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Zou Z, Li H, Yu K, Ma K, Wang Q, Tang J, Liu G, Lim K, Hooper G, Woodfield T, Cui X, Zhang W, Tian K. The potential role of synovial cells in the progression and treatment of osteoarthritis. EXPLORATION (BEIJING, CHINA) 2023; 3:20220132. [PMID: 37933282 PMCID: PMC10582617 DOI: 10.1002/exp.20220132] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/15/2023] [Indexed: 11/08/2023]
Abstract
Osteoarthritis (OA), the commonest arthritis, is characterized by the progressive destruction of cartilage, leading to disability. The Current early clinical treatment strategy for OA often centers on anti-inflammatory or analgesia medication, weight loss, improved muscular function and articular cartilage repair. Although these treatments can relieve symptoms, OA tends to be progressive, and most patients require arthroplasty at the terminal stages of OA. Recent studies have shown a close correlation between joint pain, inflammation, cartilage destruction and synovial cells. Consequently, understanding the potential mechanisms associated with the action of synovial cells in OA could be beneficial for the clinical management of OA. Therefore, this review comprehensively describes the biological functions of synovial cells, the synovium, together with the pathological changes of synovial cells in OA, and the interaction between the cartilage and synovium, which is lacking in the present literature. Additionally, therapeutic approaches based on synovial cells for OA treatment are further discussed from a clinical perspective, highlighting a new direction in the treatment of OA.
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Affiliation(s)
- Zaijun Zou
- Department of Sports MedicineThe First Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Han Li
- Department of Sports MedicineThe First Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Kai Yu
- Department of Bone and JointCentral Hospital of Zhuang He CityDalianLiaoningChina
| | - Ke Ma
- Department of Clinical MedicineChina Medical UniversityShenyangLiaoningChina
| | - Qiguang Wang
- National Engineering Research Center for BiomaterialsSichuan UniversityChengduSichuanChina
| | - Junnan Tang
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina
| | - Guozhen Liu
- School of MedicineThe Chinese University of Hong Kong (Shenzhen)ShenzhenGuangdongChina
| | - Khoon Lim
- Christchurch Regenerative Medicine and Tissue Engineering Group (CReaTE)Department of Orthopaedic Surgery and Musculoskeletal MedicineUniversity of OtagoChristchurchNew Zealand
| | - Gary Hooper
- Christchurch Regenerative Medicine and Tissue Engineering Group (CReaTE)Department of Orthopaedic Surgery and Musculoskeletal MedicineUniversity of OtagoChristchurchNew Zealand
| | - Tim Woodfield
- Christchurch Regenerative Medicine and Tissue Engineering Group (CReaTE)Department of Orthopaedic Surgery and Musculoskeletal MedicineUniversity of OtagoChristchurchNew Zealand
| | - Xiaolin Cui
- Department of Sports MedicineThe First Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
- School of MedicineThe Chinese University of Hong Kong (Shenzhen)ShenzhenGuangdongChina
- Christchurch Regenerative Medicine and Tissue Engineering Group (CReaTE)Department of Orthopaedic Surgery and Musculoskeletal MedicineUniversity of OtagoChristchurchNew Zealand
| | - Weiguo Zhang
- Department of Sports MedicineThe First Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
- Key Laboratory of Molecular Mechanisms for Repair and Remodeling of Orthopaedic DiseasesLiaoning ProvinceDalianLiaoningChina
| | - Kang Tian
- Department of Sports MedicineThe First Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
- Key Laboratory of Molecular Mechanisms for Repair and Remodeling of Orthopaedic DiseasesLiaoning ProvinceDalianLiaoningChina
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Kraeutler MJ, Aliberti GM, Scillia AJ, McCarty EC, Mulcahey MK. A Systematic Review of Basic Science and Animal Studies on the Use of Doxycycline to Reduce the Risk of Posttraumatic Osteoarthritis After Anterior Cruciate Ligament Rupture/Transection. Am J Sports Med 2021; 49:2255-2261. [PMID: 33216621 DOI: 10.1177/0363546520965971] [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: 01/31/2023]
Abstract
