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Rošin M, Kelam N, Jurić I, Racetin A, Ogorevc M, Corre B, Čarić D, Filipović N, Vukojević K. Syndecans, Exostosins and Sulfotransferases as Potential Synovial Inflammation Moderators in Patients with Hip Osteoarthritis. Int J Mol Sci 2024; 25:4557. [PMID: 38674142 PMCID: PMC11049902 DOI: 10.3390/ijms25084557] [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: 03/07/2024] [Revised: 04/07/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
The gradual deterioration of articular cartilage was thought to be the central event in osteoarthritis (OA), but recent studies demonstrated the importance of low-grade synovitis in the progression of OA. The Syndecan (SDC) family of membrane proteoglycans is known to be involved in the regulation of inflammation, but there is limited evidence considering the role of syndecans in OA synovitis. Our study aimed to investigate the hip OA synovial membrane expression patterns of SDC1, SDC2 and SDC4, as well as exostosins and sulfotransferases (enzymes involved in the polymerisation and modification of syndecans' heparan sulphate chains). Synovial membrane samples of patients with OA (24) were divided into two groups according to their Krenn synovitis score severity. The immunohistochemical expressions of SDC1, SDC2, SDC4, EXT1, EXT2, NDST1 and NDST2 in synovial intima and subintima were then analysed and compared with the control group (patients with femoral neck fracture). According to our study, the immunoexpression of SDC1, NDST1 and EXT2 is significantly increased in the intimal cells of OA synovial membrane in patients with lower histological synovitis scores and SDC4 in patients with higher synovitis scores, in comparison with non-OA controls. The difference in the expression of SDC2 among the OA and non-OA groups was insignificant. SDC1, SDC4, NDST1 and EXT2 seem to be involved as inflammation moderators in low-grade OA synovitis and, therefore, should be further investigated as potential markers of disease progression and therapeutic goals.
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Affiliation(s)
- Matko Rošin
- Surgery Department, Orthopaedics and Traumatology Division, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia; (M.R.); (D.Č.)
| | - Nela Kelam
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (N.K.); (A.R.); (M.O.); (N.F.)
| | - Ivana Jurić
- Department of Emergency Medicine, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia;
| | - Anita Racetin
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (N.K.); (A.R.); (M.O.); (N.F.)
| | - Marin Ogorevc
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (N.K.); (A.R.); (M.O.); (N.F.)
| | - Brieuc Corre
- Faculty of Medicine and Health Sciences, University of Brest, 29200 Brest, France;
| | - Davor Čarić
- Surgery Department, Orthopaedics and Traumatology Division, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia; (M.R.); (D.Č.)
| | - Natalija Filipović
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (N.K.); (A.R.); (M.O.); (N.F.)
| | - Katarina Vukojević
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia; (N.K.); (A.R.); (M.O.); (N.F.)
- Center for Translational Research in Biomedicine, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia
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Herrero-Beaumont G, Castro-Dominguez F, Migliore A, Naredo E, Largo R, Reginster JY. Systemic osteoarthritis: the difficulty of categorically naming a continuous condition. Aging Clin Exp Res 2024; 36:45. [PMID: 38376694 PMCID: PMC10879223 DOI: 10.1007/s40520-024-02714-w] [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: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/21/2024]
Abstract
Osteoarthritis (OA) is a disease with systemic implications that go beyond joint problems. Its pathogenic mechanisms involve a variety of systemic conditions that contribute to joint damage. These include metabolic dysfunction, chronic low-grade inflammation, neuroplastic pain, and the influence of the central nervous system in the development of neuropathic pain. Besides, OA can negatively affect other aspects of health, such as quality of life, reduced physical activity, social isolation, depression, and anxiety. OA can be considered a complex system in which pathological interactions involve not only obesity and metabolic dysfunction, but also fragility syndrome, sarcopenia, neurological complications, and systemic energy redistribution. Complex systems are composed of multiple interacting and dynamic parts and exhibit emergent properties that cannot be fully explained by examining their individual components. Chronic low-grade inflammation is characteristic of OA, occurring both in the affected joint, and systemically, mainly due to adipose tissue inflammation in obese patients. Obesity is a key factor in the progression of OA, so primary treatment should focus on its control, while maintaining muscle health. The chronic inflammation could lead to changes in energy distribution among the affected joint tissues. Therefore, OA should be approached as a systemic disease, considering individual patient factors, such as genetics, inflammatory response, and lifestyle. Medical care should be more holistic and personalized. Consideration of a name change, such as "systemic OA", could help to move away from the perception of a disease focused only on the joints.
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Affiliation(s)
| | | | - Alberto Migliore
- Rheumatology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Esperanza Naredo
- Bone and Joint Research Unit, Rheumatology Dept, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Raquel Largo
- Bone and Joint Research Unit, Rheumatology Dept, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Jean-Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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Gu Y, Hu Y, Zhang H, Wang S, Xu K, Su J. Single-cell RNA sequencing in osteoarthritis. Cell Prolif 2023; 56:e13517. [PMID: 37317049 PMCID: PMC10693192 DOI: 10.1111/cpr.13517] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/30/2023] [Accepted: 05/26/2023] [Indexed: 06/16/2023] Open
Abstract
Osteoarthritis is a progressive and heterogeneous joint disease with complex pathogenesis. The various phenotypes associated with each patient suggest that better subgrouping of tissues associated with genotypes in different phases of osteoarthritis may provide new insights into the onset and progression of the disease. Recently, single-cell RNA sequencing was used to describe osteoarthritis pathogenesis on a high-resolution view surpassing traditional technologies. Herein, this review summarizes the microstructural changes in articular cartilage, meniscus, synovium and subchondral bone that are mainly due to crosstalk amongst chondrocytes, osteoblasts, fibroblasts and endothelial cells during osteoarthritis progression. Next, we focus on the promising targets discovered by single-cell RNA sequencing and its potential applications in target drugs and tissue engineering. Additionally, the limited amount of research on the evaluation of bone-related biomaterials is reviewed. Based on the pre-clinical findings, we elaborate on the potential clinical values of single-cell RNA sequencing for the therapeutic strategies of osteoarthritis. Finally, a perspective on the future development of patient-centred medicine for osteoarthritis therapy combining other single-cell multi-omics technologies is discussed. This review will provide new insights into osteoarthritis pathogenesis on a cellular level and the field of applications of single-cell RNA sequencing in personalized therapeutics for osteoarthritis in the future.
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Affiliation(s)
- Yuyuan Gu
- Institute of Translational MedicineShanghai UniversityShanghaiChina
- Organoid Research CenterShanghai UniversityShanghaiChina
- School of MedicineShanghai UniversityShanghaiChina
| | - Yan Hu
- Institute of Translational MedicineShanghai UniversityShanghaiChina
- Organoid Research CenterShanghai UniversityShanghaiChina
| | - Hao Zhang
- Institute of Translational MedicineShanghai UniversityShanghaiChina
- Organoid Research CenterShanghai UniversityShanghaiChina
| | - Sicheng Wang
- Institute of Translational MedicineShanghai UniversityShanghaiChina
- Organoid Research CenterShanghai UniversityShanghaiChina
- Department of OrthopedicsShanghai Zhongye HospitalShanghaiChina
| | - Ke Xu
- Institute of Translational MedicineShanghai UniversityShanghaiChina
- Organoid Research CenterShanghai UniversityShanghaiChina
- Wenzhou Institute of Shanghai UniversityWenzhouChina
| | - Jiacan Su
- Institute of Translational MedicineShanghai UniversityShanghaiChina
- Organoid Research CenterShanghai UniversityShanghaiChina
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Dissanayaka T, Nakandala P, Malwanage K, Hill AT, Ashthree DN, Lane MM, Travicia N, Gamage E, Marx W, Jaberzadeh S. The effects of anodal tDCS on pain reduction in people with knee osteoarthritis: A systematic review and meta-analysis. Neurophysiol Clin 2023; 53:102921. [PMID: 37984240 DOI: 10.1016/j.neucli.2023.102921] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To synthesise the literature on the efficacy of primary motor cortex anodal transcranial direct current stimulation (M1-a-tDCS), as a standalone or priming technique, for pain reduction in people with knee osteoarthritis (KOA). METHODS The systematic literature search was conducted in MEDLINE, CINAHL, Embase and CENTRAL according to PRISMA statement. RESULTS Fourteen studies involving 740 people with KOA were included. In the meta-analysis, six studies compared a-tDCS alone with sham stimulation, and five studies compared a-tDCS combined with other methods with sham stimulation. We found positive effect of a-tDCS alone on pain in KOA (standard mean difference (SMD) -0.52; 95% CI, -0.78 to -0.25; P=0.001; I2 = 69%). Further, a-tDCS with other treatments showed positive effect (SMD -1.23; 95% CI, -1.59 to -0.88; P<0.001; I2 = 48%) on pain in people with KOA. This evidence showed low certainty due to a high risk of bias and imprecision. DISCUSSION AND CONCLUSION A-tDCS could be considered as standalone and an adjunct treatment for pain reduction in people with KOA. Future randomised studies should address quality issues, including small sample size, to enhance the overall certainty of the findings. SIGNIFICANCE A-tDCS can be used as a standalone and adjunct treatment for KOA. STUDY REGISTRATION PROSPERO number CRD42021255114.
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Affiliation(s)
- Thusharika Dissanayaka
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary Healthcare, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia.
| | | | - Kavinda Malwanage
- Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka
| | - Aron T Hill
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne, Australia; Department of Psychiatry, Central Clinical School, Monash University, Melbourne, Australia
| | - Deborah N Ashthree
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Melissa M Lane
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Nikolaj Travicia
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Elizabeth Gamage
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Wolfgang Marx
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary Healthcare, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Roemer FW, Jarraya M, Collins JE, Kwoh CK, Hayashi D, Hunter DJ, Guermazi A. Structural phenotypes of knee osteoarthritis: potential clinical and research relevance. Skeletal Radiol 2023; 52:2021-2030. [PMID: 36161341 PMCID: PMC10509066 DOI: 10.1007/s00256-022-04191-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 02/02/2023]
Abstract
A joint contains many different tissues that can exhibit pathological changes, providing many potential targets for treatment. Researchers are increasingly suggesting that osteoarthritis (OA) comprises several phenotypes or subpopulations. Consequently, a treatment for OA that targets only one pathophysiologic abnormality is unlikely to be similarly efficacious in preventing or delaying the progression of all the different phenotypes of structural OA. Five structural phenotypes have been proposed, namely the inflammatory, meniscus-cartilage, subchondral bone, and atrophic and hypertrophic phenotypes. The inflammatory phenotype is characterized by marked synovitis and/or joint effusion, while the meniscus-cartilage phenotype exhibits severe meniscal and cartilage damage. Large bone marrow lesions characterize the subchondral bone phenotype. The hypertrophic and atrophic OA phenotype are defined based on the presence large osteophytes or absence of any osteophytes, respectively, in the presence of concomitant cartilage damage. Limitations of the concept of structural phenotyping are that they are not mutually exclusive and that more than one phenotype may be present. It must be acknowledged that a wide range of views exist on how best to operationalize the concept of structural OA phenotypes and that the concept of structural phenotypic characterization is still in its infancy. Structural phenotypic stratification, however, may result in more targeted trial populations with successful outcomes and practitioners need to be aware of the heterogeneity of the disease to personalize their treatment recommendations for an individual patient. Radiologists should be able to define a joint at risk for progression based on the predominant phenotype present at different disease stages.
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Affiliation(s)
- Frank W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 4th floor, Boston, MA, 02118, USA.
- Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander University Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany.
| | - Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard University, 55 Fruit St, Boston, MA, 02114, USA
| | - Jamie E Collins
- Orthopaedics and Arthritis Center of Outcomes Research, Brigham and Women's Hospital, Harvard Medical, School, 75 Francis Street, BTM Suite 5016, Boston, MA, 02115, USA
| | - C Kent Kwoh
- University of Arizona Arthritis Center, The University of Arizona College of Medicine, 1501 N. Campbell Avenue, Suite, Tucson, AZ, 8303, USA
| | - Daichi Hayashi
- Department of Radiology, Stony Brook University Renaissance School of Medicine, State University of New York, 101 Nicolls Rd, HSc Level 4, Room 120, Stony Brook, NY, 11794-8460, USA
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Reserve Rd, St. Leonards, 2065, NSW, Australia
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 4th floor, Boston, MA, 02118, USA
- Department of Radiology, VA Boston Healthcare System, 1400 VFW Parkway, Suite 1B105, West Roxbury, MA, 02132, USA
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Guo J, Ye W, Wu X, Huang H, Li B, Sun Z, Ren Z, Yang Z. TNF-α activates RELA expression via TNFRSF1B to upregulate OPA1 expression and inhibit chondrogenic differentiation of human adipose stem cells. J Orthop Surg Res 2023; 18:430. [PMID: 37312126 DOI: 10.1186/s13018-023-03846-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/09/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Tumor necrosis factor-alpha (TNF-α), one of the pro-inflammatory cytokines mediating the local inflammatory process in joints, inhibits cartilage formation and has a detrimental effect on stem cell-based cartilage regeneration for the treatment of osteoarthritis (OA). However, the mechanisms behind this inhibitory effect are still poorly understood. Mitochondrial morphological changes mediated by mitochondrial fusion and fission are highly plastic, are quite sensitive to environmental stimuli and play a crucial role in maintaining cell structure and function. In our study, chondrogenic differentiated human adipose stem cells (hADSCs) were exposed to TNF-α and the effect of TNF-α on the ability of hADSCs to chondrogenic differentiate and on mitochondrial fusion and fission was observed and analyzed. The aim was to investigate the role and mechanisms of mitochondrial fusion and fission regulation in the chondrogenic differentiation of hADSCs under normal conditions and under exposure to TNF-α. METHODS We used flow cytometry to identify hADSCs immunophenotypes CD29, CD44, CD34, CD45, and HLA-DR. Alcian blue staining and Sirius red staining were used to observe the formation of proteoglycans and collagen during the chondrogenic differentiation of hADSCs, respectively. The mRNA and protein expression levels of the cartilage formation marker SOX9, type II collagen (COL2A1), and Aggrecan were measured by real-time fluorescent quantitative PCR (RT-qPCR) and western blot, respectively. The fluorescent probes MitoTracker® Red CMXRos and JC-1 were used to visualize mitochondria morphology and detect mitochondrial membrane electricity (MMP). Affymetrix PrimeView™ chips were used for gene expression profiling. RESULTS The results showed that the chondrogenic differentiation of hADSCs was inhibited in the presence of TNF-α that optic atrophy 1 (OPA1) expression was significantly upregulated and mitochondria were prolonged and interconnected during this process. Gene microarray and RT-qPCR data showed that the presence of TNF-α led to increased expression of TNFα receptor 2 (TNFRSF1B) and RELA during chondrogenic differentiation of hADSCs. CONCLUSIONS TNF-α inhibits chondrogenic differentiation of human adipose stem cells by activating RELA expression through TNFRSF1B upregulating OPA1 expression thereby increasing mitochondrial fusion.
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Affiliation(s)
- Jiajia Guo
- Medical College of Guizhou University, Guiyang, 550025, Guizhou, China
| | - Wang Ye
- Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China
| | - Xinglin Wu
- Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China
| | - Haifeng Huang
- Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China
| | - Bo Li
- Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China
| | - Zeyu Sun
- Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China
| | - Zhijing Ren
- Department of Clinical Laboratory, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China.
| | - Zhen Yang
- Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China.
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Park SY, Chae DS, Lee JS, Cho BK, Lee NY. Point-of-Care Testing of the MTF1 Osteoarthritis Biomarker Using Phenolphthalein-Soaked Swabs. BIOSENSORS 2023; 13:bios13050535. [PMID: 37232895 DOI: 10.3390/bios13050535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023]
Abstract
Osteoarthritis (OA) is the most common joint disease, which accompanies pain and inconvenience in daily life owing to degradation of cartilage and adjacent tissues. In this study, we propose a simple point-of-care testing (POCT) kit for the detection of the MTF1 OA biomarker to achieve on-site clinical diagnosis of OA. The kit contains an FTA card for patient sample treatments, a sample tube for loop-mediated isothermal amplification (LAMP), and a phenolphthalein-soaked swab for naked eye detection. The MTF1 gene was isolated from synovial fluids using an FTA card and amplified using the LAMP method at 65 °C for 35 min. A test part of the phenolphthalein-soaked swab was decolorized in the presence of the MTF1 gene due to the pH change after the LAMP, but the color remained pink in the absence of the MTF1 gene. The control part of the swab served as a reference color in relation to the test part. When real-time LAMP (RT-LAMP), gel electrophoresis, and colorimetric detection of the MTF1 gene were performed, the limit of detection (LOD) was confirmed at 10 fg/μL, and the overall processes were completed in 1 h. The detection of an OA biomarker in the form of POCT was reported for the first time in this study. The introduced method is expected to serve as a POCT platform directly applicable by clinicians for easy and rapid identification of OA.
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Affiliation(s)
- So Yeon Park
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si 13120, Republic of Korea
| | - Dong-Sik Chae
- Department of Orthopedic Surgery, College of Medicine, Catholic Kwandong University, Incheon 21431, Republic of Korea
| | - Jae Sun Lee
- Chief Researcher, Healthcontents, Co., Ltd., Cheongju 28119, Republic of Korea
| | - Byung-Ki Cho
- Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Nae Yoon Lee
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si 13120, Republic of Korea
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Liu Z, Liu H, Li D, Ma L, Lu T, Sun H, Zhang Y, Yang H. Comprehensive analysis of m6A RNA methylation modification patterns and the immune microenvironment in osteoarthritis. Front Immunol 2023; 14:1128459. [PMID: 37006311 PMCID: PMC10062708 DOI: 10.3389/fimmu.2023.1128459] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BackgroundOsteoarthritis (OA) is the most common joint degenerative disease, and so far, there is no effective therapy to prevent or delay its development. Considerable attention is now being given to the impact of m6A RNA methylation modification on the disease immune regulation. However, much remains unknown about the function of m6A modification in OA.MethodsA total of 63 OA and 59 healthy samples were applied to comprehensively examine the m6A regulators mediated RNA methylation modification pattern in OA, and evaluate the impacts of distinct patterns on the characteristics of OA immune microenvironment, including immune infiltration cells, immune responses and human leukocyte antigen (HLAs) genes expression. In addition, we screened out the m6A phenotype-related genes and further explored their potential biological functions. At last, we verified the expression of key m6A regulators and their associations with immune cells, in vitro.ResultsMost of m6A regulators was differentially expressed in OA samples compared to the normal tissues. Based on six hub-m6A regulators identified as abnormally expressed in OA samples, we developed a classifier to distinguish OA patients from healthy individuals. We noted that immune characteristics of OA were correlated with m6A regulators. For instance, YTHDF2 had a strongest significantly positive correlation with regulatory T cells (Tregs) and IGFBP2 was strongest negatively associated with dendritic cells (DCs), which were confirmed by the immunohistochemistry (IHC) staining. Two distinct m6A modification patterns were determined: pattern B had higher infiltrating immunocytes and more active immune responses than pattern A, and two patterns differed in the expression of HLA genes. We also identified 1,592 m6A phenotype-related genes that could mediate the OA synovitis and cartilage degradation by the PI3K-Akt signaling pathway. Quantitative real-time polymerase chain reaction (qRT-PCR) results indicated that IGFBP2 was significantly overexpressed, while YTHDF2 mRNA expression was decreased in OA samples, which was consistent with our findings.ConclusionOur research proves the essential impact of m6A RNA methylation modification on the OA immune microenvironment, and helps to explain the regulatory mechanism behind it, which may open up a new direction for more precise immunotherapy of osteoarthritis.
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Affiliation(s)
- Zhixin Liu
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Heng Liu
- NHC Key Laboratory of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Deqiang Li
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Liang Ma
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Tongxin Lu
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Hao Sun
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yuankai Zhang
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong, China
- *Correspondence: Yuankai Zhang, ; Hui Yang,
| | - Hui Yang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China
- *Correspondence: Yuankai Zhang, ; Hui Yang,
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Paesa M, Alejo T, Garcia-Alvarez F, Arruebo M, Mendoza G. New insights in osteoarthritis diagnosis and treatment: Nano-strategies for an improved disease management. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2023; 15:e1844. [PMID: 35965293 DOI: 10.1002/wnan.1844] [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: 12/02/2021] [Revised: 06/02/2022] [Accepted: 07/12/2022] [Indexed: 11/07/2022]
Abstract
Osteoarthritis (OA) is a common chronic joint pathology that has become a predominant cause of disability worldwide. Even though the origin and evolution of OA rely on different factors that are not yet elucidated nor understood, the development of novel strategies to treat OA has emerged in the last years. Cartilage degradation is the main hallmark of the pathology though alterations in bone and synovial inflammation, among other comorbidities, are also involved during OA progression. From a molecular point of view, a vast amount of signaling pathways are implicated in the progression of the disease, opening up a wide plethora of targets to attenuate or even halt OA. The main purpose of this review is to shed light on the recent strategies published based on nanotechnology for the early diagnosis of the disease as well as the most promising nano-enabling therapeutic approaches validated in preclinical models. To address the clinical issue, the key pathways involved in OA initiation and progression are described as the main potential targets for OA prevention and early treatment. Furthermore, an overview of current therapeutic strategies is depicted. Finally, to solve the drawbacks of current treatments, nanobiomedicine has shown demonstrated benefits when using drug delivery systems compared with the administration of the equivalent doses of the free drugs and the potential of disease-modifying OA drugs when using nanosystems. We anticipate that the development of smart and specific bioresponsive and biocompatible nanosystems will provide a solid and promising basis for effective OA early diagnosis and treatment. This article is categorized under: Diagnostic Tools > In Vivo Nanodiagnostics and Imaging Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement.
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Affiliation(s)
- Monica Paesa
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Aragón Materials Science Institute, ICMA, Zaragoza, Spain
| | - Teresa Alejo
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Aragón Materials Science Institute, ICMA, Zaragoza, Spain
- Health Research Institute Aragon (IIS Aragon), Zaragoza, Spain
| | - Felicito Garcia-Alvarez
- Health Research Institute Aragon (IIS Aragon), Zaragoza, Spain
- Hospital Clínico Universitario Lozano Blesa, Department of Orthopedic Surgery & Traumatology, University of Zaragoza, Zaragoza, Spain
| | - Manuel Arruebo
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Aragón Materials Science Institute, ICMA, Zaragoza, Spain
- Health Research Institute Aragon (IIS Aragon), Zaragoza, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Madrid, Spain
| | - Gracia Mendoza
- Health Research Institute Aragon (IIS Aragon), Zaragoza, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, Madrid, Spain
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10
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Migliore A, Alekseeva L, Avasthi SR, Bannuru RR, Chevalier X, Conrozier T, Crimaldi S, de Campos GC, Diracoglu D, Gigliucci G, Herrero-Beaumont G, Iolascon G, Ionescu R, Jerosch J, Lains J, Maheu E, Makri S, Martusevich N, Matucci-Cerinic M, Pavelka K, Petrella RJ, Raman R, Tarantino U. Early Osteoarthritis Questionnaire (EOAQ): a tool to assess knee osteoarthritis at initial stage. Ther Adv Musculoskelet Dis 2023; 15:1759720X221131604. [PMID: 36860967 PMCID: PMC9969428 DOI: 10.1177/1759720x221131604] [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: 10/05/2021] [Accepted: 09/22/2022] [Indexed: 02/27/2023] Open
Abstract
Background Early stage of osteoarthritis (OA) is characterized by joint stiffness and pain as well as by subclinical structural changes that may affect cartilage, synovium, and bone. At the moment, the lack of a validated definition of early osteoarthritis (EOA) does not allow to make an early diagnosis and adopt a therapeutic strategy to slow disease progression. Also, no questionnaires are available to evaluate the early stage, and therefore this remains an unmet need. Objective Therefore, the purpose of the technical experts panel (TEP) of 'International Symposium of intra-articular treatment' (ISIAT) was to create a specific questionnaire to evaluate and monitor the follow-up and clinical progress of patients affected by early knee OA. Design The items for the Early Osteoarthritis Questionnaire (EOAQ) were identified according to the following steps: items generation, items reduction, and pre-test submission. Methods During the first step, literature has been reviewed and a comprehensive list of items about pain and function in knee EOA was drafted. Then, during the ISIAT (5th edition 2019), the draft has been discussed by the board, which reformulated, deleted, or subdivided some of the items. After the ISIAT symposium, the draft was submitted to 24 subjects affected by knee OA. A score based on the importance and the frequency was created and the items with a score ⩾0.75 were selected. After intermediate evaluation made by a sample of patients, the second and final version of the questionnaire EOAQ was submitted to the whole board for final analysis and acceptance in a second meeting (29 January 2021). Results After an exhaustive elaboration, the final version of the questionnaire contains two domains (Clinical Features and Patients Reported Outcome) with respectively 2 and 9 questions, for a total of 11 questions. Questions mainly explored the fields of early symptoms and patients reported outcomes. Marginally, the need of the symptoms treatment and the use of painkillers were investigated. Conclusions Adoption of diagnostic criteria of early OA is strongly encouraged and a specific questionnaire for the whole management of the clinical features and patients' outcome might really improve the evolution of OA in the early stages of the disease, when the treatment is expected to be more effective.
