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Yuan Z, Jiang D, Yang M, Tao J, Hu X, Yang X, Zeng Y. Emerging Roles of Macrophage Polarization in Osteoarthritis: Mechanisms and Therapeutic Strategies. Orthop Surg 2024; 16:532-550. [PMID: 38296798 PMCID: PMC10925521 DOI: 10.1111/os.13993] [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: 10/11/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 02/02/2024] Open
Abstract
Osteoarthritis (OA) is the most common chronic degenerative joint disease in middle-aged and elderly people, characterized by joint pain and dysfunction. Macrophages are key players in OA pathology, and their activation state has been studied extensively. Various studies have suggested that macrophages might respond to stimuli in their microenvironment by changing their phenotypes to pro-inflammatory or anti-inflammatory phenotypes, which is called macrophage polarization. Macrophages accumulate and become polarized (M1 or M2) in many tissues, such as synovium, adipose tissue, bone marrow, and bone mesenchymal tissues in joints, while resident macrophages as well as other stromal cells, including fibroblasts, chondrocytes, and osteoblasts, form the joint and function as an integrated unit. In this study, we focus exclusively on synovial macrophages, adipose tissue macrophages, and osteoclasts, to investigate their roles in the development of OA. We review recent key findings related to macrophage polarization and OA, including pathogenesis, molecular pathways, and therapeutics. We summarize several signaling pathways in macrophage reprogramming related to OA, including NF-κB, MAPK, TGF-β, JAK/STAT, PI3K/Akt/mTOR, and NLRP3. Of note, despite the increasing availability of treatments for osteoarthritis, like intra-articular injections, surgery, and cellular therapy, the demand for more effective clinical therapies has remained steady. Therefore, we also describe the current prospective therapeutic methods that deem macrophage polarization to be a therapeutic target, including physical stimulus, chemical compounds, and biological molecules, to enhance cartilage repair and alleviate the progression of OA.
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Affiliation(s)
- Zimu Yuan
- West China Medical SchoolSichuan UniversityChengduChina
- West China HospitalSichuan UniversityChengduChina
| | - Decheng Jiang
- West China Medical SchoolSichuan UniversityChengduChina
- West China HospitalSichuan UniversityChengduChina
| | - Mengzhu Yang
- West China Medical SchoolSichuan UniversityChengduChina
- West China HospitalSichuan UniversityChengduChina
| | - Jie Tao
- West China Medical SchoolSichuan UniversityChengduChina
- West China HospitalSichuan UniversityChengduChina
| | - Xin Hu
- Orthopedic Research Institute, Department of OrthopedicsWest China Hospital, Sichuan UniversityChengduChina
| | - Xiao Yang
- National Engineering Research Center for BiomaterialsSichuan UniversityChengduChina
| | - Yi Zeng
- Orthopedic Research Institute, Department of OrthopedicsWest China Hospital, Sichuan UniversityChengduChina
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Lei C, Chen H, Zheng S, Pan Q, Xu J, Li Y, Liu Y. The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials. Int J Surg 2024; 110:1711-1722. [PMID: 38051935 PMCID: PMC10942168 DOI: 10.1097/js9.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Currently, there is poor evidence of the effect of hydrotherapy on patients with knee osteoarthritis (OA). The authors performed a meta-analysis from randomized controlled trials to determine the efficacy and safety of a hydrotherapy program on measures of pain and knee function in individuals living with knee OA. METHODS A literature review included PubMed, EMBASE, Cochrane Library, Science Citation Index, ScienceDirect, and Ovid. Studies evaluating the efficacy of hydrotherapy for knee OA up to August 2023 were included. The research was reported based on the preferred reporting items for systematic reviews and meta-analysis guidelines to ensure the reliability and verity of results. Statistical analysis was performed using Stata/SE version 15.0. RESULTS A total of six randomized controlled trials were included for data extraction and meta-analysis. The present study revealed that there were significant differences between the two groups regarding the pain intensity at 1 week (WMD=-0.429; 95% CI: -0.679 to -0.179; P =0.001), 4 week (WMD=-0.308; 95% CI: -0.587 to -0.030; P =0.030) and 8 week (WMD=-0.724; 95% CI: -1.099 to -0.348, P <0.001). Furthermore, hydrotherapy was associated with improved outcome of the Western Ontario and McMaster Universities Arthritis index at 1 week (WMD=-3.314; 95% CI: -6.484 to -0.145, P =0.040), 4 week (WMD= -3.630; 95% CI: -6.893 to -0.366, P =0.029) and 8 week (WMD=-3.775; 95% CI: -7.315 to -0.235; P =0.037). No serious adverse events were observed in all patients who received hydrotherapy. CONCLUSION Hydrotherapy is efficacious and safe for reducing pain and improving functional status in individuals with knee OA, without increasing the risk of adverse effects.
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Affiliation(s)
| | - Haiting Chen
- Department of Emergency Medical Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China
| | | | - Qingyun Pan
- Department of Endocrine, The Fifth Hospital of Wuhan, Wuhan
| | - Jing Xu
- Department of Neurorehabilitation Ward 2, Taihe Hospital (Affiliated Hospital of Hubei University of Medical), Shiyan, Hubei
| | - Yuan Li
- Department of General Surgery
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Ishaq I, Skinner IW, Mehta P, Verhagen AP. Description of massage interventions in randomised clinical trials for neck pain; a review using the TIDieR checklist. Clin Rehabil 2024; 38:375-392. [PMID: 37908084 DOI: 10.1177/02692155231210377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
OBJECTIVE How interventions are reported can impact the ability to implement these intervention in clinical practice. Therefore, our aim is to assess the reporting of massage interventions in randomised controlled trials for patients with neck pain. DATA SOURCES This manuscript concerns a secondary analysis of trials evaluating massage for neck pain selected for a scoping review. An updated literature search was completed using four databases to 31 July 2023. REVIEW METHODS Trials were selected that evaluate massage interventions. Two independent assessors extracted descriptive information, methodological quality (PEDro-scale) and assessed completeness of reporting of the intervention using the Template for Intervention Description and Replication (TIDier-checklist). We present frequencies of the extracted data. RESULTS We included 35 trials (2840 patients) with neck pain. Most trials (n = 23) included patients with chronic non-specific neck pain. We found a wide variety of massage interventions from Chinese massage, Swedish massage to myofascial release. In addition, the dose, number of sessions and the duration of the intervention varied widely. The methodological quality overall was fair to good (varied between 4-8/10), and we found a moderate completeness of reporting. All trials provided the name of the intervention, 30 (86%) provided a rationale and 26 (74%) trials described details of the massage intervention. CONCLUSION The massage interventions were moderately described in trials in patients with neck pain, but provided enough information to guide the decision making for designing future Network Meta-analysis as to what trials need to be considered when grouping massage interventions in a clinically relevant way.
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Affiliation(s)
- Iqra Ishaq
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
| | - Ian W Skinner
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
- School of Allied Health Exercise and Sports Sciences, Charles Sturt University, Port Macquarie, Australia
| | - Poonam Mehta
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
| | - Arianne P Verhagen
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
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Lippi L, de Sire A, Folli A, Turco A, Moalli S, Marcasciano M, Ammendolia A, Invernizzi M. Obesity and Cancer Rehabilitation for Functional Recovery and Quality of Life in Breast Cancer Survivors: A Comprehensive Review. Cancers (Basel) 2024; 16:521. [PMID: 38339271 PMCID: PMC10854903 DOI: 10.3390/cancers16030521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/12/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Obesity is a global health challenge with increasing prevalence, and its intricate relationship with cancer has become a critical concern in cancer care. As a result, understanding the multifactorial connections between obesity and breast cancer is imperative for risk stratification, tailored screening, and rehabilitation treatment planning to address long-term survivorship issues. The review follows the SANRA quality criteria and includes an extensive literature search conducted in PubMed/Medline, Web of Science, and Scopus. The biological basis linking obesity and cancer involves complex interactions in adipose tissue and the tumor microenvironment. Various mechanisms, such as hormonal alterations, chronic inflammation, immune system modulation, and mitochondrial dysfunction, contribute to cancer development. The review underlines the importance of comprehensive oncologic rehabilitation, including physical, psychological, and nutritional aspects. Cancer rehabilitation plays a crucial role in managing obesity-related symptoms, offering interventions for physical impairments, pain management, and lymphatic disorders, and improving both physical and psychological well-being. Personalized and technology-driven approaches hold promise for optimizing rehabilitation effectiveness and improving long-term outcomes for obese cancer patients. The comprehensive insights provided in this review contribute to the evolving landscape of cancer care, emphasizing the importance of tailored rehabilitation in optimizing the well-being of obese cancer patients.