BACKGROUND Posttraumatic osteoarthritis (PTOA) after injury to the anterior cruciate ligament (ACL) is common. PURPOSE To perform a systematic review of basic science and animal studies to determine the effect of doxycycline treatment on the prevention of PTOA after ACL rupture/transection. STUDY DESIGN Systematic review. METHODS A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases to identify basic science and animal studies evaluating the effect of doxycycline treatment on the prevention of PTOA of the knee joint after ACL/cranial cruciate ligament (CCL) injury. The search phrase used was "doxycycline cruciate ligament." Inclusion criteria were basic science and animal studies evaluating the effect of oral administration of doxycycline in ACL/CCL-deficient animals with or without a control group. RESULTS Seven studies met inclusion criteria and were included in this systematic review. Five studies were performed in dogs, 1 in rabbits, and 1 in mice. Overall, the effects of doxycycline treatment on the prevention of PTOA after ACL/CCL rupture/transection were mixed. In dogs, no significant effects of doxycycline treatment were found in terms of matrix metalloproteinase (MMP) activity, while a mouse study found significantly lower MMP-13 expression on the tibia in doxycycline-treated animals, suggesting that doxycycline may protect against proteoglycan loss and decrease osteoarthritis progression. Cartilage nitric oxide concentrations were lower in doxycycline-treated dogs compared with untreated dogs, suggesting decreased cartilage degradation among doxycycline-treated dogs, although there were no significant effects on cartilage stromelysin levels with no significant effects in terms of physiological remodeling or catabolism of cartilage. Bone formation or resorption was not found to be affected by doxycycline treatment. One study demonstrated a substantial beneficial effect of doxycycline on gross morphology of the medial femoral condyle. Doxycycline was found to conserve bone strain energy density and appeared to limit subchondral bone loss in 1 study. CONCLUSION Based on the limited available animal studies, doxycycline appears to demonstrate some benefits in the prevention of PTOA after ACL/CCL rupture/transection. Additional studies are needed to further characterize the potential benefits, side effects, dosage, and duration of this treatment after ACL injury in human patients.
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Affiliation(s)
- Matthew J Kraeutler
- St Joseph's University Medical Center, Department of Orthopaedic Surgery, Paterson, New Jersey, USA
| | - Gianna M Aliberti
- Tulane University School of Medicine, Department of Orthopaedic Surgery, New Orleans, Louisiana, USA
| | - Anthony J Scillia
- St Joseph's University Medical Center, Department of Orthopaedic Surgery, Paterson, New Jersey, USA.,New Jersey Orthopaedic Institute, Wayne, New Jersey, USA
| | - Eric C McCarty
- University of Colorado School of Medicine, Department of Orthopedics, Aurora, Colorado, USA
| | - Mary K Mulcahey
- Tulane University School of Medicine, Department of Orthopaedic Surgery, New Orleans, Louisiana, USA
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From Pathogenesis to Therapy in Knee Osteoarthritis: Bench-to-Bedside. Int J Mol Sci 2021; 22:ijms22052697. [PMID: 33800057 PMCID: PMC7962130 DOI: 10.3390/ijms22052697] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/25/2021] [Accepted: 03/04/2021] [Indexed: 12/22/2022] Open
Abstract
Osteoarthritis (OA) is currently the most widespread musculoskeletal condition and primarily affects weight-bearing joints such as the knees and hips. Importantly, knee OA remains a multifactorial whole-joint disease, the appearance and progression of which involves the alteration of articular cartilage as well as the synovium, subchondral bone, ligaments, and muscles through intricate pathomechanisms. Whereas it was initially depicted as a predominantly aging-related and mechanically driven condition given its clear association with old age, high body mass index (BMI), and joint malalignment, more recent research identified and described a plethora of further factors contributing to knee OA pathogenesis. However, the pathogenic intricacies between the molecular pathways involved in OA prompted the study of certain drugs for more than one therapeutic target (amelioration of cartilage and bone changes, and synovial inflammation). Most clinical studies regarding knee OA focus mainly on improvement in pain and joint function and thus do not provide sufficient evidence on the possible disease-modifying properties of the tested drugs. Currently, there is an unmet need for further research regarding OA pathogenesis as well as the introduction and exhaustive testing of potential disease-modifying pharmacotherapies in order to structure an effective treatment plan for these patients.
