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Hu Q, Williams SL, Palladino A, Ecker M. Screening of MMP-13 Inhibitors Using a GelMA-Alginate Interpenetrating Network Hydrogel-Based Model Mimicking Cytokine-Induced Key Features of Osteoarthritis In Vitro. Polymers (Basel) 2024; 16:1572. [PMID: 38891518 PMCID: PMC11174780 DOI: 10.3390/polym16111572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/26/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Osteoarthritis (OA) is a chronic joint disease characterized by irreversible cartilage degradation. Current clinical treatment options lack effective pharmaceutical interventions targeting the disease's root causes. MMP (matrix metalloproteinase) inhibitors represent a new approach to slowing OA progression by addressing cartilage degradation mechanisms. However, very few drugs within this class are in preclinical or clinical trial phases. Hydrogel-based 3D in vitro models have shown promise as preclinical testing platforms due to their resemblance to native extracellular matrix (ECM), abundant availability, and ease of use. Metalloproteinase-13 (MMP-13) is thought to be a major contributor to the degradation of articular cartilage in OA by aggressively breaking down type II collagen. This study focused on testing MMP-13 inhibitors using a GelMA-alginate hydrogel-based OA model induced by cytokines interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α). The results demonstrate a significant inhibition of type II collagen breakdown by measuring C2C concentration using ELISA after treatment with MMP-13 inhibitors. However, inconsistencies in human cartilage explant samples led to inconclusive results. Nonetheless, the study highlights the GelMA-alginate hydrogel-based OA model as an alternative to human-sourced cartilage explants for in vitro drug screening.
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Affiliation(s)
- Qichan Hu
- Department of Biomedical Engineering, University of North Texas, Denton, TX 76203, USA
| | - Steven L. Williams
- Department of Biological Sciences, University of North Texas, Denton, TX 76203, USA
| | - Alessandra Palladino
- Department of Biomedical Engineering, University of North Texas, Denton, TX 76203, USA
| | - Melanie Ecker
- Department of Biomedical Engineering, University of North Texas, Denton, TX 76203, USA
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Lehtovirta S, Casula V, Haapea M, Nortunen S, Lepojärvi S, Pakarinen H, Nieminen MT, Lammentausta E, Niinimäki J. Assessment of articular cartilage of ankle joint in stable and unstable unilateral weber type-B/SER-type ankle fractures shortly after trauma using T2 relaxation time. Acta Radiol Open 2023; 12:20584601231202033. [PMID: 37779823 PMCID: PMC10540593 DOI: 10.1177/20584601231202033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/01/2023] [Indexed: 10/03/2023] Open
Abstract
Background Early detection of post-traumatic cartilage damage in the ankle joint in magnetic resonance images can be difficult due to disturbances to structures usually appearing over time. Purpose To study the articular cartilage of unilateral Weber type-B/SER-type ankle fractures shortly post-trauma using T2 relaxation time. Material and Methods Fifty one fractured ankles were gathered from consecutively screened patients, compiled initially for RCT studies, and treated at Oulu University Hospital and classified as stable (n = 28) and unstable fractures (n = 23) based on external-rotation stress test: medial clear space of ≥5 mm was interpreted as unstable. A control group of healthy young individuals (n = 19) was also gathered. All ankles were imaged on average 9 (range: 1 to 25) days after injury on a 3.0T MRI unit for T2 relaxation time assessment, and the cartilage was divided into sub-regions for comparison. Results Control group displayed significantly higher T2 values in tibial cartilage compared to stable (six out of nine regions, p-values = .003-.043) and unstable (six out of nine regions, p-values = .001-.037) ankle fractures. No differences were detected in talar cartilage. Also, no differences were observed between stable and unstable fractures in tibial or talar cartilage. Conclusions Lower T2 relaxation times of tibial cartilage in fractured ankles suggest intact extra cellular matrix (ECM) of the cartilage. Severity of the ankle fracture, measured by ankle stability, does not seem to increase ECM degradation immediately after trauma.
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Affiliation(s)
- Sami Lehtovirta
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Victor Casula
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Marianne Haapea
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | | | | | | | - Miika T. Nieminen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Eveliina Lammentausta
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Jaakko Niinimäki
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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Colombini A, Doro G, Ragni E, Forte L, de Girolamo L, Zerbinati F. Treatment with CR500® improves algofunctional scores in patients with knee osteoarthritis: a post-market confirmatory interventional, single arm clinical investigation. BMC Musculoskelet Disord 2023; 24:647. [PMID: 37573322 PMCID: PMC10422714 DOI: 10.1186/s12891-023-06754-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/25/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a progressive and degenerative condition. Several pharmacological and non-pharmacological treatments are able to improve the OA symptoms and the structural characteristics of the affected joints. Among these, infiltrative therapy with hyaluronic acid (HA) is the most used and consolidated procedure for the pain management. The addition of skin conditioning peptides to HA promotes the cartilage remodeling processes and a better permeation of the HA-based gel containing a peptide mixture, CR500®. Furthermore, the topic route of administration is convenient over the routinely used intra-articular injective procedures. In this study, the effectiveness of CR500® was evaluated in terms of improvement of the algo-functional symptoms related to unilateral knee OA. METHODS 38 mild and moderate OA patients were enrolled at a screening visit (V-1), treated at baseline visit (V1), and then continued the topical application of CR500® twice a week for 4 weeks, and followed-up for 3 visits (V2-V4) from week 2 to 4. Lequesne Knee Index (LKI) and Knee injury and Osteoarthritis Outcome Score (KOOS) were collected. Synovial fluid was collected and used for the quantification of neoepitope of type II collagen (C2C), C-terminal telopeptide of type II collagen (CTX-II), type II collagen propeptide (CPII), tumor necrosis factor alpha (TNFα) and HA. The expression of CD11c and CD206 was evaluated on cell pellets. RESULTS Three patients were excluded, thus 35 patients were included in the analysis. The treatment with CR500® was safe and well tolerated, with 7.9% patients had mild adverse events, not related to the device. The LKI total score showed a significant decrease from V1 to V4. KOOS score also showed a significant improvement of patient condition at V2, V3 and V4 in comparison with V1 for all subscales, except for KOOS sport subscale which improved only from V3. At V1 a negative correlation among KOOS pain subscale values and C2C, CPII and TNFα levels was observed, as well as a positive correlation between KOOS pain subscale and CD11c/CD206 ratio. CONCLUSION CR500® is safe and appear to be effective in improving pain and function in OA patients during the 4 weeks of treatment. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05661162. This trial was registered on 22/12/2022.
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Affiliation(s)
- Alessandra Colombini
- Laboratorio di Biotecnologie Applicate all'Ortopedia, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, Milan, 20161, Italy
| | - Gianluca Doro
- Orthopedics and Traumatology Department, Humanitas Mater Domini, Varese, Italy
| | - Enrico Ragni
- Laboratorio di Biotecnologie Applicate all'Ortopedia, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, Milan, 20161, Italy
| | | | - Laura de Girolamo
- Laboratorio di Biotecnologie Applicate all'Ortopedia, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, Milan, 20161, Italy.
| | - Fabio Zerbinati
- Orthopedics and Traumatology Department, Humanitas Mater Domini, Varese, Italy
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Thompson MA, Martin SA, Hislop BD, Younkin R, Andrews TM, Miller K, June RK, Adams ES. Sex-specific effects of calving season on joint health and biomarkers in Montana ranchers. BMC Musculoskelet Disord 2023; 24:80. [PMID: 36717802 PMCID: PMC9887842 DOI: 10.1186/s12891-022-05979-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/11/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Agricultural workers have a higher incidence of osteoarthritis (OA), but the etiology behind this phenomenon is unclear. Calving season, which occurs in mid- to late-winter for ranchers, includes physical conditions that may elevate OA risk. Our primary aim was to determine whether OA biomarkers are elevated at the peak of calving season compared to pre-season, and to compare these data with joint health survey information from the subjects. Our secondary aim was to detect biomarker differences between male and female ranchers. METHODS During collection periods before and during calving season, male (n = 28) and female (n = 10) ranchers completed joint health surveys and provided samples of blood, urine, and saliva for biomarker analysis. Statistical analyses examined associations between mean biomarker levels and survey predictors. Ensemble cluster analysis identified groups having unique biomarker profiles. RESULTS The number of calvings performed by each rancher positively correlated with plasma IL-6, serum hyaluronic acid (HA) and urinary CTX-I. Thiobarbituric acid reactive substances (TBARS), a marker of oxidative stress, was significantly higher during calving season than pre-season and was also correlated with ranchers having more months per year of joint pain. We found evidence of sexual dimorphism in the biomarkers among the ranchers, with leptin being elevated and matrix metalloproteinase-3 diminished in female ranchers. The opposite was detected in males. WOMAC score was positively associated with multiple biomarkers: IL-6, IL-2, HA, leptin, C2C, asymmetric dimethylarginine, and CTX-I. These biomarkers represent enzymatic degradation, inflammation, products of joint destruction, and OA severity. CONCLUSIONS The positive association between number of calvings performed by each rancher (workload) and both inflammatory and joint tissue catabolism biomarkers establishes that calving season is a risk factor for OA in Montana ranchers. Consistent with the literature, we found important sex differences in OA biomarkers, with female ranchers showing elevated leptin, whereas males showed elevated MMP-3.
