1
|
Juma SN, Liao J, Huang Y, Vlashi R, Wang Q, Wu B, Wang D, Wu M, Chen G. Osteoarthritis versus psoriasis arthritis: Physiopathology, cellular signaling, and therapeutic strategies. Genes Dis 2024; 11:100986. [PMID: 38292181 PMCID: PMC10825447 DOI: 10.1016/j.gendis.2023.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/15/2023] [Indexed: 02/01/2024] Open
Abstract
Osteoarthritis and psoriasis arthritis are two degenerative forms of arthritis that share similar yet also different manifestations at the histological, cellular, and clinical levels. Rheumatologists have marked them as two entirely distinct arthropathies. Given recent discoveries in disease initiation and progression, potential mechanisms, cellular signaling pathways, and ongoing clinical therapeutics, there are now more opportunities for discovering osteoarthritis drugs. This review summarized the osteoarthritis and psoriasis arthritis signaling pathways, crosstalk between BMP, WNT, TGF-β, VEGF, TLR, and FGF signaling pathways, biomarkers, and anatomical pathologies. Through bench research, we demonstrated that regenerative medicine is a promising alternative for treating osteoarthritis by highlighting significant scientific discoveries on entheses, multiple signaling blockers, and novel molecules such as immunoglobulin new antigen receptors targeted for potential drug evaluation. Furthermore, we offered valuable therapeutic approaches with a multidisciplinary strategy to treat patients with osteoarthritis or psoriasis arthritis in the coming future in the clinic.
Collapse
Affiliation(s)
- Salma Nassor Juma
- College of Life Science and Medicine, Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, China
| | - Junguang Liao
- College of Life Science and Medicine, Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, China
| | - Yuping Huang
- College of Life Science and Medicine, Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, China
| | - Rexhina Vlashi
- College of Life Science and Medicine, Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, China
| | - Qingwan Wang
- College of Life Science and Medicine, Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, China
| | - Bocong Wu
- College of Life Science and Medicine, Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, China
| | - Dan Wang
- College of Life Science and Medicine, Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, China
| | - Mengrui Wu
- Department of Cell and Developmental Biology, College of Life Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Guiqian Chen
- College of Life Science and Medicine, Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Zhejiang Sci-Tech University, Hangzhou, Zhejiang 310018, China
| |
Collapse
|
2
|
Dunshee LC, McDonough R, Price C, Kiick KL. Retention of peptide-based vesicles in murine knee joints after intra-articular injection. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
3
|
Driban JB, Harkey MS, Salzler MJ. It's Time to Abandon the Label Posttraumatic Osteoarthritis. J Athl Train 2022; 57:309-311. [PMID: 35439316 PMCID: PMC9020601 DOI: 10.4085/1062-6050-1015.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
4
|
Growth and mechanobiology of the tendon-bone enthesis. Semin Cell Dev Biol 2022; 123:64-73. [PMID: 34362655 PMCID: PMC8810906 DOI: 10.1016/j.semcdb.2021.07.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 12/15/2022]
Abstract
Tendons are cable-like connective tissues that transfer both active and passive forces generated by skeletal muscle to bone. In the mature skeleton, the tendon-bone enthesis is an interfacial zone of transitional tissue located between two mechanically dissimilar tissues: compliant, fibrous tendon to rigid, dense mineralized bone. In this review, we focus on emerging areas in enthesis development related to its structure, function, and mechanobiology, as well as highlight established and emerging signaling pathways and physiological processes that influence the formation and adaptation of this important transitional tissue.