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Affiliation(s)
- Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (A.T.); (S.M.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Arianna Folli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (A.T.); (S.M.); (M.I.)
| | - Alessio Turco
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (A.T.); (S.M.); (M.I.)
| | - Stefano Moalli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (A.T.); (S.M.); (M.I.)
| | - Marco Marcasciano
- Experimental and Clinical Medicine Department, Division of Plastic and Reconstructive Surgery, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (A.T.); (S.M.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Zhang H, Zheng C, Chen W, Li X, Wang J, Wang T, Zhao Q, Huang H, Li Y, Yang C, Xie K, Pan S, Wang B, Wang C, Tang Y, Li K, Liu J, Wang L. PP2 alleviates the progression of osteoarthritis by inhibiting Wnt/β-catenin and activating TGF-β/Smad signaling. Int Immunopharmacol 2023; 124:110948. [PMID: 37774483 DOI: 10.1016/j.intimp.2023.110948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE We aimed to explore the effect and mechanism of the Src inhibitor PP2 on osteoarthritis (OA) progression. METHODS The protein expressions of Src, p-Src (y418) and p-FAK in normal and OA human chondrocytes were detected by immunofluorescence (IF) analysis. Chondrocytes from the femur and tibial plateau of 3-day-old mice were extracted and inoculated into 6-well plates. The chondrocytes were co-cultured with IL-1β and different doses of PP2, and then the degeneration of extracellular matrix was analyzed. A mouse OA model was induced by destabilizing medial meniscectomy of the right knee. Two weeks after the operation, different doses of PP2 were injected intraperitoneally. The drug was given three times a week for 6 weeks, and then the mice were sacrificed. Histopathological, IF and immunoblotting analyses were used to detect key OA catabolic markers and protein expression and related signaling. RESULTS The levels of Src, p-Src (y418) and p-FAK in the knee cartilage tissue of patients with OA were abnormally increased. After chondrocytes were co-treated with IL-1β and different doses of PP2, the results showed that PP2 reduced the abnormal increase of β-catenin, p-β-catenin and other proteins induced by IL-1β, and reversed the decrease of p-Smad3, aggrecan and collagen Ⅱ protein levels. Meanwhile, intraperitoneal injection of PP2 in vivo significantly reduced the degeneration of articular cartilage in the OA mouse model. CONCLUSION Our data indicate that targeting Src with PP2 protected against cartilage destruction in an OA mouse model by inhibiting Wnt/β-catenin and activating TGF-β/Smad signaling, suggesting that Src may be a potential therapeutic target for OA treatment.
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Affiliation(s)
- Hao Zhang
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Chuanchuan Zheng
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Wei Chen
- Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, China
| | - Xiaoqiang Li
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Jinshu Wang
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Taikun Wang
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Qi Zhao
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Hao Huang
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Yiting Li
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Chengliang Yang
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Kegong Xie
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Shengcai Pan
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Binghao Wang
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China
| | - Chong Wang
- School of Mechanical Engineering, Dongguan University of Technology, Dongguan, Guangdong 523820, China
| | - Yujin Tang
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China.
| | - Kai Li
- Academy of Orthopedics, Guangdong Province, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, 510630, China.
| | - Jia Liu
- Department of Orthopedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Guangxi Key Laboratory of basic and translational research of Bone and Joint Degenerative Diseases, Guangxi Biomedical Materials Engineering Research Center for Bone and Joint Degenerative Diseass, Guangxi Health Commission Key Laboratory of Clinical Medicine Research on Bone and Joint Degenerative Diseases Cohort, Guangxi Health Commission Key Laboratory of Biomedical Materials Research, Baise, 533000, Guangxi, China.
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites, School of Material Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
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Zhou F, Liu J, Xu X, Luo Y, Yang S. Albiflorin alleviation efficacy in osteoarthritis injury using in-vivo and in-vitro models. J Pharm Pharmacol 2023; 75:1332-1343. [PMID: 37403239 DOI: 10.1093/jpp/rgad064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/25/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVES Osteoarthritis seriously affects the daily life of people. Albiflorin (AF) has anti-inflammatory and antioxidant functions in various human diseases. This study aimed to clarify the function and mechanism of AF in osteoarthritis. METHODS The functions of AF on rat chondrocyte proliferation and apoptosis, inflammatory response, oxidative stress and extracellular matrix (ECM) degradation in rat chondrocytes induced by interleukin-1beta (IL-1β) were evaluated by Western blot, immunofluorescence, flow cytometry and enzyme-linked immunosorbent assay. The mechanism of AF on the IL-1β induced rat chondrocyte injury was investigated by multiple experiments in vitro. Meanwhile, the AF function in vivo was assessed using haematoxylin-eosin staining, Alcian blue, Safranin O/Fast green staining, immunohistochemical analysis and TUNEL assay. KEY FINDINGS Functionally, AF accelerated the rat chondrocyte proliferation and repressed cell apoptosis. Meanwhile, AF reduced the inflammatory response, oxidative stress and ECM degradation in rat chondrocytes caused by IL-1β. Mechanistically, the receptor activator of the NF-kappaB ligand (RANKL), an activator for the NF-κB signalling pathway, partially reversed the alleviating effect of AF on IL-1β-induced chondrocyte injury. Furthermore, the in-vitro results confirmed that AF exerted protective properties against osteoarthritis injury in vivo. CONCLUSION Albiflorin relieved osteoarthritis injury in rats by inactivating the NF-κB pathway.
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Affiliation(s)
- Feng Zhou
- Department of Orthopedics & Soft Tissue, Hunan Cancer Hospital, Changsha, Hunan, P.R. China
| | - Jianfan Liu
- Department of Orthopedics & Soft Tissue, Hunan Cancer Hospital, Changsha, Hunan, P.R. China
| | - Xuezheng Xu
- Department of Orthopedics & Soft Tissue, Hunan Cancer Hospital, Changsha, Hunan, P.R. China
| | - Yi Luo
- Department of Orthopedics & Soft Tissue, Hunan Cancer Hospital, Changsha, Hunan, P.R. China
| | - Shuo Yang
- Department of Orthopedics & Soft Tissue, Hunan Cancer Hospital, Changsha, Hunan, P.R. China
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Peng P, Gao S, Xiao F, He M, Fang W, Zhang Y, Wei Q. Association of macronutrients intake distribution with osteoarthritis risk among adults in NHANES, 2013-2016. Front Nutr 2023; 10:976619. [PMID: 37032765 PMCID: PMC10078944 DOI: 10.3389/fnut.2023.976619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 02/20/2023] [Indexed: 04/11/2023] Open
Abstract
The association between dietary macronutrient distribution and the risk of OA remains unknown. We aimed to evaluate how dietary macronutrient distribution was correlated with the risk of OA in US adults. We performed a cross-sectional study consisting of 7,725 participants from National Health and Nutrition Examination Survey (NHANES) 2013-2016. Dietary macronutrient intake and OA status were assessed by using dietary recall method and self-reported questionnaire, respectively. We evaluated the association between dietary macronutrient distribution and the risk of OA using multivariate regression models. We conducted the isocaloric substitution analysis using the multivariate nutrient density method. Higher percentage of energy intake from fat was associated with higher risk of OA [OR = 1.05 (95% CI, 1.00, 1.09); P = 0.034]. No significant correlation was observed between the percentage of energy intake from carbohydrate or protein and risk of OA. Isocaloric substitution analysis revealed that only the substitution between fat and carbohydrate was significantly associated with the risk of OA [OR = 1.05 (95% CI, 1.003 to 1.09); P = 0.037]. Our findings suggested that a diet with low percentage of energy intake from fat may be beneficial in the prevention of OA. Further prospective cohort studies are needed to assess our results.
