in maximum principal stresses throughout the depth of cartilage were 7% and 9%, respectively, in the lateral compartment and 9% and 11% in the medial compartment. This study revealed that it is possible to match simultaneously maximum principal stresses and strains of cartilage between non-fibril-reinforced and fibril-reinforced knee joint models during gait. Depending on the research question (such as analysis of fibril strain necessitates the use of fibril-reinforced material models) or clinical demand (fast simulations with simpler material models), the choice of the material model should be done carefully.
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Affiliation(s)
- Olesya Klets
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital Oulu, Finland.
| | - Mika E Mononen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Miika T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital Oulu, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital Oulu, Finland
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Brill N, Wirtz M, Merhof D, Tingart M, Jahr H, Truhn D, Schmitt R, Nebelung S. Polarization-sensitive optical coherence tomography-based imaging, parameterization, and quantification of human cartilage degeneration. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:76013. [PMID: 27447953 DOI: 10.1117/1.jbo.21.7.076013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 07/06/2016] [Indexed: 05/18/2023]
Abstract
Polarization-sensitive optical coherence tomography (PS-OCT) is a light-based, high-resolution, real-time, noninvasive, and nondestructive imaging modality yielding quasimicroscopic cross-sectional images of cartilage. As yet, comprehensive parameterization and quantification of birefringence and tissue properties have not been performed on human cartilage. PS-OCT and algorithm-based image analysis were used to objectively grade human cartilage degeneration in terms of surface irregularity, tissue homogeneity, signal attenuation, as well as birefringence coefficient and band width, height, depth, and number. Degeneration-dependent changes were noted for the former three parameters exclusively, thereby questioning the diagnostic value of PS-OCT in the assessment of human cartilage degeneration.
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Affiliation(s)
- Nicolai Brill
- Fraunhofer Institute for Production Technology, Steinbachstraße 17, Aachen 52074, Germany
| | - Mathias Wirtz
- Fraunhofer Institute for Production Technology, Steinbachstraße 17, Aachen 52074, Germany
| | - Dorit Merhof
- RWTH Aachen University, Institute of Imaging and Computer Vision, Kopernikusstraße 16, Aachen 52074, Germany
| | - Markus Tingart
- Aachen University Hospital, Department of Orthopaedic Surgery, Pauwelsstraße 30, Aachen 52074, Germany
| | - Holger Jahr
- Aachen University Hospital, Department of Orthopaedic Surgery, Pauwelsstraße 30, Aachen 52074, Germany
| | - Daniel Truhn
- Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Pauwelsstraße 30, Aachen 52074, Germany
| | - Robert Schmitt
- Fraunhofer Institute for Production Technology, Steinbachstraße 17, Aachen 52074, GermanyeRWTH Aachen University, Laboratory for Machine Tools and Production Engineering, Manfred-Weck Haus, Steinbachstraße 19, Aachen 52074, Germany
| | - Sven Nebelung
- Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Pauwelsstraße 30, Aachen 52074, Germany
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A micro-architecturally biomimetic collagen template for mesenchymal condensation based cartilage regeneration. Acta Biomater 2016; 30:212-221. [PMID: 26602826 DOI: 10.1016/j.actbio.2015.11.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 11/12/2015] [Accepted: 11/16/2015] [Indexed: 11/23/2022]
Abstract
The unique arcade-like orientation of collagen fibers enables cartilage to bear mechanical loads. In this study continuous-length aligned collagen threads were woven to emulate the interdigitated arcade structure of the cartilage. The weaving pattern provided a macropore network within which micromass cell pellets were seeded to take advantage of mesenchymal condensation driven chondrogenesis. Compression tests showed that the baseline scaffold had a modulus of 0.83±0.39MPa at a porosity of 80%. The modulus of pellet seeded scaffolds increased by 60% to 1.33±0.37MPa after 28days of culture, converging to the modulus of the native cartilage. The scaffolds displayed duress under displacement controlled low-cycle fatigue at 15% strain amplitude such that load reduction stabilized at 8% after 4500 cycles of loading. The woven structure demonstrated a substantial elastic recoil where 40% mechanical strain was close to completely recovered following unloading. A robust chondrogenesis was observed as evidenced by positive staining for GAGs and type II collagen and aggrecan. Dimethyl methylene blue and sircol assays showed GAGs and collagen productions to increase from 3.36±1.24 and 31.46±3.22 at day 3 to 56.61±12.12 and 136.70±12.29μg/μg of DNA at day 28 of culture. This woven collagen scaffold holds a significant potential for cartilage regeneration with shorter in vitro culture periods due to functionally sufficient mechanical robustness at the baseline. In conclusion, the mimicry of cartilage's arcade architecture resulted in substantial improvement of mechanical function while enabling one of the first pellet delivery platforms enabled by a macroporous network. STATEMENT OF SIGNIFICANCE Mesenchymal condensation is critical for driving chondrogenesis, making high density cell seeding a standard in cartilage tissue engineering. Efforts to date have utilized scaffold free delivery of MSCs in pellet form. This study developed a macroporous scaffold that is fabricated by weaving highly aligned collagen threads. The scaffold can deliver high density cell condensates while providing mechanical stiffness comparable to that of cartilage. The scaffold also mimicked the arcade-like orientation of collagen fibers in cartilage. A highly robust chondrogenesis was observed in this mesenchymal cell pellet delivery system. Baseline mechanical robustness of this scaffold system will enable delivery of cell pellets as early as three days.