Collapse
|
5
|
Campos Y, Fuentes G, Almirall A, Que I, Schomann T, Chung CK, Jorquera-Cordero C, Quintanilla L, Rodríguez-Cabello JC, Chan A, Cruz LJ. The Incorporation of Etanercept into a Porous Tri-Layer Scaffold for Restoring and Repairing Cartilage Tissue. Pharmaceutics 2022; 14:pharmaceutics14020282. [PMID: 35214015 PMCID: PMC8878505 DOI: 10.3390/pharmaceutics14020282] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
Cartilage diseases currently affect a high percentage of the world’s population. Almost all of these diseases, such as osteoarthritis (OA), cause inflammation of this soft tissue. However, this could be controlled with biomaterials that act as an anti-inflammatory delivery system, capable of dosing these drugs over time in a specific area. The objective of this study was to incorporate etanercept (ETA) into porous three-layer scaffolds to decrease the inflammatory process in this soft tissue. ETA is a blocker of pro-inflammatory cytokines, such as tumour necrosis factor alpha (TNF-α) and interleukin 6 (IL-6). For this reason, the scaffold was built based on natural polymers, including chitosan and type I collagen. The scaffold was grafted next to subchondral bone using hydroxyapatite as filler. One of the biomaterials obtained was also crosslinked to compare its mechanical properties with the non-treated one. Both samples’ physicochemical properties were studied with SEM, micro-CT and photoacoustic imaging, and their rheological properties were also compared. The cell viability and proliferation of the human chondrocyte C28/I2 cell line were studied in vitro. An in vitro and in vivo controlled release study was evaluated in both specimens. The ETA anti-inflammatory effect was also studied by in vitro TNF-α and IL-6 production. The crosslinked and non-treated scaffolds had rheological properties suitable for this application. They were non-cytotoxic and favoured the in vitro growth of chondrocytes. The in vitro and in vivo ETA release showed desirable results for a drug delivery system. The TNF-α and IL-6 production assay showed that this drug was effective as an anti-inflammatory agent. In an in vivo OA mice model, safranin-O and fast green staining was carried out. The OA cartilage tissue improved when the scaffold with ETA was grafted in the damaged area. These results demonstrate that this type of biomaterial has high potential for clinical applications in tissue engineering and as a controlled drug delivery system in OA articular cartilage.
Collapse
Affiliation(s)
- Yaima Campos
- Translational Nanobiomaterials and Imaging, Department of Radiology, Bldg. 2, k4-44, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (Y.C.); (I.Q.); (T.S.); (C.K.C.)
- Biomaterials Center, University of Havana, Avenida Universidad Entre G y Ronda, Vedado, Plaza, La Habana CP 10400, Cuba;
| | - Gastón Fuentes
- Translational Nanobiomaterials and Imaging, Department of Radiology, Bldg. 2, k4-44, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (Y.C.); (I.Q.); (T.S.); (C.K.C.)
- Biomaterials Center, University of Havana, Avenida Universidad Entre G y Ronda, Vedado, Plaza, La Habana CP 10400, Cuba;
- Bioforge Lab, CIBER-BBN, Campus Miguel Delibes, Universidad de Valladolid, Edificio LUCIA, Paseo Belén 19, 47011 Valladolid, Spain; (L.Q.); (J.C.R.-C.)
- Correspondence: (G.F.); (L.J.C.)
| | - Amisel Almirall
- Biomaterials Center, University of Havana, Avenida Universidad Entre G y Ronda, Vedado, Plaza, La Habana CP 10400, Cuba;
| | - Ivo Que
- Translational Nanobiomaterials and Imaging, Department of Radiology, Bldg. 2, k4-44, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (Y.C.); (I.Q.); (T.S.); (C.K.C.)
| | - Timo Schomann
- Translational Nanobiomaterials and Imaging, Department of Radiology, Bldg. 2, k4-44, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (Y.C.); (I.Q.); (T.S.); (C.K.C.)
- Percuros B.V., Zernikedreef 8, 2333 CL Leiden, The Netherlands; (C.J.-C.); (A.C.)
| | - Chih Kit Chung
- Translational Nanobiomaterials and Imaging, Department of Radiology, Bldg. 2, k4-44, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (Y.C.); (I.Q.); (T.S.); (C.K.C.)
- Percuros B.V., Zernikedreef 8, 2333 CL Leiden, The Netherlands; (C.J.-C.); (A.C.)
| | - Carla Jorquera-Cordero
- Percuros B.V., Zernikedreef 8, 2333 CL Leiden, The Netherlands; (C.J.-C.); (A.C.)