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Affiliation(s)
- Peng Peng
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shihua Gao
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fangjun Xiao
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mincong He
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou, China
- Department of Orthopaedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weiuhua Fang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yunqi Zhang
- Department of Pharmacy, Guangzhou Institute of Dermatology, Guangzhou, China
- *Correspondence: Yunqi Zhang,
| | - Qiushi Wei
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, Guangzhou, China
- Department of Orthopaedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
- Qiushi Wei,
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Thiengwittayaporn S, Wattanapreechanon P, Sakon P, Peethong A, Ratisoontorn N, Charoenphandhu N, Charoensiriwath S. Development of a mobile application to improve exercise accuracy and quality of life in knee osteoarthritis patients: a randomized controlled trial. Arch Orthop Trauma Surg 2023; 143:729-738. [PMID: 34453570 PMCID: PMC8397851 DOI: 10.1007/s00402-021-04149-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/23/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Knee Osteoarthritis (OA) is a degenerative joint disease that needs consistent exercise and an accurate understanding of the condition for long-term maintenance. While the accessibility of outpatient care is essential for disease management, many patients lack the resources to receive adequate healthcare. To address this challenge, we developed a not-for-profit interactive mobile application that provides a disease-specific educational background and a structured exercise regimen to patients. MATERIAL AND METHODS "Rak Kao" (English translation: Love-Your-Knee) mobile application was designed to analyze the questionnaire data to assess the stage of knee OA and generate a personalized recommendation of treatment and exercise type using rule-based and Artificial Intelligence (AI) techniques. A single-blinded study was conducted with patients (n = 82) who were randomly assigned to the mobile application group (M-group) and the handout group (H-group). Patient groups were controlled for age, gender, BMI, onset of pain, grade of disease, education level, and occupation. Accuracy in performance of three prescribed knee exercises (catch-bend-down, stretch-touch-feet, and sit-stretch-hold) was evaluated. Clinical outcomes were evaluated before and after the 4-weeks program to assess the range of motion, symptoms, pain, physical activity, and quality of life via the KOOS and KSS scores. RESULTS Completion of the study led to significantly more overall exercise accuracy in the M-group (76.2%) than the H-group (52.5%). Activities of daily life, quality of life, ability to do sports and recreational activities were significantly more improved in the M-group than the H-group (p < .01). No difference in the range of motion between groups. Satisfaction of patients' experience was higher in the M-group than the H-group (p = .001) after the 4-week regimen. CONCLUSIONS With the better accuracy and outcomes for rehabilitation in the M-group than the H-group, we strongly recommend using our mobile application as a better alternative than handouts for exercises and information for patients with knee OA. TRIAL REGISTRATION ClinicalTrials.gov: NCT03666585.
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Affiliation(s)
- Satit Thiengwittayaporn
- Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Bangkok, 10300, Dusit, Thailand.
| | - Pichayut Wattanapreechanon
- Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Bangkok, 10300 Dusit Thailand
| | - Phraew Sakon
- Hematology and Oncology Department, Boston Children’s Hospital, Boston, MA USA
| | - Apatha Peethong
- Human Behavior Analytics Research Team (HBA), Data Science and Analytics Research Group (DSARG), National Electronics and Computer Technology Center (NECTEC), Khlong Nueng, Pathumthani, Khlong Luang Thailand
| | - Nantaporn Ratisoontorn
- Human Behavior Analytics Research Team (HBA), Data Science and Analytics Research Group (DSARG), National Electronics and Computer Technology Center (NECTEC), Khlong Nueng, Pathumthani, Khlong Luang Thailand
| | - Narattaphol Charoenphandhu
- Center of Calcium and Bone Research (COCAB), Department of Physiology, Faculty of Science, Mahidol University, Bangkok, Thailand ,Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, Thailand ,The Academy of Science, The Royal Society of Thailand, Bangkok, Dusit Thailand
| | - Supiya Charoensiriwath
- Human Behavior Analytics Research Team (HBA), Data Science and Analytics Research Group (DSARG), National Electronics and Computer Technology Center (NECTEC), Khlong Nueng, Pathumthani, Khlong Luang Thailand
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Zhang L, Wang Y, Ye T, Hu Y, Wang S, Qian T, Wu C, Yue S, Sun X, Zhang Y. Quality of clinical practice guidelines relevant to rehabilitation of knee osteoarthritis: A systematic review. Clin Rehabil 2022; 37:986-1008. [DOI: 10.1177/02692155221144892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective This systematic review summarized the rehabilitation recommendations for treating and managing knee osteoarthritis (OA) in practice guidelines and evaluated their applicability and quality using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Data Sources PubMed, the Cochrane Library, EMBASE, CINAHL, PEDro, Guideline central, Guideline International Network and Agency for Healthcare Research and Quality (AHRQ) were used to search for relevant studies published between 1 January 2008 and 31 May 2022. Methods AGREE II was used to evaluate the included guidelines quality, SPSS 25.0 statistical software was used for data analysis, and the intra-group correlation coefficient value was calculated to verify the consistency between the raters. The two-way random effects model was used to calculate concordance scores, and each domain's total scores were calculated. Additionally, the median and interquartile range for domain and total scores were calculated. Results Twenty-four guidelines recommending knee OA rehabilitation were included. Inter-rater consistency evaluation ranged from 0.62 to 0.90. The domains where the guideline's overall and rehabilitation parts scored highest and lowest were scope and purpose (domain 1) and applicability (domain 5), respectively. The highly recommended rehabilitation opinions included aerobic exercise programs (21/24), weight control (16/24), self-education and management (16/24), gait/walking aids (7/24), and tai chi (6/24). However, the orthopedic insole and hot/cold therapy roles remain controversial. Conclusion The clinical practice guidelines' overall quality for knee OA rehabilitation is good; however, the applicability is slightly poor. Therefore, we should improve the promoting factors and hindering factors, guideline application recommendations, tools, and resources when developing relevant guidelines.
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Affiliation(s)
- Lechi Zhang
- Department of Physical Medicine & Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Yanqin Wang
- Department of Physical Medicine & Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tianfen Ye
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Yinqi Hu
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Shujia Wang
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Tingting Qian
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Chengfan Wu
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Shouwei Yue
- Department of Physical Medicine & Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiubin Sun
- Department of Biostatistics, School of Public Health, Cheeloo Collage of Medicine, Shandong University, Jinan, China
| | - Yang Zhang
- Department of Physical Medicine & Rehabilitation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Rostron ZPJ, Zacharias A, Semciw AI, Kingsley M, Pizzari T, Woodley SJ, Green R. Effects of a targeted resistance intervention compared to a sham intervention on gluteal muscle hypertrophy, fatty infiltration and strength in people with hip osteoarthritis: analysis of secondary outcomes from a randomised clinical trial. BMC Musculoskelet Disord 2022; 23:944. [PMID: 36309690 PMCID: PMC9617418 DOI: 10.1186/s12891-022-05907-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Background People with hip osteoarthritis are typically offered a combination of education and exercise to address muscle atrophy and weakness. Limited evidence exists to assess the efficacy of exercise programs on muscle structure or function in this population. The aim of this study was to evaluate the effects of targeted resistance exercise on gluteal muscle hypertrophy and strength in people with mild-to-moderate hip osteoarthritis. Methods Twenty-seven participants with radiologically confirmed hip osteoarthritis recruited from a single site of a multi-site, double-blind clinical trial were randomly allocated to receive a 12-week targeted gluteal intervention or sham intervention. Magnetic resonance imaging and hand-held dynamometry were used to determine change in gluteal muscle volume, fatty infiltration and hip muscle strength. For gluteal muscle volume and strength outcomes mixed model analyses of variance (ANOVA) were conducted. A general linear model (ANOVA) analysis with fixed effects parameter estimates was used to assess the impact of sex on gluteal muscle size and strength of the affected limb only. For muscle fat index a mixed method ANOVA was used to assess the differences between groups and over time. Results In the targeted intervention group, gluteus minimus volume increased from baseline to post-intervention in both limbs (pooled mean difference: 0.06 cm3/kg, 95% confidence interval: 0.01 to 0.11) while no change occurred in the sham group (time x group effect: P = 0.025). Gluteus medius, gluteus maximus and tensor fascia lata volume did not change significantly over time. Hip strength (abduction, adduction, flexion, extension, external and internal rotation) improved similarly in both groups (time main effect: P ≤ 0.042). There was a consistent, albeit non-significant, pattern of reduced fatty infiltration after the targeted intervention. Conclusion Targeted resistance exercise resulted in gluteus minimus hypertrophy, but improvements in hip strength occurred in both groups. Clinicians delivering hip osteoarthritis rehabilitation programs might consider implementing a targeted exercise program to attenuate disease associated changes within gluteal muscles. Trial registration Australian New Zealand Clinical Trials Registry, ID: ACTRN12617000970347. Registered prospectively on 5 July 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05907-4.