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Méthot S, Changoor A, Tran-Khanh N, Hoemann CD, Stanish WD, Restrepo A, Shive MS, Buschmann MD. Osteochondral Biopsy Analysis Demonstrates That BST-CarGel Treatment Improves Structural and Cellular Characteristics of Cartilage Repair Tissue Compared With Microfracture. Cartilage 2016; 7:16-28. [PMID: 26958314 PMCID: PMC4749746 DOI: 10.1177/1947603515595837] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The efficacy and safety of BST-CarGel, a chitosan-based medical device for cartilage repair, was compared with microfracture alone at 1 year during a multicenter randomized controlled trial (RCT) in the knee. The quality of repair tissue of osteochondral biopsies collected from a subset of patients was compared using blinded histological assessments. METHODS The international RCT evaluated repair tissue quantity and quality by 3-dimensional quantitative magnetic resonance imaging as co-primary endpoints at 12 months. At an average of 13 months posttreatment, 21/41 BST-CarGel and 17/39 microfracture patients underwent elective second look arthroscopies as a tertiary endpoint, during which ICRS (International Cartilage Repair Society) macroscopic scoring was carried out, and osteochondral biopsies were collected. Stained histological sections were evaluated by blinded readers using ICRS I and II histological scoring systems. Collagen organization was evaluated using a polarized light microscopy score. RESULTS BST-CarGel treatment resulted in significantly better ICRS macroscopic scores (P = 0.0002) compared with microfracture alone, indicating better filling, integration, and tissue appearance. Histologically, BST-CarGel resulted in a significant improvement of structural parameters-Surface Architecture (P = 0.007) and Surface/Superficial Assessment (P = 0.042)-as well as cellular parameters-Cell Viability (P = 0.006) and Cell Distribution (P = 0.032). No histological parameters were significantly better for the microfracture group. BST-CarGel treatment also resulted in a more organized repair tissue with collagen stratification more similar to native hyaline cartilage, as measured by polarized light microscopy scoring (P = 0.0003). CONCLUSION Multiple and independent analyses in this biopsy substudy demonstrated that BST-CarGel treatment results in improved structural and cellular characteristics of repair tissue at 1 year posttreatment compared with microfracture alone, supporting previously reported results by quantitative magnetic resonance imaging.
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Affiliation(s)
- Stéphane Méthot
- Bio-Orthopaedics Division, Piramal Life Sciences, Laval, Quebec, Canada,Stéphane Méthot, Bio-Orthopaedics Division, Piramal Life Sciences, 475 Armand-Frappier, Laval, Quebec, H7V 4B3, Canada.