- Department of Orthopaedics, University Medical Centre of Utrecht Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Luis Quintanilla
- Bioforge Lab, CIBER-BBN, Campus Miguel Delibes, Universidad de Valladolid, Edificio LUCIA, Paseo Belén 19, 47011 Valladolid, Spain; (L.Q.); (J.C.R.-C.)
| | - José C. Rodríguez-Cabello
- Bioforge Lab, CIBER-BBN, Campus Miguel Delibes, Universidad de Valladolid, Edificio LUCIA, Paseo Belén 19, 47011 Valladolid, Spain; (L.Q.); (J.C.R.-C.)
| | - Alan Chan
- Percuros B.V., Zernikedreef 8, 2333 CL Leiden, The Netherlands; (C.J.-C.); (A.C.)
- Department of Orthopaedics, University Medical Centre of Utrecht Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Luis J. Cruz
- Translational Nanobiomaterials and Imaging, Department of Radiology, Bldg. 2, k4-44, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (Y.C.); (I.Q.); (T.S.); (C.K.C.)
- Correspondence: (G.F.); (L.J.C.)
| |
Collapse
|
6
|
Werdyani S, Liu M, Zhang H, Sun G, Furey A, Randell EW, Rahman P, Zhai G. Endotypes of primary osteoarthritis identified by plasma metabolomics analysis. Rheumatology (Oxford) 2021; 60:2735-2744. [PMID: 33159799 PMCID: PMC8213424 DOI: 10.1093/rheumatology/keaa693] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/14/2020] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To identify endotypes of osteoarthritis (OA) by a metabolomics analysis. METHODS Study participants included hip/knee OA patients and controls. Fasting plasma samples were metabolomically profiled. Common factor analysis and K-means clustering were applied to the metabolomics data to identify the endotypes of OA patients. Logistic regression was utilized to identify the most significant metabolites contributing to the endotypes. Clinical and epidemiological factors were examined in relation to the identified OA endotypes. RESULTS Six hundred and fifteen primary OA patients and 237 controls were included. Among the 186 metabolites measured, 162 passed the quality control analysis. The 615 OA patients were classified in three clusters (A, 66; B, 200; and C, 349). Patients in cluster A had a significantly higher concentration of butyrylcarnitine (C4) than other clusters and controls (all P < 0.0002). Elevated C4 is thought to be related to muscle weakness and wasting. Patients in cluster B had a significantly lower arginine concentration than other clusters and controls (all P < 7.98 × 10-11). Cluster C patients had a significantly lower concentration of lysophosphatidylcholine (with palmitic acid), which is a pro-inflammatory bioactive compound, than other clusters and controls (P < 3.79 × 10-6). Further, cluster A had a higher BMI and prevalence of diabetes than other clusters (all P ≤ 0.0009), and also a higher prevalence of coronary heart disease than cluster C (P = 0.04). Cluster B had a higher prevalence of coronary heart disease than cluster C (P = 0.003) whereas cluster C had a higher prevalence of osteoporosis (P = 0.009). CONCLUSION Our data suggest three possible clinically actionable endotypes in primary OA: muscle weakness, arginine deficit and low inflammatory OA.
Collapse
Affiliation(s)
- Salem Werdyani
- Division of Biomedical Sciences (Genetics), Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Ming Liu
- Division of Biomedical Sciences (Genetics), Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Hongwei Zhang
- Discipline of Medicine, Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Guang Sun
- Discipline of Medicine, Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Andrew Furey
- Discipline of Surgery, Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Edward W Randell
- Department of Laboratory Medicine, Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Proton Rahman
- Discipline of Medicine, Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL, Canada
| | - Guangju Zhai
- Division of Biomedical Sciences (Genetics), Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL, Canada
| |
Collapse
|
7
|
Greif DN, Emerson CP, Jose J, Toumi H, Best TM. Enthesopathy-An Underappreciated Role in Osteoarthritis? Curr Sports Med Rep 2021; 19:495-497. [PMID: 33156036 DOI: 10.1249/jsr.0000000000000775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Osteoarthritis (OA) continues to be a debilitating disease worldwide, to date, no therapies have been definitely proven to modify disease progression or moderate symptom relief long term other than joint replacement. A contributing factor may be the lack of attention to the potential role of the periarticular enthesis and development and progression of OA. The enthesis is the site of attachment for a tendon, ligament, or joint capsule to the bony skeleton, thereby allowing centralized transmission and dissipation of mechanical loads. Because of this design, the enthesis is a site of stress concentration subject to inflammation during sports-related activities or spondyloarthropathies, which may lead to long-term degeneration. Our hypothesis is that functional incompetence of the enthesis resulting from either degenerative or inflammatory changes could be an initiating factor for OA and may thus provide a novel basis for the development of future disease management in this phenotype of patients.