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The Effectiveness and Safety of Mesenchymal Stem Cells in the Treatment of Osteoarthritis: A Systematic Review and Meta-analysis of 28 Randomized Controlled Trials. Stem Cells Int 2022; 2022:6151866. [PMID: 36277037 PMCID: PMC9581629 DOI: 10.1155/2022/6151866] [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: 03/11/2022] [Revised: 06/08/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To evaluate the effectiveness and safety of mesenchymal stem cells (MSCs) in the treatment of osteoarthritis (OA). Methods Chinese databases (such as CNKI and SinoMed) and English databases (such as PubMed and Embase) were searched to collect randomized controlled trials (RCTs) of MSCs in the treatment of OA. The retrieval time is from inception to October 10, 2021. The literature was strictly selected according to the inclusion and exclusion criteria, data was extracted, and the quality was evaluated. RevMan 5.3 software was used for meta-analysis. STATA was used to evaluate publication bias. The registration number of this systematic review and meta-analysis is CRD42021277145. Results A total of 28 RCTs involving 1494 participants were included. The primary outcomes showed that MSCs may reduce WOMAC pain and VAS at the 3rd-month follow-up [WOMAC pain: -3.81 (-6.95, -0.68), P = 0.02. VAS: -1.11 (-1.53, -0.68), P < 0.00001], and the effect lasts for at least 12 months [WOMAC pain: -4.29 (-7.12, -1.47), P = 0.003. VAS: -1.77 (-2.43, -1.12), P < 0.00001]. MSCs may also reduce WOMAC stiffness and physical function at the 6th-month follow-up [WOMAC stiffness: -1.12 (-2.09, -0.14), P = 0.03. WOMAC physical function: -4.40 (-6.84, -1.96), P = 0.0004], and the effect lasts for at least 12 months [WOMAC stiffness: -0.99 (-1.95, -0.03), P = 0.04. WOMAC physical function: -3.26 (-5.91, -0.61), P = 0.02]. The improvement of WOMAC pain, VAS, WOMAC stiffness, and WOMAC physical function may be clinically significant. Meanwhile, after the MSC injection, Lequesne had been reduced compared with the control group [-4.49 (-8.21, -0.77), P = 0.002]. For adverse events, there is no significant difference in the safety of MSC injection and the control group [1.20 (0.97, 1.48), P = 0.09]. The quality of WOMAC physical function and adverse events were moderate. Conclusion Based on current evidence, MSCs may be a safety therapy that have a good curative effect in the treatment of OA, the onset time is no later than 3 months, and the time to maintain the curative effect is no less than 12 months. However, these results should be generalized with caution due to the generally low quality of evidence and RCTs.
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12
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Gates LS, Perry TA, Golightly YM, Nelson AE, Callahan LF, Felson D, Nevitt M, Jones G, Cooper C, Batt ME, Sanchez-Santos MT, Arden NK. Recreational Physical Activity and Risk of Incident Knee Osteoarthritis: An International Meta-Analysis of Individual Participant-Level Data. Arthritis Rheumatol 2022; 74:612-622. [PMID: 34730279 PMCID: PMC9450021 DOI: 10.1002/art.42001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/13/2021] [Accepted: 10/07/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The effect of physical activity on the risk of developing knee osteoarthritis (OA) is unclear. We undertook this study to examine the relationship between recreational physical activity and incident knee OA outcomes using comparable physical activity and OA definitions. METHODS Data were acquired from 6 global, community-based cohorts of participants with and those without knee OA. Eligible participants had no evidence of knee OA or rheumatoid arthritis at baseline. Participants were followed up for 5-12 years for incident outcomes including the following: 1) radiographic knee OA (Kellgren-Lawrence [K/L] grade ≥2), 2) painful radiographic knee OA (radiographic OA with knee pain), and 3) OA-related knee pain. Self-reported recreational physical activity included sports and walking/cycling activities and was quantified at baseline as metabolic equivalents of task (METs) in days per week. Risk ratios (RRs) were calculated and pooled using individual participant data meta-analysis. Secondary analysis assessed the association between physical activity, defined as time (hours per week) spent in recreational physical activity and incident knee OA outcomes. RESULTS Based on a total of 5,065 participants, pooled RR estimates for the association of MET days per week with painful radiographic OA (RR 1.02 [95% confidence interval (95% CI) 0.93-1.12]), radiographic OA (RR 1.00 [95% CI 0.94-1.07]), and OA-related knee pain (RR 1.00 [95% CI 0.96-1.04]) were not significant. Similarly, the analysis of hours per week spent in physical activity also showed no significant associations with all outcomes. CONCLUSION Our findings suggest that whole-body, physiologic energy expenditure during recreational activities and time spent in physical activity were not associated with incident knee OA outcomes.
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Affiliation(s)
| | | | | | | | | | - David Felson
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Graeme Jones
- University of Tasmania, Hobart, Tasmania, Australia
| | - Cyrus Cooper
- Southampton General Hospital and University of Southampton, Southampton, UK
| | - Mark E Batt
- Nottingham University Hospitals, Nottingham, UK
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Lavin KM, Coen PM, Baptista LC, Bell MB, Drummer D, Harper SA, Lixandrão ME, McAdam JS, O’Bryan SM, Ramos S, Roberts LM, Vega RB, Goodpaster BH, Bamman MM, Buford TW. State of Knowledge on Molecular Adaptations to Exercise in Humans: Historical Perspectives and Future Directions. Compr Physiol 2022; 12:3193-3279. [PMID: 35578962 PMCID: PMC9186317 DOI: 10.1002/cphy.c200033] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situation, the study of exercise as a preventative or therapeutic treatment has never been more interdisciplinary, or more impactful. During the early stages of the NIH Common Fund Molecular Transducers of Physical Activity Consortium (MoTrPAC) Initiative, the field is well-positioned to build substantially upon the existing understanding of the mechanisms underlying benefits associated with exercise. Thus, we present a comprehensive body of the knowledge detailing the current literature basis surrounding the molecular adaptations to exercise in humans to provide a view of the state of the field at this critical juncture, as well as a resource for scientists bringing external expertise to the field of exercise physiology. In reviewing current literature related to molecular and cellular processes underlying exercise-induced benefits and adaptations, we also draw attention to existing knowledge gaps warranting continued research effort. © 2021 American Physiological Society. Compr Physiol 12:3193-3279, 2022.
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Affiliation(s)
- Kaleen M. Lavin
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Human Health, Resilience, and Performance, Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Paul M. Coen
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Liliana C. Baptista
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Margaret B. Bell
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Devin Drummer
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sara A. Harper
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Manoel E. Lixandrão
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jeremy S. McAdam
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Samia M. O’Bryan
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sofhia Ramos
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Lisa M. Roberts
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Rick B. Vega
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Bret H. Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Marcas M. Bamman
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Human Health, Resilience, and Performance, Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Thomas W. Buford
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Protection against Osteoarthritis Symptoms by Aerobic Exercise with a High-Protein Diet by Reducing Inflammation in a Testosterone-Deficient Animal Model. Life (Basel) 2022; 12:life12020177. [PMID: 35207465 PMCID: PMC8875430 DOI: 10.3390/life12020177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 12/17/2022] Open
Abstract
A testosterone deficiency potentially increases osteoarthritis (OA) symptoms, and dietary protein and exercise affect them. However, their efficacy and their interactions are still unclear. We hypothesized that a high-protein diet (HPD) and regular exercise modulated OA symptoms in testosterone-deficient rats, and it was examined in bilateral orchidectomized (ORX) and monoiodoacetate (MIA)-injected rats. The ORX rats were given a 30 energy percent (En%) protein (HPD) or 17.5 En% protein (CD). Both groups had 39 En% fat in the diet. Non-ORX-CD rats (sham-operation of ORX) were given the CD and no exercise (normal control). After an eight-week intervention, all rats had an injection of MIA into the left knee, and the treatments were continued for an additional four weeks. The non-ORX-CD rats showed a significant increase in body weight compared to the ORX rats, but the ORX rats had elevated fat mass. ORX exacerbated the glucose tolerance by lowering the serum insulin concentrations and increasing insulin resistance. ORX exacerbated the OA symptoms more than the non-ORX-CD. The HPD and exercise improved bone mineral density and glucose metabolism without changing serum testosterone concentrations, while only exercise increased the lean body mass and decreased fat mass, lipid peroxide, and inflammation. Exercise, but not HPD, reduced the OA symptoms, the weight distribution in the left leg, and running velocity and provided better relief than the non-ORX-CD rats. Exercise with HPD improved the histology of the knee joint in the left leg. Exercise reduced lipid peroxide contents and TNF-α and IL-1β mRNA expression in the articular cartilage, while exercise with HPD decreased MMP-3 and MMP-13 mRNA expression as much as in the non-ORX-CD group. In conclusion, moderate aerobic exercise with HPD alleviated OA symptoms and articular cartilage degradation in a similar way in the non-ORX rats with OA by alleviating inflammation and oxidative stress.
