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Mulrooney E, Neogi T, Dagfinrud H, Hammer HB, Pettersen PS, Kvien TK, Magnusson K, Haugen IK. Hand osteoarthritis phenotypes based on a biopsychosocial approach, and their associations with cross-sectional and longitudinal pain. Osteoarthritis Cartilage 2024; 32:963-971. [PMID: 38697510 PMCID: PMC11254542 DOI: 10.1016/j.joca.2024.04.011] [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: 11/05/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE Hand osteoarthritis (OA) pain is characterized as heterogeneous and multifactorial. Differences in pain may be explained by underlying phenotypes, which have not been previously explored DESIGN: Latent class analysis determined classes of participants with hand OA from the Nor-Hand study baseline examination (2016-17) based on a biopsychosocial framework. Outcomes were hand and overall bodily pain intensity (Numeric Rating Scale, 0-10) at baseline and follow-up (2019-21), The relations of the classes to pain outcomes at baseline, follow-up, and change over time were analysed in separate models by linear regression, using the overall healthiest class as reference. RESULTS Five classes differing in radiographic hand OA burden and OA burden in the lower extremities by ultrasound, demographic factors, psychosocial burden and pain sensitization was identified. Persons with the least severe OA but higher burden of biopsychosocial factors reported the most hand pain (beta 3.65, 95% CI 2.53, 4.75). Pain was less pronounced in persons with the most severe hand OA but low burden of biopsychosocial factors (beta 1.03, 95% CI 0.41, 1.65). Results were similar for overall bodily pain and at follow-up. Changes in pain were small, but the association between a separate class defined by higher levels of biopsychosocial burden and pain changes was significant. CONCLUSION The five hand OA phenotypes were associated with pain at baseline and 3.5 years later. The phenotype with the least OA severity, but higher burden of biopsychosocial factors reported more pain than the phenotype with the most severe OA, reflecting the symptom-structure discordance of the hand OA pain experience.
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Affiliation(s)
- Elisabeth Mulrooney
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Tuhina Neogi
- Section of Rheumatology, Boston University School of Medicine, Boston, United States
| | - Hanne Dagfinrud
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hilde B Hammer
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Pernille S Pettersen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tore K Kvien
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Karin Magnusson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden
| | - Ida K Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Ben Amara H, Farjam P, Lutz TM, Omar O, Palmquist A, Lieleg O, Browne M, Taylor A, Verkerke GJ, Rouwkema J, Thomsen P. Toward a disruptive, minimally invasive small finger joint implant concept: Cellular and molecular interactions with materials in vivo. Acta Biomater 2024; 183:130-145. [PMID: 38815684 DOI: 10.1016/j.actbio.2024.05.042] [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: 01/23/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
Osteoarthritis (OA) poses significant therapeutic challenges, particularly OA that affects the hand. Currently available treatment strategies are often limited in terms of their efficacy in managing pain, regulating invasiveness, and restoring joint function. The APRICOTⓇ implant system developed by Aurora Medical Ltd (Chichester, UK) introduces a minimally invasive, bone-conserving approach for treating hand OA (https://apricot-project.eu/). By utilizing polycarbonate urethane (PCU), this implant incorporates a caterpillar track-inspired design to promote the restoration of natural movement to the joint. Surface modifications of PCU have been proposed for the biological fixation of the implant. This study investigated the biocompatibility of PCU alone or in combination with two surface modifications, namely dopamine-carboxymethylcellulose (dCMC) and calcium-phosphate (CaP) coatings. In a rat soft tissue model, native and CaP-coated PCU foils did not increase cellular migration or cytotoxicity at the implant-soft tissue interface after 3 d, showing gene expression of proinflammatory cytokines similar to that in non-implanted sham sites. However, dCMC induced an amplified initial inflammatory response that was characterized by increased chemotaxis and cytotoxicity, as well as pronounced gene activation of proinflammatory macrophages and neoangiogenesis. By 21 d, inflammation subsided in all the groups, allowing for implant encapsulation. In a rat bone model, 6 d and 28 d after release of the periosteum, all implant types were adapted to the bone surface with a surrounding fibrous capsule and no protracted inflammatory response was observed. These findings demonstrated the biocompatibility of native and CaP-coated PCU foils as components of APRICOTⓇ implants. STATEMENT OF SIGNIFICANCE: Hand osteoarthritis treatments require materials that minimize irritation of the delicate finger joints. Differing from existing treatments, the APRICOTⓇ implant leverages polycarbonate urethane (PCU) for minimally invasive joint replacement. This interdisciplinary, preclinical study investigated the biocompatibility of thin polycarbonate urethane (PCU) foils and their surface modifications with calcium-phosphate (CaP) or dopamine-carboxymethylcellulose (dCMC). Cellular and morphological analyses revealed that both native and Ca-P coated PCU elicit transient inflammation, similar to sham sites, and a thin fibrous encapsulation in soft tissues and on bone surfaces. However, dCMC surface modification amplified initial chemotaxis and cytotoxicity, with pronounced activation of proinflammatory and neoangiogenesis genes. Therefore, native and CaP-coated PCU possess sought-for biocompatible properties, crucial for patient safety and performance of APRICOTⓇ implant.
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Affiliation(s)
- Heithem Ben Amara
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Pardis Farjam
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands
| | - Theresa M Lutz
- School of Engineering and Design, Department of Materials Engineering, Technical University of Munich, Munich, Germany
| | - Omar Omar
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Anders Palmquist
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Oliver Lieleg
- School of Engineering and Design, Department of Materials Engineering, Technical University of Munich, Munich, Germany
| | - Martin Browne
- Bioengineering Science Research Group, School of Engineering, University of Southampton, Southampton, UK
| | | | - Gijsbertus J Verkerke
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands
| | - Jeroen Rouwkema
- Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
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Huang L, Zhang ZY, Gao M, Wang XQ, Duan XQ, Liu ZL. The Effectiveness of Exercise-Based Rehabilitation in People With Hand Osteoarthritis: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther 2024; 54:1-11. [PMID: 38506711 DOI: 10.2519/jospt.2024.12241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE: To investigate the effectiveness of exercise-based rehabilitation programs compared with nonexercise intervention or no intervention for people with hand osteoarthritis (OA). DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: We searched 5 databases on July 23, 2023. STUDY SELECTION CRITERIA: We included randomized controlled trials that compared the effectiveness of rehabilitation programs that included an exercise component, with nonexercise intervention or no intervention for people with hand OA. DATA SYNTHESIS: Standardized mean differences (SMDs) were pooled using a random-effects model. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. The certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. RESULTS: Fourteen trials were included in the meta-analysis (n = 1341 participants). In the immediate term (<24 weeks), there was low-certainty evidence of an effect of exercise-based rehabilitation on improving pain (13 trials; SMD = -0.65; 95% CI: -1.06, -0.25), function (11 trials; SMD = -0.35; 95% CI: -0.54, -0.15), and grip strength (14 trials; SMD = 0.21; 95% CI: 0.03, 0.38). There was moderate-certainty evidence of an effect on reducing stiffness (7 trials; SMD = -0.33; 95% CI: -0.51, -0.16). There was low-certainty evidence of no effect on improving pinch strength and quality of life. For the long term (≥24 weeks), there was low-certainty evidence that exercise-based rehabilitation had no additional effect on improving pain, function, and stiffness. CONCLUSION: Exercise-based rehabilitation improved pain, function, stiffness, and grip strength in people with hand OA in the immediate term; the benefits were not maintained in the long term. J Orthop Sports Phys Ther 2024;54(7):1-11. Epub 20 March 2024. doi:10.2519/jospt.2024.12241.
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Saito S, Makino A, Morimoto N. Sustained increase of pinch strength after traction treatment for symptomatic distal interphalangeal joint osteoarthritis. Heliyon 2024; 10:e32830. [PMID: 38975115 PMCID: PMC11226916 DOI: 10.1016/j.heliyon.2024.e32830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Background Symptomatic distal interphalangeal joint osteoarthritis is a common joint disease that causes hand disability and reduces quality of life. There are few conservative treatment options for this condition. The purpose of this study was to investigate the effect of traction treatment on symptomatic distal interphalangeal joint osteoarthritis. Methods This prospective, longitudinal study involved multiple time-series observations and within-subject controls. The most painful distal interphalangeal joints in patients with hand osteoarthritis were treated by daily, 15-min joint traction at home using a finger trap orthosis. The corresponding contralateral digits were used as within-subject controls. The primary outcome measure was two-point pinch strength, and the secondary outcome measures were radiographic findings and treatment adherence. Longitudinal and pairwise comparison analyses of the treated and control digits examined improvements in two-point pinch strength at months 1, 3, and 6 from baseline. The durability of treatment effects after treatment discontinuation was investigated at month 12. Results Eighteen treated digits and 18 corresponding control digits were eligible for analysis. There was a significant increase in two-point pinch strength after 1-month traction, and this increase was maintained until month 6 despite the absence of radiographic changes. Compared to controls, significant improvement in two-point pinch strength relative to baseline was seen at every observation time point, with a moderate to large effect size. There was no time-treatment interaction. Treatment adherence was high. At months 3 and 6, around 60-80 % of digits were voluntarily treated. Pinch strength was comparable between months 6 and 12, with greater improvement than in the control group. Conclusion Joint traction treatment can improve pinch strength in symptomatic distal interphalangeal joint osteoarthritis. Larger, randomized studies on traction treatment and the effect on hand function are warranted.
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Affiliation(s)
- Susumu Saito
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Japan
| | - Aiko Makino
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Japan
| | - Naoki Morimoto
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Japan
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Liu Y, Jiang W, Huang J, Zhong L. Bioinformatic analysis combined with immune infiltration to explore osteoarthritis biomarkers and drug prediction. Medicine (Baltimore) 2024; 103:e38430. [PMID: 38905428 PMCID: PMC11191918 DOI: 10.1097/md.0000000000038430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/10/2024] [Indexed: 06/23/2024] Open
Abstract
Along with global aging, osteoarthritis (OA) appears to have a high incidence and disability rate, which seriously affects the quality of life of patients, making age a major risk factor. However, the pathology of OA is under-researched, and there is no obvious and effective treatment. Research has demonstrated the importance of aging, inflammation, and immunology in the onset and course of OA. This study aims to anticipate therapeutic drugs based on critical genes associated with OA and to elucidate the roles of genes and possible biomarkers associated with inflammation, immunology, and cellular senescence in OA. The OA gene expression matrix was first obtained from the Gene Expression Omnibus database. Screening for OA significant differentially expressed genes by bioinformatics identification. Specific biological processes and related signaling pathways of the differential genes were enriched. Then elucidate the status of immune cell involvement in OA based on immune infiltration analysis. Finally predict therapeutic agents based on pivotal genes. A total of 198 differentially expressed genes were identified in OA, and TP53, EGFR, TGFB1, LEP, CD4, MAPK8, SCARB1, ADIPOQ, JAK2, and SERPINE1 were further identified as important hub genes. The enrichment results showed that the development of arthritis was mainly related to immune cell differentiation, amino acid metabolism and cellular senescence process. The validation of immune infiltration results indicated that NK_cells, CD4_Tcells, Macrophages, Monocytic_lineage, Dendritic_cells, Basophils, CD8+_naive_T-cells may play an important role in the immune process of OA. Key Drug Prediction of Hub Genes found that Halicin, Ruxolitinib, Tofacitinib, Clenoliximab, Baricitinib may be a key drug or component in the treatment of OA.
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Affiliation(s)
- Yan Liu
- Gerontology Medicine Department, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, China
| | - Wei Jiang
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, China
| | - Juan Huang
- Rehabilitation Medicine Department, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, China
| | - Li Zhong
- Gerontology Medicine Department, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, Luzhou, China
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Gracia-Ibáñez V, Rodríguez-Cervantes PJ, Granell P, Vergara M, Sancho-Bru JL. Using active or functional range of motion as a further indicator to detect hand osteoarthritis. A preliminary study. Disabil Rehabil 2024; 46:2269-2281. [PMID: 37273230 DOI: 10.1080/09638288.2023.2219068] [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: 09/26/2022] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE Propose further indicators for helping to detect hand osteoarthritis (HOA) using either active or functional ranges of motion (AROM or FROM). METHOD Hand kinematics data of 16 hand joint angles from previous studies were used, taken from healthy participants and HOA patients with differently affected joints and distinct levels of compromise. Data consisted of: (i) AROM (extreme values and ranges); (ii) FROM while performing the Sollerman Hand Function Test (mean, extreme percentiles and ranges). Two linear discriminant analyses (stepwise method) were conducted, one per dataset (AROM and FROM), with condition (healthy/patient) as the grouping variable. The potential predictors were the data from the joints with significant differences between samples for each analysis (A-predictors and F-predictors). RESULTS Good sensitivity-specificity values of 85.2-90.9% and 93.8-93.9% for F-predictors and A-predictors, respectively. Sets of predictors corresponded to the joints more commonly affected by HOA. F-predictors: lower maximal flexion of carpometacarpal and interphalangeal thumb joints, higher maximal flexion of thumb metacarpal joint, lower flexion/extension range of ring proximal interphalangeal joint and higher maximal little finger adduction. A-predictors: narrower flexion/extension range of the thumb carpometacarpal joint, lesser extension of the ring metacarpophalangeal joint; lower flexion of the middle finger proximal interphalangeal joint along with a narrower palmar arch range. CONCLUSION Both sets of predictors provide discrimination capacity of HOA with good sensitivity-specificity, slightly better for A-predictors. The AROM measurement is technically less demanding and can be clinically applied even with manual goniometry.