Collapse
Affiliation(s)
- Dylan N Greif
- University of Miami Sports Medicine Institute, Department of Orthopedic Surgery, University of Miami, Coral Gables, FL
| | - Christopher P Emerson
- University of Miami Sports Medicine Institute, Department of Orthopedic Surgery, University of Miami, Coral Gables, FL
| | - Jean Jose
- Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL
| | - Hechmi Toumi
- Service de Rhumatologie, Centre Hospitalier Régional d'Orléans, Univ. Orleans, Orleans, France
| | - Thomas M Best
- University of Miami Sports Medicine Institute, Department of Orthopedic Surgery, University of Miami, Coral Gables, FL
| |
Collapse
|
8
|
Scott ME, Dust WN, Cooper DML, Walker EG, Lieverse AR. The physiopathology of osteoarthritis: Paleopathological implications of non-articular lesions from a modern surgical sample. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 32:31-40. [PMID: 33276205 DOI: 10.1016/j.ijpp.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This research focused on osteoarthritis (OA) lesions on modern patients to 1) identify consistently observed lesions not included within current paleopathological measures of OA, 2) assess the correspondence of bone and cartilage lesions with clinical OA diagnostic criteria, and 3) discuss the correspondence of bone lesions with sources of pain reported in clinical literature. MATERIALS Tibial plateaus from 62 patients undergoing total knee replacement surgery due to OA were examined. METHODS Plateaus were scored for several non-standard OA criteria, including non-articular and X-ray visible lesions and pre-maceration cartilage lesions, as well as articular surface criteria standard in paleopathology. RESULTS Proliferative bone in the intercondylar region was present in 95 % of specimens, while areas of dense trabecular bone and lytic defects, both on the inferior side of the plateaus, were present in 98 % and 83 %, respectively. CONCLUSIONS The inferior lytic defects may be physical evidence of bone marrow lesions (BML), a clinical OA indicator visible via MRI. Previous research has linked BML to pain, inflammation, and ligament pathology. The latter conditions have also been associated with intercondylar enthesophytes and third intercondylar tubercle of Parsons (TITP), both of which were observed in the intercondylar regions. SIGNIFICANCE Several non-articular lesions not currently included in paleopathological measures of OA were consistently observed. SUGGESTIONS FOR FUTURE RESEARCH A similar analysis of a control sample of non-OA tibial plateaus would better contextualize these results. LIMITATIONS The sample's high average age (65.8 years) and severe OA stage may hamper generalizability to archaeological collections.
Collapse
Affiliation(s)
- Maryann E Scott
- Department of Archaeology and Anthropology, University of Saskatchewan, 55 Campus Dr., Saskatoon, Saskatchewan, S7N 5B1, Canada.