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Platt BN, Jacobs CA, Conley CEW, Stone AV. Tetracycline use in treating osteoarthritis: a systematic review. Inflamm Res 2021; 70:249-259. [PMID: 33512569 DOI: 10.1007/s00011-021-01435-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/11/2020] [Accepted: 01/11/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND AIMS The purpose of the review was to synthesize the current literature regarding tetracyclines in the treatment of osteoarthritis. METHODS Using multiple databases, a systematic review was performed with customized search terms crafted to identify studies examining doxycycline or minocycline in the treatment of osteoarthritis. Results were classified into basic science mechanistic studies, in vivo animal studies, and human clinical trials. A total of 1446 potentially relevant studies were reviewed, and after exclusion criteria were applied, 23 investigations were included in the final analysis. RESULTS From 12 basic science mechanistic studies, we report on three main mechanisms by which tetracyclines may exert benefit in osteoarthritis progression: matrix metalloproteinase inhibition, immunomodulation, and nitric oxide synthase inhibition. Seven animal studies showed generally encouraging results. Four articles reported human clinical studies, showing mixed results in the treatment of osteoarthritis, potentially related to the choice of patient population, primary outcomes, and timing of treatment. CONCLUSION Tetracyclines have the potential to benefit osteoarthritis patients via multiple mechanisms. Further study is warranted to examine the optimal dose and timing of tetracycline treatment in osteoarthritis.
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Affiliation(s)
- Brooks N Platt
- Division of Sports Medicine, Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, 740 S. Limestone, K403, Lexington, KY, 40536, USA
| | - Cale A Jacobs
- Division of Sports Medicine, Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, 740 S. Limestone, K403, Lexington, KY, 40536, USA
| | - Caitlin E W Conley
- Division of Sports Medicine, Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, 740 S. Limestone, K403, Lexington, KY, 40536, USA
| | - Austin V Stone
- Division of Sports Medicine, Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, 740 S. Limestone, K403, Lexington, KY, 40536, USA.
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Huang Z, Perry E, Huebner JL, Katz B, Li YJ, Kraus VB. Biomarkers of inflammation - LBP and TLR- predict progression of knee osteoarthritis in the DOXY clinical trial. Osteoarthritis Cartilage 2018; 26:1658-1665. [PMID: 30144513 PMCID: PMC6263786 DOI: 10.1016/j.joca.2018.08.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/25/2018] [Accepted: 08/10/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate systemic inflammatory biomarkers in symptomatic knee osteoarthritis (OA) and their association with radiographic and biochemical OA progression. METHODS Lipopolysaccharide (LPS) binding protein (LBP), soluble Toll-like receptor 4 (sTLR4) and interleukin 6 (IL-6) were measured in plasma of 431 knee OA patients from the doxycycline (DOXY) trial at baseline and 18 months. Plasma lipopolysaccharide and lipopolysaccharide binding protein (LBP) were also measured at 12 months. As a biochemical indicator of disease activity and OA progression, urinary (u) C-telopeptide of Type II collagen (uCTX-II) was measured in samples collected at baseline and 18 months. Change over 16 months in radiographic tibiofemoral joint space width (JSW in mm) and joint space narrowing (JSN≥0.5 mm) were used to indicate radiographic OA progression. Change over 18 months for uCTX-II was used as a secondary outcome. Both univariate and multivariable regression analyses were performed to test the association between Z-score transformed biomarkers and outcomes. RESULTS Baseline LBP and time-integrated concentration (TIC) of LBP over 12 and 18 months were associated with worsening joint space width (JSW) (parameter estimates: -0.1 to -0.07) and JSN (OR: 1.32 to 1.42) adjusting for treatment group, age, body mass index (BMI) and corresponding baseline radiographic measures. Baseline sTLR4 and TIC over 18 months were associated with change in uCTX-II over 18 months (adjusted parameter estimates: 0.0017 to 0.0020). Results were not modified by treatment with doxycycline. CONCLUSION Plasma LBP and sTLR4 were associated with knee OA progression over 16-18 months. These results lend further support for a role of systemic low-grade inflammation in the pathogenesis of knee OA progression.