| | - Adele Changoor
- Institute of Biomedical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - Nicolas Tran-Khanh
- Department of Chemical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - Caroline D. Hoemann
- Institute of Biomedical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada,Department of Chemical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
| | - William D. Stanish
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alberto Restrepo
- Bio-Orthopaedics Division, Piramal Life Sciences, Laval, Quebec, Canada
| | - Matthew S. Shive
- Bio-Orthopaedics Division, Piramal Life Sciences, Laval, Quebec, Canada
| | - Michael D. Buschmann
- Institute of Biomedical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada,Department of Chemical Engineering, École Polytechnique de Montréal, Montreal, Quebec, Canada
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Räsänen LP, Mononen ME, Lammentausta E, Nieminen MT, Jurvelin JS, Korhonen RK. Three dimensional patient-specific collagen architecture modulates cartilage responses in the knee joint during gait. Comput Methods Biomech Biomed Engin 2015; 19:1225-40. [PMID: 26714834 DOI: 10.1080/10255842.2015.1124269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Site-specific variation of collagen fibril orientations can affect cartilage stresses in knee joints. However, this has not been confirmed by 3-D analyses. Therefore, we present a novel method for evaluation of the effect of patient-specific collagen architecture on time-dependent mechanical responses of knee joint cartilage during gait. 3-D finite element (FE) models of a human knee joint were created with the collagen architectures obtained from T2 mapped MRI (patient-specific model) and from literature (literature model). The effect of accuracy of the implementation of collagen fibril architecture into the model was examined by using a submodel with denser FE mesh. Compared to the literature model, fibril strains and maximum principal stresses were reduced especially in the superficial/middle regions of medial tibial cartilage in the patient-specific model after the loading response of gait (up to -413 and -26%, respectively). Compared to the more coarsely meshed joint model, the patient-specific submodel demonstrated similar strain and stress distributions but increased values particularly in the superficial cartilage regions (especially stresses increased >60%). The results demonstrate that implementation of subject-specific collagen architecture of cartilage in 3-D modulates location- and time-dependent mechanical responses of human knee joint cartilage. Submodeling with more accurate implementation of collagen fibril architecture alters cartilage stresses particularly in the superficial/middle tissue.
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Affiliation(s)
- Lasse P Räsänen
- a Department of Applied Physics , University of Eastern Finland , Kuopio , Finland.,b Diagnostic Imaging Centre, Kuopio University Hospital , Kuopio , Finland
| | - Mika E Mononen
- a Department of Applied Physics , University of Eastern Finland , Kuopio , Finland
| | - Eveliina Lammentausta
- c Department of Diagnostic Radiology , Oulu University Hospital , Oulu , Finland.,e Medical Research Center, University of Oulu and Oulu University Hospital , Oulu , Finland
| | - Miika T Nieminen
- c Department of Diagnostic Radiology , Oulu University Hospital , Oulu , Finland.,d Department of Radiology , Institute of Diagnostics, University of Oulu , Oulu , Finland.,e Medical Research Center, University of Oulu and Oulu University Hospital , Oulu , Finland
| | - Jukka S Jurvelin
- a Department of Applied Physics , University of Eastern Finland , Kuopio , Finland.,b Diagnostic Imaging Centre, Kuopio University Hospital , Kuopio , Finland
| | - Rami K Korhonen
- a Department of Applied Physics , University of Eastern Finland , Kuopio , Finland.,b Diagnostic Imaging Centre, Kuopio University Hospital , Kuopio , Finland
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45
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Shive MS, Stanish WD, McCormack R, Forriol F, Mohtadi N, Pelet S, Desnoyers J, Méthot S, Vehik K, Restrepo A. BST-CarGel® Treatment Maintains Cartilage Repair Superiority over Microfracture at 5 Years in a Multicenter Randomized Controlled Trial. Cartilage 2015; 6:62-72. [PMID: 26069709 PMCID: PMC4462252 DOI: 10.1177/1947603514562064] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The efficacy and safety of BST-CarGel®, a chitosan scaffold for cartilage repair was compared with microfracture alone at 1 year during a multicenter randomized controlled trial in the knee. This report was undertaken to investigate 5-year structural and clinical outcomes. DESIGN The international randomized controlled trial enrolled 80 patients, aged 18 to 55 years, with grade III or IV focal lesions on the femoral condyles. Patients were randomized to receive BST-CarGel® treatment or microfracture alone, and followed standardized 12-week rehabilitation. Co-primary endpoints of repair tissue quantity and quality were evaluated by 3-dimensional MRI quantification of the degree of lesion filling (%) and T2 relaxation times. Secondary endpoints were clinical benefit measured with WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) questionnaires and safety. General estimating equations were used for longitudinal statistical analysis of repeated measures. RESULTS Blinded MRI analysis demonstrated that BST-CarGel®-treated patients showed a significantly greater treatment effect for lesion filling (P = 0.017) over 5 years compared with microfracture alone. A significantly greater treatment effect for BST-CarGel® was also found for repair tissue T2 relaxation times (P = 0.026), which were closer to native cartilage compared to the microfracture group. BST-CarGel® and microfracture groups showed highly significant improvement at 5 years from pretreatment baseline for each WOMAC subscale (P < 0.0001), and there were no differences between the treatment groups. Safety was comparable for both groups. CONCLUSIONS BST-CarGel® was shown to be an effective mid-term cartilage repair treatment. At 5 years, BST-CarGel® treatment resulted in sustained and significantly superior repair tissue quantity and quality over microfracture alone. Clinical benefit following BST-CarGel® and microfracture treatment were highly significant over baseline levels.