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Affiliation(s)
| | - Liudmila Alekseeva
- Department of Metabolic Diseases of Bone and
Joints, VA Nasonova Research Institute of Rheumatology, Moscow, Russian
Federation
| | - Sachin R. Avasthi
- Department of Emergency Medicine, Dr Ram
Manohar Lohia Hospital, Lucknow, India
| | - Raveendhara R. Bannuru
- Centre for Treatment Comparison and Integrative
Analysis Division of Rheumatology, Tufts Medical Centre, Boston, MA,
USA
| | | | | | - Sergio Crimaldi
- Chirurgia Ortopedica Mininvasiva e Nuove
Tecnologie, Humanitas Research Hospital, Castellanza, Italy
| | - Gustavo C. de Campos
- Department of Orthopaedics and Traumatology,
University of Campinas, São Paulo, Brazil
| | - Demirhan Diracoglu
- Department of Physical Medicine and
Rehabilitation Division of Pain Medicine, Istanbul University, Istanbul,
Turkey
| | | | | | - Giovanni Iolascon
- Department of Medical and Surgical Specialties
and Dentistry, University of Campania ‘L Vanvitelli’, Caserta, Italy
| | - Ruxandra Ionescu
- Department of Internal Medicine and
Rheumatology Sf. Maria Hospital, University of Medicine and Pharmacy ‘Carol
Davila’, Bucharest, Romania
| | - Jörg Jerosch
- Orthopaedic Department, Johanna Etienne
Hospital, Neuss, Germany
| | - Jorge Lains
- Physical Rehabilitation Medicine Department,
Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal
| | - Emmanuel Maheu
- Rheumatology Department, AP-HP, Saint-Antoine
Hospital, Paris, France
| | - Souz Makri
- EUPATI Graduate and Patient Advocate,
Brussels, Belgium
| | - Natalia Martusevich
- Department of Rheumatology, Belorussian State
Medical University, Minsk, Belarus
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical
Medicine, University of Florence, Florence, Italy
| | | | - Robert J. Petrella
- Department of Family Medicine, School of
Kinesiology University Western Ontario, Ontario, ON, Canada
| | - Raghu Raman
- Academic Department of Orthopaedics, Hull and
East Yorkshire NHS Trust Castle Hill Hospital, Cottingham, UK
| | - Umberto Tarantino
- Department of Orthopaedics and Traumatology,
‘Policlinico Tor Vergata’ Foundation, Rome, Italy
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11
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Young-Shand KL, Roy PC, Dunbar MJ, Abidi SSR, Astephen Wilson JL. Gait biomechanics phenotypes among total knee arthroplasty candidates by machine learning cluster analysis. J Orthop Res 2023; 41:335-344. [PMID: 35538599 DOI: 10.1002/jor.25363] [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: 12/22/2020] [Revised: 03/28/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023]
Abstract
Knee osteoarthritis patient phenotyping is relevant to developing targeted treatments and assessing the treatment efficacy of total knee arthroplasty (TKA). This study aimed to identify clusters among TKA candidates based on demographic and knee mechanic features during gait, and compare gait changes between clusters postoperatively. TKA patients underwent 3D gait analysis 1-week pre (n = 134) and 1-year post-TKA (n = 105). Principal component analysis was applied to frontal and sagittal knee angle and moment waveforms, extracting major patterns of variability. Age, sex, body mass index, gait speed, and frontal and sagittal pre-TKA angle and moment PC scores previously identified as relevant to TKA outcomes were standardized (mean = 0, SD = 1, [134 × 15]). Multidimensional scaling and machine learning-based hierarchical clustering were applied. Final clusters were validated by examining intercluster differences pre-TKA and gait feature changes (PostPCscore - PrePCscore ) by k-way Χ2 and ANOVA tests. Four TKA candidate phenotypes yielded optimum clustering metrics, interpreted as higher and lower functioning clusters that were predominantly male and female. Higher functioning clusters pre-TKA (clusters 1 and 4) had more dynamic sagittal flexion moment (p < 0.001) and frontal plane adduction moment (p < 0.001) loading/un-loading patterns during stance. Post-TKA, higher functioning clusters demonstrated less knee mechanic improvements during gait (flexion angle p < 0.001; flexion moment p < 0.001). TKA candidates can be characterized by four clusters, predominately separated by sex and knee joint biomechanics. Post-TKA knee kinematics and kinetics improvements were cluster-specific; lower functioning clusters experienced more improvement. Cluster-based patient profiling may aid in triaging and developing OA management and surgical strategies meeting group-level function needs.
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Affiliation(s)
- Kathryn L Young-Shand
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Patrice C Roy
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michael J Dunbar
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Syed S R Abidi
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Janie L Astephen Wilson
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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12
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Hosokawa Y, Onodera T, Homan K, Yamaguchi J, Kudo K, Kameda H, Sugimori H, Iwasaki N. Establishment of a New Qualitative Evaluation Method for Articular Cartilage by Dynamic T2w MRI Using a Novel Contrast Medium as a Water Tracer. Cartilage 2022; 13:19476035221111503. [PMID: 36072990 PMCID: PMC9459471 DOI: 10.1177/19476035221111503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE In the early stages of cartilage damage, diagnostic methods focusing on the mechanism of maintaining the hydrostatic pressure of cartilage are thought to be useful. 17O-labeled water, which is a stable isotope of oxygen, has the advantage of no radiation exposure or allergic reactions and can be detected by magnetic resonance imaging (MRI). This study aimed to evaluate MRI images using 17O-labeled water in a rabbit model. DESIGN Contrast MRI with 17O-labeled water and macroscopic and histological evaluations were performed 4 and 8 weeks after anterior cruciate ligament transection surgery in rabbits. A total of 18 T2-weighted images were acquired, and 17O-labeled water was manually administered on the third scan. The 17O concentration in each phase was calculated from the signal intensity at the articular cartilage. Macroscopic and histological grades were evaluated and compared with the 17O concentration. RESULTS An increase in 17O concentration in the macroscopic and histologically injured areas was observed by MRI. Macroscopic evaluation showed that the 17O concentration significantly increased in the damaged site group. Histological evaluations also showed that 17O concentrations significantly increased at 36 minutes 30 seconds after initiating MRI scanning in the Osteoarthritis Research Society International (OARSI) grade 3 (0.493 in grade 0, 0.659 in grade 1, 0.4651 in grade 2, and 0.9964 in grade 3, P < 0.05). CONCLUSION 17O-labeled water could visualize earlier articular cartilage damage, which is difficult to detect by conventional methods.
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Affiliation(s)
- Yoshiaki Hosokawa
- Department of Orthopaedic Surgery,
Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo,
Japan
| | - Tomohiro Onodera
- Department of Orthopaedic Surgery,
Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo,
Japan,Tomohiro Onodera, Department of Orthopaedic
Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido
University, Sapporo 060-8648, Japan.
| | - Kentaro Homan
- Department of Orthopaedic Surgery,
Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo,
Japan
| | - Jun Yamaguchi
- Department of Orthopaedic Surgery,
Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo,
Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging,
Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Kameda
- Department of Diagnostic Imaging,
Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Norimasa Iwasaki
- Department of Orthopaedic Surgery,
Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo,
Japan
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13
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Zeng CY, Zhang ZR, Tang ZM, Hua FZ. Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Front Physiol 2022; 12:794062. [PMID: 34975542 PMCID: PMC8716769 DOI: 10.3389/fphys.2021.794062] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/19/2021] [Indexed: 01/09/2023] Open
Abstract
Knee osteoarthritis is a chronic degenerative disease. Cartilage and subchondral bone degeneration, as well as synovitis, are the main pathological changes associated with knee osteoarthritis. Mechanical overload, inflammation, metabolic factors, hormonal changes, and aging play a vital role in aggravating the progression of knee osteoarthritis. The main treatments for knee osteoarthritis include pharmacotherapy, physiotherapy, and surgery. However, pharmacotherapy has many side effects, and surgery is only suitable for patients with end-stage knee osteoarthritis. Exercise training, as a complementary and adjunctive physiotherapy, can prevent cartilage degeneration, inhibit inflammation, and prevent loss of the subchondral bone and metaphyseal bone trabeculae. Increasing evidence indicates that exercise training can improve pain, stiffness, joint dysfunction, and muscle weakness in patients with knee osteoarthritis. There are several exercise trainings options for the treatment of knee osteoarthritis, including aerobic exercise, strength training, neuromuscular exercise, balance training, proprioception training, aquatic exercise, and traditional exercise. For Knee osteoarthritis (KOA) experimental animals, those exercise trainings can reduce inflammation, delay cartilage and bone degeneration, change tendon, and muscle structure. In this review, we summarize the main symptoms of knee osteoarthritis, the mechanisms of exercise training, and the therapeutic effects of different exercise training methods on patients with knee osteoarthritis. We hope this review will allow patients in different situations to receive appropriate exercise therapy for knee osteoarthritis, and provide a reference for further research and clinical application of exercise training for knee osteoarthritis.
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Affiliation(s)
- Chu-Yang Zeng
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhen-Rong Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
| | - Zhi-Ming Tang
- Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Fu-Zhou Hua
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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14
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Young-Shand K, Roy P, Dunbar M, Abidi SSR, Wilson J. Assessing Knee Osteoarthritis Severity and Biomechanical Changes After Total Knee Arthroplasty Using Self-organizing Maps. Artif Intell Med 2022. [DOI: 10.1007/978-3-031-09342-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Applications of transcriptomics in support of drug development for osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100221. [DOI: 10.1016/j.ocarto.2021.100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/31/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022] Open
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16
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Rocha B, Illiano A, Calamia V, Pinto G, Amoresano A, Ruiz-Romero C, Blanco FJ. Targeted phospholipidomic analysis of synovial fluid as a tool for osteoarthritis deep phenotyping. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100219. [DOI: 10.1016/j.ocarto.2021.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/14/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022] Open
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17
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Terpstra SES, van der Velde JHPM, de Mutsert R, Schiphof D, Reijnierse M, Rosendaal FR, van de Stadt LA, Kloppenburg M, Loef M. The association of clinical and structural knee osteoarthritis with physical activity in the middle-aged population: the NEO study. Osteoarthritis Cartilage 2021; 29:1507-1514. [PMID: 34311090 DOI: 10.1016/j.joca.2021.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/02/2021] [Accepted: 07/17/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate if knee osteoarthritis (OA) is associated with lower physical activity in the general middle-aged Dutch population, and if physical activity is associated with patient-reported outcomes in knee OA. DESIGN Clinical knee OA was defined in the Netherlands Epidemiology of Obesity population using the ACR criteria, and structural knee OA on MRI. We assessed knee pain and function with the Knee Injury and Osteoarthritis Score (KOOS), health-related quality of life (HRQoL) with the Short Form-36, and physical activity (in Metabolic Equivalent of Task (MET) hours) with the Short Questionnaire to Assess Health-enhancing physical activity. We analysed the associations of knee OA with physical activity, and of physical activity with knee pain, function, and HRQoL in knee OA with linear regression adjusted for potential confounders. RESULTS Clinical knee OA was present in 14% of 6,212 participants, (mean age 56 years, mean BMI 27 kg/m2, 55% women, 24% having any comorbidity) and structural knee OA in 12%. Clinical knee OA was associated with 9.60 (95% CI 3.70; 15.50) MET hours per week more physical activity, vs no clinical knee OA. Structural knee OA was associated with 3.97 (-7.82; 15.76) MET hours per week more physical activity, vs no structural knee OA. In clinical knee OA, physical activity was not associated with knee pain, function or HRQoL. CONCLUSIONS Knee OA was not associated with lower physical activity, and in knee OA physical activity was not associated with patient-reported outcomes. Future research should indicate the optimal treatment advice regarding physical activity for individual knee OA patients.
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Affiliation(s)
- S E S Terpstra
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
| | - J H P M van der Velde
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - R de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - D Schiphof
- Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - M Reijnierse
- Department of Radiology, Leiden University Medical Center, The Netherlands.