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Affiliation(s)
- ZeYu Huang
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, SiChuan University, ChengDu, SiChuan Province, People’s Republic of China;,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Emily Perry
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Janet L. Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Barry Katz
- Department of Biostatistics, Indiana University, Indianapolis, IN, USA
| | - Yi-Ju Li
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA,Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA,Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA,Correspondence Virginia Byers Kraus Professor of Medicine, Division of Rheumatology and Duke Molecular Physiology Institute, Duke University School of Medicine, 300 N Duke Street, Durham, NC 27701-2047 USA, Tel: +1-919-681-6652/Fax: 919-684-8907/
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Bajpayee AG, De la Vega RE, Scheu M, Varady NH, Yannatos IA, Brown LA, Krishnan Y, Fitzsimons TJ, Bhattacharya P, Frank EH, Grodzinsky AJ, Porter RM. Sustained intra-cartilage delivery of low dose dexamethasone using a cationic carrier for treatment of post traumatic osteoarthritis. Eur Cell Mater 2017; 34:341-364. [PMID: 29205258 PMCID: PMC5744663 DOI: 10.22203/ecm.v034a21] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Disease-modifying osteoarthritis drugs (DMOADs) should reach their intra-tissue target sites at optimal doses for clinical efficacy. The dense, negatively charged matrix of cartilage poses a major hindrance to the transport of potential therapeutics. In this work, electrostatic interactions were utilised to overcome this challenge and enable higher uptake, full-thickness penetration and enhanced retention of dexamethasone (Dex) inside rabbit cartilage. This was accomplished by using the positively charged glycoprotein avidin as nanocarrier, conjugated to Dex by releasable linkers. Therapeutic effects of a single intra-articular injection of low dose avidin-Dex (0.5 mg Dex) were evaluated in rabbits 3 weeks after anterior cruciate ligament transection (ACLT). Immunostaining confirmed that avidin penetrated the full cartilage thickness and was retained for at least 3 weeks. Avidin-Dex suppressed injury-induced joint swelling and catabolic gene expression to a greater extent than free Dex. It also significantly improved the histological score of cell infiltration and morphogenesis within the periarticular synovium. Micro-computed tomography confirmed the reduced incidence and volume of osteophytes following avidin-Dex treatment. However, neither treatment restored the loss of cartilage stiffness following ACLT, suggesting the need for a combinational therapy with a pro-anabolic factor for enhancing matrix biosynthesis. The avidin dose used caused significant glycosaminoglycan (GAG) loss, suggesting the use of higher Dex : avidin ratios in future formulations, such that the delivered avidin dose could be much less than that shown to affect GAGs. This charge-based delivery system converted cartilage into a drug depot that could also be employed for delivery to nearby synovium, menisci and ligaments, enabling clinical translation of a variety of DMOADs.
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Affiliation(s)
- Ambika G. Bajpayee
- Departments of Bioengineering and Mechanical Engineering, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA,Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Rodolfo E. De la Vega
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA,Current affiliation: Rehabilitation Medicine Research Centre, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Maximiliano Scheu
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA,Department of Orthopaedic Surgery, Clínica Alemana de Santiago, Avenida Vitacura 5951, Vitacura, Chile
| | - Nathan H. Varady
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Isabel A. Yannatos
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Lennart A. Brown
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Yamini Krishnan
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Tomas J. Fitzsimons
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Paulomi Bhattacharya
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Eliot H. Frank
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Alan J. Grodzinsky
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA,Departments of Biological, Mechanical and Electrical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Ryan M. Porter
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA,Address for correspondence: Ryan M. Porter, University of Arkansas for Medical Sciences, Division of Endocrinology and Metabolism, 4301 W. Markham Street, Mail Slot #587, Little Rock, AR 72205, Telephone : +1 5015266990,
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Karsdal MA, Michaelis M, Ladel C, Siebuhr AS, Bihlet AR, Andersen JR, Guehring H, Christiansen C, Bay-Jensen AC, Kraus VB. Disease-modifying treatments for osteoarthritis (DMOADs) of the knee and hip: lessons learned from failures and opportunities for the future. Osteoarthritis Cartilage 2016; 24:2013-2021. [PMID: 27492463 DOI: 10.1016/j.joca.2016.07.017] [Citation(s) in RCA: 231] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 06/30/2016] [Accepted: 07/26/2016] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is the biggest unmet medical need among the many musculoskeletal conditions and the most common form of arthritis. It is a major cause of disability and impaired quality of life in the elderly. We review several ambitious but failed attempts to develop joint structure-modifying treatments for OA. Insights gleaned from these attempts suggest that these failures arose from unrealistic hypotheses, sub-optimal selection of patient populations or drug dose, and/or inadequate sensitivity of the trial endpoints. The long list of failures has prompted a paradigm shift in OA drug development with redirection of attention to: (1) consideration of the benefits of localized vs systemic pharmacological agents, as indicated by the increasing number of intra-articularly administered compounds entering clinical development; (2) recognition of OA as a complex disease with multiple phenotypes, that may each require somewhat different approaches for optimizing treatment; and (3) trial enhancements based on guidance regarding biomarkers provided by regulatory agencies, such as the Food and Drug Administration (FDA), that could be harnessed to help turn failures into successes.