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Affiliation(s)
- Verónica Gracia-Ibáñez
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Castelló, Spain
| | | | - Pablo Granell
- Consorci Hospitalari Provincial de Castelló, Castelló, Spain
| | - Margarita Vergara
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Castelló, Spain
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Bawa Z, Lewis D, Gavin PD, Libinaki R, Joubran L, El-Tamimy M, Taylor G, Meltzer R, Bedoya-Pérez M, Kevin RC, McGregor IS. An open-label feasibility trial of transdermal cannabidiol for hand osteoarthritis. Sci Rep 2024; 14:11792. [PMID: 38783008 PMCID: PMC11116491 DOI: 10.1038/s41598-024-62428-x] [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: 02/23/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
Hand osteoarthritis (OA) is an irreversible degenerative condition causing chronic pain and impaired functionality. Existing treatment options are often inadequate. Cannabidiol (CBD) has demonstrated analgesic and anti-inflammatory effects in preclinical models of arthritis. In this open-label feasibility trial, participants with symptomatically active hand OA applied a novel transdermal CBD gel (4% w/w) three times a day for four weeks to their most painful hand. Changes in daily self-reported pain scores were measured on a 0-10 Numeric Pain Rating Scale (NPRS). Hand functionality was determined via daily grip strength measures using a Bluetooth equipped squeeze ball and self-report questionnaire. Quality of life (QoL) ratings around sleep, anxiety, stiffness and fatigue were also measured. All self-report measures and grip strength data were gathered via smartphone application. Urinalysis was conducted at trial end to determine systemic absorption of CBD. Eighteen participants were consented and 15 completed the trial. Pain ratings were significantly reduced over time from pre-treatment baseline including current pain (- 1.91 ± 0.35, p < 0.0001), average pain (- 1.92 ± 0.35, p < 0.0001) and maximum pain (- 1.97 ± 0.34, p < 0.0001) (data represent mean reduction on a 0-10 NPRS scale ± standard error of the mean (SEM)). A significant increase in grip strength in the treated hand (p < 0.0001) was observed although self-reported functionality did not improve. There were significant (p < 0.005) improvements in three QoL measures: fatigue, stiffness and anxiety. CBD and its metabolites were detected at low concentrations in all urine samples. Measured reductions in pain and increases in grip strength seen during treatment reverted back towards baseline during the washout phase. In summary, pain, grip strength and QoL measures, using smartphone technology, was shown to improve over time following transdermal CBD application suggesting feasibility of this intervention in relieving osteoarthritic hand pain. Proof of efficacy, however, requires further confirmation in a placebo-controlled randomised trial.Trial registration: ANZCTR public trials registry (ACTRN12621001512819, 05/11/2021).
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Affiliation(s)
- Zeeta Bawa
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Lewis
- The Daniel Lewis Rheumatology Centre, Melbourne, Victoria, Australia
| | - Paul D Gavin
- Avecho Biotechnology, Melbourne , Victoria, Australia
| | | | - Lida Joubran
- Avecho Biotechnology, Melbourne , Victoria, Australia
| | | | - Greg Taylor
- The NTF Group, Sydney, New South Wales, Australia
| | - Ryan Meltzer
- The NTF Group, Sydney, New South Wales, Australia
| | - Miguel Bedoya-Pérez
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Richard C Kevin
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Iain S McGregor
- The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia.
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.
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Lin Y, Jiang S, Su J, Xie W, Rahmati M, Wu Y, Yang S, Ru Q, Li Y, Deng Z. Novel insights into the role of ubiquitination in osteoarthritis. Int Immunopharmacol 2024; 132:112026. [PMID: 38583240 DOI: 10.1016/j.intimp.2024.112026] [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: 03/22/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
Ubiquitination (Ub) and deubiquitination are crucial post-translational modifications (PTMs) that precisely regulate protein degradation. Under the catalysis of a cascade of E1-E2-E3 ubiquitin enzymes, ubiquitination extensively regulates protein degradation exerting direct impact on various cellular processes, while deubiquitination opposes the effect of ubiquitination and prevents proteins from degradation. Notably, such dynamic modifications have been widely investigated to be implicated in cell cycle, transcriptional regulation, apoptosis and so on. Therefore, dysregulation of ubiquitination and deubiquitination could lead to certain diseases through abnormal protein accumulation and clearance. Increasing researches have revealed that the dysregulation of catalytic regulators of ubiquitination and deubiquitination triggers imbalance of cartilage homeostasis that promotes osteoarthritis (OA) progression. Hence, it is now believed that targeting on Ub enzymes and deubiquitinating enzymes (DUBs) would provide potential therapeutic pathways. In the following sections, we will summarize the biological role of Ub enzymes and DUBs in the development and progression of OA by focusing on the updating researches, with the aim of deepening our understanding of the underlying molecular mechanism of OA pathogenesis concerning ubiquitination and deubiquitination, so as to explore novel potential therapeutic targets of OA treatment.
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Affiliation(s)
- Yuzhe Lin
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China; Xiangya School of Medicine, Central South University, Changsha, China
| | - Shide Jiang
- Department of Orthopedics, The Central Hospital of Yongzhou, Yongzhou, 425000, China
| | - Jingyue Su
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenqing Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran; Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Yuxiang Wu
- Department of Health and Physical Education, Jianghan University, Wuhan 430056, China
| | - Shengwu Yang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qin Ru
- Xiangya School of Medicine, Central South University, Changsha, China; Department of Health and Physical Education, Jianghan University, Wuhan 430056, China.
| | - Yusheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Zhenhan Deng
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Wu R, Peng Q, Wang W, Zheng J, Zhou Y, Yang Q, Zhang X, Li H, Meng L. Systematic review and network meta-analysis on the efficacy and safety of parmacotherapy for hand osteoarthritis. PLoS One 2024; 19:e0298774. [PMID: 38722915 PMCID: PMC11081354 DOI: 10.1371/journal.pone.0298774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/31/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE Hand osteoarthritis poses a significant health challenge globally due to its increasing prevalence and the substantial burden on individuals and the society. In current clinical practice, treatment options for hand osteoarthritis encompass a range of approaches, including biological agents, antimetabolic drugs, neuromuscular blockers, anti-inflammatory drugs, hormone medications, pain relievers, new synergistic drugs, and other medications. Despite the diverse array of treatments, determining the optimal regimen remains elusive. This study seeks to conduct a network meta-analysis to assess the effectiveness and safety of various drug intervention measures in the treatment of hand osteoarthritis. The findings aim to provide evidence-based support for the clinical management of hand osteoarthritis. METHODS We performed a comprehensive search across PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials was conducted until September 15th, 2022, to identify relevant randomized controlled trials. After meticulous screening and data extraction, the Cochrane Handbook's risk of bias assessment tool was applied to evaluate study quality. Data synthesis was carried out using Stata 15.1 software. RESULTS 21 studies with data for 3965 patients were meta-analyzed, involving 20 distinct Western medicine agents. GCSB-5, a specific herbal complex that mainly regulate pain in hand osteoarthritis, showed the greatest reduction in pain [WMD = -13.00, 95% CI (-26.69, 0.69)]. CRx-102, s specific medication characterized by its significant effect for relieving joint stiffness symptoms, remarkably mitigated stiffness [WMD = -7.50, 95% CI (-8.90, -6.10)]. Chondroitin sulfate displayed the highest incidence of adverse events [RR = 0.26, 95% CI (0.06, 1.22)]. No substantial variation in functional index for hand osteoarthritis score improvement was identified between distinct agents and placebo. CONCLUSIONS In summary, GCSB-5 and CRx-102 exhibit efficacy in alleviating pain and stiffness in HOA, respectively. However, cautious interpretation of the results is advised. Tailored treatment decisions based on individual contexts are imperative.
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Affiliation(s)
- Ruiqi Wu
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Qinglin Peng
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Weiwei Wang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Jixian Zheng
- Hainan Medical University, Haikou, 570100, Hainan, China
| | - Yi Zhou
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Qipei Yang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Xuan Zhang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Hongyu Li
- Guangxi Orthopedic Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Lin Meng
- Guangxi Orthopedic Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
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Li R, Koh JH, Park WJ, Choi Y, Kim WU. Serum and urine lipidomic profiles identify biomarkers diagnostic for seropositive and seronegative rheumatoid arthritis. Front Immunol 2024; 15:1410365. [PMID: 38765010 PMCID: PMC11099275 DOI: 10.3389/fimmu.2024.1410365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024] Open
Abstract
Objective Seronegative rheumatoid arthritis (RA) is defined as RA without circulating autoantibodies such as rheumatoid factor and anti-citrullinated protein antibodies; thus, early diagnosis of seronegative RA can be challenging. Here, we aimed to identify diagnostic biomarkers for seronegative RA by performing lipidomic analyses of sera and urine samples from patients with RA. Methods We performed untargeted lipidomic analysis of sera and urine samples from 111 RA patients, 45 osteoarthritis (OA) patients, and 25 healthy controls (HC). These samples were divided into a discovery cohort (n = 97) and a validation cohort (n = 84). Serum samples from 20 patients with systemic lupus erythematosus (SLE) were also used for validation. Results The serum lipidome profile of RA was distinguishable from that of OA and HC. We identified a panel of ten serum lipids and three urine lipids in the discovery cohort that showed the most significant differences. These were deemed potential lipid biomarker candidates for RA. The serum lipid panel was tested using a validation cohort; the results revealed an accuracy of 79%, a sensitivity of 71%, and a specificity of 86%. Both seropositive and seronegative RA patients were differentiated from patients with OA, SLE, and HC. Three urinary lipids showing differential expression between RA from HC were identified with an accuracy of 84%, but they failed to differentiate RA from OA. There were five lipid pathways that differed between seronegative and seropositive RA. Conclusion Here, we identified a panel of ten serum lipids as potential biomarkers that can differentiate RA from OA and SLE, regardless of seropositivity. In addition, three urinary lipids had diagnostic utility for differentiating RA from HC.
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Affiliation(s)
- Rong Li
- Natural Product Research Center, Korea Institute of Science and Technology (KIST), Gangneung, Republic of Korea
- Department of Marine Bio Food Science, Gangneung-Wonju National University, Gangneung, Republic of Korea
| | - Jung Hee Koh
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Center for Integrative Rheumatoid Transcriptomics and Dynamics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woo Jung Park
- Department of Marine Bio Food Science, Gangneung-Wonju National University, Gangneung, Republic of Korea
| | - Yongsoo Choi
- Natural Product Research Center, Korea Institute of Science and Technology (KIST), Gangneung, Republic of Korea
- Division of National Product Applied Science, KIST School, Korea University of Science and Technology, Seoul, Republic of Korea
| | - Wan-Uk Kim
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Center for Integrative Rheumatoid Transcriptomics and Dynamics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Genaro LE, Marconato JV, Tagliaferro EPDS, Pinotti FE, Valsecki Júnior A, Adas Saliba T, Rosell FL. Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:539. [PMID: 38791748 PMCID: PMC11121688 DOI: 10.3390/ijerph21050539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 05/26/2024]
Abstract
This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.
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Affiliation(s)
- Luis Eduardo Genaro
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - José Victor Marconato
- School of Medicine, San Francisco University, Bragança Paulista 12.916-900, SP, Brazil;
| | - Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Felipe Eduardo Pinotti
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Aylton Valsecki Júnior
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Tânia Adas Saliba
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Fernanda Lopez Rosell
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
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Bean MB, Favero M, Ramonda R, Scanzello CR. Erosive Hand Osteoarthritis: Recent Advances and Future Treatments. Curr Rheumatol Rep 2024; 26:103-111. [PMID: 38214806 PMCID: PMC10965372 DOI: 10.1007/s11926-023-01130-9] [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] [Accepted: 12/28/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE OF THE REVIEW Erosive hand osteoarthritis (EHOA) is an aggressive form of hand osteoarthritis that leads to significant disability, and recent data suggests that it is increasing in prevalence. This review provides an update of our current understanding of epidemiology, genetic associations, biomarkers, pathogenesis, and treatment of EHOA, with particular focus on studies published within the last 5 years. RECENT FINDINGS New studies of EHOA have identified new genetic loci associated with disease, including variants in genes involved in inflammation and bone remodeling. Preclinical studies implicate pathways of innate immunity, including some that may be causal in the condition. Recent novel studies showed that inflammatory features identified by ultrasound and MRI are associated with development of erosive lesions over time on conventional radiography. In the future, these imaging modalities may be useful in identifying patients at risk of adverse outcomes. Promising new findings in genetics, biomarkers, and treatment targets will hopefully allow for future therapeutic options for this debilitating condition.
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Affiliation(s)
- Marta B Bean
- Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
| | - Marta Favero
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
- Medicine Unit 1, Ca' Foncello Hospital, Treviso, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED, Padova University Hospital, Padova, Italy
| | - Carla R Scanzello
- Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Department of Medicine & Translational Musculoskeletal Research Center, Corp. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA
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Silva-Díaz M, Pértega-Díaz S, Balboa-Barreiro V, Tilve-Álvarez CM, Raga-Sivira A, Rego-Pérez I, Blanco FJ, Oreiro N. Metabolic syndrome is not associated with erosive hand osteoarthritis: a cross-sectional study using data from the PROCOAC cohort. Sci Rep 2024; 14:5968. [PMID: 38472231 DOI: 10.1038/s41598-024-55374-1] [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: 10/05/2023] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
To delineate the phenotype of erosive hand osteoarthritis (EHOA) in a Spanish population and assess its correlation with metabolic syndrome. We conducted a cross-sectional study using baseline data from the Prospective Cohort of Osteoarthritis from A Coruña (PROCOAC). Demographic and clinical variables, obtained through questionnaires, clinical examinations, and patient analytics, were compared among individuals with hand OA, with and without EHOA. We performed appropriate univariate and multivariate stepwise regression analyses using SPSS v28. Among 1039 subjects diagnosed with hand OA, 303 exhibited EHOA. Multivariate logistic regression analysis revealed associations with inflamed joints, nodular hand OA, and total AUSCAN. Furthermore, the association with a lower prevalence of knee OA remained significant. The influence of metabolic syndrome (MetS) on EHOA patients was analyzed by including MetS as a covariate in the model. It was observed that MetS does not significantly impact the presence of EHOA, maintaining the effect size of other factors. In conclusion, in the PROCOAC cohort, EHOA is associated with nodular hand OA, inflammatory hand OA, and a higher total AUSCAN. However, EHOA is linked to a lower prevalence of knee OA. Importantly, in our cohort, no relationship was found between EHOA and MetS.
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Affiliation(s)
- Maite Silva-Díaz
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain
| | - Sonia Pértega-Díaz
- Grupo de Investigación en Reumatología y Salud (GIR-S), Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña, A Coruña, Spain
| | - Vanesa Balboa-Barreiro
- Unidad de Epidemiología Clínica y Bioestadística, INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Carlos M Tilve-Álvarez
- Avances en Telemedicina e Informática Sanitaria (ATIS), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Ana Raga-Sivira
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain
| | - Ignacio Rego-Pérez
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain.
| | - Francisco J Blanco
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain.