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - L A van de Stadt
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - M Loef
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
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18
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Lv Z, Yang YX, Li J, Fei Y, Guo H, Sun Z, Lu J, Xu X, Jiang Q, Ikegawa S, Shi D. Molecular Classification of Knee Osteoarthritis. Front Cell Dev Biol 2021; 9:725568. [PMID: 34513847 PMCID: PMC8429960 DOI: 10.3389/fcell.2021.725568] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/09/2021] [Indexed: 01/15/2023] Open
Abstract
Knee osteoarthritis (KOA) is the most common form of joint degeneration with increasing prevalence and incidence in recent decades. KOA is a molecular disorder characterized by the interplay of numerous molecules, a considerable number of which can be detected in body fluids, including synovial fluid, urine, and blood. However, the current diagnosis and treatment of KOA mainly rely on clinical and imaging manifestations, neglecting its molecular pathophysiology. The mismatch between participants' molecular characteristics and drug therapeutic mechanisms might explain the failure of some disease-modifying drugs in clinical trials. Hence, according to the temporal alteration of representative molecules, we propose a novel molecular classification of KOA divided into pre-KOA, early KOA, progressive KOA, and end-stage KOA. Then, progressive KOA is furtherly divided into four subtypes as cartilage degradation-driven, bone remodeling-driven, inflammation-driven, and pain-driven subtype, based on the major pathophysiology in patient clusters. Multiple clinical findings of representatively investigated molecules in recent years will be reviewed and categorized. This molecular classification allows for the prediction of high-risk KOA individuals, the diagnosis of early KOA patients, the assessment of therapeutic efficacy, and in particular, the selection of homogenous patients who may benefit most from the appropriate therapeutic agents.
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Affiliation(s)
- Zhongyang Lv
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yannick Xiaofan Yang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiawei Li
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yuxiang Fei
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Hu Guo
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Ziying Sun
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jun Lu
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xingquan Xu
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Qing Jiang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Science (IMS, RIKEN), Tokyo, Japan
| | - Dongquan Shi
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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19
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Xie J, Wang Y, Lu L, Liu L, Yu X, Pei F. Cellular senescence in knee osteoarthritis: molecular mechanisms and therapeutic implications. Ageing Res Rev 2021; 70:101413. [PMID: 34298194 DOI: 10.1016/j.arr.2021.101413] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/06/2021] [Accepted: 07/16/2021] [Indexed: 02/08/2023]
Abstract
Cellular senescence is the inability of cells to proliferate, which has both beneficial and detrimental effects on tissue development and homeostasis. Chronic accumulation of senescent cells is associated with age-related disease, including osteoarthritis, a common joint disease responsible for joint pain and disability in older adults. The pathology of this disease includes loss of cartilage, synovium inflammation, and subchondral bone remodeling. Senescent cells are present in the cartilage of people with advanced osteoarthritis, but the link between cellular senescence and this disease is unclear. In this review, we summarize current evidence for the role of cellular senescence of different cell types in the onset and progression of osteoarthritis. We focus on the underlying mechanisms of senescence in chondrocytes, which maintain the cartilage in joints, and review the role of the Forkhead family of transcription factors, which are involved in cartilage maintenance and osteoarthritis. Finally, we discuss the potential therapeutic value and implications of targeting senescent cells using senolytic agents or immune therapies, targeting the senescence-associated secretory phenotype of these cells using senomorphic agents, and renewing the plasticity of stem cells and chondrocytes. Our review highlights current gaps in understanding of the mechanism of senescence that may, when addressed, provided new options for modifying and treating disease in osteoarthritis.
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20
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Osteoporosis is associated with varus deformity in postmenopausal women with knee osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2021; 22:694. [PMID: 34391392 PMCID: PMC8364705 DOI: 10.1186/s12891-021-04580-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 08/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Varus deformity of the knee is a common pathological characteristic in knee osteoarthritis (KOA), and not enough attention has been given to the relationship between knee varus deformity and the state of systemic bone mass. The purpose of this study was to evaluate the potential relationship between bone mineral density (BMD) and varus deformity in postmenopausal women with KOA. METHODS A total of 202 postmenopausal women with KOA(KL grade ≥ 2)in our department from January 2018 to June 2020 were reviewed in this cross-sectional study. The hip-knee-ankle angle of the lower extremity (HKA), medial distal femoral angle (MDFA), medial proximal tibial angle (MPTA), and the angle of the joint line (JLCA) were measured in all patients. According to the HKA Angle, these participants were divided into the varus deformity group (HKA < 175.3°) and the normal limb alignment group (175.3°≤ HKA ≤ 180.3°). The BMD of the lumbar (L1-L4), left femoral neck, and left hip were measured by dual-energy X-ray absorptiometry in all patients. The difference in BMD between the knee varus deformity group and the normal limb alignment group was compared, and the relationship between the different angles of limb alignment and the BMD values at different sites was evaluated. RESULTS There were 144 cases (71.3 %) in the varus deformity group and 58 cases (28.7 %) in the normal limb alignment group. BMD at different joint sites within the knee varus deformity group was lower than of the normal limb alignment group, and the prevalence of osteoporosis was higher. After adjusting for confounding factors such as age, BMI, pain duration, and affected side, binary logistic regression showed that osteoporosis was an independent risk factor for varus deformity of KOA, and multiple linear regression showed that the BMD of spine, femoral neck, and hip was significantly associated with varus deformity of KOA. Pearson correlation analysis showed that BMD of the lumbar spine (L1-L4), left femoral neck and left hip joint were positively correlated with the HKA, but negatively correlated with JLCA. MPTA was positively correlated with the left femoral neck and left hip joint BMD, but not correlated with lumbar bone density. Furthermore, in the normal limb alignment group, the HKA was only negatively correlated with JLCA, but not significantly correlated with MDFA and MPTA. In the varus deformity group, the HKA was not only negatively correlated with JLCA but also positively correlated with MDFA and MPTA. CONCLUSIONS Osteoporosis should be a major risk factor for varus deformity in postmenopausal women with KOA. The progression of varus deformity of the knee should be concerned in postmenopausal women who simultaneously has KOA and osteoporosis.
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21
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Wang H, Zhu Z, Wu J, Wang H, Gao L, Xiao J. Effect of type II diabetes-induced osteoarthritis on articular cartilage aging in rats: A study in vivo and in vitro. Exp Gerontol 2021; 150:111354. [PMID: 33872738 DOI: 10.1016/j.exger.2021.111354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Some evidence suggests that type II diabetes mellitus (T2DM) and osteoarthritis (OA) usually occur together clinically, and the symptoms are more obvious compared with non-diabetic patients with OA. We aimed to explore the effects in cartilage degradation, damage, and aging after T2DM combined with OA. METHODS Thirty male Sprague-Dawley (SD) rats were randomly divided into the young-control group (YCG, n = 10), old-control group (OCG, n = 10), and old T2DM-induced OA group (OTOG, n = 10) after the pre-experiment. T2DM model was established using a high-fat diet and streptozotocin. In vivo, all rats were evaluated by behavior, histology, immunohistochemistry, and enzyme-linked immunosorbent assay (ELISA). In vitro, chondrocytes of 17-day-old SD rats were cultured to obtain the passage 1 (P1) and passage 5 (P5) chondrocytes. The effects of different concentrations glucose on chondrocyte senescence were evaluated by chondrocyte staining, immunofluorescence, western blotting, and ROS analysis. RESULTS The results of histology (hematoxylin-eosin staining, safranin O-fast green staining, alizarin red S staining, and Mankin score), immunohistochemistry (COL-II, MMP-13, and p21), ELISA (IL-6 and IL-8), western blotting (COL-II, MMP-13, p21, p53, and p16), immunofluorescence, and ROS analysis indicated that the degeneration and aging in the articular cartilage of OTOG were more serious than other groups. Moreover, high concentration glucose can accelerated the degradation and aging degree of cartilage. The changes in P5 are more obvious than in P1 cells. CONCLUSION T2DM-induced OA can aggravate the aging of articular cartilage in aging individuals. High concentration glucose can cause a certain degree of damage, degradation, and aging of chondrocytes.
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Affiliation(s)
- Haoran Wang
- Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, China
| | - Zihan Zhu
- Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, China
| | - Junnan Wu
- Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, China
| | - Hongbin Wang
- Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, China
| | - Li Gao
- Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, China
| | - Jianhua Xiao
- Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, China.
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22
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Monticone M, Sconza C, Portoghese I, Nishigami T, Wand BM, Sorrentino G, Lemorini G, Respizzi S, Giordano A, Franchignoni F. Cross-cultural adaptation, reliability and validity of the Fremantle Knee Awareness Questionnaire in Italian subjects with painful knee osteoarthritis. Health Qual Life Outcomes 2021; 19:114. [PMID: 33827594 PMCID: PMC8025485 DOI: 10.1186/s12955-021-01754-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
Background and aim Growing attention is being given to utilising physical function measures to better understand and manage knee osteoarthritis (OA). The Fremantle Knee Awareness Questionnaire (FreKAQ), a self-reported measure of body-perception specific to the knee, has never been validated in Italian patients. The aims of this study were to culturally adapt and validate the Italian version of the FreKAQ (FreKAQ-I), to allow for its use with Italian-speaking patients with painful knee OA. Methods The FreKAQ-I was developed by means of forward–backward translation, a final review by an expert committee and a test of the pre-final version to evaluate its comprehensibility. The psychometric testing included: internal structural validity by Rasch analysis; construct validity by assessing hypotheses of FreKAQ correlations with the knee injury and osteoarthritis outcome score (KOOS), a pain intensity numerical rating scale (PI-NRS), the pain catastrophising scale (PCS), and the Hospital anxiety and depression score (HADS) (Pearson’s correlations); known-group validity by evaluating the ability of FreKAQ scores to discriminate between two groups of participants with different clinical profiles (Mann–Whitney U test); reliability by internal consistency (Cronbach’s alpha) and test–retest reliability (intraclass correlation coefficient, ICC2.1); and measurement error by calculating the minimum detectable change (MDC). Results It took one month to develop a consensus-based version of the FreKAQ-I. The questionnaire was administered to 102 subjects with painful knee OA and was well accepted. Internal structural validity confirmed the substantial unidimensionality of the FreKAQ-I: variance explained was 53.3%, the unexplained variance in the first contrast showed an eigenvalue of 1.8, and no local dependence was detected. Construct validity was good as all of the hypotheses were met; correlations: KOOS (rho = 0.38–0.51), PI-NRS (rho = 0.35–0.37), PCS (rho = 0.47) and HADS (Anxiety rho = 0.36; Depression rho = 0.43). Regarding known-groups validity, FreKAQ scores were significantly different between groups of participants demonstrating high and low levels of pain intensity, pain catastrophising, anxiety, depression and the four KOOS subscales (p ≤ 0.004). Internal consistency was acceptable (α = 0.74) and test–retest reliability was excellent (ICC = 0.92, CI 0.87–0.94). The MDC95 was 5.22 scale points. Conclusion The FreKAQ-I is unidimensional, reliable and valid in Italian patients with painful knee OA. Its use is recommended for clinical and research purposes. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01754-4.