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Affiliation(s)
| | | | - C Ladel
- Merck KGaA, Darmstadt, Germany
| | | | | | | | | | | | | | - V B Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Duke University School of Medicine, Durham, NC, USA
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Mohan G, Magnitsky S, Melkus G, Subburaj K, Kazakia G, Burghardt AJ, Dang A, Lane NE, Majumdar S. Kartogenin treatment prevented joint degeneration in a rodent model of osteoarthritis: A pilot study. J Orthop Res 2016; 34:1780-1789. [PMID: 26895619 PMCID: PMC6348064 DOI: 10.1002/jor.23197] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/15/2016] [Indexed: 02/04/2023]
Abstract
Osteoarthritis (OA) is a major degenerative joint disease characterized by progressive loss of articular cartilage, synovitis, subchondral bone changes, and osteophyte formation. Currently there is no treatment for OA except temporary pain relief and end-stage joint replacement surgery. We performed a pilot study to determine the effect of kartogenin (KGN, a small molecule) on both cartilage and subchondral bone in a rat model of OA using multimodal imaging techniques. OA was induced in rats (OA and KGN treatment group) by anterior cruciate ligament transection (ACLT) surgery in the right knee joint. Sham surgery was performed on the right knee joint of control group rats. KGN group rats received weekly intra-articular injection of 125 μM KGN 1 week after surgery until week 12. All rats underwent in vivo magnetic resonance imaging (MRI) at 3, 6, and 12 weeks after surgery. Quantitative MR relaxation measures (T1ρ and T2 ) were determined to evaluate changes in articular cartilage. Cartilage and bone turnover markers (COMP and CTX-I) were determined at baseline, 3, 6, and 12 weeks. Animals were sacrificed at week 12 and the knee joints were removed for micro-computed tomography (micro-CT) and histology. KGN treatment significantly lowered the T1ρ and T2 relaxation times indicating decreased cartilage degradation. KGN treatment significantly decreased COMP and CTX-I levels indicating decreased cartilage and bone turnover rate. KGN treatment also prevented subchondral bone changes in the ACLT rat model of OA. Thus, kartogenin is a potential drug to prevent joint deterioration in post-traumatic OA. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1780-1789, 2016.