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Affiliation(s)
- Matthew A. Thompson
- grid.41891.350000 0001 2156 6108Department of Chemical & Biological Engineering, Montana State University, Bozeman, MT USA
| | - Stephen A. Martin
- grid.41891.350000 0001 2156 6108Center for American Indian and Rural Health Equity, Translational Biomarkers Core Laboratory, Montana State University, Bozeman, MT USA
| | - Brady D. Hislop
- grid.41891.350000 0001 2156 6108Department of Mechanical & Industrial Engineering, Montana State University, PO Box 173800, Bozeman, MT 59717-3800 USA
| | - Roubie Younkin
- grid.41891.350000 0001 2156 6108MSU Extension Office, Montana State University, Bozeman, MT USA
| | - Tara M. Andrews
- grid.41891.350000 0001 2156 6108MSU Extension Office, Montana State University, Bozeman, MT USA
| | - Kaleena Miller
- grid.41891.350000 0001 2156 6108MSU Extension Office, Montana State University, Bozeman, MT USA
| | - Ronald K. June
- grid.41891.350000 0001 2156 6108Department of Mechanical & Industrial Engineering, Montana State University, PO Box 173800, Bozeman, MT 59717-3800 USA
| | - Erik S. Adams
- grid.41891.350000 0001 2156 6108Department of Mechanical & Industrial Engineering, Montana State University, PO Box 173800, Bozeman, MT 59717-3800 USA ,grid.34477.330000000122986657School of Medicine, Montana WWAMI, University of Washington, Seattle, WA USA
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Soluble and EV-Associated Diagnostic and Prognostic Biomarkers in Knee Osteoarthritis Pathology and Detection. Life (Basel) 2023; 13:life13020342. [PMID: 36836699 PMCID: PMC9961153 DOI: 10.3390/life13020342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/13/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023] Open
Abstract
Osteoarthritis (OA) is the most common degenerative disease of the connective tissue of the human musculoskeletal system. Despite its widespread prevalence, there are many limitations in its diagnosis and treatment. OA diagnosis currently relies on the presence of clinical symptoms, sometimes accompanied by changes in joint X-rays or MRIs. Biomarkers help not only to diagnose early disease progression but also to understand the process of OA in many ways. In this article, we briefly summarize information on articular joints and joint tissues, the pathogenesis of OA and review the literature about biomarkers in the field of OA, specifically inflammatory cytokines/chemokines, proteins, miRNA, and metabolic biomarkers found in the blood, synovial fluid and in extracellular vesicles.
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Aulin C, Larsson S, Vogl T, Roth J, Åkesson A, Swärd P, Heinbäck R, Erlandsson Harris H, Struglics A. The alarmins high mobility group box protein 1 and S100A8/A9 display different inflammatory profiles after acute knee injury. Osteoarthritis Cartilage 2022; 30:1198-1209. [PMID: 35809846 DOI: 10.1016/j.joca.2022.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/13/2022] [Accepted: 06/26/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare the concentrations of high mobility group box 1 protein (HMGB1) and S100A8/A9 in synovial fluid between patients with knee injuries and osteoarthritis (OA), and knee healthy subjects. To investigate associations of alarmin levels with different joint injuries and with biomarkers of inflammation, Wnt signaling, complement system, bone and cartilage degradation. METHODS HMGB1 and S100A8/A9 were measured in synovial fluid by immunoassays in patients with knee injuries, with OA and from knee healthy subjects, and were related to time from injury and with biomarkers obtained from previous studies. Hierarchical cluster and enrichment analyses of biomarkers associated to HMGB1 and S100A8/A9 were performed. RESULTS The synovial fluid HMGB1 and S100A8/A9 concentrations were increased early after knee injury; S100A8/A9 levels were negatively associated to time after injury and was lower in the old compared to recent injury group, while HMGB1 was not associated to time after injury. The S100A8/A9 levels were also increased in OA. The initial inflammatory response was similar between the alarmins, and HMGB1 and S100A8/A9 shared 9 out of 20 enriched pathways. The alarmins displayed distinct response profiles, HMGB1 being associated to cartilage biomarkers while S100A8/A9 was associated to proinflammatory cytokines. CONCLUSIONS HMGB1 and S100A8/A9 are increased as an immediate response to knee trauma. While they share many features in inflammatory and immunoregulatory mechanisms, S100A8/A9 and HMGB1 are associated to different downstream responses, which may have impact on the OA progression after acute knee injuries.
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Affiliation(s)
- C Aulin
- Center for Molecular Medicine, Department of Medicine Solna, Karolinska Institutet, and Division of Rheumatology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
| | - S Larsson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Lund, Sweden
| | - T Vogl
- University of Muenster, Institute of Immunology, Münster, Germany
| | - J Roth
- University of Muenster, Institute of Immunology, Münster, Germany
| | - A Åkesson
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - P Swärd
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Lund, Sweden
| | - R Heinbäck
- Center for Molecular Medicine, Department of Medicine Solna, Karolinska Institutet, and Division of Rheumatology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - H Erlandsson Harris
- Center for Molecular Medicine, Department of Medicine Solna, Karolinska Institutet, and Division of Rheumatology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - A Struglics
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Lund, Sweden
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Kraus VB, Karsdal MA. Clinical monitoring in osteoarthritis: Biomarkers. Osteoarthritis Cartilage 2022; 30:1159-1173. [PMID: 34536529 PMCID: PMC8924021 DOI: 10.1016/j.joca.2021.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/23/2021] [Accepted: 04/07/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this overview of osteoarthritis (OA) biomarkers is to provide the non-specialist with a toolbox, based on experience acquired by biomarker researchers over many years, to understand biomarkers in general and their use in the OA field. METHODS We provide an update on this subject since the OARSI Primer on osteoarthritis (OA) nearly a decade ago. RESULTS Since the last update, the importance of molecular biomarkers has been increasingly recognized in the field, but no OA-related biomarkers have been adopted for routine use in clinical practice. The current lack of chondroprotective treatments for OA impairs the assessment, validation and qualification of the potential role of biomarkers as tools for monitoring disease status and patient responses to treatment of OA. Yet there is no lack of an evolving compendium of OA-related biomarkers, ever more fit-for-purpose, that could currently facilitate drug development for OA. We provide an abbreviated update and overview of specific soluble OA-related biomarkers for this new OARSI Primer on OA with OA-relevant examples encompassing the concepts of biomarker nomenclature, qualification, interpretation, measurement, reporting requirements, application to research, drug discovery and clinical care, and future needs for biomarker advancement. CONCLUSION Appropriate biomarkers should play a role at all stages of OA diagnosis, prognosis, drug development, and treatment. The future of OA biomarker research and development holds great promise as its foundation is increasingly robust.
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Affiliation(s)
- V B Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Duke University School of Medicine, Durham, NC, USA.
| | - M A Karsdal
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
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Östlind E, Eek F, Stigmar K, Sant’Anna A, Ekvall Hansson E, Struglics A. Associations Between Physical Activity, Self-reported Joint Function, and Molecular Biomarkers in Working Age Individuals With Hip and/or Knee Osteoarthritis. CLINICAL MEDICINE INSIGHTS: ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2022; 15:11795441221081063. [PMID: 35342314 PMCID: PMC8950022 DOI: 10.1177/11795441221081063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/28/2022] [Indexed: 11/18/2022]
Abstract
Objective: Previous research has suggested an association between physical activity (PA), joint function, and molecular biomarkers, but more studies are needed. The aim of this study was to explore the associations between PA or self-reported joint function and molecular biomarkers of cartilage and inflammation in individuals with hip and/or knee osteoarthritis (OA). Specific objectives were to explore the correlations between (1) the change over 3 months in self-reported PA/joint function and the change in molecular biomarkers (2) objectively measured PA and molecular biomarkers measured at 3-month follow-up. Design: Working age participants (n = 91) were recruited from a cluster randomized controlled trial. Self-reported PA, joint function, and serum samples were collected at baseline and after 3 months. Serum concentrations of the inflammatory marker C-reactive protein (CRP) and the cartilage markers Alanine-Arginine-Glycine-Serine (ARGS)-aggrecan, cartilage oligomeric matrix protein (COMP), and type II collagen C2C were analyzed by immunoassays. Objectively measured PA (steps/day) was collected during 12 weeks from activity trackers used by 53 participants. Associations were analyzed with Spearman’s rank correlation. Results: There was a weak negative correlation between the change in self-reported PA and the change in COMP (rs = −0.256, P = .040) but not for the other molecular biomarkers. There were no correlations between the change in self-reported joint function and the change in molecular biomarkers or between the average steps/day and the molecular biomarkers at follow-up (rs ⩽ −0.206, P ⩾ .06). Conclusion: In general, no or only weak associations were found between PA/joint function and molecular biomarkers. Future research recommends including participants with lower PA, extend the follow-up, and use a design that allows comparisons.