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Affiliation(s)
- Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Neurorehabilitation Unit, Department of Neuroscience and Rehabilitation, G. Brotzu Hospital, Cagliari, Italy
| | - Cristiano Sconza
- Department of Physical and Rehabilitation Medicine, Humanitas Clinical and Research Centre IRCSS, Rozzano, Milan, Italy
| | - Igor Portoghese
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, Strada Statale, 554 - Monserrato, Cagliari, Italy.
| | - Tomohiko Nishigami
- Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Hiroshima, Japan
| | - Benedict M Wand
- The School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Gregorio Sorrentino
- Physical Medicine and Rehabilitation School, University of Milano-Bicocca, Milan, Italy
| | - Giulia Lemorini
- Physical Medicine and Rehabilitation School, University of Milan, Milan, Italy
| | - Stefano Respizzi
- Department of Physical and Rehabilitation Medicine, Humanitas Clinical and Research Centre IRCSS, Rozzano, Milan, Italy
| | - Andrea Giordano
- ICS Maugeri, IRCCS, Bioengineering Unit, Institute of Veruno, Veruno, NO, Italy
| | - Franco Franchignoni
- ICS Maugeri, IRCCS, Physical Medicine and Rehabilitation Unit, Institute of Tradate, Tradate, VA, Italy
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23
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Herrero-Beaumont G, Largo R. Glucosamine and O-GlcNAcylation: a novel immunometabolic therapeutic target for OA and chronic, low-grade systemic inflammation? Ann Rheum Dis 2020; 79:1261-1263. [PMID: 32554393 DOI: 10.1136/annrheumdis-2020-217454] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Gabriel Herrero-Beaumont
- Rheumatology, Fundacion Jimenez Diaz, Madrid, Spain .,Joint and Bone Research Unit, Rheumatology Department, IIS-Fundacion Jimenez Diaz, Madrid, Spain
| | - Raquel Largo
- Joint and Bone Research Unit, Rheumatology Department, IIS-Fundacion Jimenez Diaz, Madrid, Spain
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24
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Roman-Blas JA, Mendoza-Torres LA, Largo R, Herrero-Beaumont G. Setting up distinctive outcome measures for each osteoarthritis phenotype. Ther Adv Musculoskelet Dis 2020; 12:1759720X20937966. [PMID: 32973934 PMCID: PMC7491224 DOI: 10.1177/1759720x20937966] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) is an evolving chronic joint disease with a huge global impact. Given the intricate nature of the etiopathogenesis and subsequent high heterogeneity in the clinical course of OA, it is crucial to discriminate between etiopathogenic endotypes and clinical phenotypes, especially in the early stages of the disease. In this sense, we propose that an OA phenotype should be properly assessed with a set of outcome measures including those specifically related to the main underlying pathophysiological mechanisms. Thus, each OA phenotype can be related to different and clinically meaningful outcomes. OA phenotyping would lead to an adequate patient stratification in well-designed clinical trials and the discovery of precise therapeutic approaches. A significant effort will be required in this field in light of inconclusive results of clinical trials of tissue-targeting agents for the treatment of OA.
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Affiliation(s)
- Jorge A Roman-Blas
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz, UAM, Av. Reyes Catolicos 2, Madrid, 28040, Spain
| | | | - Raquel Largo
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
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25
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Arthritis and the role of endogenous glucocorticoids. Bone Res 2020; 8:33. [PMID: 32963891 PMCID: PMC7478967 DOI: 10.1038/s41413-020-00112-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/09/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022] Open
Abstract
Rheumatoid arthritis and osteoarthritis, the most common forms of arthritis, are chronic, painful, and disabling conditions. Although both diseases differ in etiology, they manifest in progressive joint destruction characterized by pathological changes in the articular cartilage, bone, and synovium. While the potent anti-inflammatory properties of therapeutic (i.e., exogenous) glucocorticoids have been heavily researched and are widely used in clinical practice, the role of endogenous glucocorticoids in arthritis susceptibility and disease progression remains poorly understood. Current evidence from mouse models suggests that local endogenous glucocorticoid signaling is upregulated by the pro-inflammatory microenvironment in rheumatoid arthritis and by aging-related mechanisms in osteoarthritis. Furthermore, these models indicate that endogenous glucocorticoid signaling in macrophages, mast cells, and chondrocytes has anti-inflammatory effects, while signaling in fibroblast-like synoviocytes, myocytes, osteoblasts, and osteocytes has pro-inflammatory actions in rheumatoid arthritis. Conversely, in osteoarthritis, endogenous glucocorticoid signaling in both osteoblasts and chondrocytes has destructive actions. Together these studies provide insights into the role of endogenous glucocorticoids in the pathogenesis of both inflammatory and degenerative joint disease.
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26
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Akhbari P, Karamchandani U, Jaggard MKJ, Graça G, Bhattacharya R, Lindon JC, Williams HRT, Gupte CM. Can joint fluid metabolic profiling (or "metabonomics") reveal biomarkers for osteoarthritis and inflammatory joint disease?: A systematic review. Bone Joint Res 2020; 9:108-119. [PMID: 32435463 PMCID: PMC7229296 DOI: 10.1302/2046-3758.93.bjr-2019-0167.r1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aims Metabolic profiling is a top-down method of analysis looking at metabolites, which are the intermediate or end products of various cellular pathways. Our primary objective was to perform a systematic review of the published literature to identify metabolites in human synovial fluid (HSF), which have been categorized by metabolic profiling techniques. A secondary objective was to identify any metabolites that may represent potential biomarkers of orthopaedic disease processes. Methods A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using the MEDLINE, Embase, PubMed, and Cochrane databases. Studies included were case series, case control series, and cohort studies looking specifically at HSF. Results The primary analysis, which pooled the results from 17 published studies and four meeting abstracts, identified over 200 metabolites. Seven of these studies (six published studies, one meeting abstract) had asymptomatic control groups and collectively suggested 26 putative biomarkers in osteoarthritis, inflammatory arthropathies, and trauma. These can broadly be categorized into amino acids plus related metabolites, fatty acids, ketones, and sugars. Conclusion The role of metabolic profiling in orthopaedics is fast evolving with many metabolites already identified in a variety of pathologies. However, these results need to be interpreted with caution due to the presence of multiple confounding factors in many of the studies. Future research should include largescale epidemiological metabolic profiling studies incorporating various confounding factors with appropriate statistical analysis to account for multiple testing of the data. Cite this article:Bone Joint Res. 2020;9(3):108–119.
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Affiliation(s)
- Pouya Akhbari
- Department of Orthopaedics & Trauma, Imperial College Healthcare NHS Trust, London, UK
| | | | - Matthew K J Jaggard
- Department of Orthopaedics & Trauma, Imperial College Healthcare NHS Trust, London, UK
| | - Goncalo Graça
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Rajarshi Bhattacharya
- Department of Orthopaedics & Trauma, Imperial College Healthcare NHS Trust, London, UK
| | - John C Lindon
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Horace R T Williams
- Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Chinmay M Gupte
- Department of Surgery and Cancer, Imperial College London, and Department of Orthopaedics & Trauma, Imperial College Healthcare NHS Trust, London, UK
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27
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Yu SP, Hunter DJ. What is the selection process for osteoarthritis pharmacotherapy? Expert Opin Pharmacother 2020; 21:1393-1397. [PMID: 32352847 DOI: 10.1080/14656566.2020.1761325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Osteoarthritis is the most prevalent joint condition that continues to increase with an ever-aging population and the rising tide of obesity. There are multiple recommendations/guidelines for the management of osteoarthritis. The basis of management should focus on self-management and education, lifestyle modifications, exercise and when appropriate, weight loss. Pharmacotherapy is targeted toward pain palliation with no agents available presently to target prevention and disease modification. The selection of pharmacotherapy should be tailored to the individual, taking into account of personal preferences and interactions with underlying co-morbidities. This editorial provides a guide to the selection process of presently available pharmacotherapy in osteoarthritis.
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Affiliation(s)
- Shirley P Yu
- Department of Rheumatology, Royal North Shore Hospital , Sydney, Australia.,Institute of Bone and Joint Research, University of Sydney , Sydney, Australia
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital , Sydney, Australia.,Institute of Bone and Joint Research, University of Sydney , Sydney, Australia
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28
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Herrero-Beaumont G, Roman-Blas JA, Mediero A, Sánchez-Pernaute O, Largo R. Treating osteoporotic osteoarthritis, or the art of cutting a balding man's hair. Osteoarthritis Cartilage 2020; 28:239-241. [PMID: 31863830 DOI: 10.1016/j.joca.2019.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/14/2019] [Accepted: 10/28/2019] [Indexed: 02/02/2023]
Affiliation(s)
- G Herrero-Beaumont
- Bone and Joint Research Unit, Rheumatology Department, IIS-Fundación Jiménez Díaz-Autonomous University of Madrid, Madrid, Spain.
| | - J A Roman-Blas
- Bone and Joint Research Unit, Rheumatology Department, IIS-Fundación Jiménez Díaz-Autonomous University of Madrid, Madrid, Spain
| | - A Mediero
- Bone and Joint Research Unit, Rheumatology Department, IIS-Fundación Jiménez Díaz-Autonomous University of Madrid, Madrid, Spain
| | - O Sánchez-Pernaute
- Bone and Joint Research Unit, Rheumatology Department, IIS-Fundación Jiménez Díaz-Autonomous University of Madrid, Madrid, Spain
| | - R Largo
- Bone and Joint Research Unit, Rheumatology Department, IIS-Fundación Jiménez Díaz-Autonomous University of Madrid, Madrid, Spain
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29
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Trivedi S, Fang W, Ayyalasomayajula I, Vangsness CT. Pharmacotherapeutic considerations and options for the management of osteoarthritis in women. Expert Opin Pharmacother 2020; 21:557-566. [DOI: 10.1080/14656566.2020.1718649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Sunny Trivedi
- University of Florida College of Medicine, Gainesville, FL, USA
| | - William Fang
- Department of Orthopaedic Surgery, Keck School of Medicine USC, Los Angeles, CA, USA
| | | | - C. Thomas Vangsness
- Department of Orthopaedic Surgery, Keck School of Medicine USC, Los Angeles, CA, USA
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30
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Migliore A, Gigliucci G, Petrella RJ, Bannuru RR, Chevalier X, Maheu E, Raman R, Herrero-Beaumont G, Isailovic N, Matucci Cerinc M. It Is the Time to Think About a Treat-to-Target Strategy for Knee Osteoarthritis. Ther Clin Risk Manag 2020; 15:1479-1482. [PMID: 31920321 PMCID: PMC6935020 DOI: 10.2147/tcrm.s221562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/04/2019] [Indexed: 11/23/2022] Open
Abstract
Osteoarthritis (OA) is a rheumatic disease that affects the well-being of the patient, compromises physical and mental function, and affects other quality of life aspects. In the literature, several evidence-based guidelines and recommendations for the management of knee osteoarthritis (KOA) are available. These recommendations list the different therapeutic options rather than addressing a hierarchy between the treatments and defining the real target. Therefore, a question arises: are patients and physicians satisfied with the current management of KOA? Actually, the answer may be negative, thus suggesting a change in our therapeutic strategies. In this article, we address this challenge by suggesting that it is time to develop a “treat to target strategy” for KOA.
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Affiliation(s)
- A Migliore
- Rheumatology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - G Gigliucci
- Rheumatology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - R J Petrella
- Department of Family Medicine, School of Kinesiology Western University, Western Centre for Public Health & Family, London, Ontario, Canada
| | - R R Bannuru
- Center for Treatment Comparison and Integrative Analysis Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - X Chevalier
- Department of Rheumatology, Hôpital Henri Mondor, Creteil, France
| | - E Maheu
- Rheumatology Department, AP-HP, Saint-Antoine Hospital, Paris, France
| | - R Raman
- Academic Department of Orthopaedics, Hull and East Yorkshire NHS Trust, Castle Hill Hospital, Cottingham, UK
| | - G Herrero-Beaumont
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
| | - N Isailovic
- Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - M Matucci Cerinc
- Division of Rheumatology AOUC, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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31
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Migliore A, Gigliucci G, Alekseeva L, Avasthi S, Bannuru RR, Chevalier X, Conrozier T, Crimaldi S, Damjanov N, de Campos GC, Diracoglu D, Herrero-Beaumont G, Iolascon G, Ionescu R, Isailovic N, Jerosch J, Lains J, Maheu E, Makri S, Martusevich N, Matucci Cerinc M, Micu M, Pavelka K, Petrella RJ, Tarantino U, Raman R. Treat-to-target strategy for knee osteoarthritis. International technical expert panel consensus and good clinical practice statements. Ther Adv Musculoskelet Dis 2019; 11:1759720X19893800. [PMID: 31903099 PMCID: PMC6923692 DOI: 10.1177/1759720x19893800] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 11/15/2019] [Indexed: 12/22/2022] Open
Abstract
Background: In this work, we aimed to establish a clinical target in the management of
knee osteoarthritis (KOA) and to propose good clinical practice (GCP)
statements for carrying out a treat-to-target strategy. Methods: A steering committee of seven experts had formulated a provisional set of
recommendations that were exposed for discussion and modification to a
technical expert panel (TEP) of 25 multidisciplinary experts from Europe,
North America, South America and Asia. The level of evidence and strength of
each recommendation was discussed. The TEP formulated overarching principles
and GCP statements based on the level of agreement for each item with a vote
using a 10-point numerical scale. Results: Two overarching principles and 10 GCP statements were formulated by the TEP.