| | - William N Dust
- Division of Orthopedics, Royal University Hospital, 103 Hospital Dr., Saskatoon, Saskatchewan, S7N 0W8, Canada
| | - David M L Cooper
- Department of Anatomy, Physiology and Pharmacology, University of Saskatchewan, GA20 Health Sciences Building, 107 Wiggins Rd., Saskatoon, Saskatchewan, S7N 5E5, Canada
| | - Ernest G Walker
- Department of Archaeology and Anthropology, University of Saskatchewan, 55 Campus Dr., Saskatoon, Saskatchewan, S7N 5B1, Canada
| | - Angela R Lieverse
- Department of Archaeology and Anthropology, University of Saskatchewan, 55 Campus Dr., Saskatoon, Saskatchewan, S7N 5B1, Canada
| |
Collapse
|
9
|
Barton KI, Heard BJ, Kroker A, Sevick JL, Raymond DA, Chung M, Achari Y, Martin CR, Frank CB, Boyd SK, Shrive NG, Hart DA. Structural Consequences of a Partial Anterior Cruciate Ligament Injury on Remaining Joint Integrity: Evidence for Ligament and Bone Changes Over Time in an Ovine Model. Am J Sports Med 2021; 49:637-648. [PMID: 33523721 DOI: 10.1177/0363546520985279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Severe injury to the knee joint often results in accelerated posttraumatic osteoarthritis (PTOA). In an ovine knee injury model, altered kinematics and degradation of the cartilage have been observed at 20 and 40 weeks after partial anterior cruciate ligament (ACL) transection (p-ACL Tx) surgery. However, changes to the integrity of the remaining intact intra-articular ligaments (posterolateral [PL] band and posterior cruciate ligament [PCL]) as well as the subchondral bone after anteromedial (AM) band Tx remain to be characterized. PURPOSE (1) To investigate histological alterations to the remaining intact intra-articular ligaments, the synovium, and the infrapatellar fat pad (IPFP) and (2) to quantify subchondral bone changes at the contact surfaces of the proximal tibia at 20 and 40 weeks after AM band Tx. STUDY DESIGN Descriptive laboratory study. METHODS Mature female Suffolk cross sheep were allocated into 3 groups: nonoperative controls (n = 6), 20 weeks after partial ACL transection (p-ACL Tx; n = 5), and 40 weeks after p-ACL Tx (n = 6). Ligament, synovium, and IPFP sections were stained and graded. Tibial subchondral bone microarchitecture was assessed using high-resolution peripheral quantitative computed tomography. RESULTS p-ACL Tx of the AM band led to significant change in histological scores of the PL band and the PCL at 20 weeks after p-ACL Tx (P = .031 and P = .033, respectively) and 40 weeks after p-ACL Tx (P = .011 and P = .029) as compared with nonoperative controls. Alterations in inflammatory cells and collagen fiber orientation contributed to the greatest extent of the combined histological score in the PL band and PCL. p-ACL Tx did not lead to chronic activation of the synovium or IPFP. Trabecular bone mineral density was strongly inversely correlated with combined gross morphological damage in the top and middle layers of the subchondral bone in the lateral tibial plateau for animals at 40 weeks after p-ACL Tx. CONCLUSION p-ACL Tx influences the integrity (biology and structure) of remaining intact intra-articular ligaments and bone microarchitecture in a partial knee injury ovine model. CLINICAL RELEVANCE p-ACL Tx leads to alterations in structural integrity of the remaining intact ligaments and degenerative changes in the trabecular bone mineral density, which may be detrimental to the injured athlete's knee joint in the long term.
Collapse
Affiliation(s)
- Kristen I Barton
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Bryan J Heard
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Andres Kroker
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Canada
| | - Johnathan L Sevick
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Canada
| | - Duncan A Raymond
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - May Chung
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Yamini Achari
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - C Ryan Martin
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Section of Orthopaedics, Foothills Hospital, Calgary, Canada
| | | | - Steven K Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Canada
| | - Nigel G Shrive
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Schulich School of Engineering, University of Calgary, Calgary, Canada
| | - David A Hart
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Canada.,Bone and Joint Health Strategic Clinical Network, Alberta Health Services, Edmonton, Canada
| |
Collapse
|
10
|
Nouri Barkestani M, Naserian S, Uzan G, Shamdani S. Post-decellularization techniques ameliorate cartilage decellularization process for tissue engineering applications. J Tissue Eng 2021; 12:2041731420983562. [PMID: 33738088 PMCID: PMC7934046 DOI: 10.1177/2041731420983562] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/06/2020] [Indexed: 12/17/2022] Open
Abstract
Due to the current lack of innovative and effective therapeutic approaches, tissue engineering (TE) has attracted much attention during the last decades providing new hopes for the treatment of several degenerative disorders. Tissue engineering is a complex procedure, which includes processes of decellularization and recellularization of biological tissues or functionalization of artificial scaffolds by active cells. In this review, we have first discussed those conventional steps, which have led to great advancements during the last several years. Moreover, we have paid special attention to the new methods of post-decellularization that can significantly ameliorate the efficiency of decellularized cartilage extracellular matrix (ECM) for the treatment of osteoarthritis (OA). We propose a series of post-decellularization procedures to overcome the current shortcomings such as low mechanical strength and poor bioactivity to improve decellularized ECM scaffold towards much more efficient and higher integration.