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Affiliation(s)
- Geetha Mohan
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California,,Department of Internal Medicine, University of California at Davis Medical Center, Sacramento, California
| | - Sergey Magnitsky
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Gerd Melkus
- Department of Medical Imaging, Ottawa Hospital, Ottawa, Ontario, Canada
| | | | - Galateia Kazakia
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Andrew J. Burghardt
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Alexis Dang
- Department of Orthopaedic Surgery, University of California, San Francisco, California
| | - Nancy E. Lane
- Department of Internal Medicine, University of California at Davis Medical Center, Sacramento, California
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
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9
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Yan F, Xie F, Gong X, Wang F, Yang L. Effect of anterior cruciate ligament rupture on secondary damage to menisci and articular cartilage. Knee 2016; 23:102-5. [PMID: 26298288 DOI: 10.1016/j.knee.2015.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 06/05/2015] [Accepted: 07/14/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of anterior cruciate ligament (ACL) rupture on secondary damage to menisci and articular cartilage. METHOD A total of 366 patients with knee ACL rupture were divided into the following six groups based on the time span from the initial injury to ACL reconstruction: (1) <1.5months; (2) between 1.5 and three months; (3) between three and six months; (4) between six and 12months; (5) between 12 and 24months, and (6) >24months. During ACL reconstruction, impairment of meniscal or chondral integrity was systematically documented. RESULTS Of the 366 patients involved in this study, meniscal and chondral damage were found in 223 (60.9%) and 75 (20.5%) patients, respectively. In addition, the incidence of medial meniscal and chondral damage was significantly increased when ACL reconstruction was delayed. The incidence of medial meniscal and chondral damage was found to be 6.1 and 9.9 times higher in patients with a time from initial injury (TFI) of >24months than those with a TFI of <1.5months, respectively. CONCLUSION In this study, correlations between secondary damage to the menisci and/or the articular cartilage and time after initial injury were found in Chinese population. Our data suggested that ACL reconstruction should be performed as early as possible after ACL rupture to avoid secondary meniscal and/or chondral damage. It is recommended that the best time range for ACL reconstruction is between four and six weeks after initial injury.
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Affiliation(s)
- Fei Yan
- Center of Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing, Shapingba, People's Republic of China
| | - Feng Xie
- Military Training Medicine Institute in the 150th Hospital of PLA, Luoyang, Henan, People's Republic of China
| | - Xiaoyuan Gong
- Center of Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing, Shapingba, People's Republic of China
| | - Fuyou Wang
- Center of Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing, Shapingba, People's Republic of China
| | - Liu Yang
- Center of Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing, Shapingba, People's Republic of China.
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Repair of articular cartilage defects in the knee with autologous iliac crest cartilage in a rabbit model. Knee Surg Sports Traumatol Arthrosc 2015; 23:1119-27. [PMID: 24573237 DOI: 10.1007/s00167-014-2906-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 02/05/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To demonstrate that iliac crest cartilage may be used to repair articular cartilage defects in the knees of rabbits. METHODS Full-thickness cartilage defects were created in the medial femoral condyle on both knees of 36 New Zealand white rabbits. The 72 defects were randomly assigned to be repaired with ipsilateral iliac crest cartilage (Group I), osteochondral tissues removed at defect creation (Group II), or no treatment (negative control, Group III). Animals were killed at 6, 12, and 24 weeks post-operatively. The repaired tissues were harvested for magnetic resonance imaging (MRI), histological studies (haematoxylin and eosin and immunohistochemical staining), and mechanical testing. RESULTS At 6 weeks, the iliac crest cartilage graft was not yet well integrated with the surrounding articular cartilage, but at 12 weeks, the graft deep zone had partial ossification. By 24 weeks, the hyaline cartilage-like tissue was completely integrated with the surrounding articular cartilage. Osteochondral autografts showed more rapid healing than Group I at 6 weeks and complete healing at 12 weeks. Untreated defects were concave or partly filled with fibrous tissue throughout the study. MRI showed that Group I had slower integration with surrounding normal cartilage compared with Group II. The mechanical properties of Group I were significantly lower than those of Group II at 12 weeks, but this difference was not significant at 24 weeks. CONCLUSION Iliac crest cartilage autografts were able to repair knee cartilage defects with hyaline cartilage and showed comparable results with osteochondral autografts in the rabbit model.