These GCP statements suggest: treatment should achieve clinical improvement
bringing the patient to the Patient Acceptable Symptom State (PASS);
pharmacological and nonpharmacological treatment should begin as early as
possible, with an early diagnosis of symptomatic KOA; the patient should be
evaluated every 3–6 months; risk factors of KOA progression should be
identified and managed with patients at the beginning of the treatment and
monitored regularly; treatment should be adapted according to patient
phenotype and disease severity; healthy lifestyle must be promoted and
monitored. The level of agreement average ranged from 8.7 to 9.6 on
scale. Conclusions: The proposed overarching principles and GCP statements have the aim of
involving patients, general practitioners and multidisciplinary specialists
in sharing a therapeutic treat-to-target strategy for KOA management based
on the best evidence and expert opinions.
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Affiliation(s)
- Alberto Migliore
- Rheumatology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | | | - Liudmila Alekseeva
- Department of Metabolic Diseases of Bone and Joints, VA Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
| | - Sachin Avasthi
- Department of Emergency Medicine, Dr Ram Manohar Lohia Hospital, Lucknow, India
| | - Raveendhara R Bannuru
- Centre for Treatment Comparison and Integrative Analysis Division of Rheumatology, Tufts Medical Centre, Boston, MA, USA
| | | | | | - Sergio Crimaldi
- Chirurgia Ortopedica Mininvasiva e Nuove Tecnologie, Humanitas Research Hospital, Castellanza, Italy
| | - Nemanja Damjanov
- Institute of Rheumatology, University of Belgrade Medical School, Belgrade, Serbia
| | | | - Demirhan Diracoglu
- Department of Physical Medicine and Rehabilitation Division of Pain Medicine, Istanbul University, Istanbul, Turkey
| | | | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania 'L Vanvitelli', Caserta, Italy
| | - Ruxandra Ionescu
- Department of Internal Medicine and Rheumatology Sf. Maria Hospital, University of Medicine and Pharmacy 'Carol Davila', Bucharest, Romania
| | - Natasa Isailovic
- Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital, Via A. Manzoni 56, Rozzano, Milan 20089, Italy
| | - Jörg Jerosch
- Orthopaedic Department, Johanna Etienne Hospital, Neuss, Germany
| | - Jorge Lains
- Physical Rehabilitation Medicine Department, Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal
| | - Emmanuel Maheu
- Rheumatology Department, AP-HP, Saint-Antoine Hospital, Paris, France
| | - Souzi Makri
- EUPATI Graduate and Patient Advocate, Brussels, Belgium
| | - Natalia Martusevich
- Department of Rheumatology, Belorussian State Medical University, Minsk, Belarus
| | - Marco Matucci Cerinc
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Mihaela Micu
- Second Rehabilitation Department, Rehabilitation Clinical Hospital, Cluj-Napoca, Romania
| | | | - Robert J Petrella
- Department of Family Medicine, School of Kinesiology University Western Ontario, Ontario, Canada
| | - Umberto Tarantino
- Department of Orthopaedics and Traumatology, 'Policlinico Tor Vergata' Foundation, Rome, Italy
| | - Raghu Raman
- Academic Department of Orthopaedics, Hull and East Yorkshire NHS Trust Castle Hill Hospital, Cottingham, UK
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32
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Carlson AK, Rawle RA, Wallace CW, Brooks EG, Adams E, Greenwood MC, Olmer M, Lotz MK, Bothner B, June RK. Characterization of synovial fluid metabolomic phenotypes of cartilage morphological changes associated with osteoarthritis. Osteoarthritis Cartilage 2019; 27:1174-1184. [PMID: 31028882 PMCID: PMC6646055 DOI: 10.1016/j.joca.2019.04.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) is a multifactorial disease with etiological heterogeneity. The objective of this study was to classify OA subgroups by generating metabolomic phenotypes from human synovial fluid. DESIGN Post mortem synovial fluids (n = 75) were analyzed by high performance-liquid chromatography mass spectrometry (LC-MS) to measure changes in the global metabolome. Comparisons of healthy (grade 0), early OA (grades I-II), and late OA (grades III-IV) donor populations were considered to reveal phenotypes throughout disease progression. RESULTS Global metabolomic profiles in synovial fluid were distinct between healthy, early OA, and late OA donors. Pathways differentially activated among these groups included structural deterioration, glycerophospholipid metabolism, inflammation, central energy metabolism, oxidative stress, and vitamin metabolism. Within disease states (early and late OA), subgroups of donors revealed distinct phenotypes. Synovial fluid metabolomic phenotypes exhibited increased inflammation (early and late OA), oxidative stress (late OA), or structural deterioration (early and late OA) in the synovial fluid. CONCLUSION These results revealed distinct metabolic phenotypes in human synovial fluid, provide insight into pathogenesis, represent novel biomarkers, and can move toward developing personalized interventions for subgroups of OA patients.
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Affiliation(s)
- A K Carlson
- Montana State University, Departments of Mechanical & Industrial Engineering, Chemistry & Biochemistry, Chemical & Biological Engineering, Mathematical Sciences, WWAMI, USA; Carroll College, Life and Environmental Sciences Department, USA
| | - R A Rawle
- Montana State University, Departments of Mechanical & Industrial Engineering, Chemistry & Biochemistry, Chemical & Biological Engineering, Mathematical Sciences, WWAMI, USA
| | - C W Wallace
- Montana State University, Departments of Mechanical & Industrial Engineering, Chemistry & Biochemistry, Chemical & Biological Engineering, Mathematical Sciences, WWAMI, USA
| | - E G Brooks
- Montana State University, Departments of Mechanical & Industrial Engineering, Chemistry & Biochemistry, Chemical & Biological Engineering, Mathematical Sciences, WWAMI, USA
| | - E Adams
- Montana State University, Departments of Mechanical & Industrial Engineering, Chemistry & Biochemistry, Chemical & Biological Engineering, Mathematical Sciences, WWAMI, USA
| | - M C Greenwood
- Montana State University, Departments of Mechanical & Industrial Engineering, Chemistry & Biochemistry, Chemical & Biological Engineering, Mathematical Sciences, WWAMI, USA
| | - M Olmer
- The Scripps Research Institute, Department of Molecular and Experimental Medicine, USA
| | - M K Lotz
- The Scripps Research Institute, Department of Molecular and Experimental Medicine, USA
| | - B Bothner
- Montana State University, Departments of Mechanical & Industrial Engineering, Chemistry & Biochemistry, Chemical & Biological Engineering, Mathematical Sciences, WWAMI, USA
| | - R K June
- Montana State University, Departments of Mechanical & Industrial Engineering, Chemistry & Biochemistry, Chemical & Biological Engineering, Mathematical Sciences, WWAMI, USA.
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33
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Osteoarthritis phenotypes and novel therapeutic targets. Biochem Pharmacol 2019; 165:41-48. [PMID: 30831073 DOI: 10.1016/j.bcp.2019.02.037] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 02/28/2019] [Indexed: 02/07/2023]
Abstract
The success of disease-modifying osteoarthritis drug (DMOAD) development is still elusive. While there have been successes in preclinical and early clinical studies, phase 3 clinical trials have failed so far and there is still no approved, widely available DMOAD on the market. The latest research suggests that, among other causes, poor trial outcomes might be explained by the fact that osteoarthritis (OA) is a heterogeneous disease with distinct phenotypes. OA trials might be more successful if they would address and target a specific phenotype. The increasing availability of advanced techniques to detect particular OA characteristics expands the possibilities to distinguish between such potential OA phenotypes. Magnetic resonance imaging is among the key imaging techniques to stratify and monitor patients with changes in bone, cartilage and inflammation. Biochemical markers have mainly used as secondary parameters and could further delineate phenotypes. Moreover, post-hoc analyses of trial data have suggested the existence of distinct pain phenotypes and their relevance in the design of clinical trials. Although ongoing work in the field supports the concept of OA heterogeneity, this has not yet resulted in more effective treatment options. This paper reviews the current knowledge about potential OA phenotypes and suggests that combining patient clinical data, quantitative imaging, biochemical markers and utilizing data-driven approaches in patient selection and efficacy assessment will allow for more successful development of effective DMOADs.
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34
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Alcaraz MJ, Guillén MI, Ferrándiz ML. Emerging therapeutic agents in osteoarthritis. Biochem Pharmacol 2019; 165:4-16. [PMID: 30826327 DOI: 10.1016/j.bcp.2019.02.034] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 02/28/2019] [Indexed: 12/27/2022]
Abstract
Osteoarthritis (OA) is the most common joint disorder and a leading cause of disability. Current treatments for OA can improve symptoms but do not delay the progression of disease. In the last years, much effort has been devoted to developing new treatments for OA focused on pain control, inflammatory mediators or degradation of articular tissues. Although promising results have been obtained in ex vivo studies and animal models of OA, few of these agents have completed clinical trials. Available clinical data support the interest of nerve growth factor as a target in pain control as well as the disease-modifying potential of inhibitors of Wnt signaling or catabolic enzymes such as aggrecanases and cathepsin K, and anabolic strategies like fibroblast growth factor-18 or cellular therapies. Carefully controlled studies in patients selected according to OA phenotypes and with a long follow-up will help to confirm the relevance of these new approaches as emerging therapeutic treatments in OA.
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Affiliation(s)
- María José Alcaraz
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Av. Vicent A. Estellés s/n, 46100 Burjasot, Valencia, Spain.
| | - María Isabel Guillén
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Av. Vicent A. Estellés s/n, 46100 Burjasot, Valencia, Spain; Department of Pharmacy, Cardenal Herrera-CEU University, Ed. Ciencias de la Salud, 46115 Alfara, Valencia, Spain
| | - María Luisa Ferrándiz
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Av. Vicent A. Estellés s/n, 46100 Burjasot, Valencia, Spain
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Zolotovskaya IA, Davydkin IL, Poverennova IE. Therapy of nonspecific lower back pain in patients with high cardiovascular risk. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:18-23. [DOI: 10.17116/jnevro201911908118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Che Ahmad Tantowi NA, Lau SF, Mohamed S. Ficus deltoidea Prevented Bone Loss in Preclinical Osteoporosis/Osteoarthritis Model by Suppressing Inflammation. Calcif Tissue Int 2018; 103:388-399. [PMID: 29808374 DOI: 10.1007/s00223-018-0433-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/15/2018] [Indexed: 12/27/2022]
Abstract
Osteoporosis (OP) and osteoarthritis (OA) are debilitating musculoskeletal diseases of the elderly. Ficus deltoidea (FD) or mistletoe fig, a medicinal plant, was pre-clinically evaluated against OP- and OA-related bone alterations, in postmenopausal OA rat model. Thirty twelfth-week-old female rats were divided into groups (n = 6). Four groups were bilateral ovariectomized (OVX) and OA-induced by intra-articular monosodium iodoacetate (MIA) injection into the right knee joints. The Sham control and OVX-OA non-treated groups were given deionized water. The three other OVX-OA groups were orally administered daily with FD extract (200, 400 mg/kg) or diclofenac (5 mg/kg) for 4 weeks. The rats' bones and blood were evaluated for protein and mRNA expressions of osteoporosis and inflammatory indicators, and micro-CT computed tomography for bone microstructure. The non-treated OVX-OA rats developed severe OP bone loss and bone microstructural damage in the subchondral and metaphyseal regions, supported by reduced serum bone formation markers (osteocalcin, osteoprotegerin) and increased bone resorption markers (RANKL and CTX-I). The FD extract significantly (p < 0.05) mitigated these bone microstructural and biomarker changes by dose-dependently down-regulating pro-inflammatory NF-κβ, TNF-α, and IL-6 mRNA expressions. The FD extract demonstrated good anti-osteoporotic properties in this OP/OA preclinical model by stimulating bone formation and suppressing bone resorption via anti-inflammatory pathways. This is among the few reports relating the subchondral bone plate and trabecular thickening with the metaphyseal trabecular osteopenic bone loss under osteoporotic-osteoarthritis conditions, providing some insights on the debated inverse relationship between osteoporosis and osteoarthritis.
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Affiliation(s)
- Nur Adeelah Che Ahmad Tantowi
- UPM-MAKNA Laboratory of Cancer Research, Institute of Bioscience, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | - Seng Fong Lau
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM, Serdang, Malaysia
| | - Suhaila Mohamed
- UPM-MAKNA Laboratory of Cancer Research, Institute of Bioscience, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia.