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Affiliation(s)
- Elin Östlind
- Research Group Physiotherapy, Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Dalby Healthcare Center, Region Skåne, Lund, Sweden
| | - Frida Eek
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
| | - Kjerstin Stigmar
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
| | | | - Eva Ekvall Hansson
- Division of Physiotherapy, Department of Health Sciences, Lund University, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
| | - André Struglics
- Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden
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Black RM, Wang Y, Struglics A, Lorenzo P, Chubinskaya S, Grodzinsky AJ, Önnerfjord P. Proteomic clustering reveals the kinetics of disease biomarkers in bovine and human models of post-traumatic osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3. [DOI: 10.1016/j.ocarto.2021.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Joint effusion at 6 months is a significant predictor of joint effusion 1 year after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2021; 29:3839-3845. [PMID: 33475806 DOI: 10.1007/s00167-021-06433-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE This study aimed to assess the risk factors for prolonged joint effusion in patients undergoing double-bundle anterior cruciate ligament reconstruction (ACLR). METHODS In total, 160 patients who underwent primary ACLR using autograft hamstring between 2015 and 2018 were retrospectively reviewed. Joint effusion was defined as any grade ≥ 2 (range, 0-3) according to the MRI Osteoarthritis Knee Score (MOAKS). Univariate and multivariate logistic regression analyses were performed. RESULTS The median age of the patients was 25 years (range 14-68 years) at the time of the surgery; there were 89 women and 71 men. At 1 year, 46 (28.8%) patients experienced knee joint effusion, as defined by the MOAKS. Univariate analysis revealed that age, preoperative Kellgren-Lawrence (K-L) grade, and joint effusion at 6 months were significantly associated with joint effusion at 1 year. In the multivariate analysis, joint effusion at 6 months was significantly associated with joint effusion at 1 year (odds ratio, 68.0; 95% confidence interval, 22.1-209.4). No significant difference in the Lysholm scores was observed between patients with and without joint effusion at 1 year (n.s.). CONCLUSIONS Joint effusion at 6 months was significantly associated with joint effusion 1 year after ACLR. LEVEL OF EVIDENCE III.
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Markus DH, Berlinberg EJ, Strauss EJ. Current State of Synovial Fluid Biomarkers in Sports Medicine. JBJS Rev 2021; 9:01874474-202108000-00003. [PMID: 34398863 DOI: 10.2106/jbjs.rvw.21.00024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» While the gross mechanical abnormalities contributing to posttraumatic osteoarthritis (PTOA) have been well described, new research is demonstrating that these insults to the articular cartilage may also initiate changes in the joint microenvironment that seed the development of PTOA. » A growing amount of literature has identified key biomarkers that exhibit altered expression in the synovial fluid following a knee injury, with a portion of these molecules remaining elevated in the years following an injury. » These biomarkers have the potential to aid in the early detection of PTOA before radiographic evidence becomes apparent. Furthermore, deciphering the processes that occur within the articular microenvironment after trauma may allow for better identification of therapeutic targets for the prevention and earlier treatment of PTOA.
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Yang G, Sun S, Wang J, Li W, Wang X, Yuan L, Li S. S-Allylmercaptocysteine Targets Nrf2 in Osteoarthritis Treatment Through NOX4/NF-κB Pathway. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:4533-4546. [PMID: 33149551 PMCID: PMC7604485 DOI: 10.2147/dddt.s258973] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/07/2020] [Indexed: 01/24/2023]
Abstract
Purpose This study aimed to explore the potential role and mechanism of garlic-derived S-allylmercaptocysteine (SAMC), the major water-soluble fraction of garlic, in osteoarthritis (OA) both in vivo and in vitro. Methods The effect of SAMC in a surgical-induced OA model was examined by X-ray, staining, ELISA, and immunoblotting. Then the key role of Nrf2 by SAMC treatment in IL-1β stimulated chondrocytes in vitro was determined by gene-knockdown technique. Results SAMC could stabilize the extracellular matrix (ECM) by decreasing metalloproteinase (MMPs) expression to suppress type II collagen degradation in OA rats. The inflammatory cytokines, such as IL-1β, TNF-α, and IL-6, were elevated in OA, which could be down-regulated by SAMC treatment. This effect was parallel with NF-κB signaling inhibition by SAMC. As oxidative stress has been shown to participate in the inflammatory pathways in OA conditions, the key regulator Nrf2 in redox-homeostasis was evaluated in SAMC-treated OA rats. Nrf2 and its down-stream gene NQO-1 were activated in the SAMC-treated group, accompanied by NAD(P)H oxidases 4 (NOX4) expression down-regulated. As a result, the toxic lipid peroxidation byproduct 4-hydroxynonenal (4HNE) was reduced in articular cartilage. In IL-1β-stimulated primary rat chondrocytes, which could mimic OA in vitro, SAMC could ameliorate collagen destruction, inhibit inflammation, and maintain redox-homeostasis. Interestingly, after Nrf2 gene knockdown by adenovirus, the protective effect of SAMC in IL-1β-stimulated chondrocytes disappeared. Conclusion Overall, our study demonstrated that SAMC targeted Nrf2 to protect OA both in vivo and in vitro, which would be a new pharmaceutical way for OA therapy.
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Affiliation(s)
- Guang Yang
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, People's Republic of China
| | - Shui Sun
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, People's Republic of China
| | - Jian Wang
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, People's Republic of China
| | - Wei Li
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, People's Republic of China
| | - Xianquan Wang
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, People's Republic of China
| | - Lin Yuan
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, People's Republic of China
| | - Siying Li
- Department of Physiology & Pathophysiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, People's Republic of China
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Mass Spectrometry Imaging as a Potential Tool to Investigate Human Osteoarthritis at the Tissue Level. Int J Mol Sci 2020; 21:ijms21176414. [PMID: 32899238 PMCID: PMC7503948 DOI: 10.3390/ijms21176414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 12/25/2022] Open
Abstract
Osteoarthritis (OA) is the most common degenerative joint disease, predicted to increase in incidence year by year due to an ageing population. Due to the biological complexity of the disease, OA remains highly heterogeneous. Although much work has been undertaken in the past few years, underlying molecular mechanisms leading to joint tissue structural deterioration are not fully understood, with only few validated markers for disease diagnosis and progression being available. Discovery and quantitation of various OA-specific biomarkers is still largely focused on the bodily fluids which does not appear to be reliable and sensitive enough. However, with the advancement of spatial proteomic techniques, several novel peptides and proteins, as well as N-glycans, can be identified and localised in a reliable and sensitive manner. To summarise the important findings from OA biomarker studies, papers published between 2000 and 2020 were searched via Google Scholar and PubMed. Medical subject heading (MeSH) terms ‘osteoarthritis’, ‘biomarker’, ‘synovial fluid’, ‘serum’, ‘urine’, ’matrix-assisted laser desorption/ionisation’, ‘mass spectrometry imaging’, ‘proteomic’, ‘glycomic’, ‘cartilage’, ‘synovium’ AND ‘subchondral bone’ were selectively used. The literature search was restricted to full-text original research articles and written only in English. Two main areas were reviewed for OA biomarker studies: (1) an overview of disease-specific markers detected from different types of OA bio-samples, and (2) an up-to-date summary of the tissue-specific OA studies that have utilised matrix-assisted laser desorption/ionisation mass spectrometry imaging (MALDI-MSI). Overall, these OA biomarkers could provide clinicians with information for better the diagnosis, and prognosis of individual patients, and ultimately help facilitate the development of disease-modifying treatments.
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Bay-Jensen AC, Engstroem A, Sharma N, Karsdal MA. Blood and urinary collagen markers in osteoarthritis: markers of tissue turnover and disease activity. Expert Rev Mol Diagn 2019; 20:57-68. [PMID: 31847627 DOI: 10.1080/14737159.2020.1704257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction: The need for diagnostic markers in osteoarthritis (OA) is acute and immediate, as sensitive and precise tools that monitor disease activity and treatment response are lacking. Collagens - types I, II, and III - are the skeleton of the extracellular matrix of joint tissues. Joint collagens are generally turned over at a low rate, but the balance between formation and degradation is disturbed, leading to the loss of, for example, cartilage.Areas covered: We discuss the markers reflecting collagen turnover and provide examples of how they have been applied in OA research, as well as how we believe these should be used in the future. We have searched PubMed for full-text articles written in English using different combinations of the following terms: OA, biomarker, and collagen. The result is a narrative review that gives examples from the literature.Expert opinion: Collagen markers show promise, as they are direct measures of tissue balance. Until now, collagen markers have mainly been tested in observational cohorts, which may provide insights into the association between the candidate marker and clinical variables; however, these do not advance the development of qualified markers that can be used for drug development or in clinical practice.