- Grupo de Investigación en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, A Coruña, Spain.
| | - Natividad Oreiro
- Grupo de Investigación Clinica en Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario A Coruña (CHUAC), SERGAS, As Xubias, 15006, A Coruña, Spain
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Valerio T, Milan JL, Goislard de Monsabert B, Vigouroux L. The effect of trapeziometacarpal joint passive stiffness on mechanical loadings of cartilages. J Biomech 2024; 166:112042. [PMID: 38498967 DOI: 10.1016/j.jbiomech.2024.112042] [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: 09/05/2023] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024]
Abstract
Hypermobility of the trapeziometacarpal joint is commonly considered to be a potential risk factor for osteoarthritis. Nevertheless, the results remain controversial due to a lack of quantitative validation. The objective of this study was to evaluate the effect of joint laxity on the mechanical loadings of cartilage. A patient-specific finite element model of trapeziometacarpal joint passive stiffness was developed. The joint passive stiffness was modeled by creating linear springs all around the joint. The linear spring stiffness was determined by using an optimization process to fit force-displacement data measured during laxity tests performed on eight healthy volunteers. The estimated passive stiffness parameters were then included in a full thumb finite element simulation of a pinch grip task driven by muscle forces to evaluate the effect on trapeziometacarpal loading. The correlation between stiffness and the loading of cartilage in terms of joint contact pressure and maximum shear strain was analyzed. A significant negative correlation was found between the trapeziometacarpal joint passive stiffness and the contact pressure on trapezium cartilage during the simulated pinch grip task. These results therefore suggest that the hypermobility of the trapeziometacarpal joint could affect the contact pressure on trapezium cartilage and support the existence of an increased risk associated with hypermobility.
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Affiliation(s)
- Thomas Valerio
- Aix-Marseille University, CNRS, ISM, Marseille, France; Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.
| | - Jean-Louis Milan
- Aix-Marseille University, CNRS, ISM, Marseille, France; Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
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Gulati M, Brewer G, Judge A, Kennedy D, Vincent TL, Watt FE. Could sex-specific subtypes of hand osteoarthritis exist? A retrospective study in women presenting to secondary care. FRONTIERS IN PAIN RESEARCH 2024; 5:1331187. [PMID: 38410176 PMCID: PMC10895010 DOI: 10.3389/fpain.2024.1331187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/25/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Hand osteoarthritis is more common in women, and its risk increases around the time of the menopause. We set out to describe the timing between menopause and the onset of symptomatic hand osteoarthritis (OA), and associations with the use of hormone replacement therapy (HRT) or its discontinuation, describing any identifiable subgroups of women. Methods Retrospective healthcare-records study of sequential women referred to a specialist hand OA clinic, 2007-2015. Confirmation of hand OA diagnosis was by clinican, by accepted criteria. Demographics and clinical variables were from healthcare-records, recorded by standardised proforma. Outcomes of interest were reported age of onset of hand symptoms, reported age at final menstrual period (FMP), time from FMP to reported onset of hand symptoms and time from cessation of HRT to reported onset of hand symptoms. Exposure categories for systemic HRT use were never users, current users, previous users. Analysis of Variance compared groups; linear regression analysed associations of exposure with outcome. Results 82/92(89%) of eligible women were post-menopausal, mean age at FMP 49.9 years (SD5.4). In these post-menopausal women, median time from FMP to hand symptom onset was 3 years. 48/82 (59%) developed hand symptoms within the defined peri-menopausal period (FMP ± 4 years), whilst some women developed their symptoms before or after (range -25, 30 years). In women who discontinued HRT prior to symptom onset, the median time from HRT cessation to onset of hand symptoms was 6 months. Past HRT users were older at hand symptom onset than women who had not taken HRT [coeff.4.7 years (0.92, 8.39); P = 0.015]. Conclusions This study adds to evidence associating the menopause/sex hormone deficiency with hand OA symptom onset in a sizeable subgroup of women (but not all). HRT use/cessation appears to influence the timing of onset of hand OA symptoms. It is not possible to interpret from this type of study whether sex hormone deficiency is causative of disease or modulates its symptoms. It is also not possible to judge whether painful hand osteoarthritis in post-menopausal women is a subtype of disease. Further investigation is indicated of sex-specific subtypes and potential for personalised medicine for post-menopausal women with hand osteoarthritis, as a clearly definable high-risk subgroup.
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Affiliation(s)
- Malvika Gulati
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
- Department of Rheumatology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Gretchen Brewer
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Andrew Judge
- Musculoskeletal Research Unit, University of Bristol, Bristol, United Kingdom
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre (NIHR Bristol BRC), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Donna Kennedy
- Therapies Department, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Tonia L. Vincent
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
- Department of Rheumatology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Fiona E. Watt
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
- Department of Rheumatology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- Department of Immunology & Inflammation, Hammersmith Campus, Imperial College London, London, United Kingdom
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Song S, Graham-Engeland JE, Kim J. Associations Between Psychological Stress and Hand Pain Among Rural and Urban Adults: Findings From the KoGES Community Cohort Study. THE JOURNAL OF PAIN 2024; 25:362-375. [PMID: 37659447 DOI: 10.1016/j.jpain.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
Despite known health disparities in chronic pain conditions between rural and urban adults, few studies have examined whether longitudinal associations between psychological stress and hand pain differ. Utilizing community-based cohort data, this study examined whether rural and urban adults differed in the extent to which psychological distress was associated with hand osteoarthritis (OA) symptoms and later functional limitations related to hand pain. Community-dwelling adults (mean age = 51.97, 52.3% women) in a rural (n = 2,971) and urban area (n = 2,782) provided demographic data at baseline and, at a 4-year follow-up, responded to questionnaires about psychological distress and clinical symptoms of hand OA. Levels of functional limitations in hands were assessed at an 8-year follow-up. Ordinal logistic and linear regression were conducted to examine the effects of psychological distress on hand OA symptoms and functional limitations, and whether associations between psychological distress and these pain outcomes were moderated by residential area. The results showed that psychological distress was associated with a higher risk for hand OA symptoms and functional limitations, even after adjusting for demographic and health covariates. There was significant moderation by residential area, such that the association between psychological distress and hand OA was significant only among rural adults and the association with functional limitations was stronger in rural adults than urban adults. Findings suggest greater vulnerability to hand arthritis and hand-related functional limitations among rural adults and the potential for tailored intervention programs to help resolve health disparities among rural communities. PERSPECTIVE: This study compares the association between psychological distress and hand pain outcomes between rural and urban adults using community-based cohort data and suggests that rural adults are more vulnerable to experiencing negative effects of psychological distress on concurrent hand OA symptoms and longitudinal functional limitations in hands.
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Affiliation(s)
- Sunmi Song
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul, South Korea; Department of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea; Department of Physical Therapy, College of Health Science, Korea University, Seoul, South Korea
| | | | - Junesun Kim
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul, South Korea; Department of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea; Department of Physical Therapy, College of Health Science, Korea University, Seoul, South Korea; BK21FOUR Program: Learning Health Systems, College of Health Science, Korea University, Seoul, South Korea
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Hamzehpour H, Óskarsdóttir Á, Jónsson H, Jónsdóttir F, Sigurjónsson ÓE, Snorradottir BS. Transdermal Drug Delivery of Tazarotene: Determining Tazarotene's Potential in Local Transdermal Therapy. Pharmaceutics 2023; 16:64. [PMID: 38258075 PMCID: PMC10820539 DOI: 10.3390/pharmaceutics16010064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
Retinoid-based drugs, while effective, are associated with systemic toxicity. Topical alternatives offer a safer option, and tazarotene, a third-generation synthetic retinoid, holds promise. This study investigates tazarotene's transdermal delivery potential, focusing on its application for joint-related conditions. The aim of this study was to investigate the suitability of tazarotene as a candidate for transdermal delivery into joints. In vitro permeation studies, using porcine skin, assessed tazarotene's transdermal drug delivery from solution and gel formulations. A tape-stripping analysis determined stratum corneum retention and a pilot study using porcine joints assessed tazarotene's ability to reach articular cartilage. Ultra Performance Liquid Chromatography coupled with a mass detector method was used to quantify tazarotene and tazarotenic acid permeation. The results validate that tazarotene can permeate porcine skin and accumulate in articular cartilage in detectable amounts. The detection of tazarotene and tazarotenic acid in both the in vitro permeation studies and the pilot study on porcine joints validate the drug's potential therapeutic use for hand osteoarthritis. This study lays the groundwork for future research, contributing insights into tazarotene's potential for transdermal drug delivery and guiding further exploration in topical retinoid applications.
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Affiliation(s)
- Helena Hamzehpour
- Faculty of Pharmaceutical Sciences, University of Iceland, 107 Reykjavik, Iceland; (H.H.)
| | - Ástrós Óskarsdóttir
- Faculty of Pharmaceutical Sciences, University of Iceland, 107 Reykjavik, Iceland; (H.H.)
| | - Helgi Jónsson
- Faculty of Medicine, University of Iceland, 107 Reykjavik, Iceland;
| | - Fjóla Jónsdóttir
- Faculty of Industrial Engineering, Mechanical Engineering and Computer Science, University of Iceland, 107 Reykjavik, Iceland;
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Srikesavan C, Dean B, Toye F, Bolt A, Thurley N. Experiences of people with hand osteoarthritis and perceptions of clinicians and carers on quality of life and treatment services: A qualitative synthesis. HAND THERAPY 2023; 28:121-132. [PMID: 38033524 PMCID: PMC10683712 DOI: 10.1177/17589983231210762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/11/2023] [Indexed: 12/02/2023]
Abstract
Introduction We aimed to synthesise the experiences of people living with hand osteoarthritis (HOA) and the perceptions of clinicians and carers relating to the quality of life and treatment services. Methods We undertook a systematic search on MEDLINE, Embase, and CINAHL electronic databases for qualitative studies in HOA. We used the Critical Appraisal Skills Programme (CASP) checklist to assess methodological quality and thematically-synthesise the findings. We used GRADE-CERQual (Grading of Recommendations Assessment, Development, and Evaluation- Confidence in the Evidence from Reviews of Qualitative Research) to assess the quality of the evidence. Results We identified 13 studies involving people with HOA (288 women and 39 men, average age 61.4 years) and clinicians. Five themes were identified from studies involving people with HOA: i) My hands are painful whenever I use them; ii) It stops me doing everyday activities; iii) It stops me doing things I value; iv) It's psychologically challenging and v) I find ways of doing things. The quality of evidence was moderate except for pain with low quality of evidence. Most studies were conducted in Europe and the United Kingdom with participants recruited predominantly from hospital settings. We were not able to synthesise the three studies that involved clinicians as each explored different topics of HOA. There were no studies that involved carers. Conclusions Our findings highlighted the impact of HOA in various areas of life and the need for personalised psychological support in practice.
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Affiliation(s)
- Cynthia Srikesavan
- Nuffield Department of Orthopaedics and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Benjamin Dean
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Francine Toye
- Physiotherapy Research Unit, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Oxford, UK
| | - Alex Bolt
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Neal Thurley
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
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Zhu Y, Li J, Zhang Y, Zhang W, Doherty M, Yang Z, Cui Y, Zeng C, Lei G, Yang T, Wei J. Association between hyperuricaemia and hand osteoarthritis: data from the Xiangya Osteoarthritis Study. RMD Open 2023; 9:e003683. [PMID: 38053456 DOI: 10.1136/rmdopen-2023-003683] [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: 09/04/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023] Open
Abstract
OBJECTIVE The pathogenesis of hand osteoarthritis (OA) remains unknown. Hyperuricaemia, which is related to inflammation, may play a role in hand OA, but evidence is lacking. In a large population-based study, we examined the association between hyperuricaemia and hand OA. METHODS Participants were from the Xiangya OA Study, a community-based observational study. Hyperuricaemia was defined as serum urate >416 µmol/L in men and >357 µmol/L in women. Radiographic hand OA (RHOA) was defined as presence of the modified Kellgren-Lawrence grade ≥2 in any hand joint. Symptomatic hand OA (SHOA) was defined as presence of both self-reported symptoms and RHOA in the same hand. The associations of hyperuricaemia with RHOA or SHOA were examined using generalised estimating equations. RESULTS Among 3628 participants, the prevalence of RHOA was higher in participants with hyperuricaemia than those with normouricaemia (26.9% vs 20.9%), with an adjusted OR (aOR) of 1.34 (95% CI 1.11 to 1.61). The associations were consistent in men (aOR 1.33, 95% CI 1.01 to 1.74) and women (aOR 1.35, 95% CI 1.05 to 1.74). Hyperuricaemia was mainly associated with bilateral RHOA (aOR 1.54, 95% CI 1.18 to 2.01) but not unilateral RHOA (aOR 1.13, 95% CI 0.89 to 1.45). Prevalence of SHOA was higher, although statistically insignificant, in participants with hyperuricaemia (aOR 1.39, 95% CI 0.94 to 2.07). CONCLUSION In this population-based study, hyperuricaemia was associated with a higher prevalence of hand OA. Future prospective studies are required to investigate the temporal relationship. TRIAL REGISTRATION NUMBER NCT04033757.