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11
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Kotecha M, Klatt D, Magin RL. Monitoring cartilage tissue engineering using magnetic resonance spectroscopy, imaging, and elastography. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:470-84. [PMID: 23574498 DOI: 10.1089/ten.teb.2012.0755] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A key technical challenge in cartilage tissue engineering is the development of a noninvasive method for monitoring the composition, structure, and function of the tissue at different growth stages. Due to its noninvasive, three-dimensional imaging capabilities and the breadth of available contrast mechanisms, magnetic resonance imaging (MRI) techniques can be expected to play a leading role in assessing engineered cartilage. In this review, we describe the new MR-based tools (spectroscopy, imaging, and elastography) that can provide quantitative biomarkers for cartilage tissue development both in vitro and in vivo. Magnetic resonance spectroscopy can identify the changing molecular structure and alternations in the conformation of major macromolecules (collagen and proteoglycans) using parameters such as chemical shift, relaxation rates, and magnetic spin couplings. MRI provides high-resolution images whose contrast reflects developing tissue microstructure and porosity through changes in local relaxation times and the apparent diffusion coefficient. Magnetic resonance elastography uses low-frequency mechanical vibrations in conjunction with MRI to measure soft tissue mechanical properties (shear modulus and viscosity). When combined, these three techniques provide a noninvasive, multiscale window for characterizing cartilage tissue growth at all stages of tissue development, from the initial cell seeding of scaffolds to the development of the extracellular matrix during construct incubation, and finally, to the postimplantation assessment of tissue integration in animals and patients.
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Affiliation(s)
- Mrignayani Kotecha
- Department of Bioengineering, University of Illinois at Chicago , Chicago, Illinois
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Davies PSE, Graham SM, MacFarlane RJ, Leonidou A, Mantalaris A, Tsiridis E. Disease-modifying osteoarthritis drugs: in vitro and in vivo data on the development of DMOADs under investigation. Expert Opin Investig Drugs 2013; 22:423-41. [PMID: 23409708 DOI: 10.1517/13543784.2013.770837] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Osteoarthritis is a disabling affliction, and disease-modifying osteoarthritis drugs (DMOADs) would be highly desirable adjuncts to symptomatic relief as they may delay the disease process. AREAS COVERED This study is a comprehensive review of the recent literature on the efficacy of DMOADs in the treatment of OA. In vitro and in vivo evidence was collected using MEDLINE® (1950 to November 2012) and EMBASE (1980 to November 2012) databases. Several drugs have demonstrated DMOAD effects in OA. They can be divided into three groups based on their predominant mode of action: those targeting cartilage, inflammatory pathways and subchondral bone. OARSI guidelines recommend glucosamine and chondroitin sulphates and diacerein as DMOADS, and NICE will recommend glucosamine sulphate in the next update of guidelines. Exploration of improved outcome measures and identification of subgroups of patients most likely to benefit from different DMOADs are likely to be the most important areas of development over the coming years. EXPERT OPINION It is expected that a wider range of prospective clinical studies will be embarked upon in the coming years. Trials including MRI as well as joint space narrowing (JSN) should be designed in a systematic manner, powered with sufficient numbers to demonstrate clinical benefit at different stages of disease.
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Affiliation(s)
- Peter S E Davies
- Orthopaedics, Royal Liverpool and Broadgreen University Hospital, Liverpool , UK
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Abstract
Experimental animals in biomedical research provide insights into disease mechanisms and models for determining the efficacy and safety of new therapies and for discovery of corresponding biomarkers. Although mouse and rat models are most widely used, observations in these species cannot always be faithfully extrapolated to human patients. Thus, a number of domestic species are additionally used in specific disease areas. This review summarizes the most important applications of domestic animal models and emphasizes the new possibilities genetic tailoring of disease models, specifically in pigs, provides.
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Affiliation(s)
- A Bähr
- Chair for Molecular Animal Breeding and Biotechnology, Department of Veterinary Sciences, Ludwig-Maximilians-Universität München, Munich, Germany
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Inflammation and Joint Tissue Interactions in OA: Implications for Potential Therapeutic Approaches. ARTHRITIS 2012; 2012:741582. [PMID: 22745906 PMCID: PMC3382955 DOI: 10.1155/2012/741582] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 04/04/2012] [Accepted: 04/26/2012] [Indexed: 01/15/2023]
Abstract
It is increasingly recognized that the pathogenesis of cartilage degradation in osteoarthritis (OA) is multifactorial and involves the interactions between cartilage and its surrounding tissues. These interactions regulate proinflammatory cytokine-mediated cartilage destruction, contributing to OA progression as well as cartilage repair. This review explores the pathogenesis of OA in the context of the multiple tissue types in the joint and discusses the implications of such complex tissue interaction in the development of anti-inflammatory therapeutics for the treatment of OA.
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