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Affiliation(s)
| | - Amalie Engstroem
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, Herlev, Denmark.,Biomedical institute, University of Copenhagen, Copenhagen, Denmark
| | - Neha Sharma
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, Herlev, Denmark.,Biomedical institute, University of Copenhagen, Copenhagen, Denmark
| | - Morten Asser Karsdal
- Department of Rheumatology, Nordic Bioscience, Biomarkers and Research, Herlev, Denmark
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Bauer C, Göçerler H, Niculescu‐Morzsa E, Jeyakumar V, Stotter C, Tóth I, Klestil T, Franek F, Nehrer S. Effect of osteochondral graft orientation in a biotribological test system. J Orthop Res 2019; 37:583-592. [PMID: 30690777 PMCID: PMC6594111 DOI: 10.1002/jor.24236] [Citation(s) in RCA: 4] [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: 03/16/2018] [Accepted: 01/11/2019] [Indexed: 02/04/2023]
Abstract
Autologous osteochondral transplantation (AOT) utilizing autografts is a widely used technique for the treatment of small-to-medium cartilage defects occurring in knee and ankle joints. The application of viable cartilage and bone ensures proper integration, early weight bearing, as well as restoration of biomechanical and biotribological properties. However, alignment of the autografts onto the defect site remains a pivotal aspect of reinstating the properties of the joint toward successful autograft integration. This is the first study to perform tests with different orientations of osteochondral grafts in a cartilage-on-cartilage test system. The objective was to estimate if there are differences between aligned and 90°-rotated grafts concerning molecular biological and biomechanical parameters. Tissue viability, assessed by XTT assay indicated lower metabolic activity in tested osteochondral grafts (aligned, p = 0.0148 and 90°-rotated, p = 0.0760) in favor of a higher anabolic gene expression (aligned, p = 0.0030 and 90°-rotated, 0.0027). Tissue structure was evaluated by Safranin O histology and microscopic images of the surface. Aligned and 90°-rotated grafts revealed no apparent differences between proteoglycan content or cracks and fissures on the cartilage surface. Test medium analyzed after tribological tests for their sulfated glycosaminoglycan content revealed no differences (p = 0.3282). During the tests, both the friction coefficient and the relative displacement between the two cartilage surfaces were measured, with no significant difference in both parameters (COF, p = 0.2232 and relative displacement, p = 0.3185). From the methods we deployed, this study can infer that there are no differences between aligned and 90°-rotated osteochondral grafts after tribological tests in the used ex vivo tissue model. © 2019 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res.
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Affiliation(s)
- Christoph Bauer
- Danube University Krems, Department for Health Sciences, Medicine and ResearchCenter for Regenerative Medicine and OrthopedicsDr.‐Karl‐Dorrek‐Strasse 303500KremsAustria
| | | | - Eugenia Niculescu‐Morzsa
- Danube University Krems, Department for Health Sciences, Medicine and ResearchCenter for Regenerative Medicine and OrthopedicsDr.‐Karl‐Dorrek‐Strasse 303500KremsAustria
| | - Vivek Jeyakumar
- Danube University Krems, Department for Health Sciences, Medicine and ResearchCenter for Regenerative Medicine and OrthopedicsDr.‐Karl‐Dorrek‐Strasse 303500KremsAustria
| | - Christoph Stotter
- Danube University Krems, Department for Health Sciences, Medicine and ResearchCenter for Regenerative Medicine and OrthopedicsDr.‐Karl‐Dorrek‐Strasse 303500KremsAustria,LK Baden‐Mödling‐HainburgDepartment of Orthopedics and TraumatologyBadenAustria
| | | | - Thomas Klestil
- LK Baden‐Mödling‐HainburgDepartment of Orthopedics and TraumatologyBadenAustria,Danube University Krems, Department for Health Sciences, Medicine and ResearchCenter for Health Sciences and MedicineKremsAustria
| | | | - Stefan Nehrer
- Danube University Krems, Department for Health Sciences, Medicine and ResearchCenter for Regenerative Medicine and OrthopedicsDr.‐Karl‐Dorrek‐Strasse 303500KremsAustria
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16
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Peffers MJ, Smagul A, Anderson JR. Proteomic analysis of synovial fluid: current and potential uses to improve clinical outcomes. Expert Rev Proteomics 2019; 16:287-302. [PMID: 30793992 DOI: 10.1080/14789450.2019.1578214] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Synovial fluid (SF) is in close proximity to tissues which are primarily altered during articular disease and has significant potential to better understand the underlying disease pathogeneses of articular pathologies and biomarker discovery. Although development of mass spectrometry-based methods has allowed faster and higher sensitivity techniques, interrogation of the SF proteome has been hindered by its large protein concentration dynamic range, impeding quantification of lower abundant proteins. Areas covered: Recent advances have developed methodologies to reduce the large protein concentration dynamic range of SF and subsequently allow deeper exploration of the SF proteome. This review concentrates on methods to overcome biofluid complexity, mass spectrometry proteomics methodologies, extracellular vesicles proteomics and the application of advances within the field in clinical disease, including osteoarthritis, rheumatoid arthritis, spondyloarthritis and juvenile arthritis. A narrative review was conducted with articles searched using PubMed, 1991-2018. Expert opinion: The SF proteomics field faces various challenges, including the requirement for rigorous and standardised methods of sample collection/storage, the sensitivity and specificity of proteomic assays, techniques to combat the large protein concentration dynamic range and comprehensive data analysis to reduce falsely identified markers. Additionally, there are challenges in developing multi 'omic' integration techniques, with computational integration enhancing analysis.
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Affiliation(s)
- Mandy Jayne Peffers
- a Comparative Musculoskeletal Biology, Institute of Ageing and Chronic Disease , University of Liverpool , Liverpool , UK
| | - Aibek Smagul
- a Comparative Musculoskeletal Biology, Institute of Ageing and Chronic Disease , University of Liverpool , Liverpool , UK
| | - James Ross Anderson
- a Comparative Musculoskeletal Biology, Institute of Ageing and Chronic Disease , University of Liverpool , Liverpool , UK
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17
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Laudon J, Whittaker JL, Ren G, Jaremko JL, Emery CA, Krawetz RJ. Serum cartilage oligomeric matrix protein (COMP) expression in individuals who sustained a youth sport-related intra-articular knee injury 3-10 years previously and uninjured matched controls. Osteoarthritis Cartilage 2019; 27:286-293. [PMID: 30317002 DOI: 10.1016/j.joca.2018.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 09/22/2018] [Accepted: 09/26/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study investigates the relationship between a youth sport-related intra-articular knee injury and cartilage oligomeric matrix protein (COMP), a biomarker of cartilage turnover. DESIGN Participants included a sub-sample (n = 170) of the Alberta Youth Prevention of Early Osteoarthritis (PrE-OA) study group. Specifically, 85 individuals with a 3-10 year history of sport-related intra-articular knee injury and 85 age, sex and sport-matched controls. COMP levels were investigated in serum. Between group differences in COMP levels, COMP fragmentation patterns and, the relationship between serum COMP and clinical outcomes (i.e., Magnetic Resonance Imaging (MRI) Osteoarthritis Knee Score; MOAKS, Knee Osteoarthritis Outcome Score; KOOS, Fat mass index; FMI) were examined. RESULTS Participant median age was 22.3 years (range 16-26) and 63% were female. Although there was no difference in COMP levels between previously injured and uninjured females, previously injured males demonstrated an ∼15% greater (171.5 ng/ml, 95% CI 11.0-428.0, P = 0.04) serum COMP level than uninjured males. However after controlling for FMI, this difference was absent. Within the injured participants, COMP levels were associated with MOAKSSYNOVITIS and FMI. Furthermore, COMP fragmentation patterns were distinct between injured and uninjured individuals. CONCLUSIONS In this study group, serum COMP levels were greater in injured males, but not females, compared to matched controls. However, after controlling for FMI, no differences in COMP were observed. A unique COMP fragmentation pattern was observed in injured vs uninjured participants. These results further the hypothesis that COMP levels and/or degradation of the protein may be a marker of cartilage injury which could predispose to later OA.
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Affiliation(s)
- J Laudon
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.
| | - J L Whittaker
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada; Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada; Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada.
| | - G Ren
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada.
| | - J L Jaremko
- Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - C A Emery
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, Alberta, Canada.