Collapse
Affiliation(s)
| | - Sina Naserian
- INSERM UMR-S-MD 1197, Hôpital Paul Brousse, Villejuif, France.,Université Paris-Saclay, CNRS, Centre de Nanosciences et Nanotechnologies C2N, UMR9001, Palaiseau, France.,CellMedEx, Saint Maur Des Fossés, France
| | - Georges Uzan
- INSERM UMR-S-MD 1197, Hôpital Paul Brousse, Villejuif, France.,Paris-Saclay University, Villejuif, France
| | - Sara Shamdani
- INSERM UMR-S-MD 1197, Hôpital Paul Brousse, Villejuif, France.,CellMedEx, Saint Maur Des Fossés, France
| |
Collapse
|
11
|
DNA methyltransferase genes polymorphisms are associated with primary knee osteoarthritis: a matched case-control study. Rheumatol Int 2019; 40:573-581. [PMID: 31713648 DOI: 10.1007/s00296-019-04474-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/02/2019] [Indexed: 10/25/2022]
Abstract
DNA methylation is an epigenetic mechanism involved in the development of primary osteoarthritis (OA). The association between DNA methyltransferases (DNMTs) genes polymorphisms and diseases in which DNA methylation plays a role in their pathogenesis has been described (e.g., cancer); however, its relationship with OA has not been investigated. The aim of this study was to analyze the association between DNMT1, DNMT3A, and DNMT3B polymorphisms with radiologic primary knee OA in Mexican mestizo population. A matched case-control study was conducted (ratio, 1:1). Cases included 244 subjects with definite radiographic knee OA (grade ≥ 2). Controls were matched by age and gender and were subjects with no definite radiographic knee OA/normal (grade < 2). The DNMTs polymorphisms were genotyped by TaqMan allelic discrimination assays. Conditional logistic regression was carried out, and the genetic association was tested under co-dominant, dominant, and recessive inheritance models. Haplotypes for DNMT1 polymorphisms were constructed and their associations were also tested. The CC genotypes of rs2228611 and rs2228612 of DNMT1 were associated with a lower risk for primary knee OA under a co-dominant and a recessive model [OR (95% CI) 0.4 (0.2-0.8)/0.5 (0.3-0.8) and 0.3 (0.1-0.8)/0.3 (0.1-0.7), respectively]. The CT haplotype of DNMT1 polymorphisms was associated with a lower risk [OR (95% CI) 0.71 (0.51-0.97)]. The CC genotype of rs2424913 of DNMT3B was associated with an increased risk under a co-dominant and a dominant model [OR (95% CI) 3.0 (1.1-8.0), and 1.6 (1.1-2.4), respectively]. Our results show that DNMTs polymorphisms are associated with primary knee OA.
Collapse
|
12
|
Intraarticular Ligament Degeneration Is Interrelated with Cartilage and Bone Destruction in Osteoarthritis. Cells 2019; 8:cells8090990. [PMID: 31462003 PMCID: PMC6769780 DOI: 10.3390/cells8090990] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/18/2019] [Accepted: 08/20/2019] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) induces inflammation and degeneration of all joint components including cartilage, joint capsule, bone and bone marrow, and ligaments. Particularly intraarticular ligaments, which connect the articulating bones such as the anterior cruciate ligament (ACL) and meniscotibial ligaments, fixing the fibrocartilaginous menisci to the tibial bone, are prone to the inflamed joint milieu in OA. However, the pathogenesis of ligament degeneration on the cellular level, most likely triggered by OA associated inflammation, remains poorly understood. Hence, this review sheds light into the intimate interrelation between ligament degeneration, synovitis, joint cartilage degradation, and dysbalanced subchondral bone remodeling. Various features of ligament degeneration accompanying joint cartilage degradation have been reported including chondroid metaplasia, cyst formation, heterotopic ossification, and mucoid and fatty degenerations. The entheses of ligaments, fixing ligaments to the subchondral bone, possibly influence the localization of subchondral bone lesions. The transforming growth factor (TGF)β/bone morphogenetic (BMP) pathway could present a link between degeneration of the osteochondral unit and ligaments with misrouted stem cell differentiation as one likely reason for ligament degeneration, but less studied pathways such as complement activation could also contribute to inflammation. Facilitation of OA progression by changed biomechanics of degenerated ligaments should be addressed in more detail in the future.