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Affiliation(s)
| | - William D. Stanish
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robert McCormack
- Department of Orthopedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Nicholas Mohtadi
- University of Calgary Sports Medicine Centre, Calgary, Alberta, Canada
| | - Stéphane Pelet
- Department of Orthopedics, CHA-Pavillon Enfant-Jésus, Quebec, Quebec, Canada
| | | | | | - Kendra Vehik
- Department of Epidemiology and Biostatistics, University of South Florida, Tampa, Florida, USA
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Cernohorsky P, Kok AC, de Bruin DM, Brandt MJ, Faber DJ, Tuijthof GJ, Kerkhoffs GM, Strackee SD, van Leeuwen TG. Comparison of optical coherence tomography and histopathology in quantitative assessment of goat talus articular cartilage. Acta Orthop 2015; 86:257-63. [PMID: 25350610 PMCID: PMC4404781 DOI: 10.3109/17453674.2014.979312] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE Optical coherence tomography (OCT) is a light-based imaging technique suitable for depiction of thin tissue layers such as articular cartilage. Quantification of results and direct comparison with a reference standard is needed to confirm the role of OCT in cartilage evaluation. MATERIALS AND METHODS Goat talus articular cartilage repair was assessed quantitatively with OCT and compared with histopathology using semi-automated analysis software. Osteochondral defects were created centrally in goat tali with subsequent healing over 24 weeks. After sacrifice, the tali were analyzed using OCT and processed into histopathology slides. Cartilage thickness, repair tissue area, and surface roughness were measured. Also, light attenuation coefficient measurements were performed to assess differences in the properties of healthy tissue and repair tissue. RESULTS Intra-class correlation coefficients for resemblance between the 2 techniques were 0.95 (p < 0.001) for thickness, 0.73 (p = 0.002) for repair tissue area, and 0.63 (p = 0.015) for surface roughness. Light attenuation differed significantly between healthy cartilage (8.2 (SD 3.9) mm(-1)) and repair tissue (2.8 (SD 1.5) mm(-1)) (p < 0.001). INTERPRETATION Compared to histopathology as the standard reference method, OCT is a reproducible technique in quantitative analysis of goat talus articular cartilage, especially when assessing cartilage thickness and to a lesser extent when measuring repair tissue area and surface roughness. Moreover, differences in local light attenuation suggest measurable variation in tissue structure, enhancing the clinical applicability of quantitative measurements from cartilage OCT images.
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Affiliation(s)
| | - Aimee C Kok
- Orthopedic Surgery, Orthopedic Research Center Amsterdam
| | - Daniel Martijn de Bruin
- Biomedical Engineering and Physics,Urology, Academic Medical Center, University of Amsterdam, Amsterdam
| | | | | | - Gabrielle J Tuijthof
- Orthopedic Surgery, Orthopedic Research Center Amsterdam,Faculty of 3ME, BioMechanical Engineering, Delft University of Technology, Delft, the Netherlands
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47
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Short-term consolidation of articular cartilage in the long-term context of osteoarthritis. J Theor Biol 2015; 368:102-12. [DOI: 10.1016/j.jtbi.2015.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/04/2014] [Accepted: 01/04/2015] [Indexed: 01/18/2023]
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48
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Nebelung S, Marx U, Brill N, Arbab D, Quack V, Jahr H, Tingart M, Zhou B, Stoffel M, Schmitt R, Rath B. Morphometric grading of osteoarthritis by optical coherence tomography--an ex vivo study. J Orthop Res 2014; 32:1381-8. [PMID: 24992396 DOI: 10.1002/jor.22673] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 06/01/2014] [Indexed: 02/04/2023]
Abstract
Optical Coherence Tomography (OCT) yields microscopic cross-sectional images of cartilage in real time and at high resolution. As yet, comprehensive grading of degenerative cartilage changes based on OCT has rarely been performed. This study investigated the potential of quantitative OCT using algorithm-based image parameters such as irregularity (OII - Optical Irregularity Index), homogeneity (OHI - Optical Homogeneity Index) and attenuation (OAI - Optical Attenuation Index) in the objective grading of cartilage degeneration. Therefore, OCT was used to image and assess 113 human osteochondral samples obtained from total knee replacements. Processing included the analysis of OII (by calculation of the standard deviation with regards to a fitted surface), of OHI (by edge detection of tissue signal changes) and of OAI (by analysis of relative imaging depth). Additionally, samples were subject to macroscopic (Outerbridge grading), biomechanical (elastic stiffness), qualitative OCT and histological evaluation (Modified Mankin grading). Significant correlations were found between all outcome measures. OII and OHI were effective in assessing cartilage surface, integrity and homogeneity, while OAI could discriminate between unmineralized and mineralized cartilage, respectively. Therefore, quantitative OCT holds potential as a diagnostic tool for more reliable, standardized and objective assessment of cartilage tissue properties.