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Affiliation(s)
- Yanqiu Zhu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jiatian Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Weiya Zhang
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, University of Nottingham, Nottingham, UK
| | - Michael Doherty
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, University of Nottingham, Nottingham, UK
| | - Zidan Yang
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Cui
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, China
| | - Chao Zeng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Tuo Yang
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
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Wei J, Yang Z, Li J, Zhang Y, Zhang W, Doherty M, Yang T, Yang Y, Li H, Wang Y, Wu Z, Li C, Lei G, Zeng C. Association between gut microbiome-related metabolites and symptomatic hand osteoarthritis in two independent cohorts. EBioMedicine 2023; 98:104892. [PMID: 38006743 PMCID: PMC10775900 DOI: 10.1016/j.ebiom.2023.104892] [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: 05/15/2023] [Revised: 09/26/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Since gut microbiome dysbiosis can cause inflammatory disorders by affecting host metabolism, we postulate that the gut microbiome and related metabolites could play a role in hand osteoarthritis. We characterised gut microbiome-related metabolites in people with symptomatic hand osteoarthritis (SHOA) in two independent cohorts. METHODS Using data collected from a large-sample community-based observational study (discovery cohort), we assessed the relations of the microbial function and plasma key metabolites related to altered microbial function with SHOA. Finally, we verified the relations of plasma metabolites to SHOA in an independent observational study (validation cohort). FINDINGS In the discovery cohort (n = 1359), compared to those without SHOA, participants with SHOA had significantly altered microbial functions related to tryptophan metabolism (Q = 0.025). Therefore we measured the plasma tryptophan metabolites and found that participants with SHOA had higher levels of 5-hydroxyindoleacetic acid (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.09-1.42) and 5-hydroxytryptophol (OR = 1.13, 95% CI: 1.04-1.23), but lower levels of indole-3-lactic acid (ILA) (OR = 0.85, 95% CI: 0.72-1.00), skatole (OR = 0.93, 95% CI: 0.88-0.99) and 3-hydroxyanthranilic acid (OR = 0.90, 95% CI: 0.85-0.96). Findings from the validation cohort (n = 142) verified that lower levels of ILA were related to SHOA (OR = 0.70, 95% CI: 0.53-0.92). INTERPRETATION Alterations of the microbial function of tryptophan biosynthesis and tryptophan metabolites, especially lower levels of ILA, are associated with SHOA. These findings suggest the role of the microbiome and tryptophan metabolites in developing of SHOA and may contribute to future translational opportunities. FUNDING National Key Research and Development Plan and National Natural Science Foundation of China.
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Affiliation(s)
- Jie Wei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China; Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
| | - Zidan Yang
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China; Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China; Bioinformatics Center, Xiangya Hospital, Central South University, Changsha, China
| | - Jiatian Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA; The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Weiya Zhang
- Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK; Pain Centre Versus Arthritis, Nottingham, UK
| | - Michael Doherty
- Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK; Pain Centre Versus Arthritis, Nottingham, UK
| | - Tuo Yang
- Academic Rheumatology, Clinical Sciences Building, University of Nottingham, City Hospital, Nottingham, UK; Pain Centre Versus Arthritis, Nottingham, UK; Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Yuanheng Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China; Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
| | - Yilun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China; Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
| | - Ziying Wu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Changjun Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital, Central South University, Changsha, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China; Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, China; Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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21
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Wang Y, Jones G, Keen HI, Hill CL, Wluka AE, Kasza J, Teichtahl AJ, Antony B, O'Sullivan R, Cicuttini FM. Methotrexate to treat hand osteoarthritis with synovitis (METHODS): an Australian, multisite, parallel-group, double-blind, randomised, placebo-controlled trial. Lancet 2023; 402:1764-1772. [PMID: 37839420 DOI: 10.1016/s0140-6736(23)01572-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Hand osteoarthritis is a disabling condition with few effective therapies. Hand osteoarthritis with synovitis is a common inflammatory phenotype associated with pain. We aimed to examine the efficacy and safety of methotrexate at 6 months in participants with hand osteoarthritis and synovitis. METHODS In this multisite, parallel-group, double-blind, randomised, placebo-controlled trial, participants (aged 40-75 years) with hand osteoarthritis (Kellgren and Lawrence grade ≥2 in at least one joint) and MRI-detected synovitis of grade 1 or more were recruited from the community in Melbourne, Hobart, Adelaide, and Perth, Australia. Participants were randomly assigned (1:1) using block randomisation, stratified by study site and self-reported sex, to receive methotrexate 20 mg or identical placebo orally once weekly for 6 months. The primary outcome was pain reduction (measured with a 100 mm visual analogue scale; VAS) in the study hand at 6 months assessed in the intention-to-treat population. Safety outcomes were assessed in all randomly assigned participants. This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000877381). FINDINGS Between Nov 22, 2017, and Nov 8, 2021, of 202 participants who were assessed for eligibility, 97 (48%) were randomly assigned to receive methotrexate (n=50) or placebo (n=47). 68 (70%) of 97 participants were female and 29 (30%) were male. 42 (84%) of 50 participants in the methotrexate group and 40 (85%) of 47 in the placebo group provided primary outcome data. The mean change in VAS pain at 6 months was -15·2 mm (SD 24·0) in the methotrexate group and -7·7 mm (25·3) in the placebo group, with a mean between-group difference of -9·9 (95% CI -19·3 to -0·6; p=0·037) and an effect size (standardised mean difference) of 0·45 (0·03 to 0·87). Adverse events occurred in 31 (62%) of 50 participants in the methotrexate group and 28 (60%) of 47 participants in the placebo group. INTERPRETATION Treatment of hand osteoarthritis and synovitis with 20 mg methotrexate for 6 months had a moderate but potentially clinically meaningful effect on reducing pain, providing proof of concept that methotrexate might have a role in the management of hand osteoarthritis with an inflammatory phenotype. FUNDING National Health and Medical Research Council of Australia.
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Affiliation(s)
- Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Helen I Keen
- Rheumatology Group, School of Medicine, University of Western Australia, Perth, WA, Australia; Department of Rheumatology, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Catherine L Hill
- The Queen Elizabeth Hospital and Department of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Anita E Wluka
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Alfred Hospital, Melbourne, VIC, Australia
| | - Jessica Kasza
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Richard O'Sullivan
- Lumus Imaging, Richmond, VIC, Australia; Department of Medicine, Central Clinical School, Monash University, Prahran, VIC, Australia
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Alfred Hospital, Melbourne, VIC, Australia.
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22
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Li H, Jiang X, Xiao Y, Zhang Y, Zhang W, Doherty M, Nestor J, Li C, Ye J, Sha T, Lyu H, Wei J, Zeng C, Lei G. Combining single-cell RNA sequencing and population-based studies reveals hand osteoarthritis-associated chondrocyte subpopulations and pathways. Bone Res 2023; 11:58. [PMID: 37914703 PMCID: PMC10620170 DOI: 10.1038/s41413-023-00292-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/17/2023] [Accepted: 09/07/2023] [Indexed: 11/03/2023] Open
Abstract
Hand osteoarthritis is a common heterogeneous joint disorder with unclear molecular mechanisms and no disease-modifying drugs. In this study, we performed single-cell RNA sequencing analysis to compare the cellular composition and subpopulation-specific gene expression between cartilage with macroscopically confirmed osteoarthritis (n = 5) and cartilage without osteoarthritis (n = 5) from the interphalangeal joints of five donors. Of 105 142 cells, we identified 13 subpopulations, including a novel subpopulation with inflammation-modulating potential annotated as inflammatory chondrocytes. Fibrocartilage chondrocytes exhibited extensive alteration of gene expression patterns in osteoarthritic cartilage compared with nonosteoarthritic cartilage. Both inflammatory chondrocytes and fibrocartilage chondrocytes showed a trend toward increased numbers in osteoarthritic cartilage. In these two subpopulations from osteoarthritic cartilage, the ferroptosis pathway was enriched, and expression of iron overload-related genes, e.g., FTH1, was elevated. To verify these findings, we conducted a Mendelian randomization study using UK Biobank and a population-based cross-sectional study using data collected from Xiangya Osteoarthritis Study. Genetic predisposition toward higher expression of FTH1 mRNA significantly increased the risk of hand osteoarthritis (odds ratio = 1.07, 95% confidence interval: 1.02-1.11) among participants (n = 332 668) in UK Biobank. High levels of serum ferritin (encoded by FTH1), a biomarker of body iron overload, were significantly associated with a high prevalence of hand osteoarthritis among participants (n = 1 241) of Xiangya Osteoarthritis Study (P-for-trend = 0.037). In conclusion, our findings indicate that inflammatory and fibrocartilage chondrocytes are key subpopulations and that ferroptosis may be a key pathway in hand osteoarthritis, providing new insights into the pathophysiology and potential therapeutic targets of hand osteoarthritis.
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Affiliation(s)
- Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, 410008, Hunan, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaofeng Jiang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, 410008, Hunan, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
| | - Yongbing Xiao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, 410008, Hunan, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02115, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Weiya Zhang
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
- Pain Centre Versus Arthritis UK, Nottingham, NG5 1PB, UK
| | - Michael Doherty
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
- Pain Centre Versus Arthritis UK, Nottingham, NG5 1PB, UK
| | - Jacquelyn Nestor
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Changjun Li
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, 410008, Hunan, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Jing Ye
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, 410008, Hunan, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
| | - Tingting Sha
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, 410008, Hunan, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
| | - Houchen Lyu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Jie Wei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China.
- Health Management Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410008, Hunan, China.
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, 410008, Hunan, China.
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, 410008, Hunan, China.
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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23
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Li X, Tao H, Zhou J, Zhang L, Shi Y, Zhang C, Sun W, Chu M, Chen K, Gu C, Yang X, Geng D, Hao Y. MAGL inhibition relieves synovial inflammation and pain via regulating NOX4-Nrf2 redox balance in osteoarthritis. Free Radic Biol Med 2023; 208:13-25. [PMID: 37516370 DOI: 10.1016/j.freeradbiomed.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
Osteoarthritis (OA) is a degenerative joint disease characterized by cartilage injury, hyperplasia of bone and inflammatory lesions of synovium. Monoacylglycerol lipase (MAGL), a member of the α/β hydrolase superfamily, is involved in regulation of injury protection and immune-inflammation response. Autoinflammatory response of the synovium and the release of inflammatory mediators play critical roles in occurrence of early-stage OA. Fibroblast-like synoviocytes (FLSs) are resident mesenchymal cells of the synovial tissue. Considering that MAGL inhibition regulates the inflammatory signaling cascade, it is crucial to ascertain the biological effects and specific mechanisms of MAGL in alleviating inflammatory infiltration of OA FLSs. The aim of this study was to investigate the effect of MAGL on biological function in OA FLSs. Results from in vitro experiments showed that MAGL blockade not only effectively inhibited proliferation, invasion and migration of FLSs, but also downregulated expression of inflammatory-associated proteins. Sequencing results indicated that MAGL inhibition significantly suppressed NOX4-mediated oxidative stress, thus promoting Nrf2 nuclear accumulation and inhibiting generation of intracellular reactive oxygen species (ROS). Attenuation of NOX4 further alleviated redox dysplasia and ultimately improved tumor-like phenotypes, such as abnormal proliferation, migration and migration of FLSs. In vivo results corroborated this finding, with MAGL inhibition found to modulate pain and disease progression in an OA rat model. Collectively, these results indicate that MAGL administration is an ideal therapy treating OA.
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Affiliation(s)
- Xueyan Li
- Anesthesiology Department, Suzhou Municipal Hospital (North District), Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China
| | - Huaqiang Tao
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China
| | - Jing Zhou
- Orthopedics and Sports Medicine Center, Suzhou Municipal Hospital, Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, 226000, China
| | - Liyuan Zhang
- Anesthesiology Department, Suzhou Municipal Hospital (North District), Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China
| | - Yi Shi
- Anesthesiology Department, Suzhou Municipal Hospital (North District), Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China
| | - Chun Zhang
- Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 999, Xiwang Road, Shanghai, China
| | - Wen Sun
- Anesthesiology Department, Suzhou Municipal Hospital (North District), Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China
| | - Miao Chu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China
| | - Kai Chen
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China
| | - Chengyong Gu
- Anesthesiology Department, Suzhou Municipal Hospital (North District), Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, China.
| | - Xing Yang
- Orthopedics and Sports Medicine Center, Suzhou Municipal Hospital, Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, 226000, China.
| | - Dechun Geng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, China.
| | - Yuefeng Hao
- Orthopedics and Sports Medicine Center, Suzhou Municipal Hospital, Nanjing Medical University Affiliated Suzhou Hospital, 242, Guangji Road, Suzhou, Jiangsu, 226000, China.
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Sankar J, Prasad CB, Mathew J, Dhir V, Jain S. Erosive hand osteoarthritis. QJM 2023; 116:871-872. [PMID: 37267217 DOI: 10.1093/qjmed/hcad114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Indexed: 06/04/2023] Open
Affiliation(s)
- J Sankar
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - C B Prasad
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - J Mathew
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - V Dhir
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - S Jain
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
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25
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Kubo T, Miyazaki K, Shibuya M, Sugihara E, Nakata M, Okuno Y. Intra-Arterial Injection of Temporary Embolic Material Through a Needle Inserted into the Radial or Ulnar Artery for Distal and Proximal Interphalangeal Joint Osteoarthritis: A Retrospective Study of 92 Patients. Cardiovasc Intervent Radiol 2023; 46:1375-1382. [PMID: 37524895 DOI: 10.1007/s00270-023-03514-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/06/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE To assess the efficacy and safety of intra-arterial injection of imipenem/cilastatin sodium (IPM/CS) via a needle placed into the radial artery or ulnar artery (RA/UA) for distal interphalangeal and proximal interphalangeal joint osteoarthritis (DIP/PIP-OA). MATERIALS AND METHODS This is a retrospective single-arm cohort study. Ninety-two patients [92% women, mean (SD) age 55(8.3) years] with a primary DIP/PIP-OA meet the American College of Rheumatology criteria for hand osteoarthritis with pain ≥ 4 on the 0-10 numeric rating scale (NRS) were enrolled. All procedures were performed by injecting IPM/CS through a 24-gauge needle percutaneously inserted into the RA/UA. Two procedures were planned; the second procedure was scheduled 1-2 months after the first. NRS, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, Patient Global Impression of Change (PGIC) scale, and procedure-related adverse events were evaluated. RESULTS Technical success, defined as injection of IPM/CS into the RA/UA, was achieved in all patients. Clinical success, defined as a reduction of 2 points or more in the NRS at 12 months, was 77% (95% confidence interval 68-85%). The NRS improved from the baseline to 3, 6, and 12 months (7.8 ± 1.6 vs. 3.8 ± 2.6, 3.9 ± 2.7, and 4.0 ± 2.8, respectively, all p < 0.001). The QuickDASH score improved from the baseline to 12 months (27 ± 15 vs. 19 ± 17, p < 0.001) respectively. No major adverse events were observed. CONCLUSIONS Intra-arterial injection of IPM/CS is a feasible treatment option for DIP/PIP-OA.