Collapse
|
13
|
Sanjurjo-Rodriguez C, Baboolal TG, Burska AN, Ponchel F, El-Jawhari JJ, Pandit H, McGonagle D, Jones E. Gene expression and functional comparison between multipotential stromal cells from lateral and medial condyles of knee osteoarthritis patients. Sci Rep 2019; 9:9321. [PMID: 31249374 PMCID: PMC6597541 DOI: 10.1038/s41598-019-45820-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 06/11/2019] [Indexed: 12/21/2022] Open
Abstract
Osteoarthritis (OA) is the most common degenerative joint disorder. Multipotential stromal cells (MSCs) have a crucial role in joint repair, but how OA severity affects their characteristics remains unknown. Knee OA provides a good model to study this, as osteochondral damage is commonly more severe in the medial weight-bearing compartment compared to lateral side of the joint. This study utilised in vitro functional assays, cell sorting, gene expression and immunohistochemistry to compare MSCs from medial and lateral OA femoral condyles. Despite greater cartilage loss and bone sclerosis in medial condyles, there was no significant differences in MSC numbers, growth rates or surface phenotype. Culture-expanded and freshly-purified medial-condyle MSCs expressed higher levels of several ossification-related genes. Using CD271-staining to identify MSCs, their presence and co-localisation with TRAP-positive chondroclasts was noted in the vascular channels breaching the osteochondral junction in lateral condyles. In medial condyles, MSCs were additionally found in small cavities within the sclerotic plate. These data indicate subchondral MSCs may be involved in OA progression by participating in cartilage destruction, calcification and sclerotic plate formation and that they remain abundant in severe disease. Biological or biomechanical modulation of these MSCs may be a new strategy towards cartilage and bone restoration in knee OA.
Collapse
Affiliation(s)
- Clara Sanjurjo-Rodriguez
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.,University of A Coruña, Cell Therapy and Regenerative Medicine group, Biomedical Sciences, Medicine and Physiotherapy department; CIBER-BBN, Institute of Biomedical Research of A Coruña (INIBIC)-Centre of Advanced Scientific Researches (CICA), A Coruña, Spain
| | - Thomas G Baboolal
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, United Kingdom
| | - Agata N Burska
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Frederique Ponchel
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Jehan J El-Jawhari
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.,Clinical Pathology department, Mansoura University, Mansoura, Egypt
| | - Hemant Pandit
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, United Kingdom.,Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Dennis McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, United Kingdom.,Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Elena Jones
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.
| |
Collapse
|
14
|
Norepinephrine Inhibits Synovial Adipose Stem Cell Chondrogenesis via α2a-Adrenoceptor-Mediated ERK1/2 Activation. Int J Mol Sci 2019; 20:ijms20133127. [PMID: 31248037 PMCID: PMC6651223 DOI: 10.3390/ijms20133127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 12/15/2022] Open
Abstract
In recent years, first evidences emerged that sympathetic neurotransmitters influence osteoarthritis (OA) manifestation. Joint-resident stem cells might contribute to cartilage repair, however, their chondrogenic function is reduced. The neurotransmitter norepinephrine (NE) was detected in the synovial fluid of trauma and OA patients. Therefore, the aim of this study was to analyse how NE influences the chondrogenesis of synovial adipose tissue-derived stem cells (sASCs). sASCs were isolated from knee-OA patients synovia. After adrenoceptor (AR) expression analysis, proliferation and chondrogenic differentiation in presence of NE and/or α- and β-AR antagonist were investigated. Cell count, viability, chondrogenic and hypertophic gene expression, sulfated glycosaminoglycan (sGAG) and type II collagen content were determined. Key AR-dependent signaling (ERK1/2, PKA) was analyzed via western blot. sASC expressed α1A-, α1B-, α2A-, α2B-, α2C-, and β2-AR in monolayer and pellet culture. NE did not affect proliferation and viability, but 10−7 and 10−6 M NE significantly reduced sGAG and type II collagen content as well as ERK1/2 phosphorylation. These effects were fully reversed by yohimbine (α2-AR antagonist). Our study confirms the important role of NE in sASC chondrogenic function and provides new insights in OA pathophysiology. Future studies might help to develop novel therapeutic options targeting neuroendocrine pathways for OA treatment.