| | - R J Krawetz
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, Alberta, Canada; Department of Cell Biology and Anatomy, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; The D-BOARD European Consortium for Biomarker Discovery, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
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Larsson S, Åkerström B, Gram M, Lohmander LS, Struglics A. α1-Microglobulin Protects Against Bleeding-Induced Oxidative Damage in Knee Arthropathies. Front Physiol 2018; 9:1596. [PMID: 30505280 PMCID: PMC6250851 DOI: 10.3389/fphys.2018.01596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/24/2018] [Indexed: 11/13/2022] Open
Abstract
Knee injury increases the risk of developing knee osteoarthritis (OA). Recent evidence suggests involvement of oxidative stress induced by inflammation and bleeding in the joint. This study investigates the role in this process of α1-microglobulin (A1M), a plasma and tissue antioxidant protein with reducing function, and heme- and radical-binding properties. We studied matched knee synovial fluid (sf) and serum (s) samples from 122 subjects (mean age 40 years, 31% females): 10 were knee healthy references, 13 had acute inflammatory arthritis (AIA), 79 knee injury 0–10 years prior to sampling, and 20 knee OA. Using immunoassays, we measured sf-A1M and s-A1M, sf-hemoglobin (sf-Hb), sf-total free heme (sf-Heme), and sf-carbonyl groups (sf-Carbonyl). We explored associations by partial correlation, or linear regression models with adjustments for age, sex and diagnosis, and evaluated diagnostic capacity by area under the receiver operator characteristics curve (AUC). The AIA group had 1.2- to 1.7-fold higher sf-A1M and s-A1M concentrations compared to the other diagnostic groups; other biomarkers showed no between-group differences. sf-A1M and s-A1M were with AUC of 0.76 and 0.78, respectively, diagnostic for AIA. In the injury group, the amount of bleeding in the joint was inversely correlated to time after injury when measured as sf-Heme (r = -0.41, p < 0.001), but not when measured as sf-Hb (r = -0.19, p = 0.098). A similar inverse association with time after injury was noted for sf-A1M (r = -0.30, p = 0.007), but not for s-A1M and sf-Carbonyl. Linear regression models showed that sf-Heme was more strongly associated with sf-A1M and sf-Carbonyl than sf-Hb. Independent of diagnosis, sf-Heme explained 5.7% of the variability in sf-A1M and 3.0% in the variability in sf-Carbonyl, but appeared unrelated to s-A1M. High sf-A1M and low sf-Heme or sf-Hb were independently associated with low sf-Carbonyl. In conclusion, our results demonstrate that independent of disease, Hb and heme within a knee joint correlates with an increased sf-A1M concentration that appears to be protective of oxidative damage, i.e., a reduction in carbonyl groups. High concentrations of A1M in synovial fluid and serum was further diagnostic for AIA.
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Affiliation(s)
- Staffan Larsson
- Department of Clinical Sciences Lund, Orthopaedics, Faculty of Medicine, Lund University, Lund, Sweden
- *Correspondence: Staffan Larsson,
| | - Bo Åkerström
- Department of Clinical Sciences Lund, Infection Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - Magnus Gram
- Department of Clinical Sciences Lund, Infection Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - L. Stefan Lohmander
- Department of Clinical Sciences Lund, Orthopaedics, Faculty of Medicine, Lund University, Lund, Sweden
| | - André Struglics
- Department of Clinical Sciences Lund, Orthopaedics, Faculty of Medicine, Lund University, Lund, Sweden
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19
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Huang X, Post JN, Zhong L, Leijten J, Larsson S, Karperien M, Struglics A. Dickkopf-related protein 1 and gremlin 1 show different response than frizzled-related protein in human synovial fluid following knee injury and in patients with osteoarthritis. Osteoarthritis Cartilage 2018. [PMID: 29526783 DOI: 10.1016/j.joca.2018.02.904] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To explore the involvement of the wingless-type MMTV integration site (WNT) and bone morphogenetic protein (BMP) antagonists dickkopf-related protein 1 (DKK1), frizzled-related protein (FRZB) and gremlin 1 (GREM1) in knee injury and osteoarthritis (OA). DESIGN The antagonists were immunoassayed in synovial fluid from a cross-sectional cohort of nine knee healthy reference subjects, patients with recent (0-77 days, n = 158) or old (1-37 years, n = 50) knee injuries, and OA (n = 22). Cartilage (ARGS-aggrecan, cartilage oligomeric matrix protein and C2C type II collagen) and other biomarkers were assessed in synovial fluid in a subset of samples. Statistical analysis was by Kendall's tau (τ) correlation, Mann-Whitney U test, and linear regression analysis. RESULTS Compared to references, median concentration of GREM1 (but not DKK1 and FRZB) was elevated 1.5-fold immediately after injury, and FRZB was reduced 1000-folds in OA. All three antagonists decreased with increasing time after injury as well as with increasing age, but the temporal change after injury was less accentuated for FRZB (peaked 8-22 days after injury) compared to that of DKK1 and GREM1 (peaked immediately after injury). In the recent injury group, there was a correlation between GREM1 and DKK1 (τ = 0.172); FRZB concentrations correlated with concentrations of cartilage biomarkers (τ between 0.257 and 0.369), while DKK1 and GREM1 were inversely correlated (τ between -0.177 and -0.217) with these markers. CONCLUSIONS Our results indicate separate roles for the antagonists, where DKK1 and GREM1 had similarities in response to injury and in OA, with a different response for FRZB.
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Affiliation(s)
- X Huang
- Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - J N Post
- Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - L Zhong
- Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - J Leijten
- Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - S Larsson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Lund, Sweden.
| | - M Karperien
- Department of Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - A Struglics
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Lund, Sweden.
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20
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Davis HC, Spang JT, Loeser RF, Larsson S, Ulici V, Blackburn JT, Creighton RA, Kamath GM, Jordan JM, Marshall SW, Pietrosimone B. Time between anterior cruciate ligament injury and reconstruction and cartilage metabolism six-months following reconstruction. Knee 2018; 25. [PMID: 29525545 PMCID: PMC5886724 DOI: 10.1016/j.knee.2018.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND To determine the association between time from injury to ACL reconstruction (TimeInjury-ACLR) and biochemical markers of cartilage metabolism and inflammation six months following ACL reconstruction (ACLR). METHODS Individuals with a unilateral ACL injury were enrolled at initial presentation in the orthopedic clinic; blood was collected six months following ACLR. Enzyme-linked immunosorbent assays were used to analyze the ratio of serum concentrations of type-II collagen breakdown (C2C) to synthesis (CPII), plasma matrix metalloproteinase-3 (MMP-3), interleukin-6 (IL-6), and serum aggrecan neoepitope (ARGS). We used separate linear regressions to assess associations between biochemical markers and TimeInjury-ACLR. RESULTS Twenty-two participants (50% females, mean [SD], age 21.9 [4.5] years old; BMI 23.8 [2.6] kg/m2) completed the study. TimeInjury-ACLR ranged from nine to 67days (31.0 [14.4days]). Greater TimeInjury-ACLR predicted greater serum C2C:CPII ratios six months following ACLR (C2C:CPII=0.15 [0.02], R2=0.213, P=0.030). Males (R2=0.733, P=0.001) but not females (R2=0.030, P=0.609) demonstrated a significant association between greater C2C:CPII and TimeInjury-ACLR at the six-month follow-up exam. TimeInjury-ACLR did not associate with IL-6, MMP-3, or ARGS at six months. CONCLUSIONS Greater time between injury and ACL reconstruction was associated with greater serum C2C:CPII six months following ACLR in males but not females, and IL-6, MMP-3, and ARGS levels were not associated with TimeInjury-ACLR in males or females. The time between ACL injury and ACLR may affect collagen metabolism in males and should be further investigated in a larger study along with other patient-relevant outcomes.
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Affiliation(s)
- Hope C. Davis
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Jeffery T. Spang
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, North Carolina, United States
| | - Richard F. Loeser
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Staffan Larsson
- Lund University, Department of Clinical Sciences, Orthopaedics, Lund, Sweden
| | - Veronica Ulici
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, North Carolina, United States
| | - J. Troy Blackburn
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill North Carolina, United States
| | - R. Alexander Creighton
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, North Carolina, United States
| | - Ganesh M Kamath
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, North Carolina, United States
| | - Joanne M. Jordan
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Stephen W. Marshall
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, North Carolina, United States
| | - Brian Pietrosimone
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill North Carolina, United States
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21
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Sieker JT, Proffen BL, Waller KA, Chin KE, Karamchedu NP, Akelman MR, Perrone GS, Kiapour AM, Konrad J, Fleming BC, Murray MM. Transcriptional profiling of synovium in a porcine model of early post-traumatic osteoarthritis. J Orthop Res 2018; 36:10.1002/jor.23876. [PMID: 29460983 PMCID: PMC6102098 DOI: 10.1002/jor.23876] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 02/15/2018] [Indexed: 02/04/2023]
Abstract
To determine the transcriptional profile of synovium during the molecular phase of post-traumatic osteoarthritis, anterior cruciate ligament transections (ACL) were performed in 36 Yucatan minipigs. Equal numbers were randomly assigned to no further treatment, ACL reconstruction or repair. Perimeniscal synovium for histopathology and RNA-sequencing was harvested at 1 and 4 weeks post-operatively and from six healthy control animals. Microscopic synovitis scores significantly worsened at 1 (p < 0.001) and 4 weeks (p = 0.003) post-surgery relative to controls, and were driven by intimal hyperplasia and increased stromal cellularity without inflammatory infiltrates. Synovitis scores were similar between no treatment, reconstruction, and repair groups (p ≥ 0.668). Relative to no treatment at 1 week, 88 and 367 genes were differentially expressed in the reconstruction and repair groups, respectively (227 and 277 at 4 weeks). Relative to controls and with the treatment groups pooled, 1,683 transcripts were concordantly differentially expressed throughout the post-surgery time-course. Affected pathways included, proteolysis_connective tissue degradation (including upregulations of protease-encoding MMP1, MMP13, and ADAMTS4), and development_cartilage development (including upregulations of ACAN, SOX9, and RUNX2), among others. Using linear regression, significant associations of post-surgery synovial expression levels of 20 genes with the articular cartilage glycosaminoglycan loss were identified. These genes were predominantly related to embryonic skeletal system development and included RUNX2. In conclusion, this study confirmed an increased synovial expression of genes that may serve as targets to prevent cartilage degradation, including MMP1, MMP13, and ADAMTS4, in knees with microscopic synovitis and cartilage proteoglycan loss. Attractive novel targets include regulators of embryonic developmental processes in synovium. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
- Jakob T. Sieker
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | | | - Kimberly A. Waller
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Kaitlyn E. Chin
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | | | - Matthew R. Akelman
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | | | - Ata M. Kiapour
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Johannes Konrad
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Braden C. Fleming
- Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
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22
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Protective Effects of Garlic-Derived S-Allylmercaptocysteine on IL-1 β-Stimulated Chondrocytes by Regulation of MMPs/TIMP-1 Ratio and Type II Collagen Expression via Suppression of NF- κB Pathway. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8686207. [PMID: 29333456 PMCID: PMC5733130 DOI: 10.1155/2017/8686207] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/16/2017] [Accepted: 10/25/2017] [Indexed: 11/24/2022]
Abstract
Background Garlic-derived S-allylmercaptocysteine (SAMC) has widely been used in many disease therapies. However, the potential effects and mechanism of SAMC on IL-1β-stimulated chondrocytes are unclear. Methods Chondrocytes were isolated, and 5 ng/mL of IL-1β was added to mimic the in vitro osteoarthritis (OA) model. SAMC (20 and 60 μM) was used for the treatment in OA model. Cell viability was assessed by MTT method. Western blotting, Quantitative RT-PCR, and ELISA were performed to evaluate the mechanisms in SAMC treated OA model. Results Following 48 h of IL-1β exposure, SAMC exhibited protection effect on IL-1β-injured chondrocyte viability. Type II collagen was elevated with reduced degradation products, as a consequence of altered MMPs/TIMP-1 ratio after SAMC treatment in IL-1β-treated chondrocytes. The protein and mRNA level of TNF-α in cellular supernatant and cells were downregulated in a dose-dependent manner. Besides, IκBα in cytoplasmic fraction was increased, while p65 level in nuclear fraction was decreased after SAMC treatment in OA. Conclusions This study showed that SAMC may play a protective role in IL-1β induced osteoarthritis (OA) model. This effect may be through inhibiting the NF-κB signaling pathway, therefore altering the MMPs/TIMP-1 ratio change which induced type II collagen destruction and decreasing inflammatory cytokine secretion such as TNF-α.