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The effect of a rehabilitation program after mesenchymal stromal cell transplantation for advanced osteonecrosis of the femoral head: a 10-year follow-up study. Arch Rehabil Res Clin Transl 2022; 4:100179. [PMID: 35282152 PMCID: PMC8904865 DOI: 10.1016/j.arrct.2022.100179] [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] [Indexed: 11/22/2022] Open
Abstract
Objective To assess the status of 10 patients with advanced osteonecrosis of the femoral head who underwent mesenchymal stromal cell transplants and a 12-week rehabilitation program 10 years earlier. Design Retrospective study. Setting University clinical research laboratory. Participants Patients (N=10) who had undergone mesenchymal stromal cell transplantation and rehabilitation for a single hip osteonecrosis of the femoral head 10 years prior to the current study were recruited by telephone. The average age was 31.7 years and all participants were men; radiographic stages were 3A in 6 patients and 3B in 4 patients before treatment. Intervention A 12-week rehabilitation program with follow-up once every 1 to 2 years was performed after mesenchymal stromal cell transplantation. Main Outcome Measures Radiographic analysis, clinical score, timed Up and Go test, hip function (range of motion, muscle strength), and Short Form-36 scores were assessed before treatment and 1 and 10 years after treatment. Results Upon imaging, 5 hips were found to be stable (stable group) and 5 had progressed (progressed group); 2 of the latter group required a total hip arthroplasty. The pretreatment radiographic stage of the progressed group was more advanced than that of the stable group. Body mass index was higher in the progressed group than in the stable group. Hip function and clinical score at 1 and 10 years after treatment improved in the hips of 8 patients without total hip arthroplasty. There were no severe adverse events during the rehabilitation. Conclusions The 12-week rehabilitation program and annual follow-up after mesenchymal stromal cell transplantation for osteonecrosis of the femoral head was associated with pain reduction, maintaining hip muscle strength, widening range of motion, and improving quality of life. The level and timing of weight-bearing and social activity should be planned according to the individual's lifestyle and body composition.
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The Use of Scoring Hip Osteoarthritis with MRI as an Assessment Tool for Physiotherapeutic Treatment in Patients with Osteoarthritis of the Hip. J Clin Med 2021; 11:jcm11010017. [PMID: 35011758 PMCID: PMC8745579 DOI: 10.3390/jcm11010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/12/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
Rehabilitation programs are considered effective at reducing the impact of osteoarthritis (OA) of the hip; however, studies using reliable measures related to OA biomarkers to assess the effects of rehabilitation are lacking. The objective of this study was to investigate whether an MRI-based (Magnetic Resonance Imaging-based), semi-quantitative system for an OA severity assessment is feasible for the evaluation of the structural changes in the joint observed during a long-term physiotherapy program in patients with hip OA. The study group consisted of 37 adult OA patients who participated in a 12-month physiotherapy program. The Scoring hip osteoarthritis with MRI (SHOMRI) system was used to evaluate the severity of structural changes related to hip OA. Hip disability and the osteoarthritis outcome score (HOOS) and the core set of performance-based tests recommended by Osteoarthritis Research Society International were used for functional assessment. SHOMRI showed excellent inter- and intra-rater agreement, proving to be a reliable method for the evaluation of hip abnormalities. At the 12-month follow-up no statistically significant changes were observed within the hip joint; however, a trend of structural progression was detected. There was a negative correlation between most of the SHOMRI and HOOS subscales at baseline and the 12-month follow-up. Although SHOMRI provides a reliable assessment of the hip joint in patients with OA it showed a limited value in detecting significant changes over time in the patients receiving physiotherapy over a 12-month period.
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Han AJ, Alexander LC, Huebner JL, Reed AB, Kraus VB. Increase in Free and Total Plasma TGF-β1 Following Physical Activity. Cartilage 2021; 13:1741S-1748S. [PMID: 32340467 PMCID: PMC8808803 DOI: 10.1177/1947603520916523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate effects of physical activity and food consumption on plasma concentrations of free and total transforming growth factor beta-1 (TGF-β1), beta-2 (TGF-β2), and beta-3 (TGF-β3) in individuals with knee osteoarthritis (OA). METHODS Participants (n = 40 in 2 cohorts of 20; mean age 70 years) with radiographic knee OA were admitted overnight for serial blood sampling. Cohorts 1 and 2 assessed the impacts of food intake and activity, respectively, on TGF-β concentrations. Cohort 1 blood draws included 2 hours postprandial the evening of day 1 (T3), fasting before rising on day 2 (T0), nonfasting 1 hour after rising (T1B), and 4 hours after rising (T2). Cohort 2 blood draws included T3, T0, fasting 1 hour after rising and performing activities of daily living (T1A), and nonfasting 2 hours after rising (T1B). By sandwich ELISAs, we quantified plasma free and total TGF-β1 concentrations in all samples, and plasma total TGF-β2 and TGF-β3 in cohort 2. RESULTS Free TGF-β1 represented a small fraction of the total systemic concentration (mean 0.026%). In cohort 2, free and total TGF-β1 and total TGF-β2 concentration significantly increased in fasting samples collected after an hour (T1A) of activities of daily living (free TGF-β1: P = 0.006; total TGF-β1: P < 0.001; total TGF-β2: P = 0.001). Total TGF-β3 increased nonsignificantly following activity (P = 0.590) and decreased (P = 0.035) after food consumption while resting (T1B). CONCLUSIONS Increased plasma concentrations of TGF-β with physical activity suggests activity should be standardized prior to TGF-β1 analyses.
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Affiliation(s)
- Ashley J. Han
- Department of Medicine, Duke Molecular
Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Louie C. Alexander
- Department of Medicine, Duke Molecular
Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Janet L. Huebner
- Department of Medicine, Duke Molecular
Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Alexander B. Reed
- Department of Medicine, Duke Molecular
Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Virginia B. Kraus
- Department of Medicine, Duke Molecular
Physiology Institute, Duke University School of Medicine, Durham, NC, USA,Department of Medicine, Division of
Rheumatology, Duke University School of Medicine, Durham, NC, USA,Virginia B. Kraus, Department of Medicine,
Duke Molecular Physiology Institute, Duke University School of Medicine, PO Box
104775, Carmichael Building, 300 North Duke Street, Durham, NC 27701, USA.
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Rostron ZPJ, Green RA, Kingsley M, Zacharias A. Efficacy of Exercise-Based Rehabilitation Programs for Improving Muscle Function and Size in People with Hip Osteoarthritis: A Systematic Review with Meta-Analysis. BIOLOGY 2021; 10:biology10121251. [PMID: 34943166 PMCID: PMC8698712 DOI: 10.3390/biology10121251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022]
Abstract
Objective: To determine the effect of exercise-based rehabilitation programs on hip and knee muscle function and size in people with hip osteoarthritis. Methods: Seven databases were systematically searched in order to identify studies that assessed muscle function (strength or power) and size in people with hip osteoarthritis after exercise-based rehabilitation programs. Studies were screened for eligibility and assessed for quality of evidence using the GRADE approach. Data were pooled, and meta-analyses was completed on 7 of the 11 included studies. Results: Six studies reported hip and/or knee function outcomes, and two reported muscle volumes that could be included in meta-analyses. Meta-analyses were conducted for four strength measures (hip abduction, hip extension, hip flexion, and knee extension) and muscle size (quadriceps femoris volume). For hip abduction, there was a low certainty of evidence with a small important effect (effect size = 0.28, 95% CI = 0.01, 0.54) favouring high-intensity resistance interventions compared to control. There were no other comparisons or overall meta-analyses that identified benefits for hip or knee muscle function or size. Conclusion: High-intensity resistance programs may increase hip abduction strength slightly when compared with a control group. No differences were identified in muscle function or size when comparing a high versus a low intensity group. It is unclear whether strength improvements identified in this review are associated with hypertrophy or other neuromuscular factors.