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Kriegova E, Manukyan G, Mikulkova Z, Gabcova G, Kudelka M, Gajdos P, Gallo J. Gender-related differences observed among immune cells in synovial fluid in knee osteoarthritis. Osteoarthritis Cartilage 2018; 26:1247-1256. [PMID: 29753948 DOI: 10.1016/j.joca.2018.04.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/15/2018] [Accepted: 04/09/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is no existing comprehensive report on the cellular composition of synovial fluids (SFs) from knee osteoarthritis (OA). We therefore aimed to characterise the immune cell composition in SFs from knee OA (KOA) and in subgroups according to gender. DESIGN The immunophenotyping of monocyte/macrophage lineage cells, T and B cells, NK cells, neutrophils, dendritic and mast cells (MC) present in SFs from 53 patients (24 males/29 females) with KOA was performed using 6-colour flow cytometry. RESULTS SFs from patients with OA contained 90% hematopoietic cells. Lymphocytes were the predominant cell population (44.8%) in the SFs of OA patients, with CD4+ T lymphocytes being more prevalent than CD8+ T cells (CD4+/CD8+ ratio = 1.3). Within the monocyte/macrophage lineage gating, monocytes accounted for 33.9%, macrophages 14.8%, myeloid dendritic cells 16.4%. The rest of the hematopoietic cells were comprised of neutrophils (8%), NK cells (3.8%), T regulatory cells (1.2%), plasmacytoid dendritic cells (1.1%), mast cells (0.3%). In OA females, a higher percentage of CD4+ T cells (P = 0.023), macrophages (P = 0.012), and a lower percentage of monocytes (P = 0.008) and CD8+ T cells (P = 0.002) were detected in comparison to OA males. CONCLUSIONS Based on the immune cell composition of SFs, data mining analysis revealed distinct phenotypes (monocyte- and lymphocyte-predominant) within each gender group. This first study on the cellular complexity of SFs in KOA showed marked differences between male and female patients. The findings give a rational starting point for patient stratification according to their phenotypes, as is required for phenotype-specific treatment strategies.
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Affiliation(s)
- E Kriegova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacky University & University Hospital, Olomouc, Czech Republic.
| | - G Manukyan
- Department of Immunology, Faculty of Medicine and Dentistry, Palacky University & University Hospital, Olomouc, Czech Republic; Laboratory of Molecular and Cellular Immunology, Institute of Molecular Biology NAS RA, Yerevan, Armenia.
| | - Z Mikulkova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacky University & University Hospital, Olomouc, Czech Republic.
| | - G Gabcova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacky University & University Hospital, Olomouc, Czech Republic.
| | - M Kudelka
- Dept. of Computer Science, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Czech Republic.
| | - P Gajdos
- Dept. of Computer Science, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Czech Republic.
| | - J Gallo
- Dept. of Orthopaedics, Faculty of Medicine and Dentistry, Palacky University & University Hospital, Olomouc, Czech Republic.
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Luo X, Jiang Y, Bi R, Jiang N, Zhu S. Inhibition of notch signaling pathway temporally postpones the cartilage degradation progress of temporomandibular joint arthritis in mice. J Craniomaxillofac Surg 2018; 46:1132-1138. [PMID: 29779621 DOI: 10.1016/j.jcms.2018.04.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/26/2018] [Accepted: 04/25/2018] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The aim of this study is to explore the role of Notch signaling pathway in the initiation and progression of temporomandibular joint osteoarthritis (TMJOA). METHODS 48 mice were divided into DAPT-TMJOA, Control-TMJOA and Control-Sham groups. Animals received discectomy/Sham surgery in their right TMJ, following the DAPT/saline intra-articular injections every week. Mice were sacrificed at 1/4/8 weeks post-surgery. Safranin-O and H&E staining were performed on the TMJ sections for the modified Mankin's score. qPCR and immunohistochemistry were used to evaluate Notch1, Jagged1 and Hes5 expressions. RESULTS The mRNA expressions of Notch1, Jagged1 and Hes5 were significantly increased in Control-TMJOA group compared with Control-Sham group. Immunostaining revealed a dramatic elevation of Notch1, Jagged1 and Hes5 signals distributed in the cartilage at 1 and 4 weeks after discectomy. However, the increased number of those immuno-positive cells turned down at 8 weeks after surgery. DAPT treatment partially rescued the elevated mRNA expression and immuno-positive cell numbers of Notch1, Jagged1 and Hes5. More importantly, the cartilage destruction during TMJOA was delayed by DAPT treatment, analyzed by modified Mankin's score. CONCLUSION Notch signaling participates in the onset and development of TMJOA. Inhibiting Notch signaling activation by DAPT can partially delay the progress of TMJOA.
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Affiliation(s)
- Xueting Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yangmei Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Pérez-Baos S, Prieto-Potin I, Román-Blas JA, Sánchez-Pernaute O, Largo R, Herrero-Beaumont G. Mediators and Patterns of Muscle Loss in Chronic Systemic Inflammation. Front Physiol 2018; 9:409. [PMID: 29740336 PMCID: PMC5928215 DOI: 10.3389/fphys.2018.00409] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/04/2018] [Indexed: 12/25/2022] Open
Abstract
Besides its primary function in locomotion, skeletal muscle (SKM), which represents up to half of human's weight, also plays a fundamental homeostatic role. Through the secretion of soluble peptides, or myokines, SKM interacts with major organs involved in metabolic processes. In turn, metabolic cues from these organs are received by muscle cells, which adapt their response accordingly. This is done through an intricate intracellular signaling network characterized by the cross-talking between anabolic and catabolic pathways. A fine regulation of the network is required to protect the organism from an excessive energy expenditure. Systemic inflammation evokes a catabolic reaction in SKM known as sarcopenia. In turn this response comprises several mechanisms, which vary depending on the nature of the insult and its magnitude. In this regard, aging, chronic inflammatory systemic diseases, osteoarthritis and idiopathic inflammatory myopathies can lead to muscle loss. Interestingly, sarcopenia may persist despite remission of chronic inflammation, an issue which warrants further research. The Janus kinase/signal transducer and activator of transcription (JAK/STAT) system stands as a major participant in muscle loss during systemic inflammation, while it is also a well-recognized orchestrator of muscle cell turnover. Herein we summarize current knowledge about models of sarcopenia, their triggers and major mediators and their effect on both protein and cell growth yields. Also, the dual action of the JAK/STAT pathway in muscle mass changes is discussed. We highlight the need to unravel the precise contribution of this system to sarcopenia in order to design targeted therapeutic strategies.
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Affiliation(s)
- Sandra Pérez-Baos
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Iván Prieto-Potin
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Jorge A Román-Blas
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Olga Sánchez-Pernaute
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Raquel Largo
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
| | - Gabriel Herrero-Beaumont
- Bone and Joint Research Unit, Service of Rheumatology, IIS-Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain
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Nelson FRT. The Value of Phenotypes in Knee Osteoarthritis Research. Open Orthop J 2018; 12:105-114. [PMID: 29619124 PMCID: PMC5859455 DOI: 10.2174/1874325001812010105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/15/2018] [Accepted: 02/23/2018] [Indexed: 01/20/2023] Open
Abstract
Background: Over the past decade, phenotypes have been used to help categorize knee osteoarthritis patients relative to being subject to disease, disease progression, and treatment response. A review of potential phenotype selection is now appropriate. The appeal of using phenotypes is that they most rely on simple physical examination, clinically routine imaging, and demographics. The purpose of this review is to describe the panoply of phenotypes that can be potentially used in osteoarthritis research. Methods: A search of PubMed was used singularly to review the literature on knee osteoarthritis phenotypes. Results: Four phenotype assembly groups were based on physical features and noninvasive imaging. Demographics included metabolic syndrome (dyslipidemia, hypertension, obesity, and diabetes). Mechanical characteristics included joint morphology, alignment, the effect of injury, and past and present history. Associated musculoskeletal disorder characteristics included multiple joint involvement, spine disorders, neuromuscular diseases, and osteoporosis. With the knee as an organ, tissue characteristics were used to focus on synovium, meniscus, articular cartilage, patella fat pad, bone sclerosis, bone cysts, and location of pain. Discussion: Many of these phenotype clusters require further validation studies. There is special emphasis on knee osteoarthritis phenotypes due to its predominance in osteoarthritic disorders and the variety of tissues in that joint. More research will be required to determine the most productive phenotypes for future studies. Conclusion: The selection and assignment of phenotypes will take on an increasing role in osteoarthritis research in the future.
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Affiliation(s)
- Fred R T Nelson
- Department of Orthopaedics, Henry Ford Hospital, 2799 West Grand Blvd. Detroit Michigan 48202, USA
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Ren G, Lutz I, Railton P, Wiley JP, McAllister J, Powell J, Krawetz RJ. Serum and synovial fluid cytokine profiling in hip osteoarthritis: distinct from knee osteoarthritis and correlated with pain. BMC Musculoskelet Disord 2018; 19:39. [PMID: 29402254 PMCID: PMC5800026 DOI: 10.1186/s12891-018-1955-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/25/2018] [Indexed: 12/01/2022] Open
Abstract
Background Inflammation is associated with the onset and progression of osteoarthritis in multiple joints. It is well known that mechanical properties differ between different joints, however, it remains unknown if the inflammatory process is similar/distinct in patients with hip vs. knee OA. Without complete understanding of the role of any specific cytokine in the inflammatory process, understanding the ‘profile’ of inflammation in a given patient population is an essential starting point. The aim of this study was to identify serum cytokine profiles in hip Osteoarthritis (OA), and investigate the association between cytokine concentrations and clinical measurements within this patient population and compare these findings to knee OA and healthy control cohorts. Methods In total, 250 serum samples (100 knee OA, 50 hip OA and 100 control) and 37 synovial fluid samples (8 knee OA, 14 hip OA and 15 control) were analyzed using a multiplex ELISA based approach. Synovial biopsies were also obtained and examined for specific cytokines. Pain, physical function and activity within the hip OA cohort were examined using the HOOS, SF-36, HHS and UCLA outcome measures. Results The three cohorts showed distinct serum cytokine profiles. EGF, FGF2, MCP3, MIP1α, and IL8 were differentially expressed between hip and knee OA cohorts; while FGF2, GRO, IL8, MCP1, and VEGF were differentially expressed between hip OA and control cohorts. Eotaxin, GRO, MCP1, MIP1β, VEGF were differentially expressed between knee OA and control cohorts. EGF, IL8, MCP1, MIP1β were differentially expressed in synovial fluid from a sub-set of patients from each cohort. Specifically within the hip OA cohort, IL-6, MDC and IP10 were associated with pain and were also found to be present in synovial fluid and synovial membrane (except IL-6) of patients with hip OA. Conclusion OA may include different inflammatory subtypes according to affected joints and distinct inflammatory processes may drive OA in these joints. IL6, MDC and IP10 are associated with hip OA pain and these proteins may be able to provide additional information regarding pain in hip OA patients. Electronic supplementary material The online version of this article (10.1186/s12891-018-1955-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guomin Ren
- McCaig Institute for Bone and Joint Health, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Ian Lutz
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | | | - J Preston Wiley
- McCaig Institute for Bone and Joint Health, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.,Sports Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jenelle McAllister
- Sports Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - James Powell
- McCaig Institute for Bone and Joint Health, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.,Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Roman J Krawetz
- McCaig Institute for Bone and Joint Health, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada. .,Department of Surgery, University of Calgary, Calgary, Alberta, Canada. .,Department of Anatomy and Cell Biology, University of Calgary, Calgary, Alberta, Canada.
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Altman RD. Letter to the Editor on "The AAHKS Clinical Research Award: What Are the Costs of Knee Osteoarthritis in the Year Prior to Total Knee Arthroplasty?". J Arthroplasty 2018; 33:305-306. [PMID: 29066247 DOI: 10.1016/j.arth.2017.10.003] [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: 08/23/2017] [Accepted: 10/03/2017] [Indexed: 02/01/2023] Open
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Knee osteoarthritis phenotypes and their relevance for outcomes: a systematic review. Osteoarthritis Cartilage 2017; 25:1926-1941. [PMID: 28847624 DOI: 10.1016/j.joca.2017.08.009] [Citation(s) in RCA: 191] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/22/2017] [Accepted: 08/18/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To systematically review the literature for studies investigating knee osteoarthritis (OA) phenotypes to examine what OA characteristics are relevant for phenotyping. METHODS A comprehensive search was performed in Medline, EMBASE, Web of Sciences, CINAHL, and Scopus databases from inception to September 2016. Inclusion was limited to observational studies of individuals with symptomatic knee OA that identified phenotypes based on any OA characteristics and assessed their association with clinically important outcomes. A descriptive synthesis of the data was performed. RESULTS Of the 2777 citations retrieved, 34 studies were included. Clinical phenotypes were investigated most frequently, followed by laboratory, imaging and aetiologic phenotypes. Eight studies defined subgroups based on outcome trajectories (pain, function and radiographic progression trajectories). Most studies used a single patient or disease characteristic to identify patients subgroups while five included characteristics from multiple domains. We found evidence from multiple studies suggesting that pain sensitization, psychological distress, radiographic severity, body mass index (BMI), muscle strength, inflammation and comorbidities are associated with clinically distinct phenotypes. Gender, obesity and other metabolic abnormalities, the pattern of cartilage damage, and inflammation may be implicated in delineating distinct structural phenotypes. Only a few studies investigated the external validity of the phenotypes or their prospective validity using longitudinal outcomes. CONCLUSIONS There is marked heterogeneity in the data selected by the studies investigating knee OA phenotypes. We identified the phenotypic characteristics that can be considered for a comprehensive phenotype classification in future studies. A framework for the investigation of phenotypes could be useful for future studies. PROTOCOL REGISTRATION PROSPERO CRD42016036220.