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Pietrosimone B, Troy Blackburn J, Harkey MS, Luc BA, Hackney AC, Padua DA, Driban JB, Spang JT, Jordan JM. Walking Speed As a Potential Indicator of Cartilage Breakdown Following Anterior Cruciate Ligament Reconstruction. Arthritis Care Res (Hoboken) 2017; 68:793-800. [PMID: 26502367 DOI: 10.1002/acr.22773] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 09/28/2015] [Accepted: 10/20/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine whether or not self-selected walking speed associates with serum biomarkers of cartilage (collagen and proteoglycan) breakdown in anterior cruciate ligament reconstructed (ACLR) individuals. METHODS Twenty individuals with a history of a primary unilateral ACLR participated in this cross-sectional study. Resting blood was collected from each participant prior to completing 5 walking gait trials at a self-selected comfortable speed. Walking speed was evaluated in a 3-dimensional motion capture laboratory and determined from the velocity of the pelvic center of mass. Sera were assessed for collagen type II cleavage product (C2C) and proteoglycan (aggrecan) concentrations using commercially available specific enzyme-linked immunosorbent assays. Pearson's product-moment (r) and Spearman's (ρ) correlations were used to evaluate associations between walking speed and biomarkers of cartilage breakdown metabolism. Partial correlations were used to determine whether covariates influenced associations between walking speed and biomarkers of cartilage breakdown. RESULTS ACLR individuals with a slower walking speed demonstrated higher concentrations of serum C2C (r = -0.52, P = 0.02), while there was no significant association between walking speed and aggrecan concentrations (ρ = -0.29, P = 0.31). After accounting for the variance associated with stance phase duration, ACLR individuals with a slower walking speed still demonstrated greater serum C2C concentrations (partial r = -0.53, P = 0.02). CONCLUSION ACLR individuals who habitually walk slower may experience a greater degree of collagen breakdown, suggesting that walking speed may be a future useful clinical indicator for identifying individuals with higher levels of cartilage breakdown and preradiographic osteoarthritic joint changes.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Joanne M Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
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24
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Coculture of bovine cartilage with synovium and fibrous joint capsule increases aggrecanase and matrix metalloproteinase activity. Arthritis Res Ther 2017; 19:157. [PMID: 28679445 PMCID: PMC5498889 DOI: 10.1186/s13075-017-1318-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 05/05/2017] [Indexed: 02/02/2023] Open
Abstract
Background A hallmark of osteoarthritis is increased proteolytic cleavage of aggrecan. Cross talk between cartilage and the synovium + joint capsule (SJC) can drive cartilage degradation by activating proteases in both tissues. We investigated aggrecan proteolysis patterns in cartilage explants using a physiologically relevant explant model of joint injury combining cartilage mechanical compression and coincubation with SJC. Methods Bovine cartilage explants were untreated; coincubated with SJC; or subjected to mechanical injury and coincubated with SJC, mechanical injury alone, or mechanical injury and incubated with tumor necrosis factor-α (TNF-α). To compare the patterns of aggrecan proteolysis between 6 h and 16 days, release of sulfated glycosaminoglycans and specific proteolytic aggrecan fragments into medium or remaining in cartilage explants was measured by dimethylmethylene blue and Western blot analysis. Results Aggrecanase activity toward aggrecan was observed in all conditions, but it was directed toward the TEGE↓ARGS interglobular domain (IGD) site only when cartilage was coincubated with SJC or TNF-α. Matrix metalloproteinase (MMP) activity at the aggrecan IGD site (IPES↓FFGV) was not detected when cartilage was exposed to TNF-α (up to 6 days), but it was in all other conditions. Compared with when bovine cartilage was left untreated or subjected to mechanical injury alone, additional aggrecan fragment types were released into medium and proteolysis of aggrecan started at an earlier time when SJC was present. Conclusions Indicative of different proteolytic pathways for aggrecan degradation, the SJC increases both aggrecanase and MMP activity toward aggrecan, whereas TNF-α inhibits MMP activity against the IGD of aggrecan. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1318-9) contains supplementary material, which is available to authorized users.
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25
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Review of Prospects of Biological Fluid Biomarkers in Osteoarthritis. Int J Mol Sci 2017; 18:ijms18030601. [PMID: 28287489 PMCID: PMC5372617 DOI: 10.3390/ijms18030601] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/26/2017] [Accepted: 03/06/2017] [Indexed: 12/14/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative disease of the joints and is one of the leading causes of disability in adults. However, there are no key therapeutics for OA and medical treatment is based on managing the symptoms and slowing down progression of the disease. Diagnostics based on clinical examination and radiography have provided little information about metabolic changes in joint tissues, disease onset and progression. Due to lack of effective methods for early detection and evaluation of treatment outcome, the measurement of biochemical markers (biomarkers) shows promise as a prospective method aiding in disease monitoring. OA biomarkers that are present in biological fluids such as blood, urine and synovial fluid, sources that are easily isolated from body, are of particular interest. Moreover, there are increasingly more studies identifying and developing new biomarkers for OA. In this review, efforts have been made to summarize the biomarkers that have been reported in recent studies on patients. We also tried to classify biomarkers according to tissue metabolism (bone, cartilage and synovial metabolism markers), pathological pathways (inflammatory and genetic markers) and biological function (chemokines, growth factors, acute phase proteins, etc.).
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26
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Boeth H, MacMahon A, Poole AR, Buttgereit F, Önnerfjord P, Lorenzo P, Klint C, Pramhed A, Duda GN. Differences in biomarkers of cartilage matrix turnover and their changes over 2 years in adolescent and adult volleyball athletes. J Exp Orthop 2017; 4:7. [PMID: 28229430 PMCID: PMC5321644 DOI: 10.1186/s40634-017-0081-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed the feasibility to assess longitudinal changes in biomarkers of cartilage turnover and to determine their relationship with patient-rated outcomes over 2 years in volleyball athletes. METHODS Thirty-seven athletes were studied: 18 adolescents (age 15.9 ± 0.64 years) in a 2-year intensive volleyball training program and 19 adult recreational volleyball players (age 46.5 ± 4.9 years). Blood and serum samples were taken at baseline (BL) and 2-year follow-up (FU). Subjects completed the International Knee Documentation Committee (IKDC) Subjective Knee Form and the Short-Form 36 (SF-36) at BL. RESULTS Thirteen adolescents (72%) had open growth plates at BL (BL open adolescents), the rest had closed growth plates at BL (BL closed adolescents), and all but one adolescent had closed growth plates at FU as assessed by MRI. BL open and closed adolescents had greater levels of the cartilage degradation-based biomarkers 45 mer collagenase peptide of type II collagen (C2C-HUSA) and C-telopeptide of type II collagen (CTX-II) than adults. BL open adolescents showed decreases in C2CHUSA, collagen synthesis marker C-propeptide of type II procollagen (CPII), and CTXII, and adults showed increases in cartilage intermediate layer protein 2 (CILP-2) and C2C-HUSA. In adolescents, IKDC scores were correlated with CPII changes. In adults, SF-36 Physical Component Scores were correlated with cartilage oligomeric matrix protein (COMP) changes. CONCLUSION Significant differences in biomarker levels over time show the feasibility to assess their changes. Greater levels of C2C-HUSA and CTX-II in adolescents than in adults may reflect increased cartilage turnover in response to higher joint loading. CPII and COMP may be more reflective of subjective patient outcomes. These biomarkers may thus be useful in assessing mechanical loading-induced cartilage changes, their associated symptoms, and Osteoarthritis risk in athletes.