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Affiliation(s)
- Takatoshi Kubo
- Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Musculoskeletal Intervention Center, Okuno Clinic Tokyo, 4th Fl Ginrei Bldg., 7-8-4, Roppongi, Minato-ku, Tokyo, 106-0032, Japan
| | - Koichi Miyazaki
- Musculoskeletal Intervention Center, Okuno Clinic Osaka, 3rd Fl Shinsaibashi Front Bldg., 3-5-11, Minamifunaba, Chuo-ku, Osaka City, Osaka, 542-0081, Japan
| | - Masahiko Shibuya
- Musculoskeletal Intervention Center, Okuno Clinic Kobe, B1 Fl, 1-2-1, Sannomiyacho, Chuo-ku, Kobe City, Hyogo, 650-0021, Japan
| | - Eiji Sugihara
- Musculoskeletal Intervention Center, Okuno Clinic Tokyo, 4th Fl Ginrei Bldg., 7-8-4, Roppongi, Minato-ku, Tokyo, 106-0032, Japan
| | - Masaya Nakata
- Musculoskeletal Intervention Center, Okuno Clinic Tokyo, 4th Fl Ginrei Bldg., 7-8-4, Roppongi, Minato-ku, Tokyo, 106-0032, Japan
| | - Yuji Okuno
- Musculoskeletal Intervention Center, Okuno Clinic Tokyo, 4th Fl Ginrei Bldg., 7-8-4, Roppongi, Minato-ku, Tokyo, 106-0032, Japan.
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Gracia-Ibáñez V, Jarque-Bou NJ, Bayarri-Porcar V, Roda-Sales A, Granell P, Vergara M, Sancho-Bru JL. Impact of hand osteoarthritis in women on maximal forces in six different grasp types. Sci Rep 2023; 13:14565. [PMID: 37666905 PMCID: PMC10477324 DOI: 10.1038/s41598-023-39198-z] [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: 02/15/2023] [Accepted: 07/21/2023] [Indexed: 09/06/2023] Open
Abstract
This work aims to: (1) Provide maximal hand force data on six different grasp types for healthy subjects; (2) detect grasp types with maximal force significantly affected by hand osteoarthritis (HOA) in women; (3) look for predictors to detect HOA from the maximal forces using discriminant analyses. Thirty-three healthy subjects (37 ± 17 years, 17 women, 16 men) and 30 HOA patients (72 ± 9 years, all women) participated in the experiment. Participants were asked to exert their maximal force while performing six different grasp types 3 times. Two MANOVAs were conducted to detect if force depended on gender in healthy participants and if force significantly diminished in women with HOA. Finally, a linear discriminant analysis for detecting HOA was performed using forces of the grasp types that were significantly affected by HOA. Gender-disaggregated statistics are provided for healthy participants. Significant differences are obtained for all grasp types per gender. The women with HOA exerted significantly lower force values (p < 0.001) for all the grasp types than healthy ones. The discriminant analysis revealed that oblique grasp was the most significant one for detecting HOA. A discrimination equation was obtained with a specificity of 88.2% and a sensitivity of 83.3%. This work provides grip force data on six grasp types for healthy participants and for women with HOA. HOA women present reduced strength in all grasps due to pathology. Three of these grasps are a novelty. Oblique grasp strength may suffice to discriminate a patient with HOA, which might help non-invasive HOA detection.
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Affiliation(s)
- Verónica Gracia-Ibáñez
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castelló, Spain.
| | - Néstor J Jarque-Bou
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castelló, Spain
| | - Vicente Bayarri-Porcar
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castelló, Spain
| | - Alba Roda-Sales
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castelló, Spain
| | - Pablo Granell
- Consorci Hospitalari Provincial de Castelló, Av. del Dr. Clarà, 19, 12002, Castelló, Spain
| | - Margarita Vergara
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castelló, Spain
| | - Joaquín L Sancho-Bru
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castelló, Spain
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van der Meulen C, van de Stadt LA, Rosendaal FR, Runhaar J, Kloppenburg M. Determination and characterization of patient subgroups based on pain trajectories in hand osteoarthritis. Rheumatology (Oxford) 2023; 62:3035-3042. [PMID: 36648311 PMCID: PMC10473188 DOI: 10.1093/rheumatology/kead017] [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: 10/24/2022] [Revised: 12/06/2022] [Accepted: 12/24/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES To investigate pain, pain trajectories and their determinants in hand osteoarthritis (OA). METHODS Data from the HOSTAS (Hand OSTeoArthritis in Secondary care) consisting of consecutive hand OA patients were used. Australian Canadian Osteoarthritis Hand Index (AUSCAN) pain was measured yearly for four years. Patients with complete AUSCAN at ≥2 time points were eligible for longitudinal analysis. Associations between variables of interest and baseline AUSCAN pain were investigated with linear regression. Development of pain over time was modelled using latent class growth analysis (LCGA). Associations of LCGA classes with variables of interest were analysed using multinomial logistic regression adjusted for baseline pain. RESULTS A total of 484/538 patients [mean (s.d.) age 60.8 (8.5) years, 86% women, mean (s.d.) AUSCAN pain 9.3 (4.3)] were eligible for longitudinal analysis. Sex, marital and working status, education, disease duration and severity, anxiety and depression scores, lower health-related quality of life (HR-QoL), specific illness perceptions and coping styles were associated with baseline pain. LCGA yielded three classes, characterized by average pain levels at baseline; average pain remained stable over time within classes. Classes with more pain were positively associated with BMI, tender joint count, symptom duration, hand function scores and depression scores, negatively with physical HR-QoL, and education level. CONCLUSION Baseline pain was associated with patient and disease characteristics, and psychosocial factors. LCGA showed three pain trajectories in hand OA patients, with different baseline pain levels and stable pain over time. Classes were distinguished by BMI, education level, disease severity, depression and HR-QoL.
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Affiliation(s)
- Coen van der Meulen
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lotte A van de Stadt
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos Runhaar
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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Suh YS, Kim HO, Lee CH, Yoon CH, Cheon YH, Kim M, Lee H, Lee SI. Correspondence on '2018 update of the EULAR recommendations for the management of hand osteoarthritis'. Ann Rheum Dis 2023; 82:e209. [PMID: 33082128 DOI: 10.1136/annrheumdis-2020-218887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Young Sun Suh
- Rheumatology, Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Gyeongsangnam-do, Republic of Korea
- Rheumatology, Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-do, Republic of Korea
| | - Hyun-Ok Kim
- Rheumatology, Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Gyeongsangnam-do, Republic of Korea
- Rheumatology, Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-do, Republic of Korea
| | - Chang Han Lee
- Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
- Rehabilitation Medicine, Gyeongsang National University College of Medicine, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Chul Ho Yoon
- Rehabilitation Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
- Rehabilitation Medicine, Gyeongsang National University College of Medicine, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Yun-Hong Cheon
- Rheumatology, Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Gyeongsangnam-do, Republic of Korea
- Rheumatology, Internal Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Mingyo Kim
- Rheumatology, Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Gyeongsangnam-do, Republic of Korea
- Rheumatology, Internal Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Hanna Lee
- Rheumatology, Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Gyeongsangnam-do, Republic of Korea
- Rheumatology, Internal Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Sang-Il Lee
- Rheumatology, Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Gyeongsangnam-do, Republic of Korea
- Rheumatology, Internal Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnam-do, Republic of Korea
- Internal Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
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van der Meulen C, van de Stadt LA, Claassen A, Kroon FPB, Ritt MJPF, Rosendaal FR, Terpstra SES, Vochteloo AJH, Kloppenburg M. Surgical denervation as a treatment strategy for pain in hand osteoarthritis: a systematic literature review. RMD Open 2023; 9:e003134. [PMID: 37532467 PMCID: PMC10401234 DOI: 10.1136/rmdopen-2023-003134] [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: 03/07/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVE Surgical denervation has been proposed as a treatment for pain in hand osteoarthritis (OA). This review aimed to summarise the available evidence and to propose a research agenda. METHODS A systematic literature search was performed up to September 2022. Two investigators independently identified studies that reported on denervation for OA of the proximal interphalangeal, distal interphalangeal, metacarpophalangeal or carpometacarpal joints. Quality of studies was assessed and study characteristics, patient characteristics, details of the surgical technique and outcomes of the surgery were extracted. RESULTS Of 169 references, 17 articles reporting on 384 denervations in 351 patients were selected. Sixteen case series reported positive outcomes with respect to pain, function and patient satisfaction. One non-randomised clinical trial reported no difference in outcome when comparing denervation of the first carpometacarpal (CMC I) joint to trapeziectomy. Adverse events were frequent, with sensory abnormalities occurring the most, followed by the need for revision surgery. All studies had significant risk of bias. CONCLUSION Surgical denervation for pain in hand OA shows some promise, but the available evidence does not allow any conclusions of efficacy and higher-quality research is needed. Techniques should be harmonised and more data regarding how denervation compares to current usual care, other denervation methods or placebo in terms of outcomes and adverse events are needed.
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Affiliation(s)
| | - Lotte A van de Stadt
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
| | - Aniek Claassen
- Dutch Society for Rheumatology, Utrecht, The Netherlands
| | - Féline P B Kroon
- Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
| | - Marco J P F Ritt
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Frits R Rosendaal
- Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Anne J H Vochteloo
- Department of Orthopaedics, OCON Orthopedische kliniek, Hengelo, The Netherlands
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Kiełbowski K, Herian M, Bakinowska E, Banach B, Sroczyński T, Pawlik A. The Role of Genetics and Epigenetic Regulation in the Pathogenesis of Osteoarthritis. Int J Mol Sci 2023; 24:11655. [PMID: 37511413 PMCID: PMC10381003 DOI: 10.3390/ijms241411655] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Osteoarthritis (OA) is progressive disease characterised by cartilage degradation, subchondral bone remodelling and inflammation of the synovium. The disease is associated with obesity, mechanical load and age. However, multiple pro-inflammatory immune mediators regulate the expression of metalloproteinases, which take part in cartilage degradation. Furthermore, genetic factors also contribute to OA susceptibility. Recent studies have highlighted that epigenetic mechanisms may regulate the expression of OA-associated genes. This review aims to present the mechanisms of OA pathogenesis and summarise current evidence regarding the role of genetics and epigenetics in this process.
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Affiliation(s)
| | | | | | | | | | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.K.); (M.H.); (E.B.); (B.B.); (T.S.)
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Tveter AT, Kleven L, Osteras N, Nossum R, Eide REM, Klokkeide Å, Matre KH, Olsen M, Kjeken I. Is multimodal occupational therapy in addition to usual care cost-effective in people with thumb carpometacarpal osteoarthritis? A cost-utility analysis of a randomised controlled trial. BMJ Open 2023; 13:e063103. [PMID: 37355263 PMCID: PMC10314563 DOI: 10.1136/bmjopen-2022-063103] [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: 04/11/2022] [Accepted: 05/30/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVE The aim was to evaluate the cost-utility of a 3-month multimodal occupational therapy intervention in addition to usual care in patients with thumb carpometacarpal osteoarthritis (CMC1 OA). METHODS A cost-utility analysis was performed alongside a multicentre randomised controlled trial including three rheumatology departments in Norway. A total of 180 patients referred to surgical consultation due to CMC1 OA were randomised to either multimodal occupational therapy including patient education, hand exercises, assistive devices and orthoses (n=90), or usual care receiving only information on OA (n=90). The outcome measure was quality-adjusted life-years (QALYs) derived from the generic questionnaire EQ-5D-5L over a 2-year period. Resource use and health-related quality of life of the patients were prospectively collected at baseline, 4, 18 and 24 months. Costs were estimated by taking a healthcare and societal perspective. The results were expressed as incremental cost-effectiveness ratios, and a probabilistic sensitivity analysis with 1000 replications following intention-to-treat principle was done to account for uncertainty in the analysis. RESULTS During the 2-year follow-up period, patients receiving multimodal occupational therapy gained 0.06 more QALYs than patients receiving usual care. The mean (SD) direct costs were €3227 (3546) in the intervention group and €4378 (5487) in the usual care group, mean difference €-1151 (95% CI -2564, 262). The intervention was the dominant treatment with a probability of 94.5% being cost-effective given the willingness-to-pay threshold of €27 500. CONCLUSIONS The within-trial analysis demonstrated that the multimodal occupational therapy in addition to usual care was cost-effective at 2 years in patients with CMC1 OA. TRIAL REGISTRATION NUMBER NCT01794754.
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Affiliation(s)
- Anne Therese Tveter
- Center for Treatment in Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Linn Kleven
- Reviews and Health Technology Assessments, Norwegian Institute of Public Health, Oslo, Norway
| | - Nina Osteras
- Center for Treatment in Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Randi Nossum
- Department of Clinical services, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | | | - Åse Klokkeide
- Department of Rheumatology, Haugesund Sanitary Association Rheumatism Hospital, Haugesund, Norway
| | - Karin Hoegh Matre
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
| | - Monika Olsen
- Department of Rheumatology, Haugesund Sanitary Association Rheumatism Hospital, Haugesund, Norway
| | - Ingvild Kjeken
- Center for Treatment in Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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van Beest S, van de Stadt LA, Rosendaal FR, Kloppenburg M. Patients with clinically diagnosed hand OA not fulfilling the ACR classification criteria are in an earlier disease phase and more often have thumb base OA. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100347. [PMID: 36942210 PMCID: PMC10023912 DOI: 10.1016/j.ocarto.2023.100347] [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: 10/20/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Objective To investigate the performance of the American College of Rheumatology (ACR) classification criteria for hand osteoarthritis. Design Longitudinal data up to four years from a cohort of consecutive patients with primary hand osteoarthritis diagnosed by their rheumatologist (Hostas study) were used to classify presence or absence of hand osteoarthritis according to the 1990 ACR criteria (traditional format: one major and 4 minor ACR criteria) (ACR+/ACR-). Demographics, Australian/Canadian osteoarthritis hand index (AUSCAN) pain and function were obtained. Hand radiographs were scored according to Kellgren-Lawrence; radiographic osteoarthritis was defined as Kellgren-Lawrence ≥2 in ≥1 CMC1 joint or ≥2 DIP/PIP/MCP joints. Results Of 538 patients (mean age 61 years, 86.1% women) 485 (90.1%) fulfilled ACR criteria at baseline. Except for the minor criterion swelling of <3 MCP joints, all criteria differed between the groups. ACR- patients were younger, with higher BMI, a shorter time since diagnosis, and less bony enlargements, joint deformities and radiographic osteoarthritis, except for radiographic CMC1 osteoarthritis which was seen more often in ACR- patients. No difference in AUSCAN pain or function was seen between ACR- versus ACR+ patients. After follow-up 37/53 (69.8%) converted to ACR+, 2/53 (3.8%) did not, and 14/53 (26.4%) were lost to follow-up. Conclusions In clinical practice the majority of patients fulfill the ACR classification criteria, but those in an earlier disease phase, with less signs of hand osteoarthritis or with primarily thumb base osteoarthritis are less likely to fulfill them. New classification criteria also including earlier disease stages and with attention for hand osteoarthritis subtypes are required.