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Fernandes GS, Sarmanova A, Warner S, Harvey H, Akin-Akinyosoye K, Richardson H, Frowd N, Marshall L, Stocks J, Hall M, Valdes AM, Walsh D, Zhang W, Doherty M. Knee pain and related health in the community study (KPIC): a cohort study protocol. BMC Musculoskelet Disord 2017; 18:404. [PMID: 28934932 PMCID: PMC5609004 DOI: 10.1186/s12891-017-1761-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 09/13/2017] [Indexed: 04/10/2023] Open
Affiliation(s)
- G S Fernandes
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
| | - A Sarmanova
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom
| | - S Warner
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom
| | - H Harvey
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom
| | - K Akin-Akinyosoye
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
| | - H Richardson
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom
| | - N Frowd
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
| | - L Marshall
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
| | - J Stocks
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
| | - M Hall
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
| | - A M Valdes
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
| | - D Walsh
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
| | - W Zhang
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom. .,Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, University of Nottingham, Nottingham, NG7 2UH, United Kingdom. .,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom.
| | - M Doherty
- Academic Rheumatology, Division of Rheumatology, Orthopedics and Dermatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, NG5 1PB, United Kingdom.,Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.,Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, NG5 1PB, United Kingdom
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Herrero-Beaumont G, Largo R. Chondroitin sulfate — CONCEPT clear, uncertainties unchanged. Nat Rev Rheumatol 2017; 13:576-577. [DOI: 10.1038/nrrheum.2017.131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Huang M, Zhao J, Huang Y, Dai L, Zhang X. Meta-analysis of urinary C-terminal telopeptide of type II collagen as a biomarker in osteoarthritis diagnosis. J Orthop Translat 2017; 13:50-57. [PMID: 29662791 PMCID: PMC5892380 DOI: 10.1016/j.jot.2017.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/27/2017] [Accepted: 06/19/2017] [Indexed: 01/22/2023] Open
Abstract
Objective This study aims to discover that the urinary C-terminal telopeptide of type II collagen (uCTX-II) levels differ between osteoarthritis (OA) patients and healthy individuals (controls). According to this difference, we may conclude that uCTX-II can be a biomarker for OA diagnosis. Methods We searched MEDLINE and EMBASE databases updated to 2014 to find literature on OA biomarkers. We retrieved the publications that met the required criterion. Literature quality was assessed according to the Newcastle-Ottawa Scale. Publication bias was assessed by Begg's test and Egger's test with the software STATA version 12.0. The weighted mean difference (WMD) was calculated, and the subgroup analysis was completed using STATA 12.0. Results Six publications were included in our analysis. The WMD for OA patients versus the controls was 83.05, which was within the 95% confidence interval. For subgroup analysis, the WMD of patients with severe OA was 119.92, whereas that of patients with mild OA was 28.07. Conclusions uCTX-II levels were higher in OA patients than in controls, subgroup analysis revealed that the uCTX-II levels rised with the OA severity, the heterogeneity originated from different levels of OA severity, These results showed that uCTX-II would be a promising clinical biomarker in OA diagnosis.
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Affiliation(s)
- Mingjian Huang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200092, China.,The Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS) & Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200031, China
| | - Jingyu Zhao
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200092, China.,The Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS) & Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200031, China
| | - Yan Huang
- The Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS) & Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200031, China
| | - Liming Dai
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200092, China
| | - Xiaoling Zhang
- Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200092, China.,The Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS) & Shanghai Jiao Tong University School of Medicine (SJTUSM), Shanghai 200031, China
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47
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Marchev AS, Dimitrova PA, Burns AJ, Kostov RV, Dinkova-Kostova AT, Georgiev MI. Oxidative stress and chronic inflammation in osteoarthritis: can NRF2 counteract these partners in crime? Ann N Y Acad Sci 2017; 1401:114-135. [PMID: 28662306 DOI: 10.1111/nyas.13407] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/08/2017] [Accepted: 05/12/2017] [Indexed: 01/15/2023]
Abstract
Osteoarthritis (OA) is an age-related joint degenerative disease associated with pain, joint deformity, and disability. The disease starts with cartilage damage but then progressively involves subchondral bone, causing an imbalance between osteoclast-driven bone resorption and osteoblast-driven remodeling. Here, we summarize the data for the role of oxidative stress and inflammation in OA pathology and discuss how these two processes are integrated during OA progression, as well as their contribution to abnormalities in cartilage/bone metabolism and integrity. At the cellular level, oxidative stress and inflammation are counteracted by transcription factor nuclear factor erythroid p45-related factor 2 (NRF2), and we describe the regulation of NRF2, highlighting its role in OA pathology. We also discuss the beneficial effect of some phytonutrients, including the therapeutic potential of NRF2 activation, in OA.
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Affiliation(s)
- Andrey S Marchev
- Group of Plant Cell Biotechnology and Metabolomics, The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Plovdiv, Bulgaria
| | - Petya A Dimitrova
- Department of Immunology, The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Andrew J Burns
- Jacqui Wood Cancer Centre, Division of Cancer Research, School of Medicine, University of Dundee, Dundee, UK
| | - Rumen V Kostov
- Jacqui Wood Cancer Centre, Division of Cancer Research, School of Medicine, University of Dundee, Dundee, UK
| | - Albena T Dinkova-Kostova
- Jacqui Wood Cancer Centre, Division of Cancer Research, School of Medicine, University of Dundee, Dundee, UK
- Departments of Medicine and Pharmacology and Molecular Sciences, Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Milen I Georgiev
- Group of Plant Cell Biotechnology and Metabolomics, The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Plovdiv, Bulgaria
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48
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Shu CC, Smith MM, Smith SM, Dart AJ, Little CB, Melrose J. A Histopathological Scheme for the Quantitative Scoring of Intervertebral Disc Degeneration and the Therapeutic Utility of Adult Mesenchymal Stem Cells for Intervertebral Disc Regeneration. Int J Mol Sci 2017; 18:E1049. [PMID: 28498326 PMCID: PMC5454961 DOI: 10.3390/ijms18051049] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/28/2017] [Accepted: 05/08/2017] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to develop a quantitative histopathological scoring scheme to evaluate disc degeneration and regeneration using an ovine annular lesion model of experimental disc degeneration. Toluidine blue and Haematoxylin and Eosin (H&E) staining were used to evaluate cellular morphology: (i) disc structure/lesion morphology; (ii) proteoglycan depletion; (iii) cellular morphology; (iv) blood vessel in-growth; (v) cell influx into lesion; and (vi) cystic degeneration/chondroid metaplasia. Three study groups were examined: 5 × 5 mm lesion; 6 × 20 mm lesion; and 6 × 20 mm lesion plus mesenchymal stem cell (MSC) treatment. Lumbar intervertebral discs (IVDs) were scored under categories (i-vi) to provide a cumulative score, which underwent statistical analysis using STATA software. Focal proteoglycan depletion was associated with 5 × 5 mm annular rim lesions, bifurcations, annular delamellation, concentric and radial annular tears and an early influx of blood vessels and cells around remodeling lesions but the inner lesion did not heal. Similar features in 6 × 20 mm lesions occurred over a 3-6-month post operative period. MSCs induced a strong recovery in discal pathology with a reduction in cumulative histopathology degeneracy score from 15.2 to 2.7 (p = 0.001) over a three-month recovery period but no recovery in carrier injected discs.
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Affiliation(s)
- Cindy C Shu
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia.
| | - Margaret M Smith
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia.
| | - Susan M Smith
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia.
| | - Andrew J Dart
- Faculty of Veterinary Science, University Veterinary Teaching Hospital, University of Sydney, Camden, NSW 2050, Australia.
| | - Christopher B Little
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia.
- Sydney Medical School, Northern, The University of Sydney, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia.
| | - James Melrose
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia.
- Sydney Medical School, Northern, The University of Sydney, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia.
- Graduate School of Biomedical Engineering, University of New South Wales, Kensington, NSW 2052, Australia.
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49
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Onakpoya IJ, Spencer EA, Perera R, Heneghan CJ. Effectiveness of curcuminoids in the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized clinical trials. Int J Rheum Dis 2017; 20:420-433. [DOI: 10.1111/1756-185x.13069] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Igho J. Onakpoya
- Nuffield Department of Primary Care Health Sciences; Centre for Evidence-Based Medicine; University of Oxford; Radcliffe Observatory Quarter; Oxford UK
| | - Elizabeth A. Spencer
- Nuffield Department of Primary Care Health Sciences; Centre for Evidence-Based Medicine; University of Oxford; Radcliffe Observatory Quarter; Oxford UK
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences; Centre for Evidence-Based Medicine; University of Oxford; Radcliffe Observatory Quarter; Oxford UK
| | - Carl J. Heneghan
- Nuffield Department of Primary Care Health Sciences; Centre for Evidence-Based Medicine; University of Oxford; Radcliffe Observatory Quarter; Oxford UK
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50
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Hsu YH, Yang YY, Huwang MH, Weng YH, Jou IM, Wu PT, Lin TY, Wu LW, Chang MS. Anti-IL-20 monoclonal antibody inhibited inflammation and protected against cartilage destruction in murine models of osteoarthritis. PLoS One 2017; 12:e0175802. [PMID: 28426699 PMCID: PMC5398531 DOI: 10.1371/journal.pone.0175802] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 03/06/2017] [Indexed: 12/17/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disease characterized by progressive destruction of articular cartilage. Interleukin (IL)-20 is a proinflammatory cytokine involved in the pathogenesis of rheumatoid arthritis. We investigated the role of IL-20 in OA and evaluated whether anti-IL-20 antibody (7E) treatment attenuates disease severity in murine models of surgery-induced OA. Immunohistochemical staining was used to detect IL-20 and its receptors expression in synovial tissue and cartilage from OA patients, and in OA synovial fibroblasts (OASFs) and chondrocytes (OACCs) from rodents with surgery-induced OA. RTQ-PCR and western blotting were used to determine IL-20-regulated OA-associated gene expression in OASFs and OACCs. OA rats and OA mice were treated with 7E. Arthritis severity was determined based on the degree of cartilage damage and the arthritis severity score. We found that IL-20 and its receptors were expressed in OASFs and OACCs. IL-20 induced TNF-α, IL-1β, MMP-1, and MMP-13 expression by activating ERK-1/2 and JNK signals in OASFs. IL-20 not only upregulated MCP-1, IL-6, MMP-1, and MMP-13 expression, but also downregulated aggrecan, type 2 collagen, TGF-β, and BMP-2 expression in OACCs. Arthritis severity was significantly lower in 7E-treated OA rats, and 7E- or MSC-treated OA mice. Therefore, we concluded that IL-20 was involved in the progression and development of OA through inducing proinflammatory cytokines and OA-associated gene expression in OASFs and OACCs. 7E reduced the severity of arthritis in murine models of surgery-induced OA. Our findings provide evidence that IL-20 is a novel target and that 7E is a potential therapeutic agent for OA.
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Affiliation(s)
- Yu-Hsiang Hsu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Research Center of Clinical Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Research Center of New Antibody Drug, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Yu Yang
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Man-Hsiang Huwang
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yun-Han Weng
- Research Center of New Antibody Drug, National Cheng Kung University, Tainan, Taiwan.,Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I-Ming Jou
- Department of Orthopedics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Po-Tin Wu
- Department of Orthopedics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Tain-Yu Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Wha Wu
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Shi Chang
- Research Center of New Antibody Drug, National Cheng Kung University, Tainan, Taiwan.,Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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