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Affiliation(s)
- Heide Boeth
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Aoife MacMahon
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Robin Poole
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Buttgereit
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Patrik Önnerfjord
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Pilar Lorenzo
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Cecilia Klint
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Pramhed
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
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27
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Liu B, Goode AP, Carter TE, Utturkar GM, Huebner JL, Taylor DC, Moorman CT, Garrett WE, Kraus VB, Guilak F, DeFrate LE, McNulty AL. Matrix metalloproteinase activity and prostaglandin E2 are elevated in the synovial fluid of meniscus tear patients. Connect Tissue Res 2017; 58:305-316. [PMID: 27813662 PMCID: PMC5418110 DOI: 10.1080/03008207.2016.1256391] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Meniscus tears are a common knee injury and are associated with the development of post-traumatic osteoarthritis (OA). The purpose of this study is to evaluate potential OA mediators in the synovial fluid and serum of meniscus tear subjects compared to those in the synovial fluid of radiographic non-OA control knees. MATERIALS AND METHODS Sixteen subjects with an isolated unilateral meniscus injury and six subjects who served as reference controls (knee Kellgren-Lawrence grade 0-1) were recruited. Twenty-one biomarkers were measured in serum from meniscus tear subjects and in synovial fluid from both groups. Meniscus tear subjects were further stratified by tear type to assess differences in biomarker levels. RESULTS Synovial fluid total matrix metalloproteinase (MMP) activity and prostaglandin E2 (PGE2) were increased 25-fold and 290-fold, respectively, in meniscus tear subjects as compared to reference controls (p < 0.05). Synovial fluid MMP activity and PGE2 concentrations were positively correlated in meniscus tear subjects (R = 0.83, p < 0.0001). In meniscus tear subjects, synovial fluid levels of MMP activity, MMP-2, MMP-3, sGAG, COMP, IL-6, and PGE2 were higher than serum levels (p < 0.05). Subjects with complex meniscus tears had higher synovial fluid MMP-10 (p < 0.05) and reduced serum TNFα and IL-8 (p < 0.05) compared to other tear types. CONCLUSIONS Given the degradative and pro-inflammatory roles of MMP activity and PGE2, these molecules may alter the biochemical environment of the joint. Our findings suggest that modulation of PGE2 signaling, MMP activity, or both following a meniscus injury may be targets to promote meniscus repair and prevent OA development.
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Affiliation(s)
- Betty Liu
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA,Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Adam P. Goode
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA,Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Teralyn E. Carter
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Gangadhar M. Utturkar
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Janet L. Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Dean C. Taylor
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Claude T. Moorman
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - William E. Garrett
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Virginia B. Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Washington University and Shriners Hospitals for Children – St. Louis, St. Louis, Missouri, USA
| | - Louis E. DeFrate
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA,Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Amy L. McNulty
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA,Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
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28
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Trevino RL, Stoia J, Laurent MP, Pacione CA, Chubinskaya S, Wimmer MA. ESTABLISHING A LIVE CARTILAGE-ON-CARTILAGE INTERFACE FOR TRIBOLOGICAL TESTING. ACTA ACUST UNITED AC 2016; 9:1-11. [PMID: 29242820 DOI: 10.1016/j.biotri.2016.11.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Mechano-biochemical wear encompasses the tribological interplay between biological and mechanical mechanisms responsible for cartilage wear and degradation. The aim of this study was to develop and start validating a novel tribological testing system, which better resembles the natural joint environment through incorporating a live cartilage-on-cartilage articulating interface, joint specific kinematics, and the application of controlled mechanical stimuli for the measurement of biological responses in order to study the mechano-biochemical wear of cartilage. The study entailed two parts. In Part 1, the novel testing rig was used to compare two bearing systems: (a) cartilage articulating against cartilage (CoC) and (b) metal articulating against cartilage (MoC). The clinically relevant MoC, which is also a common tribological interface for evaluating cartilage wear, should produce more wear to agree with clinical observations. In Part II, the novel testing system was used to determine how wear is affected by tissue viability in live and dead CoC articulations. For both parts, bovine cartilage explants were harvested and tribologically tested for three consecutive days. Wear was defined as release of glycosaminoglycans into the media and as evaluation of the tissue structure. For Part I, we found that the live CoC articulation did not cause damage to the cartilage, to the extent of being comparable to the free swelling controls, whereas the MoC articulation caused decreased cell viability, extracellular matrix disruption, and increased wear when compared to CoC, and consistent with clinical data. These results provided confidence that this novel testing system will be adequate to screen new biomaterials for articulation against cartilage, such as in hemiarthroplasty. For Part II, the live and dead cartilage articulation yielded similar wear as determined by the release of proteoglycans and aggrecan fragments, suggesting that keeping the cartilage alive may not be essential for short term wear tests. However, the biosynthesis of glycosaminoglycans was significantly higher due to live CoC articulation than due to the corresponding live free swelling controls, indicating that articulation stimulated cell activity. Moving forward, the cell response to mechanical stimuli and the underlying mechano-biochemical wear mechanisms need to be further studied for a complete picture of tissue degradation.
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Affiliation(s)
- Robert L Trevino
- Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, IL
| | - Jonathan Stoia
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Michel P Laurent
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Carol A Pacione
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
| | - Susan Chubinskaya
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.,Department of Pediatrics, Rush University Medical Center, Chicago, IL
| | - Markus A Wimmer
- Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, IL.,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL
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29
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Struglics A, Okroj M, Swärd P, Frobell R, Saxne T, Lohmander LS, Blom AM. The complement system is activated in synovial fluid from subjects with knee injury and from patients with osteoarthritis. Arthritis Res Ther 2016; 18:223. [PMID: 27716448 PMCID: PMC5052889 DOI: 10.1186/s13075-016-1123-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/16/2016] [Indexed: 01/13/2023] Open
Abstract
Background The complement system is suggested to be involved in the pathogenesis of osteoarthritis (OA), and proinflammatory cytokines may play a role in OA development by inducing proteases. The association between complement factors, cytokines and OA has not been investigated. The aim of the present study was to explore the involvement of the complement system after knee trauma and in OA. Methods C4d, C3bBbP and soluble terminal complement complex (sTCC) resulting from complement activation were immunoassayed in synovial fluid from subjects with healthy knees (reference), OA, rheumatoid arthritis (RA; positive control), pyrophosphate arthritis (PPA; positive control) and knee injury; other biomarkers were previously assessed. Magnetic resonance imaging was used to assess joint injuries. Results Compared with levels in the reference group, the median concentrations of C4d, C3bBbP and sTCC in the OA, RA, PPA and knee injury groups were 2- to 34-fold increased (p < 0.001 to p = 0.044). For the knee injury group, the median concentrations of C4d, C3bBbP and sTCC were 5- to 12-fold increased (p < 0.001) at the day of injury; after 3–12 weeks, C3bBbP and sTCC concentrations were similar to reference levels; and C4d was still increased several years after injury. In the 0–12 weeks period after injury, the concentrations of C4d, C3bBbP and sTCC correlated positively with levels of interleukin (IL)-1β, IL-6 and tumour necrosis factor α (rs range 0.232–0.547); none of the measured complement factors correlated with proteolytic fragments of aggrecan or cartilage oligomeric matrix protein. Knees with osteochondral fracture, with or without disrupted cortical bone, had higher concentrations of C4d (p = 0.014, p = 0.004) and sTCC (p = 0.004, p < 0.001) compared with knees without fractures. Conclusions The complement system is activated in OA and after knee injury. Following knee injury, this activation is instant and associated with inflammation as well as with the presence of osteochondral fractures. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1123-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- André Struglics
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Faculty of Medicine, BMC C12, SE-221 84, Lund, Sweden.