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Affiliation(s)
- Zachary P. J. Rostron
- Department of Pharmacy and Biomedical Sciences, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC 3550, Australia; (R.A.G.); (A.Z.)
- Correspondence:
| | - Rodney A. Green
- Department of Pharmacy and Biomedical Sciences, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC 3550, Australia; (R.A.G.); (A.Z.)
| | - Michael Kingsley
- Department of Exercise Sciences, Faculty of Science, University of Auckland, Auckland 1023, New Zealand;
- Holsworth Research Initiative, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC 3550, Australia
| | - Anita Zacharias
- Department of Pharmacy and Biomedical Sciences, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC 3550, Australia; (R.A.G.); (A.Z.)
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Mahmoudian A, Lohmander LS, Mobasheri A, Englund M, Luyten FP. Early-stage symptomatic osteoarthritis of the knee - time for action. Nat Rev Rheumatol 2021; 17:621-632. [PMID: 34465902 DOI: 10.1038/s41584-021-00673-4] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 02/07/2023]
Abstract
Osteoarthritis (OA) remains the most challenging arthritic disorder, with a high burden of disease and no available disease-modifying treatments. Symptomatic early-stage OA of the knee (the focus of this Review) urgently needs to be identified and defined, as efficient early-stage case finding and diagnosis in primary care would enable health-care providers to proactively and substantially reduce the burden of disease through proper management including structured education, exercise and weight management (when needed) and addressing lifestyle-related risk factors for disease progression. Efforts to define patient populations with symptomatic early-stage knee OA on the basis of validated classification criteria are ongoing. Such criteria, as well as the identification of molecular and imaging biomarkers of disease risk and/or progression, would enable well-designed clinical studies, facilitate interventional trials, and aid the discovery and validation of cellular and molecular targets for novel therapies. Treatment strategies, relevant outcomes and ethical issues also need to be considered in the context of the cost-effective management of symptomatic early-stage knee OA. To move forwards, a multidisciplinary and sustained international effort involving all major stakeholders is required.
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Affiliation(s)
- Armaghan Mahmoudian
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium.,Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
| | - L Stefan Lohmander
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Martin Englund
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
| | - Frank P Luyten
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium.
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20
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Xu C, Liu T, Driban JB, McAlindon T, Eaton CB, Lu B. Dietary patterns and risk of developing knee osteoarthritis: data from the osteoarthritis initiative. Osteoarthritis Cartilage 2021; 29:834-840. [PMID: 33744430 PMCID: PMC8318673 DOI: 10.1016/j.joca.2021.02.571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Some studies have examined the association between dietary factors and risk of knee osteoarthritis (OA). We aimed to examine the prospective association of major dietary patterns with the risk of developing knee OA. METHOD We followed 2,842 participants in Osteoarthritis Initiative (OAI) aged 45-79 years and with at least one knee free from radiographic knee OA at baseline for up to 72 months. We defined knee OA incidence as Kellgren and Lawrence grade ≥2 during follow-up visits. Using principal component analysis, Western and prudent dietary patterns were derived. Cox proportional hazards models were used to assess the association between dietary patterns and incident knee OA. RESULTS Among study participants, 385 (418 knees) developed knee OA within 72 months. Following a Western dietary pattern was associated with an increased risk of knee OA (HR quartile 4 vs 1 = 1.69, 95% CI: 1.13 to 2.52, p trend: 0.03), while adherence to the prudent pattern was associated with a reduced risk of knee OA (HR quartile 4 vs 1 = 0.70, 95% CI: 0.50 to 0.98, p trend: 0.05). The observed associations attenuated after additionally adjusting for body mass index (BMI). The observed associations were mediated through BMI by approximately 30%. CONCLUSION Following a Western diet was associated with increased risk of knee OA, whereas following a prudent pattern was associated with a reduced risk of knee OA. The associations were partially mediated through BMI.
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Affiliation(s)
- Chang Xu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA;,Rutgers University, School of Public Health, Department of Biostatistics and Epidemiology, New Brunswick, NJ
| | - Tong Liu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA;,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Timothy McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Charles B. Eaton
- Brown University Center for Primary Care and Prevention, Pawtucket, RI;,Departments of Family Medicine and Epidemiology, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Bing Lu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA
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21
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Chen L, Tiwari SR, Zhang Y, Zhang J, Sun Y. Facile Synthesis of Hollow MnO 2 Nanoparticles for Reactive Oxygen Species Scavenging in Osteoarthritis. ACS Biomater Sci Eng 2021; 7:1686-1692. [PMID: 33787210 DOI: 10.1021/acsbiomaterials.1c00005] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Osteoarthritis (OA) is a progressive degenerative joint disease whose molecular mechanism has not been revealed clearly, and there is still no effective approach to cure OA completely. Recently, reactive oxygen species (ROS) are exposed as an important mediator of OA's inflammatory response, and it has been regarded as a therapeutic target for OA treatment. MnO2 nanoparticles possess good biocompatibility and can act as an artificial nanoenzyme to scavenge ROS in various diseases effectively. In this study, the modified Stöber method was applied to synthesize hollow MnO2 (H-MnO2) and H-MnO2 was modified with NH2-PEG-NH2, which possesses excellent biological stability and biocompatibility. It induced a change in the articular cartilage structure changes in vivo, with the knee tissue staining and micro-CT scanning of the whole knee suggesting that H-MnO2 nanoparticles could effectively remove ROS and significantly relieve the inflammatory response of OA without obvious side effects. This study reveals the therapeutic effects of MnO2-based nanomedicine toward OA, which provides potential alternative therapeutic options for patients with inflammation tissue.
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Affiliation(s)
- Lei Chen
- Department of Orthopedics, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, P. R. China
| | - Shashi Ranjan Tiwari
- Department of Orthopedics, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, P. R. China
| | - Yingqi Zhang
- Department of Orthopedics, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, P. R. China
| | - Jincheng Zhang
- Department of Orthopedics, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, P. R. China
| | - Yeqing Sun
- Department of Orthopedics, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai 200065, P. R. China
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22
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Fu Q, Zhu J, Wang B, Wu J, Li H, Han Y, Xiang D, Chen Y, Li L. LINC02288 promotes chondrocyte apoptosis and inflammation through miR-374a-3p targeting RTN3. J Gene Med 2021; 23:e3314. [PMID: 33491257 DOI: 10.1002/jgm.3314] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/06/2021] [Accepted: 01/15/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Dysregulation of long non-coding RNAs (lncRNAs) is related to the occurrence of osteoarthritis (OA). In the present study, we explored the role of LINC02288 and its regulatory mechanism in OA development. METHODS GSE113825 was obtained from Gene Expression Omnibus (GEO) database and analyzed to identify the differentially expressed lncRNAs in OA. Gene enrichment analyses and Kyoto Encyclopedia of Genes and Genomes biological process analysis were performed through Metascape (http://metascape.org/gp). The interactions among LINC02288, miR-374a-3p and RTN3 were determined using RNA immunoprecipitation (RIP) assays and dual luciferase reporter assays. Chondrocyte apoptosis was examined using flow cytometry. Western blot assays were conducted to assess the pro-apoptotic and anti-apoptotic markers. RESULTS We identified a total of 4,491 differentially expressed lncRNAs. We focused on LINC02288 as the top-ranked up-regulated lncRNA in OA as indicated by a significant p-value. LINC02288 was significantly up-regulated, which was further verified by a real-time polymerase chain reaction. Down-regulation of LINC02288 significantly reduced the apoptosis of OA chondrocytes induced by interleukin-1β and the production of pro-inflammatory cytokines. These effects were further verified in an OA rat model. An RIP assay and dual luciferase assay further confirmed that LINC02288 served as a sponge of miR-374a-3p. Moreover, the overexpression of RTN3 could partially reverse the effects of LINC02288 knockdown, mediating inhibitory effects on chondrocyte apoptosis and the inflammatory response. Down-regulation of LINC02288 alleviated OA development in an in vivo OA animal model. CONCLUSIONS Our findings indicate that LINC02288 contributes to OA progression by targeting the miR-374a-3p/RTN3 axis, which might provide a promising molecular therapy strategy for OA.
