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Fedoce AG, Veras FP, Rosa MH, Schneider AH, Paiva IM, Machado MR, Freitas-Filho EG, Silva JF, Machado CC, Alves-Filho JC, Cunha FQ, N Z Ramalho L, Louzada-Junior P, Bonavia AS, Tostes RC. Macrophage-derived human resistin promotes perivascular adipose tissue dysfunction in experimental inflammatory arthritis. Biochem Pharmacol 2024; 224:116245. [PMID: 38685281 DOI: 10.1016/j.bcp.2024.116245] [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: 01/22/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in rheumatoid arthritis (RA). Resistin is an adipokine that induces adipose tissue inflammation and activation of monocytes/macrophages via adenylate cyclase-associated protein-1 (CAP1). Resistin levels are increased in RA and might cause perivascular adipose tissue (PVAT) dysfunction, leading to vascular damage and CVD. This study aimed to investigate the role of resistin in promoting PVAT dysfunction by increasing local macrophage and inflammatory cytokines content in antigen-induced arthritis (AIA). Resistin pharmacological effects were assessed by using C57Bl/6J wild-type (WT) mice, humanized resistin mice expressing human resistin in monocytes-macrophages (hRTN+/-/-), and resistin knockout mice (RTN-/-) with AIA and respective controls. We investigated AIA disease activity and functional, cellular, and molecular parameters of the PVAT. Resistin did not contribute to AIA disease activity and its concentrations were augmented in the PVAT and plasma of WT AIA and hRTN+/-/- AIA animals. In vitro exposure of murine arteries to resistin impaired vascular function by decreasing the anti-contractile effect of PVAT. WT AIA mice and hRTN+/-/- AIA mice exhibited PVAT dysfunction and knockdown of resistin prevented it. Macrophage-derived cytokines, markers of types 1 and 2 macrophages, and CAP1 expression were increased in the PVAT of resistin humanized mice with AIA, but not in knockout mice for resistin. This study reveals that macrophage-derived resistin promotes PVAT inflammation and dysfunction regardless of AIA disease activity. Resistin might represent a translational target to reduce RA-driven vascular dysfunction and CVD.
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Affiliation(s)
- Aline G Fedoce
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Flávio P Veras
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Marcos H Rosa
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Ayda H Schneider
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Isadora M Paiva
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Mirele R Machado
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Edismauro G Freitas-Filho
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Cellular and Molecular Biology and Biopathogenic Agents, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Josiane F Silva
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Caio C Machado
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pathology and Legal Medicine, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - José C Alves-Filho
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Fernando Q Cunha
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Leandra N Z Ramalho
- Department of Pathology and Legal Medicine, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Paulo Louzada-Junior
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Clinical Medicine of the Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Anthony S Bonavia
- Departments of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Rita C Tostes
- Center of Research in Inflammatory Diseases (CRID), University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Pharmacology, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
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Bilski J, Schramm-Luc A, Szczepanik M, Mazur-Biały AI, Bonior J, Luc K, Zawojska K, Szklarczyk J. Adipokines in Rheumatoid Arthritis: Emerging Biomarkers and Therapeutic Targets. Biomedicines 2023; 11:2998. [PMID: 38001998 PMCID: PMC10669400 DOI: 10.3390/biomedicines11112998] [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: 10/22/2023] [Revised: 11/05/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease manifested by joint involvement, extra-articular manifestations, and general symptoms. Adipose tissue, previously perceived as an inert energy storage organ, has been recognised as a significant contributor to RA pathophysiology. Adipokines modulate immune responses, inflammation, and metabolic pathways in RA. Although most adipokines have a pro-inflammatory and aggravating effect on RA, some could counteract this pathological process. The coexistence of RA and sarcopenic obesity (SO) has gained attention due to its impact on disease severity and outcomes. Sarcopenic obesity further contributes to the inflammatory milieu and metabolic disturbances. Recent research has highlighted the intricate crosstalk between adipose tissue and skeletal muscle, suggesting potential interactions between these tissues in RA. This review summarizes the roles of adipokines in RA, particularly in inflammation, immune modulation, and joint destruction. In addition, it explores the emerging role of adipomyokines, specifically irisin and myostatin, in the pathogenesis of RA and their potential as therapeutic targets. We discuss the therapeutic implications of targeting adipokines and adipomyokines in RA management and highlight the challenges and future directions for research in this field.