| | - Marcin Okroj
- Department of Translational Medicine, Division of Medical Protein Chemistry, Lund University, Faculty of Medicine, Lund, Sweden.,Department of Medical Biotechnology, Intercollegiate Faculty of Biotechnology UG-MUG, Medical University of Gdańsk, Gdańsk, Poland
| | - Per Swärd
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Faculty of Medicine, BMC C12, SE-221 84, Lund, Sweden
| | - Richard Frobell
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Faculty of Medicine, BMC C12, SE-221 84, Lund, Sweden
| | - Tore Saxne
- Department of Clinical Sciences Lund, Rheumatology, Lund University, Faculty of Medicine, Lund, Sweden
| | - L Stefan Lohmander
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Faculty of Medicine, BMC C12, SE-221 84, Lund, Sweden
| | - Anna M Blom
- Department of Translational Medicine, Division of Medical Protein Chemistry, Lund University, Faculty of Medicine, Lund, Sweden
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30
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Chmielewski TL, George SZ, Tillman SM, Moser MW, Lentz TA, Indelicato PA, Trumble TN, Shuster JJ, Cicuttini FM, Leeuwenburgh C. Low- Versus High-Intensity Plyometric Exercise During Rehabilitation After Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2016; 44:609-17. [PMID: 26797700 DOI: 10.1177/0363546515620583] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Plyometric exercise is used during rehabilitation after anterior cruciate ligament (ACL) reconstruction to facilitate the return to sports participation. However, clinical outcomes have not been examined, and high loads on the lower extremity could be detrimental to knee articular cartilage. PURPOSE To compare the immediate effect of low- and high-intensity plyometric exercise during rehabilitation after ACL reconstruction on knee function, articular cartilage metabolism, and other clinically relevant measures. STUDY DESIGN Randomized controlled trial; Level of evidence, 2. METHODS Twenty-four patients who underwent unilateral ACL reconstruction (mean, 14.3 weeks after surgery; range, 12.1-17.7 weeks) were assigned to 8 weeks (16 visits) of low- or high-intensity plyometric exercise consisting of running, jumping, and agility activities. Groups were distinguished by the expected magnitude of vertical ground-reaction forces. Testing was conducted before and after the intervention. Primary outcomes were self-reported knee function (International Knee Documentation Committee [IKDC] subjective knee form) and a biomarker of articular cartilage degradation (urine concentrations of crosslinked C-telopeptide fragments of type II collagen [uCTX-II]). Secondary outcomes included additional biomarkers of articular cartilage metabolism (urinary concentrations of the neoepitope of type II collagen cleavage at the C-terminal three-quarter-length fragment [uC2C], serum concentrations of the C-terminal propeptide of newly formed type II collagen [sCPII]) and inflammation (tumor necrosis factor-α), functional performance (maximal vertical jump and single-legged hop), knee impairments (anterior knee laxity, average knee pain intensity, normalized quadriceps strength, quadriceps symmetry index), and psychosocial status (kinesiophobia, knee activity self-efficacy, pain catastrophizing). The change in each measure was compared between groups. Values before and after the intervention were compared with the groups combined. RESULTS The groups did not significantly differ in the change of any primary or secondary outcome measure. Of interest, sCPII concentrations tended to change in opposite directions (mean ± SD: low-intensity group, 28.7 ± 185.5 ng/mL; high-intensity group, -200.6 ± 255.0 ng/mL; P = .097; Cohen d = 1.03). Across groups, significant changes after the intervention were increased the IKDC score, vertical jump height, normalized quadriceps strength, quadriceps symmetry index, and knee activity self-efficacy and decreased average knee pain intensity. CONCLUSION No significant differences were detected between the low- and high-intensity plyometric exercise groups. Across both groups, plyometric exercise induced positive changes in knee function, knee impairments, and psychosocial status that would support the return to sports participation after ACL reconstruction. The effect of plyometric exercise intensity on articular cartilage requires further evaluation. REGISTRATION NUMBER Clinicaltrials.gov NCT01851655.
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Affiliation(s)
- Terese L Chmielewski
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA TRIA Orthopaedic Center, Bloomington, Minnesota, USA
| | - Steven Z George
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Susan M Tillman
- UF Health Rehab Center at the Orthopaedics and Sports Medicine Institute, Gainesville, Florida, USA
| | - Michael W Moser
- Department of Orthopaedics & Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Trevor A Lentz
- UF Health Rehab Center at the Orthopaedics and Sports Medicine Institute, Gainesville, Florida, USA
| | - Peter A Indelicato
- Department of Orthopaedics & Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Troy N Trumble
- Veterinary Population Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jonathan J Shuster
- Department of Health Outcomes and Policy, University of Florida, Gainesville, Florida, USA
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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31
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Vilar JM, Rubio M, Spinella G, Cuervo B, Sopena J, Cugat R, Garcia-Balletbó M, Dominguez JM, Granados M, Tvarijonaviciute A, Ceron JJ, Carrillo JM. Serum Collagen Type II Cleavage Epitope and Serum Hyaluronic Acid as Biomarkers for Treatment Monitoring of Dogs with Hip Osteoarthritis. PLoS One 2016; 11:e0149472. [PMID: 26886592 PMCID: PMC4757546 DOI: 10.1371/journal.pone.0149472] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/31/2016] [Indexed: 01/10/2023] Open
Abstract
The aim of this study was to evaluate the use of serum type II collagen cleavage epitope and serum hyaluronic acid as biomarkers for treatment monitoring in osteoarthritic dogs. For this purpose, a treatment model based on mesenchymal stem cells derived from adipose tissue combined with plasma rich in growth factors was used. This clinical study included 10 dogs with hip osteoarthritis. Both analytes were measured in serum at baseline, just before applying the treatment, and 1, 3, and 6 months after treatment. These results were compared with those obtained from force plate analysis using the same animals during the same study period. Levels of type II collagen cleavage epitope decreased and those of hyaluronic acid increased with clinical improvement objectively verified via force plate analysis, suggesting these two biomarkers could be effective as indicators of clinical development of joint disease in dogs.
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Affiliation(s)
- José M. Vilar
- Departamento de Patología Animal, Universidad de las Palmas de Gran Canaria, Arucas, Las Palmas, Spain
- * E-mail:
| | - Mónica Rubio
- Departamento Medicina y Cirugía Animal, Cátedra García Cugat, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - Giuseppe Spinella
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - Belén Cuervo
- Departamento Medicina y Cirugía Animal, Cátedra García Cugat, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - Joaquín Sopena
- Departamento Medicina y Cirugía Animal, Cátedra García Cugat, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - Ramón Cugat
- Artroscopia GC, Hospital Quirón, Barcelona, Spain
| | | | - Juan M. Dominguez
- Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain
| | - Maria Granados
- Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain
| | | | - José J. Ceron
- Departamento de Medicina y cirugía animal, Universidad de Murcia, Murcia, Spain
| | - José M. Carrillo
- Departamento Medicina y Cirugía Animal, Cátedra García Cugat, Universidad CEU Cardenal Herrera, Valencia, Spain
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32
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Bay-Jensen AC, Reker D, Kjelgaard-Petersen CF, Mobasheri A, Karsdal MA, Ladel C, Henrotin Y, Thudium CS. Osteoarthritis year in review 2015: soluble biomarkers and the BIPED criteria. Osteoarthritis Cartilage 2016; 24:9-20. [PMID: 26707988 DOI: 10.1016/j.joca.2015.10.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/16/2015] [Accepted: 10/21/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To review and summarize biomarker data published from April 2014 to May 2015 to provide insight to the ongoing work in the field of osteoarthritis (OA). Furthermore, to summarize the BIPED criteria and set it in context of the medical needs of 2015. METHODS PubMed was used as searching machine: Time period 2014/04/01-2015/05/01, MeSH term [Biomarker] AND [Osteoarthritis], Language; English, Full text available. Reviews were excluded. Only papers describing protein based biomarkers measured in human body fluids from OA patients were included. RESULTS Biomarkers of joint tissue turnover, cytokines, chemokines and peptide arrays were measured in different cohorts and studies. Amongst those were previously tested biomarkers such as osteocalcin, Carboxy-terminal cross-linked fragment of type II collagen (CTX-II) and cartilage oligomeric matrix protein (COMP). A majority of the biomarker were classified as I, B or B biomarkers according to the BIPED criteria. Work is continuing on testing biomarkers in OA. There is still a huge, unmet medical need to identify, test, validate and qualify novel and well-known biomarkers. A pre-requisite for this is better characterization and classification of biomarkers to their needs, which may not be reached before higher understanding of OA phenotypes has been gained. In addition, we provide some references to some recent guidelines from Food and Drug Administration (FDA) and European Medicines Agency (EMA) on qualification and usage of biomarkers for drug development and personalized medicine, which may provide value to the field.
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Affiliation(s)
- A C Bay-Jensen
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark.
| | - D Reker
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | | | - A Mobasheri
- Faculty of Health and Medical Sciences, University of Surrey, United Kingdom; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Arthritis Research UK Pain Centre, Medical Research Council and Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, United Kingdom; Center of Excellence in Genomic Medicine Research (CEGMR), King Fahd Medical Research Center (KFMRC), King AbdulAziz University, Jeddah, Saudi Arabia
| | - M A Karsdal
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
| | - C Ladel
- OA Research & Early Clinical Development, Merck KGaA, Darmstadt, Germany
| | - Y Henrotin
- Bone and Cartilage Research Unit, Arthropole Liège, University of Liège, Institute of Pathology, Liège, Belgium
| | - C S Thudium
- Rheumatology, Biomarkers and Research, Nordic Bioscience, Herlev, Denmark
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