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Affiliation(s)
- Qiwei Fu
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jun Zhu
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Bo Wang
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jun Wu
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Haobo Li
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yaguang Han
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Dong Xiang
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yi Chen
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Lexiang Li
- Joint Surgery and Sports Medicine Department, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
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23
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Shen Z, Ji K, Cai Z, Huang C, He X, Xu H, Chen G. Inhibition of HDAC6 by Tubastatin A reduces chondrocyte oxidative stress in chondrocytes and ameliorates mouse osteoarthritis by activating autophagy. Aging (Albany NY) 2021; 13:9820-9837. [PMID: 33744850 PMCID: PMC8064156 DOI: 10.18632/aging.202736] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study was to determine the effect of HDAC6 inhibition using the selective inhibitor Tubastatin A (TubA) on the regulation of tert-butyl hydroperoxide (TBHP)-treated chondrocytes and a mouse OA model. Using conventional molecular biology methods, our results showed that the level of HDAC6 increases both in the cartilage of osteoarthritis (OA) mice and TBHP-treated chondrocytes in vitro. TubA treatment effectively inhibits the expression of HDAC6, attenuates oxidative stress, reduces the level of apoptotic proteins to maintain chondrocyte survival, and suppresses the extracellular matrix (ECM) degradation. In addition, our results also revealed that HDAC6 inhibition by TubA activates autophagy in chondrocytes, whereas the protective effects of TubA were abolished by autophagy inhibitor intervention. Subsequently, the positive effects of HDAC6 inhibition by TubA were also found in a mouse OA model. Therefore, our study provide evidence that HDAC6 inhibition prevents OA development, and HDAC6 could be applied as a potential therapeutic target for OA management.
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Affiliation(s)
- Zhonghai Shen
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Kang Ji
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Zhenhai Cai
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Chenglong Huang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Xiaojun He
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Hongwei Xu
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Gang Chen
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
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24
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Dantas LO, Salvini TDF, McAlindon TE. Knee osteoarthritis: key treatments and implications for physical therapy. Braz J Phys Ther 2021; 25:135-146. [PMID: 33262080 PMCID: PMC7990728 DOI: 10.1016/j.bjpt.2020.08.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/11/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a chronic progressive disease that imparts a substantial socioeconomic burden to society and healthcare systems. The prevalence of knee OA has dramatically risen in recent decades due to consistent increases in life expectancy and obesity worldwide. Patient education, physical exercise, and weight loss (for overweight or obese individuals) constitute the first-line knee OA treatment approach. However, less than 40% of patients with knee OA receive this kind of intervention. There is an unmet need for healthcare professionals treating individuals with knee OA to understand the current recommended treatment strategies to provide effective rehabilitation. OBJECTIVE To guide physical therapists in their clinical decision making by summarizing the safest and most efficacious treatment options currently available, and by delineating the most traditional outcome measures used in clinical research for knee OA. CONCLUSION There is a need for healthcare providers to abandon low-quality and ineffective treatments and educate themselves and their patients about the current best evidence-based practices for knee OA.
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Affiliation(s)
- Lucas Ogura Dantas
- Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil; Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, MA, USA
| | | | - Timothy E McAlindon
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, MA, USA.
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25
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Whittaker JL, Truong LK, Dhiman K, Beck C. Osteoarthritis year in review 2020: rehabilitation and outcomes. Osteoarthritis Cartilage 2021; 29:190-207. [PMID: 33242604 DOI: 10.1016/j.joca.2020.10.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/05/2020] [Accepted: 10/28/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Systematically review and synthesize guidelines, systematic reviews, or randomized controlled trials (RCTs) published between April 1, 2019 and April 30, 2020 which evaluated or made recommendations for rehabilitation of persons with osteoarthritis. DESIGN Five electronic databases (Medline, EMBASE, Cochrane CENTRAL, CINHAL, Web of Science) were searched with a comprehensive search strategy. Guidelines for rehabilitation of persons with osteoarthritis, and systematic reviews and RCTs evaluating osteoarthritis rehabilitation that included at least one patient-reported outcome measure and/or clinical test of function were included. Two authors independently screened records and assessed methodological quality using the AGREE-II (guidelines), AMSTAR-2 (systematic reviews) or PEDro scale (RCTs). Data were extracted to summarize included records and a narrative synthesis of findings related to core recommended osteoarthritis rehabilitation treatments performed. RESULTS Of 2,479 potential records, 253 records were reviewed. Two guidelines, 18 systematic reviews and 38 RCTs were included. 84% (n = 49) of included records related to knee osteoarthritis, 13% (n = 8) to hip, 10% (n = 6) to hand, 3% (n = 2) to mixed, and 1% (n = 1) to foot osteoarthritis. Exercise-therapy, methods to deliver exercise-therapy remotely, and approaches to facilitate exercise-therapy behaviour change were the most commonly evaluated interventions (n = 27). 94% of systematic reviews and 63% of RCTs rated high-quality. CONCLUSIONS Osteoarthritis rehabilitation research continues to focus on knee osteoarthritis and exercise-based interventions. Emerging topics include rehabilitation of comorbid populations, exercise behaviour change and technology supports. A better understanding of rehabilitation of osteoarthritis in joints other than the knee, and methods to determine and promote ideal exercise-therapy prescription are needed.
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Affiliation(s)
- J L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 2177, Wesbrook Mall, V6T 1Z3, Vancouver, Canada; Arthritis Research Canada, V6X 2C7, Richmond, Canada.
| | - L K Truong
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 2177, Wesbrook Mall, V6T 1Z3, Vancouver, Canada; Arthritis Research Canada, V6X 2C7, Richmond, Canada
| | - K Dhiman
- Arthritis Research Canada, V6X 2C7, Richmond, Canada
| | - C Beck
- Woodward Library, University of British Columbia, Vancouver, Canada
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26
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Jiang L, Zhou Y, Shen J, Chen Y, Ma Z, Yu Y, Chu M, Qian Q, Zhuang X, Xia S. RNA Sequencing Reveals LINC00167 as a Potential Diagnosis Biomarker for Primary Osteoarthritis: A Multi-Stage Study. Front Genet 2021; 11:539489. [PMID: 33519887 PMCID: PMC7841430 DOI: 10.3389/fgene.2020.539489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 11/27/2020] [Indexed: 12/28/2022] Open
Abstract
Objectives Given the roles played by lncRNA in human diseases and the high incidence of OA, this study investigated the pivotal pathways involved in the disease and identified potential biomarkers for OA diagnosis. Methods We first performed an exploration of RNA-sequencing in peripheral blood leukocytes from six subjects (3 OA and 3 healthy controls). Promising candidate lncRNAs were evaluated in first stage validation using a GEO dataset (GSE114007) of 38 subjects (20 OA and 18 healthy controls), followed by a second stage validation using quantitative PCR analysis with 101 subjects (67 OA and 34 controls). The third stage investigated the potential value of validated lncRNA in the early diagnosis of OA in peripheral blood leukocytes from a total of 120 participants (60 cases and 60 controls). Results The dataset identified a total of 1,380 up-regulated and 719 down-regulated mRNAs and 5,743 up-regulated and 7,384 down-regulated lncRNAs. The up-regulated DEGs were mainly enriched in the extracellular matrix, while the down-regulated DEGs were mainly enriched in the IL-17 and wnt signaling pathways. 18 overlapping candidate lncRNAs survived after first-stage validation. 3 hub lncRNAs were selected for the second validation stage and qualified in an external sample, and lncRNA LINC00167 was further confirmed with a similar result (down-expressed in both stages). Receiver operating characteristic analysis showed that LINC00167 can distinguish OA cases from healthy controls with a high area under the curve of 0.879 (95%CI: 0.819, 0.938; P < 0.001), with a sensitivity of 80.7% and specificity of 83.5%. Conclusion The expression profile of OA was identified and critical pathways were elucidated by an integrated approach to RNA-seq from easily accessible blood. LINC00167 may serve as a potential early diagnosis marker for OA in clinical practice. The detailed mechanism of action of this lncRNA requires further elucidation in future studies.