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Affiliation(s)
- Jan Bilski
- Department of Biomechanics and Kinesiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland; (A.I.M.-B.); (K.Z.)
| | - Agata Schramm-Luc
- Department of Internal and Agricultural Medicine, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Krakow, Poland; (A.S.-L.); (K.L.)
| | - Marian Szczepanik
- Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-034 Krakow, Poland;
| | - Agnieszka Irena Mazur-Biały
- Department of Biomechanics and Kinesiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland; (A.I.M.-B.); (K.Z.)
| | - Joanna Bonior
- Department of Medical Physiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland; (J.B.); (J.S.)
| | - Kevin Luc
- Department of Internal and Agricultural Medicine, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Krakow, Poland; (A.S.-L.); (K.L.)
| | - Klaudia Zawojska
- Department of Biomechanics and Kinesiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland; (A.I.M.-B.); (K.Z.)
| | - Joanna Szklarczyk
- Department of Medical Physiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland; (J.B.); (J.S.)
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Shi H, Wu H, Winkler MA, Belin de Chantemèle EJ, Lee R, Kim HW, Weintraub NL. Perivascular adipose tissue in autoimmune rheumatic diseases. Pharmacol Res 2022; 182:106354. [PMID: 35842184 PMCID: PMC10184774 DOI: 10.1016/j.phrs.2022.106354] [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: 04/28/2022] [Revised: 06/27/2022] [Accepted: 07/11/2022] [Indexed: 01/14/2023]
Abstract
Perivascular adipose tissue (PVAT) resides at the outermost boundary of the vascular wall, surrounding most conduit blood vessels, except for the cerebral vessels, in humans. A growing body of evidence suggests that inflammation localized within PVAT may contribute to the pathogenesis of cardiovascular disease (CVD). Patients with autoimmune rheumatic diseases (ARDs), e.g., systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), psoriasis, etc., exhibit heightened systemic inflammation and are at increased risk for CVD. Data from clinical studies in patients with ARDs support a linkage between dysfunctional adipose tissue, and PVAT in particular, in disease pathogenesis. Here, we review the data linking PVAT to the pathogenesis of CVD in patients with ARDs, focusing on the role of novel PVAT imaging techniques in defining disease risk and responses to biological therapies.
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Affiliation(s)
- Hong Shi
- Division of Rheumatology, Medical College of Georgia at Augusta University, Augusta, GA, USA; Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Hanping Wu
- Department of Radiology and Imaging, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Michael A Winkler
- Department of Radiology and Imaging, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Eric J Belin de Chantemèle
- Division of Cardiology, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA; Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Richard Lee
- Department of Surgery, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Ha Won Kim
- Division of Cardiology, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA; Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Neal L Weintraub
- Division of Cardiology, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA; Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA.