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Affiliation(s)
- Sjoerd van Beest
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
- Corresponding author. Department of Rheumatology Leiden University Medical Center, C1-R PO Box, 9600 2300, RC Leiden the Netherlands
| | - Lotte A. van de Stadt
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R. Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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Valerio T, Vigouroux L, Goislard de Monsabert B, De Villeneuve Bargemon JB, Milan JL. Relationship between trapeziometacarpal joint morphological parameters and joint contact pressure: a possible factor of osteoarthritis development. J Biomech 2023; 152:111573. [PMID: 37037117 DOI: 10.1016/j.jbiomech.2023.111573] [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: 06/07/2022] [Revised: 03/10/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
The trapeziometacarpal (TMC) joint is the one of the hand joints that is most affected by osteoarthritis (OA). The objective of this study was to determine if specific morphological parameters could be related to the amount of pressure endured by the joint which is one of the factors contributing to the development of this pathology. We developed 15 individualized 3D computer aided design (CAD) models of the TMC joint, each generated from the CT scan of a different participant. For each participant, we measured several crucial morphological parameters: the width and length of the trapezium bone and dorso-volar and ulno-radial curvature, of the trapezium and the metacarpal bone. Each CAD model was converted into a finite element model, of both bones and the cartilage located in between. The joint forces applied during pinch grip and power grip tasks were then applied in order to estimate the contact pressures on joint cartilage for each model. Correlations between joint contact pressures and morphology of the trapezium and the metacarpal bone were then analysed. Important variations of TMC joint pressures were observed. For both pinch and power grip tasks, the strongest correlation with joint contact pressure was with the dorso-volar curvature of the trapezium bone. Our findings indicate that dorso-volar curvature of the trapezium bone has a significant impact on mechanical loadings on the TMC joint. This contributes to understanding the prevalence of OA in certain patients.
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Affiliation(s)
- Thomas Valerio
- Aix-Marseille University, CNRS, ISM, Marseille, France; Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.
| | | | | | | | - Jean-Louis Milan
- Aix-Marseille University, CNRS, ISM, Marseille, France; Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France
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Watt FE. Is it Autumn for colchicine and osteoarthritis? THE LANCET. RHEUMATOLOGY 2023; 5:e240-e241. [PMID: 38251582 DOI: 10.1016/s2665-9913(23)00097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/07/2023]
Affiliation(s)
- Fiona E Watt
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Hammersmith Campus, Imperial College London, London W12 0NN, UK; Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK; Rheumatology Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
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Binvignat M, Emond P, Mifsud F, Miao B, Courties A, Lefèvre A, Maheu E, Crema MD, Klatzmann D, Kloppenburg M, Richette P, Butte AJ, Mariotti-Ferrandiz E, Berenbaum F, Sokol H, Sellam J. Serum Tryptophan Metabolites are Associated with Erosive Hand Osteoarthritis and Pain: Results from the DIGICOD Cohort. Osteoarthritis Cartilage 2023:S1063-4584(23)00761-6. [PMID: 37105396 DOI: 10.1016/j.joca.2023.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To investigate host and gut-microbiota related Tryptophan metabolism in hand osteoarthritis (HOA). METHODS The baseline serum concentration of 20 Tryptophan metabolites was measured in 416 HOA patients in a cross-sectional analysis of the DIGICOD cohort. Tryptophan metabolites levels, metabolite-ratios and metabolism pathway activation were compared between erosive (N=141) and non-erosive HOA (N=275) by multiple logistic regressions adjusted on age, BMI and sex. The association between Tryptophan metabolite levels and HOA symptoms was investigated by a Spearman's rank correlation analysis. RESULTS Four serum Tryptophan metabolites, eight metabolite ratios and one metabolism pathway were associated with erosive HOA. Erosive HOA was negatively associated with Tryptophan (odds ratio (OR)=0.41, 95% confidence interval [0.24-0.70]), indole-3-aldehyde (OR=0.67 [0.51-0.90]) and 3-OH-anthranilic acid (OR=1.32 [1.13-1.54]) and positively with 5-OH-Tryptophan levels (OR=1.41 [1.13-1.77]). The pro-inflammatory kynurenine-indoleamine 2,3-dioxygenase pathway was upregulated in erosive HOA (OR=1.60 [1.11-2.29]). Eleven metabolites were correlated with HOA symptoms and were mostly pain-related. Serotonin and N-acetyl serotonin levels were negatively correlated with number of tender joints. Indole-3-aldehyde level was negatively correlated and 3-OH-anthranilic acid, 3-OH-kynurenine and 5-OH-Tryptophan levels were positively correlated with number of patients-reported painful joints. Quinolinic acid and 3-OH-kynurenine levels correlated positively with AUSCAN pain. CONCLUSIONS Tryptophan metabolites disturbance is associated with erosive HOA and pain and emphasize the role of low-grade inflammation and gut dysbiosis in HOA.
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Affiliation(s)
- Marie Binvignat
- Department of Rheumatology, Sorbonne Université, Saint-Antoine Hospital, INSERM UMRS-938, Centre de Recherche Saint-Antoine (CRSA), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Immunology, Immunopathology, Immunotherapy I3 Lab, Inserm URMS 959, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France; Bakar Computational Health Science Institute, University of California, San Francisco, San Francisco,CA, USA; Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France
| | - Patrick Emond
- IBrain Lab, Inserm UMR 1253 Université de Tours, Tours France; Department of Nuclear Medicine, Centre Hospitalo-Universitaire de Tours, Tours France
| | - Francois Mifsud
- Université de Paris, BFA, CNRS UMR 8251, 75013 Paris, France; Diabetes Center, University of California San Francisco, San Francisco, CA, USA
| | - Brenda Miao
- Bakar Computational Health Science Institute, University of California, San Francisco, San Francisco,CA, USA
| | - Alice Courties
- Department of Rheumatology, Sorbonne Université, Saint-Antoine Hospital, INSERM UMRS-938, Centre de Recherche Saint-Antoine (CRSA), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France
| | - Antoine Lefèvre
- IBrain Lab, Inserm UMR 1253 Université de Tours, Tours France
| | - Emmanuel Maheu
- Department of Rheumatology, Sorbonne Université, Saint-Antoine Hospital, INSERM UMRS-938, Centre de Recherche Saint-Antoine (CRSA), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Michel D Crema
- Institute of Sports Imaging, French National Institute of Sports (INSEP), Paris, France
| | - David Klatzmann
- Immunology, Immunopathology, Immunotherapy I3 Lab, Inserm URMS 959, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France; Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (i2B), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Margreet Kloppenburg
- Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pascal Richette
- Department of Rheumatology, Lariboisière Hospital, INSERM U1132, Université de Paris, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Atul J Butte
- Bakar Computational Health Science Institute, University of California, San Francisco, San Francisco,CA, USA
| | - Encarnita Mariotti-Ferrandiz
- Immunology, Immunopathology, Immunotherapy I3 Lab, Inserm URMS 959, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Francis Berenbaum
- Department of Rheumatology, Sorbonne Université, Saint-Antoine Hospital, INSERM UMRS-938, Centre de Recherche Saint-Antoine (CRSA), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France
| | - Harry Sokol
- Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France; Department of Gastroenterology Sorbonne Université, Saint Antoine Hospital, Centre de Recherche Saint-Antoine (CRSA) INSERM UMRS-938, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, France
| | - Jérémie Sellam
- Department of Rheumatology, Sorbonne Université, Saint-Antoine Hospital, INSERM UMRS-938, Centre de Recherche Saint-Antoine (CRSA), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France.
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Gracia-Ibáñez V, Agost MJ, Bayarri-Porcar V, Granell P, Vergara M, Sancho-Bru JL. Hand kinematics in osteoarthritis patients while performing functional activities. Disabil Rehabil 2023; 45:1124-1130. [PMID: 35298313 DOI: 10.1080/09638288.2022.2051082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To identify the impact of kinematic limitations on hand osteoarthritis patients' ability to perform daily living activities. METHODS An experiment was performed on 33 patients and 32 healthy subjects. Active ranges of motion (AROM) of 16 hand joint angles were measured, together with scores of different hand tests of dexterity (Box and Block, Nine Hole Peg, Kapandji) and function (Sollerman Hand Function Test, SHFT). Functional ranges of motion (FROM) were recorded during SHFT tasks. Results by task are also reported. RESULTS Patients' AROM is limited in flexion of thumb carpometacarpal and interphalangeal, and finger metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, and in palmar arch. Patients scored worse in gross dexterity and opposition, but only Kapandji score was correlated with AROM limitations. Pain is mostly reported in patients with limited extension of finger MCP and PIP joints. Patients used significantly different FROM in almost all the joints, and needed more time to accomplish the SHFT tasks. CONCLUSIONS AROM measurements can be used as indicators for early diagnosis. Patients use specific strategies to accomplish each task, arising from AROM limitations; some tasks with very extreme postures. The tasks where precision or force are required for thumb are the most affected ones.Implications for rehabilitationActive range of motion is an indicator for early hand osteoarthritis diagnosis.Patients' functional ranges are reduced, and thumb opposition and gross dexterity are hindered.Rehabilitation should focus especially on tasks requiring precision and thumb strength.Rehabilitation should favor the improvement of task completion times.
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Affiliation(s)
- Verónica Gracia-Ibáñez
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Castellón de la Plana, Spain
| | - Maria-Jesus Agost
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Castellón de la Plana, Spain
| | - Vicente Bayarri-Porcar
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Castellón de la Plana, Spain
| | - Pablo Granell
- Consorci Hospitalari Provincial de Castelló, Castellón de la Plana, Spain
| | - Margarita Vergara
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Castellón de la Plana, Spain
| | - Joaquin L Sancho-Bru
- Department of Mechanical Engineering and Construction, Universitat Jaume I, Castellón de la Plana, Spain
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Boneva B, Marchev A, Amirova K, Ganova P, Georgiev M, Tchorbanov A, Mihaylova N. Crocus sativus Extract as a Biological Agent for Disease-Modifying Therapy of Collagenase-Induced Mouse Model of Osteoarthritis. Life (Basel) 2023; 13:life13040894. [PMID: 37109424 PMCID: PMC10143021 DOI: 10.3390/life13040894] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Objectives: Osteoarthritis (OA) is an age-related joint disease that involves the degeneration of cartilage and is the most prevalent form of arthritis, affecting a large part of the population. OA is a multifactorial disorder, and no single etiological mechanism has been found to be common to all forms of the disease. Currently used therapies for control of the disease are mainly nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid medications. The aim of this study was to investigate the extract from Crocus sativus as a biological disease-suppressing therapy agent. Methods: Balb/c mice were injected intra-articularly with Clostridium histolyticum type IA for induction of osteoarthritis. The mice were randomized to five groups: control group, I group (CIOA untreated), II group (CIOA + 100 mg/kg/daily saffron), III group (CIOA + 50 mg/kg/daily saffron), IV group (CIOA + 25 mg/kg/daily saffron). Flow-cytometry analysis was used to study the splenocytes’ phenotype isolated from the treated animals. The serum levels of inflammatory and anti-inflammatory cytokines were analyzed with ELISA. The histological assessment was used to analyze the saffron extract effect on histopathological alterations. Results: Saffron treatment significantly decreased osteoarthritis-associated joint histological manifestations and decreased serum TNFα levels. The flow-cytometry analysis showed a decrease in pro-inflammatory immune cell subtypes in the spleen. Conclusions: The results obtained suggest that saffron affected the disease progression and could be a potential therapeutic approach in osteoarthritic patients’ therapy.
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Affiliation(s)
- Blagovesta Boneva
- Laboratory of Experimental Immunology, Institute of Microbiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Andrey Marchev
- Laboratory of Metabolomics, The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 139 Ruski Blvd, 4000 Plovdiv, Bulgaria
| | - Kristiana Amirova
- Laboratory of Metabolomics, The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 139 Ruski Blvd, 4000 Plovdiv, Bulgaria
| | - Petya Ganova
- Laboratory of Immunohistochemistry and Immunopathology, Institute of Microbiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Milen Georgiev
- Laboratory of Metabolomics, The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, 139 Ruski Blvd, 4000 Plovdiv, Bulgaria
| | - Andrey Tchorbanov
- Laboratory of Experimental Immunology, Institute of Microbiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Nikolina Mihaylova
- Laboratory of Immunohistochemistry and Immunopathology, Institute of Microbiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
- Correspondence: ; Tel.: +359-2-979-3140; Fax: +359-2-870-0109
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Cambon-Binder A, Jaisson S, Tuffet S, Courties A, Eymard F, Okwieka A, Gillery P, Miquel A, Rousseau A, Crema MD, Berenbaum F, Sellam J. Serum carboxymethyllysine concentration is associated with erosive hand osteoarthritis. Osteoarthritis Cartilage 2023:S1063-4584(23)00727-6. [PMID: 36931384 DOI: 10.1016/j.joca.2023.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/30/2023] [Accepted: 03/03/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE Carboxymethyllysine (CML) and homocitrulline (HCit) are the products of two non-enzymatic post-translational modifications of protein, a process related to age. We investigated whether serum CML and HCit concentrations were associated with hand osteoarthritis (HOA), especially erosive HOA. DESIGN Serum CML and HCit were measured by using liquid chromatography coupled with tandem mass spectrometry at inclusion in 386 patients included in the DIGICOD cohort. We investigated whether serum CML and/or HCit concentrations were associated with erosive HOA or with HOA clinical and radiological features. Moreover, we compared the tissular concentrations of CML and HCit in OA and non-OA cartilage from proximal interphalangeal and metacarpo-phalangeal (MCP) joints from human cadaveric donors. RESULTS Median (IQR) serum CML concentration was lower in patients with erosive HOA than those with non-erosive HOA (178.7 [157.1-208.8] vs 194.7 [168.9-217.1] μmol/mol Lys, p=0.002), but median HCit concentration did not differ between the groups (193.9 [162.9-232.0] vs 193.9 [155.9-224.6] μmol/mol Lys). Cartilage HCit and CML concentrations were not correlated with clinical features. Serum CML concentration was higher in OA than non-OA MCPs (7.0 vs 4.0 mmol/mol Lys, p=0.01). CONCLUSIONS Serum CML concentration was lower in erosive HOA than non-erosive HOA, and cartilage CML concentration was higher in OA than non-OA cartilage. These results encourage further studies to test whether serum CML could be a new prognostic biomarker in HOA.