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Affiliation(s)
- Sven Nebelung
- Department of Orthopaedics, Aachen University Hospital, Aachen, Germany
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Hunziker EB, Lippuner K, Shintani N. How best to preserve and reveal the structural intricacies of cartilaginous tissue. Matrix Biol 2014; 39:33-43. [PMID: 25173436 DOI: 10.1016/j.matbio.2014.08.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
No single processing technique is capable of optimally preserving each and all of the structural entities of cartilaginous tissue. Hence, the choice of methodology must necessarily be governed by the nature of the component that is targeted for analysis, for example, fibrillar collagens or proteoglycans within the extracellular matrix, or the chondrocytes themselves. This article affords an insight into the pitfalls that are to be encountered when implementing the available techniques and how best to circumvent them. Adult articular cartilage is taken as a representative pars pro toto of the different bodily types. In mammals, this layer of tissue is a component of the synovial joints, wherein it fulfills crucial and diverse biomechanical functions. The biomechanical functions of articular cartilage have their structural and molecular correlates. During the natural course of postnatal development and after the onset of pathological disease processes, such as osteoarthritis, the tissue undergoes structural changes which are intimately reflected in biomechanical modulations. The fine structural intricacies that subserve the changes in tissue function can be accurately assessed only if they are faithfully preserved at the molecular level. For this reason, a careful consideration of the tissue-processing technique is indispensable. Since, as aforementioned, no single methodological tool is capable of optimally preserving all constituents, the approach must be pre-selected with a targeted structure in view. Guidance in this choice is offered.
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Affiliation(s)
- Ernst B Hunziker
- Departments of Osteoporosis, Orthopaedic Surgery and Clinical Research, Inselspital, University of Bern, Murtenstrasse 35, P.O. Box 54, 3010 Bern, Switzerland.
| | - Kurt Lippuner
- Departments of Osteoporosis, Orthopaedic Surgery and Clinical Research, Inselspital, University of Bern, Murtenstrasse 35, P.O. Box 54, 3010 Bern, Switzerland
| | - Nahoko Shintani
- Departments of Osteoporosis, Orthopaedic Surgery and Clinical Research, Inselspital, University of Bern, Murtenstrasse 35, P.O. Box 54, 3010 Bern, Switzerland
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He B, Wu JP, Kirk TB, Carrino JA, Xiang C, Xu J. High-resolution measurements of the multilayer ultra-structure of articular cartilage and their translational potential. Arthritis Res Ther 2014; 16:205. [PMID: 24946278 PMCID: PMC4061724 DOI: 10.1186/ar4506] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Current musculoskeletal imaging techniques usually target the macro-morphology of
articular cartilage or use histological analysis. These techniques are able to reveal
advanced osteoarthritic changes in articular cartilage but fail to give detailed
information to distinguish early osteoarthritis from healthy cartilage, and this
necessitates high-resolution imaging techniques measuring cells and the extracellular
matrix within the multilayer structure of articular cartilage. This review provides a
comprehensive exploration of the cellular components and extracellular matrix of
articular cartilage as well as high-resolution imaging techniques, including magnetic
resonance image, electron microscopy, confocal laser scanning microscopy, second
harmonic generation microscopy, and laser scanning confocal arthroscopy, in the
measurement of multilayer ultra-structures of articular cartilage. This review also
provides an overview for micro-structural analysis of the main components of normal
or osteoarthritic cartilage and discusses the potential and challenges associated
with developing non-invasive high-resolution imaging techniques for both research and
clinical diagnosis of early to late osteoarthritis.
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