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Wang Z, Zhou Z, Guo P, Wang M, Sun H, Tai Y, Xiao F, Han Y, Wei W, Wang Q. DBA/1 mice display equivalent cardiac function to C57BL/6J mice. Exp Physiol 2021; 106:868-881. [PMID: 33547685 DOI: 10.1113/ep089228] [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: 10/29/2020] [Accepted: 02/02/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Do normal adult DBA/1 mice have cardiac function and performance equal to those of C57BL/6J mice? What is the main finding and its importance? Male adult DBA/1 mice show equivalent cardiac function to C57BL/6J mice up to 8 months old. Therefore, cardiac dysfunction could be investigated in an autoimmune diseases model established with DBA/1 mice. ABSTRACT Cardiovascular mortality has been increasing, and in particular, cardiovascular damage caused by some chronic autoimmune diseases accounts for a large proportion of this. C57BL/6J mice have been used mostly in studies of cardiovascular diseases. However, for purposes of modelling, this strain of mouse has a very low incidence of some chronic immune diseases such as rheumatoid arthritis, to which instead DBA/1 mice are more susceptible. Basic cardiac function differs between mice with different genetic backgrounds. Therefore, we monitored cardiac function and structure of normal male C57BL/6J and DBA/1 mice for six consecutive months. Echocardiography was used to monitor cardiac functions once a month and cardiac systolic function was measured upon isoproterenol challenge at the end of observation. The Excitation-contraction coupling-related proteins were measured by western blotting. Heart tissue sections were subject to haematoxylin-eosin, TUNEL and Alizarin red staining. The results demonstrated that systolic and diastolic function did not vary significantly and both strains were indistinguishable in appearance and structure of hearts. DBA/1 mice showed a good cardiac β-adrenergic response comparable to C57BL/6J mice with isoproterenol treatment. The phosphorylation of phospholamban at either its protein kinase A or its Ca2+ /calmodulin-dependent protein kinase II site, as well as the activation of troponin I showed no significant difference between strains. These findings suggested that there was no obvious difference in the heart structure and function of normal male DBA/1 mice compared with C57BL/6J mice. The DBA/1 mouse is a strain applicable to investigating autoimmune disease-induced heart dysfunction and exploring potential interventions.
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Affiliation(s)
- Zhen Wang
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
| | - Zhengwei Zhou
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
| | - Paipai Guo
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
| | - Manman Wang
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
| | - Hanfei Sun
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
| | - Yu Tai
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
| | - Feng Xiao
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
| | - Yongsheng Han
- Department of Emergency Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wei Wei
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
| | - Qingtong Wang
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, China
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Alabarse PV, Lora PS, Silva JM, Santo RC, Freitas EC, de Oliveira MS, Almeida AS, Immig M, Teixeira VO, Filippin LI, Xavier RM. Collagen-induced arthritis as an animal model of rheumatoid cachexia. J Cachexia Sarcopenia Muscle 2018; 9:603-612. [PMID: 29575818 PMCID: PMC5989855 DOI: 10.1002/jcsm.12280] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/21/2017] [Accepted: 12/07/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis is characterized by chronic polyarticular synovitis and presents systemic changes that impact quality of life, such as impaired muscle function, seen in up to 66% of the patients. This can progress to severely debilitating state known as rheumatoid cachexia-without loss of fat mass and body weight-for which there is little consensus in terms of diagnosis or treatment. This study aims to evaluate whether the collagen-induced arthritis (CIA) animal model also develops clinical and functional features characteristic of rheumatoid cachexia. METHODS Male DBA1/J mice were randomly divided into 2 groups: healthy animals (CO, n = 11) and CIA animals (n = 13). The clinical score and edema size, animal weight and food intake, free exploratory locomotion, grip strength, and endurance exercise performance were tested 0, 18, 35, 45, 55, and 65 days after disease induction. After euthanasia, several organs, visceral and brown fat, and muscles were dissected and weighed. Muscles were used to assess myofiber diameter. Ankle joint was used to assess arthritis severity by histological score. Statistical analysis were performed using one-way and two-way analyses of variance followed by Tukey's and Bonferroni's test or t-test of Pearson and statistical difference were assumed for a P value under 0.05. RESULTS The CIA had significantly higher arthritis scores and larger hind paw edema volumes than CO. The CIA had decreased endurance exercise performance total time (fatigue; 23, 22, 24, and 21% at 35, 45, 55, and 65 days, respectively), grip strength (27, 55, 63, 60, and 66% at 25, 35, 45, 55, and 65 days, respectively), free locomotion (43, 57, 59, and 66% at 35, 45, 55, and 65 days, respectively), and tibialis anterior and gastrocnemius muscle weight (25 and 24%, respectively) compared with CO. Sarcoplasmic ratios were also reduced in CIA (TA: 23 and GA: 22% less sarcoplasmic ratio), confirming the atrophy of skeletal muscle mass in these animals than in CO. Myofiber diameter was also reduced 45% in TA and 41% in GA in CIA when compared with the CO. Visceral and brown fat were lighter in CIA (54 and 39%, respectively) than CO group. CONCLUSIONS The CIA model is a valid experimental model for rheumatoid cachexia given that the clinical changes observed were similar to those described in patients with rheumatoid arthritis.