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Affiliation(s)
- A Cambon-Binder
- Sorbonne University, Assistance Publique-Hôpitaux de Paris (AP-HP), Orthopaedic and Upper Limb Surgery Department, Saint-Antoine Hospital, Paris, France; Centre de Recherche Saint-Antoine, INSERM UMRS_938, Paris, France
| | - S Jaisson
- MEDyC Unit CNRS UMR n° 7369, Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France; Biochemistry Department, University Hospital of Reims, Reims, France
| | - S Tuffet
- Sorbonne University, AP-HP, Service de Pharmacologie Clinique et Plateforme de Recherche Clinique de l'Est Parisien (URCEST, CRB, CRC), Saint-Antoine Hospital, Paris, France
| | - A Courties
- Centre de Recherche Saint-Antoine, INSERM UMRS_938, Paris, France; Sorbonne University, AP-HP, Rheumatology department, Saint-Antoine Hospital, Paris, France
| | - F Eymard
- Department of Rheumatology, AP-HP, Henri Mondor Hospital, 94000 Créteil, France
| | - A Okwieka
- MEDyC Unit CNRS UMR n° 7369, Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France; Biochemistry Department, University Hospital of Reims, Reims, France
| | - P Gillery
- MEDyC Unit CNRS UMR n° 7369, Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France; Biochemistry Department, University Hospital of Reims, Reims, France
| | - A Miquel
- Sorbonne University, AP-HP, Radiology Department, Saint-Antoine Hospital, Paris, France
| | - A Rousseau
- Sorbonne University, AP-HP, Service de Pharmacologie Clinique et Plateforme de Recherche Clinique de l'Est Parisien (URCEST, CRB, CRC), Saint-Antoine Hospital, Paris, France
| | - M D Crema
- Institut d'Imagerie du Sport, Institut National du Sport, de l'Expertise et de la Performance (INSEP), Paris, France
| | - F Berenbaum
- Centre de Recherche Saint-Antoine, INSERM UMRS_938, Paris, France; Sorbonne University, AP-HP, Rheumatology department, Saint-Antoine Hospital, Paris, France
| | - J Sellam
- Centre de Recherche Saint-Antoine, INSERM UMRS_938, Paris, France; Sorbonne University, AP-HP, Rheumatology department, Saint-Antoine Hospital, Paris, France.
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Hoveidaei AH, Nakhostin-Ansari A, Chalian M, Razavi SE, Khonji MS, Hosseini-Asl SH, Darijani SR, Pooyan A, LaPorte DM. Burden of Hand Osteoarthritis in the Middle East and North Africa (MENA): An Epidemiological Analysis From 1990 to 2019. J Hand Surg Am 2023; 48:245-256. [PMID: 36710229 DOI: 10.1016/j.jhsa.2022.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE Hand osteoarthritis (OA) is a common cause of disability in older people. Although often underemphasized, it may affect quality of life and imposes a considerable burden on the health system. This study evaluated the epidemiology of hand OA in the Middle East and North Africa (MENA) region. METHODS This epidemiological study was performed based on the Global Burden of Disease study from 1990 to 2019. The incidence, prevalence, and years lived with disability (YLD) in all 21 MENA countries during the study period were reported in rate, age-standardized, and percentage. RESULTS Hand osteoarthritis in MENA increased 2.7-fold, from 1.6 million cases to 4.3 million from 1990 to 2019 with an age-standardized incidence rate of 50.2 (95% CI, 38.2-66.4) per 100,000 people in 2019. Saudi Arabia had the highest age-standardized prevalence in both 1990 (2.3%) and 2019 (2.3%), whereas Turkey had the lowest (0.3%) in both years. Total YLDs due to hand osteoarthritis increased by more than 2.7-fold, from 50,335 to 135,336 during the study period. The highest rate of increase in YLD rate from 1990 to 2019 was in Iran (3.3) and the largest decrease was in Qatar (-11.5). CONCLUSIONS In contrast to the global trend, MENA hand OA prevalence and YLDs did not decrease between 1990 and 2019 and remained constant over time. Aging and increasing obesity rates, particularly among women, might be the contributing factors. Hand OA epidemiology varies by country, possibly due to genetic, ethnic, and environmental factors. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Affiliation(s)
- Amir Human Hoveidaei
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Chalian
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA
| | - Seyed Erfan Razavi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saeid Khonji
- Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Hosseini-Asl
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Atefe Pooyan
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA
| | - Dawn M LaPorte
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
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40
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Lepkowsky CM. Ageism, Mentalism, and Ableism Shape Telehealth Policy. Am J Geriatr Psychiatry 2023; 31:235-236. [PMID: 36414487 PMCID: PMC9674953 DOI: 10.1016/j.jagp.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Charles M. Lepkowsky
- Send correspondence and reprint requests to Charles M. Lepkowsky, Ph.D., Independent Practice, 1143 Deer Trail Lane, Solvang, CA
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41
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Wang W, Shi H, Liu Y, Sun Y, Chen Y, Liu Z. Efficacy and safety of acupuncture for hand osteoarthritis: study protocol for a multi-center, randomized, sham-controlled clinical trial. J Orthop Surg Res 2023; 18:89. [PMID: 36747297 PMCID: PMC9901154 DOI: 10.1186/s13018-023-03570-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hand osteoarthritis (OA) is a prevalent disorder in the general population. Patients with hand OA often report symptoms of pain, stiffness, and functional limitations, which cause clinical burden and impact on quality of daily life. However, the efficacy of current therapies for hand OA is limited. Other therapies with better effects and less adverse events are in urgent need. Acupuncture is well known for analgesia and has been proved effective in treating basal thumb joint arthritis. This study aims to clarify the efficacy and safety of acupuncture treatment for clinical symptomatic improvement of hand OA. METHODS This will be a sham-controlled, randomized, multi-center clinical trial. A total of 340 participants will be recruited and randomly allocated to either traditional acupuncture group or sham acupuncture group. All participants will receive 12 treatment sessions over 4 weeks and 2 follow-up assessments in the following 3 months at week 8 and week 16. The primary outcome will be the proportion of responders at week 5. Secondary outcomes will include visual analog scale, Australian Canadian Osteoarthritis Hand Index, Functional Index for hand OA, the number of symptomatic joints, hand grip strength and pinch strength, global assessment, the World Health Organization Quality of Life abbreviated version and expectations. Safety will be evaluated during the whole process of the trial. All outcomes will be analyzed following the intention-to-treat principle. DISCUSSION This prospective trial will provide high-quality evidence on evaluating the efficacy and safety of acupuncture treatment for hand OA. Results of this trial might contribute in offering a new option to clinical recommendations. Trial registration ClinicalTrials.gov Identifier: NCT05267093. Registered 23 February 2022.
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Affiliation(s)
- Weiming Wang
- grid.410318.f0000 0004 0632 3409Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hangyu Shi
- grid.410318.f0000 0004 0632 3409Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China ,grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, China
| | - Yan Liu
- grid.24695.3c0000 0001 1431 9176Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanjie Sun
- grid.410318.f0000 0004 0632 3409Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Chen
- New Zealand College of Chinese Medicine, Auckland, New Zealand
| | - Zhishun Liu
- Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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Khosasih V, Liu KM, Huang CM, Liou LB, Hsieh MS, Lee CH, Tsai CY, Kuo SY, Hwa SY, Yu CL, Chang CH, Lin CJ, Hsieh SC, Cheng CY, Chen WM, Chen LK, Chuang HP, Chen YT, Tsai PC, Lu LS, H’ng WS, Zhang Y, Chen HC, Chen CH, Lee MTM, Wu JY. A Functional Polymorphism Downstream of Vitamin A Regulator Gene CYP26B1 Is Associated with Hand Osteoarthritis. Int J Mol Sci 2023; 24:ijms24033021. [PMID: 36769350 PMCID: PMC9918232 DOI: 10.3390/ijms24033021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
While genetic analyses have revealed ~100 risk loci associated with osteoarthritis (OA), only eight have been linked to hand OA. Besides, these studies were performed in predominantly European and Caucasian ancestries. Here, we conducted a genome-wide association study in the Han Chinese population to identify genetic variations associated with the disease. We recruited a total of 1136 individuals (n = 420 hand OA-affected; n = 716 unaffected control subjects) of Han Chinese ancestry. We carried out genotyping using Axiom Asia Precisi on Medicine Research Array, and we employed the RegulomeDB database and RoadMap DNase I Hypersensitivity Sites annotations to further narrow down our potential candidate variants. Genetic variants identified were tested in the Geisinger's hand OA cohort selected from the Geisinger MyCode community health initiative (MyCode®). We also performed a luciferase reporter assay to confirm the potential impact of top candidate single-nucleotide polymorphisms (SNPs) on hand OA. We identified six associated SNPs (p-value = 6.76 × 10-7-7.31 × 10-6) clustered at 2p13.2 downstream of the CYP26B1 gene. The strongest association signal identified was rs883313 (p-value = 6.76 × 10-7, odds ratio (OR) = 1.76), followed by rs12713768 (p-value = 1.36 × 10-6, OR = 1.74), near or within the enhancer region closest to the CYP26B1 gene. Our findings showed that the major risk-conferring CC haplotype of SNPs rs12713768 and rs10208040 [strong linkage disequilibrium (LD); D' = 1, r2 = 0.651] drives 18.9% of enhancer expression activity. Our findings highlight that the SNP rs12713768 is associated with susceptibility to and severity of hand OA in the Han Chinese population and that the suggested retinoic acid signaling pathway may play an important role in its pathogenesis.
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Affiliation(s)
- Vivia Khosasih
- Taiwan International Graduate Program in Molecular Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Taipei 115, Taiwan
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Kai-Ming Liu
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Chung-Ming Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Correspondence: (C.-M.H.); (J.-Y.W.)
| | - Lieh-Bang Liou
- Division of Rheumatology, Allergy and Immunology, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Ming-Shium Hsieh
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Orthopedics, Taipei Medical University Hospital, Taipei 110, Taiwan
- Department of Orthopedics, En Chu Kong Hospital, New Taipei 237, Taiwan
| | - Chian-Her Lee
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Orthopedics, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chang-Youh Tsai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - San-Yuan Kuo
- Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Su-Yang Hwa
- Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Chia-Li Yu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
- Institute of Molecular Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Chih-Hao Chang
- Department of Orthopedics, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei 100, Taiwan
- Department of Orthopedics, National Taiwan University Hospital Jin-Shan Branch, New Taipei City 208, Taiwan
| | - Cheng-Jyh Lin
- Department of Orthopedics, China Medical University Hospital, Taichung 404, Taiwan
| | - Song-Chou Hsieh
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chun-Ying Cheng
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Orthopedic, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Wei-Ming Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Orthopaedics and Traumatology, Taipei Veteran General Hospital, Taipei 112, Taiwan
| | - Liang-Kuang Chen
- Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan
| | - Hui-Ping Chuang
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Ying-Ting Chen
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Pei-Chun Tsai
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Liang-Suei Lu
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Weng-Siong H’ng
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
| | - Yanfei Zhang
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA
| | - Hsiang-Cheng Chen
- Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Chien-Hsiun Chen
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
- School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Ming Ta Michael Lee
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA
- School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Jer-Yuarn Wu
- Taiwan International Graduate Program in Molecular Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Taipei 115, Taiwan
- National Center for Genome Medicine, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
- School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Correspondence: (C.-M.H.); (J.-Y.W.)
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43
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Arauz PG, Garcia J, Peralta M, Baldo M, Garcia G. Functional evaluation of optimal index finger proximal interphalangeal joint fusion angle using a simulated joint arthrodesis. J Biomech 2023; 147:111442. [PMID: 36634402 DOI: 10.1016/j.jbiomech.2023.111442] [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: 09/19/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
This study aims at qualitatively and quantitatively evaluating the effects of simulated index finger proximal interphalangeal (PIP) joint fusion angles on hand kinematic function and performance. Although arthrodesis of the index finger PIP joint is an effective medical procedure that produces a durable, pain-free, and stable joint, it permanently immobilizes the joint. Twenty healthy subjects performed basic functional hand activities with the index finger PIP joint unconstrained (UC) and constrained to selected angles under surveillance of a motion capture system. Our results indicate differences in perceived difficulty, time performance, and the functional ROM of the hand joints when the index finger PIP joint is UC and constrained to 0, 20, and 40 degrees of flexion. The mean total perceived difficulty scores for all 6 tasks were higher for the PIP at 0 degrees than for the UC condition (p < 0.001) and for the PIP at 40 degrees (p = 0.048). The functional ROM presented a smaller total number of hand joints affected by the PIP at 20 degrees (25 in total) than the PIP at 0 (31 in total) and 40 (27 in total) degrees during execution of all 6 tasks tested. Therefore, the decision on the appropriate index finger PIP angle for arthrodesis may be between 20 and 40 degrees, as globally for all 6 tasks tested, 0 degrees exhibited the worst results regarding perceived difficulty, performance time, and number of joints with affected ROM. Selecting the appropriate angle for arthrodesis should consider a more complete set of functional activities.