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Affiliation(s)
- Liying Jiang
- Shanghai Key Laboratory for Molecular Imaging, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yiqin Zhou
- Department of Joint Surgery and Sports Medicine, Shanghai Changzheng Hospital, Second Military Medical University, Huangpu, China
| | - Junjie Shen
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, China
| | - Yi Chen
- Department of Joint Surgery and Sports Medicine, Shanghai Changzheng Hospital, Second Military Medical University, Huangpu, China
| | - Ziyuan Ma
- Department of Orthopedics, School of Medical, Strategically Strategic Medical University, Guiyang, China
| | - Yuhui Yu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, China
| | - Minjie Chu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, China
| | - Qirong Qian
- Shanghai Key Laboratory for Molecular Imaging, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Xun Zhuang
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, China
| | - Shengli Xia
- Department of Orthopedics, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
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27
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Kong J, Wang J, Gong X, Zheng X, Chen T. Punicalagin Inhibits Tert-Butyl Hydroperoxide-Induced Apoptosis and Extracellular Matrix Degradation in Chondrocytes by Activating Autophagy and Ameliorates Murine Osteoarthritis. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:5521-5533. [PMID: 33364748 PMCID: PMC7751323 DOI: 10.2147/dddt.s282932] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/01/2020] [Indexed: 01/18/2023]
Abstract
Background Osteoarthritis (OA) is a prevalent articular disorder and has no entirely satisfactory treatment. Punicalagin (PUG) is a polyphenol which has shown multiple pharmacological effects on various diseases. However, the role of PUG in the treatment of OA has not been well defined. Methods The effects of PUG on anti-oxidative stress, anti-apoptosis, extracellular matrix (ECM) degradation and autophagy were evaluated in chondrocytes through Western blot and immunofluorescence (IF) staining. Meanwhile, the effects of PUG on destabilization of the medial meniscus (DMM) model were also assessed in vivo by performing histopathologic analysis and IF staining. Results In vitro, PUG treatment not only increased the level of HO-1 and SOD1 against oxidative stress but also suppressed the expression of apoptotic proteins and inhibited ECM degradation. Meanwhile, PUG treatment activated autophagy and restores autophagic flux in chondrocytes after tert-butyl hydroperoxide (TBHP) insult, inhibition of autophagy by 3-methyladenine (3-MA) partly abrogated the protective effects of PUG on chondrocytes. In vivo, degeneration of the articular cartilage following DMM was also ameliorated by PUG treatment. Conclusion PUG prevents the progression of OA through inhibition of apoptosis, oxidative stress and ECM degradation in chondrocytes, which mediated by the activation of autophagy.
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Affiliation(s)
- Jinsong Kong
- Department of Orthopaedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, People's Republic of China
| | - Jiacheng Wang
- Department of Orthopaedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, People's Republic of China
| | - Xiaokang Gong
- Department of Orthopaedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, People's Republic of China
| | - Xin Zheng
- Department of Orthopaedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, People's Republic of China
| | - Tao Chen
- Department of Orthopaedics, Taizhou Municipal Hospital, Taizhou, Zhejiang, People's Republic of China
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28
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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 Des Devel Ther 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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/07/2020] [Indexed: 01/24/2023] Open
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, Jinan250021, Shandong, People’s Republic of China
| | - Shui Sun
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan250021, Shandong, People’s Republic of China
| | - Jian Wang
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan250021, Shandong, People’s Republic of China
| | - Wei Li
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan250021, Shandong, People’s Republic of China
| | - Xianquan Wang
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan250021, Shandong, People’s Republic of China
| | - Lin Yuan
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan250021, Shandong, People’s Republic of China
| | - Siying Li
- Department of Physiology & Pathophysiology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan250012, Shandong, People’s Republic of China
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29
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Zhao G, Liu C, Chen K, Chen F, Lyu J, Chen J, Shi J, Huang G, Wei Y, Wang S, Xia J. Predictive value of adipose to muscle area ratio based on MRI at knee joint for postoperative functional outcomes in elderly osteoarthritis patients following total knee arthroplasty. J Orthop Surg Res 2020; 15:494. [PMID: 33109259 PMCID: PMC7590798 DOI: 10.1186/s13018-020-02014-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current research used a new index-adipose to muscle area ratio (AMR)-to measure fatness compared with body mass index (BMI) in elderly osteoarthritis (OA) patients following total knee arthroplasty. Our study aimed to test the relationship between the two indexes (AMR and BMI) and to examine whether AMR was a predictive factor of patient-reported outcome measures (PROMS) for elderly OA patients following total knee arthroplasty (TKA). METHODS The retrospective data of 78 OA patients (older than 60 years) following TKA was included in our study. Clinical features of patients included age, BMI, sex, AMR, side of the implant, time of follow-up, complications, the Knee Society Score (KSS score), and the Hospital for Special Surgery knee score (HSS score). The area of adipose tissue and muscle tissue was measured on the cross section (supra-patella, midline of the patella, joint line of the knee) of the knee magnetic resonance imaging (MRI). AMR was calculated as the average of adipose to muscle area ratio at the three levels. The Pearson correlation analysis, simple linear regression, and multiple linear regression were used to study the relationship between BMI, AMR, and PROMS (KSS total-post score and HSS-post score) in the study. RESULTS Of all patients, the mean (± standard deviations (SD)) of age was 67.78 ± 4.91 years. For BMI and AMR, the mean (± SD) were 26.90 ± 2.11 and 2.36 ± 0.69, respectively. In Pearson correlation analysis, BMI had a good correlation with AMR (r = 0.56, p = 0.000), and AMR (r = - 0.37, p = 0.001, HSS-post score; r = - 0.43, p = 0.000, KSS total-post score) had better correlations with PROMS postoperatively compared with BMI (r = - 0.27, p = 0.019, HSS-post score; r = - 0.33, p = 0.003, KSS total-post score). In multivariate linear regression analysis, AMR was negatively correlated with KSS total-post score as well as HSS-post score, while BMI was not. As for patients with complications, AMR values were between the 3rd quartile and 4th quartile of the AMR value in the entire study cohort. CONCLUSIONS In this study, the new obesity evaluation indicator-AMR, which was well related with BMI, was found to be a predictor of PROMS (KSS total-post score and HSS-post score) in elderly OA patients following TKA.
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Affiliation(s)
- Guanglei Zhao
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Changquan Liu
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Kangming Chen
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Feiyan Chen
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Jinyang Lyu
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Jie Chen
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Jingsheng Shi
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Gangyong Huang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Yibing Wei
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Siqun Wang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Jun Xia
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, 200040 China
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Wang L, Zhang L, Yang L, Cheng-Qi H. Effectiveness of pain coping skills training on pain, physical function, and psychological outcomes in patients with osteoarthritis: A systemic review and meta-analysis. Clin Rehabil 2020; 35:342-355. [PMID: 33103915 DOI: 10.1177/0269215520968251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the effectiveness of pain coping skills training in pain, function, and psychological outcomes for patients with osteoarthritis, compared to the control group; and to compare the effectiveness of pain coping skills training between the intervention involving and without involving exercise. DATA SOURCES PubMed, Embase, the Cochrane Library, PEDro, Clinical Trials, and the WHO Clinical Trials Registry Platform (to 30 September 2020). REVIEW METHODS To calculate the results, we used standardized mean difference, and mean difference for the outcomes of continuous variables, risk difference for the risk of adverse events. Heterogeneity was identified with I2 test, and publication bias was identified with Egger's test. RESULTS A total of 1195 patients with osteoarthritis underwent ten trials were included. The intervention group had significant differences in pain (SMD = -0.18; 95% CI -0.29 to -0.06), function (SMD = -0.19; -0.30 to -0.07), coping attempts (SMD = 0.37; 0.24 to 0.49), pain catastrophizing (SMD = -0.16; -0.29 to -0.02), and self-efficacy (SMD = 0.27; 0.07 to 0.46) than the control group. Between-group differences measured by the McMaster Universities Osteoarthritis Index subscales of pain (MD = -0.62; -1.48 to 0.24) or function (MD = -3.01; -6.26 to 0.24) were not statistically significant and did not reach the minimal clinically important differences that have been established. Subgroup analyses revealed no significant subgroup differences. Besides, no specific intervention-related adverse events were identified. CONCLUSION Our results supported the effectiveness and safety of pain coping skills training for managing osteoarthritis in pain, function, and psychological aspects. Besides, exercise could not add benefits when combined with pain coping skills training.
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Affiliation(s)
- Lin Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Liming Zhang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - Lin Yang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
| | - He Cheng-Qi
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.,Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China
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