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Affiliation(s)
- Paulo V.G. Alabarse
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2350Porto Alegre90035‐003Brazil
| | - Priscila S. Lora
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Universidade do Vale do Rio dos SinosSão LeopoldoBrazil
| | - Jordana M.S. Silva
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2350Porto Alegre90035‐003Brazil
| | - Rafaela C.E. Santo
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2350Porto Alegre90035‐003Brazil
| | - Eduarda C. Freitas
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2350Porto Alegre90035‐003Brazil
| | - Mayara S. de Oliveira
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2350Porto Alegre90035‐003Brazil
| | - Andrelise S. Almeida
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de BiomedicinaUniversidade do Vale do Rio dos SinosSão LeopoldoBrazil
| | - Mônica Immig
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de BiomedicinaUniversidade do Vale do Rio dos SinosSão LeopoldoBrazil
| | - Vivian O.N. Teixeira
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2350Porto Alegre90035‐003Brazil
| | - Lidiane I. Filippin
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Universidade La SalleCanoasBrazil
| | - Ricardo M. Xavier
- Laboratório de Doenças AutoimunesHospital de Clínicas de Porto AlegrePorto AlegreBrazil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2350Porto Alegre90035‐003Brazil
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Macchi V, Stocco E, Stecco C, Belluzzi E, Favero M, Porzionato A, De Caro R. The infrapatellar fat pad and the synovial membrane: an anatomo-functional unit. J Anat 2018; 233:146-154. [PMID: 29761471 PMCID: PMC6036933 DOI: 10.1111/joa.12820] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 01/15/2023] Open
Abstract
The infrapatellar pad, a fibro-adipose tissue with peculiar microscopic and mechanical features, is gaining wide attention in the field of rheumatological research. The purpose of this descriptive review is to summarize the most recent published evidence on the anatomic, physiologic and biomechanical inter-relationship between the infrapatellar fat pad and the knee synovial membrane. As an extrasynovial tissue, the infrapatellar fat pad does not directly interact with the articular cartilage; based on its location in close contact with the synovial membrane, and due to the metabolic properties of adipose tissue, it may influence the behavior of the synovial membrane. In fact, considering evidence of macroscopic and microscopic anatomy, the infrapatellar fat pad is the site of insertion of the infrapatellar and medial synovial plicae. Also biochemically, there is much evidence highlighting the interaction among these two structures; in the case of inflammation, the mutual interplay is ascribable to the release of pro-inflammatory mediators stimulating the proliferation of inflammatory cells and promoting tissue modifications in both. All these assumptions could support the emerging idea that the infrapatellar fat pad and the synovial membrane may be considered a morpho-functional unit.
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Affiliation(s)
- Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Elena Stocco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Elisa Belluzzi
- Musculoskeletal Pathology and Oncology Laboratory, Department of Orthopaedics and Orthopaedics Oncology, University of Padova, Padova, Italy.,Rheumatology Unit, Department of Medicine-DIMED, University Hospital of Padova, Padova, Italy
| | - Marta Favero
- Rheumatology Unit, Department of Medicine-DIMED, University Hospital of Padova, Padova, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
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