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Affiliation(s)
- Paul G Arauz
- Colegio de Ciencias e Ingenierías "El Politécnico", Universidad San Francisco de Quito USFQ, Quito 17901, Ecuador.
| | - Jose Garcia
- Colegio de Ciencias e Ingenierías "El Politécnico", Universidad San Francisco de Quito USFQ, Quito 17901, Ecuador
| | - Micaela Peralta
- Colegio de Ciencias e Ingenierías "El Politécnico", Universidad San Francisco de Quito USFQ, Quito 17901, Ecuador
| | - Marcos Baldo
- Colegio de Ciencias e Ingenierías "El Politécnico", Universidad San Francisco de Quito USFQ, Quito 17901, Ecuador
| | - Gabriela Garcia
- Colegio de Ciencias e Ingenierías "El Politécnico", Universidad San Francisco de Quito USFQ, Quito 17901, Ecuador
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Tenti S, Bruyère O, Cheleschi S, Reginster JY, Veronese N, Fioravanti A. An update on the use of conventional and biological disease-modifying anti-rheumatic drugs in hand osteoarthritis. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158618. [PMID: 36937821 PMCID: PMC10017945 DOI: 10.1177/1759720x231158618] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/02/2023] [Indexed: 03/15/2023] Open
Abstract
Osteoarthritis (OA) is a highly prevalent condition worldwide associated with pain, progressive disability, reduced participation in social activities, and impaired quality of life. Despite its growing burden, the therapeutic options are still limited and almost exclusively addressed to symptoms' management, while no disease-modifying OA drugs able to prevent or retard disease progression are actually available. For these reasons, in the last decades, relevant efforts to find new potential therapeutic targets in OA have been made and a number of existing conventional and biological disease-modifying anti-rheumatic drugs (DMARDs), including hydroxychloroquine (HCQ), methotrexate (MTX), tumor necrosis factor (TNF)-α, interleukin (IL)-1, and IL-6 inhibitors, commonly used to treat inflammatory rheumatic diseases, have been repurposed for the treatment of OA and explored also in hand osteoarthritis (HOA). The current narrative review was aimed to provide a comprehensive and updated understanding of the possibilities and the criticisms related to the treatment of HOA with conventional and biological DMARDs. Unfortunately, therapy with conventional and biologic drugs in HOA has not achieved the expected success, despite a rationale for their use exists. Thus, our findings outline the urgent need to enhance the exploration of HOA basic molecular mechanisms to find new potential therapeutic targets, personalized for each patient, and appropriate for the different subsets of HOA and for the different phases of disease.
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Affiliation(s)
- Sara Tenti
- Clinic for the Diagnosis and Management of Hand Osteoarthritis, Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 1, 53100 Siena, Italy
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health, Aspects of Musculoskeletal Health and Ageing, University of Liege, Liege, Belgium
| | - Sara Cheleschi
- Clinic for the Diagnosis and Management of Hand Osteoarthritis, Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda ospedaliero-universitaria Senese, Siena, Italy
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health, Aspects of Musculoskeletal Health and Ageing, University of Liege, Liege, Belgium
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
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Zhu L, Kamalathevan P, Koneva LA, Zarebska JM, Chanalaris A, Ismail H, Wiberg A, Ng M, Muhammad H, Walsby-Tickle J, McCullagh JSO, Watt FE, Sansom SN, Furniss D, Gardiner MD, Vincent TL, Riley N, Spiteri M, McNab I, Little C, Cogswell L, Critchley P, Giele H, Shirley R. Variants in ALDH1A2 reveal an anti-inflammatory role for retinoic acid and a new class of disease-modifying drugs in osteoarthritis. Sci Transl Med 2022; 14:eabm4054. [PMID: 36542696 DOI: 10.1126/scitranslmed.abm4054] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
More than 40% of individuals will develop osteoarthritis (OA) during their lifetime, yet there are currently no licensed disease-modifying treatments for this disabling condition. Common polymorphic variants in ALDH1A2, which encodes the key enzyme for synthesis of all-trans retinoic acid (atRA), are associated with severe hand OA. Here, we sought to elucidate the biological significance of this association. We first confirmed that ALDH1A2 risk variants were associated with hand OA in the U.K. Biobank. Articular cartilage was acquired from 33 individuals with hand OA at the time of routine hand OA surgery. After stratification by genotype, RNA sequencing was performed. A reciprocal relationship between ALDH1A2 mRNA and inflammatory genes was observed. Articular cartilage injury up-regulated similar inflammatory genes by a process that we have previously termed mechanoflammation, which we believe is a primary driver of OA. Cartilage injury was also associated with a concomitant drop in atRA-inducible genes, which were used as a surrogate measure of cellular atRA concentration. Both responses to injury were reversed using talarozole, a retinoic acid metabolism blocking agent (RAMBA). Suppression of mechanoflammation by talarozole was mediated by a peroxisome proliferator-activated receptor gamma (PPARγ)-dependent mechanism. Talarozole was able to suppress mechano-inflammatory genes in articular cartilage in vivo 6 hours after mouse knee joint destabilization and reduced cartilage degradation and osteophyte formation after 26 days. These data show that boosting atRA suppresses mechanoflammation in the articular cartilage in vitro and in vivo and identifies RAMBAs as potential disease-modifying drugs for OA.
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Affiliation(s)
- Linyi Zhu
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - Pragash Kamalathevan
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - Lada A Koneva
- Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - Jadwiga Miotla Zarebska
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - Anastasios Chanalaris
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - Heba Ismail
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
- Healthy Lifespan Institute (HELSI) and Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield S10 2TN, UK
| | - Akira Wiberg
- Botnar Research Centre, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Michael Ng
- Botnar Research Centre, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Hayat Muhammad
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - John Walsby-Tickle
- Department of Chemistry, University of Oxford, Mansfield Road, Oxford OX1 3TA, UK
| | - James S O McCullagh
- Department of Chemistry, University of Oxford, Mansfield Road, Oxford OX1 3TA, UK
| | - Fiona E Watt
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
- Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London W12 0NN, UK
| | - Stephen N Sansom
- Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - Dominic Furniss
- Botnar Research Centre, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Matthew D Gardiner
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
| | - Tonia L Vincent
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford OX3 7FY, UK
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Wan J, Qian X, He Z, Zhu Z, Cheng P, Chen A. Epidemiological trends of hand osteoarthritis from 1990 to 2019: Estimates from the 2019 Global Burden of Disease study. Front Med (Lausanne) 2022; 9:922321. [PMID: 36579153 PMCID: PMC9790907 DOI: 10.3389/fmed.2022.922321] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022] Open
Abstract
Background Hand osteoarthritis (OA) is a chronic progressive disease characterized by disabling pain in the hand, with a high clinical burden. This study is designed to assess the epidemiological patterns of hand OA from 1990 to 2019 and analyze its secular trends based on sex, age, and socio-demographic index (SDI) at global, regional, and national levels. Methods Data on the incidence and disability-adjusted life years (DALYs) of hand OA were extracted from the 2019 Global Burden of Disease (GBD), and their respective age-standardized rates (ASRs) were calculated. The estimated annual percentage changes (EAPCs) in ASR were calculated to assess the prevalent trends of the incidence and DALYs of hand OA over the recent three decades. The relationship between ASR and SDI was analyzed by Pearson's correlation analysis. Results The incidence of hand OA increased from 371.30 million in 1990 to 676.02 million in 2019, increasing by 82.07%, whereas its age-standardized incidence rate (ASIR) decreased, with a downward trend [EAPC = -0.34; 95% confidence interval: -0.39--0.28]. With the changes in age, the incidence of hand OA exhibited a unimodal distribution before 70 years of age, peaking at 50-54 years, while its incidence had an upward trend in the >70 years age groups. Overall, hand OA-related DALYs increased in the recent 30 years. Meanwhile, its annual age-standardized DALY rate decreased, with EAPCs of -0.35 (95% CI, -0.38 --0.32). The DALYs increased with age. In 2019, the ASIR and age-standardized DALY rate were positively associated with the SDI regions. The incidence and DALYs presented predominance in female patients. The burden of hand OA over the recent three decades displayed obvious geographical diversity. Conclusion The incident cases of hand OA increased globally from 1990 to 2019, while the ASIR and age-standardized DALY rate decreased. However, in many countries and regions, there was a rising trend of ASR related to incidence and DALYs. In addition, the prevalence revealed geographical, sex, and age diversity. Thus, governments and medical institutions should reallocate medical resources based on the epidemiological characteristics of hand OA.
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Affiliation(s)
- Junlai Wan
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyuan Qian
- Department of Urology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Zhiyi He
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziqing Zhu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Cheng
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Peng Cheng
| | - Anmin Chen
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Anmin Chen
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Henrotin Y, Dierckxsens Y, Delisse G, Maes N, Albert A. Curcuma longa and Boswellia serrata extract combination for hand osteoarthritis: an open-label pre-post trial. PHARMACEUTICAL BIOLOGY 2022; 60:2295-2299. [PMID: 36416059 PMCID: PMC9704064 DOI: 10.1080/13880209.2022.2147550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/24/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
CONTEXT Osteoarthritis (OA) of the hand is a common painful musculoskeletal disorder with no cure. There is a need for an efficient and safe treatment to relieve OA pain. OBJECTIVE To investigate the effects of a Curcuma longa and Boswellia serrata food supplement in addition to standard care on hand pain. MATERIALS AND METHODS This open-label, non-controlled, post-observational study was based on 232 patients suffering from hand pain with or without joint deformity. Patients received a medical prescription for a three-month treatment with a food supplement containing 89 mg of C. longa dry extract, 120 mg of B. serrata resin, and 1.8 µg vitamin D. Pain was evaluated on a 10-point visual analog scale (VAS). The number of painful hand joints, patient satisfaction, nonsteroidal anti-inflammatory drugs intake, and side effects were also recorded. RESULTS Baseline pain intensity (regression coefficient ± SE: -0.19 ± 0.01, p < 0.0001) and the number of painful joints (regression coefficient ± SE: -0.022 ± 0.0029, p < 0.0001) decreased significantly throughout the 3 months treatment period. NSAIDs intake and topical drug application were significantly decreased by 64% (p < 0.0001) and 79% (p < 0.0001) after 12 weeks, respectively. Only 3/239 (1.3%) patients reported side effects probably related to the product. 80.3% were satisfied with the treatment and 75.5% wished to continue treatment. CONCLUSION This is the first clinical trial showing that C. longa and B. serrata resin can relieve symptoms in patients with hand osteoarthritis. The study provides useful information for the design of a clinical trial including a broader population.
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Affiliation(s)
- Yves Henrotin
- Musculoskeletal Innovative Research Lab (mSKIL), Arthropôle Liège, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, CHU Sart-Tilman, Liège, Belgium
- Physical Therapy and Rehabilitation Department, Princess Paola Hospital, Marche-en-Famenne, Belgium
| | | | | | - Nathalie Maes
- Center of Biostatistics (B-STAT), University Hospital of Liège, Liège, Belgium
| | - Adelin Albert
- Center of Biostatistics (B-STAT), University Hospital of Liège, Liège, Belgium
- Department of Public Health, University of Liège, Liège, Belgium
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Circ_0022383 alleviates IL-1β-induced apoptosis, inflammation and extracellular matrix degeneration in osteoarthritis cell model by miR-3619-5p/SIRT1 axis. Int Immunopharmacol 2022; 112:109289. [DOI: 10.1016/j.intimp.2022.109289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/15/2022] [Accepted: 09/23/2022] [Indexed: 11/21/2022]
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Yang J, Liu W. The Role of AIM2 Inflammasome in Knee Osteoarthritis. J Inflamm Res 2022; 15:6453-6461. [PMID: 36467990 PMCID: PMC9717587 DOI: 10.2147/jir.s392652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
Knee osteoarthritis (KOA), whose prevalence keeps rising, is still unsolved pathobiological/therapeutical problem. Historically, knee osteoarthritis was thought to be a "wear and tear" disease, while recent etiology hypotheses stressed it as a chronic, low-grade inflammatory disease. Inflammasomes mediated by the innate immunity systems have an important role in inflammatory diseases including KOA. A deluge of recent studies focused on the NLRP3 inflammasome with suggestions that its pharmacologic block would hinder degeneration. However, known inflammasomes are numerous and can also trigger IL-1β/IL-18 production and cells' pyroptotic death. Among them, AIM2 inflammasome is involved in key aspects of various acute and chronic inflammatory diseases. Therefore, while presently leaving out little-studied inflammasomes in KOA, this review focuses on the AIM2 inflammasomes that participate in KOA's complex mechanisms in conjunction with the activation of AIM2 inflammasomes in other diseases combined with the current studies on KOA mechanisms. Although human-specific data about it are relatively scant, we stress that only a holistic view including several inflammasomes including AIM2 inflammasome and other potential pathogenetic drivers will lead to successful therapy for knee osteoarthritis.
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Affiliation(s)
- Jiyong Yang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510095, People’s Republic of China
| | - Wengang Liu
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, 510095, People’s Republic of China
- Correspondence: Wengang Liu, Orthopedics Department, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, 510095, People’s Republic of China, Email
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50
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Badley EM, Zahid S, Wilfong JM, Perruccio AV. Relationship Between Body Mass Index and Osteoarthritis for Single and Multisite Osteoarthritis of the Hand, Hip, or Knee: Findings From a Canadian Longitudinal Study on Aging. Arthritis Care Res (Hoboken) 2022; 74:1879-1887. [PMID: 34121361 DOI: 10.1002/acr.24729] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 05/10/2021] [Accepted: 06/08/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine whether an apparent association between hand osteoarthritis (OA) and adiposity is explained by the presence of OA at other joint sites. METHODS Data from the Canadian Longitudinal Study on Aging, first cycle, comprehensive cohort, were used. Respondents age 45-85 years (n = 18,279) were asked separate questions about doctor-diagnosed OA in the hand, hip, or knee. Multinomial logistic regression was used to investigate the relationship between all combinations of hand, hip, and knee OA and body mass index (BMI) and waist-to-height ratio (WHtR). RESULTS OA was reported by 34.6% of respondents, 28.0% with OA at >1 joint site. Hand OA was not significantly associated with BMI after accounting for OA at other joint sites, with similar findings for WHtR. All joint site combinations containing the knee were strongly associated with BMI, with odds ratios (ORs) ranging from OR 2.92 (95% confidence interval [95% CI] 2.53-3.37) for knee OA only with obesity class I to OR 9.98 (95% CI 7.12-13.88) for multi-joint knee, hip, hand OA with obesity class II/III. BMI distributions including knee OA were broader and shifted to higher BMI levels than those for hand or hip OA. CONCLUSION Apparent associations between hand OA and BMI may be explained by concurrent OA at other joint sites. Recognizing that OA is a multi-joint disease is crucial for studies of the associations of adiposity with OA in a particular joint, especially the hand. The association between knee OA and BMI appears to be distinct from those for OA at other joint sites.
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Affiliation(s)
- Elizabeth M Badley
- Krembil Research Institute and Schroeder Arthritis Institute, University Health Network, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shatabdy Zahid
- Krembil Research Institute and Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Jessica M Wilfong
- Krembil Research Institute and Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Anthony V Perruccio
- Krembil Research Institute and Schroeder Arthritis Institute, University Health Network, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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