Collapse
|
15
|
Borgonio-Cuadra VM, González-Huerta NC, Rojas-Toledo EX, Morales-Hernández E, Pérez-Hernández N, Rodríguez-Pérez JM, Tovilla-Zárate CA, González-Castro TB, Hernández-Díaz Y, López-Narváez ML, Miranda-Duarte A. Genetic association analysis of Osteopontin and Matrix Gla Protein genes polymorphisms with primary knee osteoarthritis in Mexican population. Clin Rheumatol 2019; 38:223-228. [PMID: 29777408 DOI: 10.1007/s10067-018-4146-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/07/2018] [Accepted: 05/10/2018] [Indexed: 11/27/2022]
Abstract
Primary osteoarthritis (OA) is a complex entity in which several loci related to different molecular pathways or classes of molecules are associated with its development as demonstrated through genetic association studies. Genes involved in bone formation and mineralization, such as osteopontin (OPN) and Matrix Gla protein (MGP), could also be related with OA. The aim of this study was to evaluate the association between the genetic variants of OPN and MGP with primary knee osteoarthritis in a Mexican population. A case-control study was conducted in 296 patients with primary knee osteoarthritis and in 354 control subjects. Study groups were assessed radiologically. The rs11730582 of OPN and rs1800802, rs1800801, and rs4236 of MGP were determined by TaqMan allele discrimination assays. The haplotypes of the polymorphisms of MGP were constructed. The association was tested through univariate and multivariate non-conditional logistic regression analyses. The polymorphisms of MGP complied with Hardy-Weinberg (HW) equilibrium. The polymorphisms of OPN and MGP were not significantly associated with primary knee osteoarthritis in the codominant, dominant, and recessive models (p > 0.05). Our study suggests that there are no associations between OPN and MGP polymorphisms with primary knee osteoarthritis in Mexican population.
Collapse
Affiliation(s)
- Verónica Marusa Borgonio-Cuadra
- Departmento of Genética, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco No. 289, Col. Arenal Guadalupe, Deleg. Tlalpan, CP 14389, Mexico City, Mexico
| | - Norma Celia González-Huerta
- Departmento of Genética, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco No. 289, Col. Arenal Guadalupe, Deleg. Tlalpan, CP 14389, Mexico City, Mexico
| | - Emma Xochitl Rojas-Toledo
- Departmento of Genética, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco No. 289, Col. Arenal Guadalupe, Deleg. Tlalpan, CP 14389, Mexico City, Mexico
| | - Eugenio Morales-Hernández
- Departmento of Radiología, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco No. 289, Col. Arenal Guadalupe, Deleg. Tlalpan, CP 14389, Mexico City, Mexico
| | - Nonanzit Pérez-Hernández
- Departmento de Biología Molecular, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Col. Belisario Domínguez, Col. Sección XVI, Tlalpan, CP 14080, Mexico City, Mexico
| | - José Manuel Rodríguez-Pérez
- Departmento de Biología Molecular, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Col. Belisario Domínguez, Col. Sección XVI, Tlalpan, CP 14080, Mexico City, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur 4ta. Sección, 86658, Comalcalco, Tabasco, Mexico
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Carretera Estatal Libre Villahermosa-Comalcalco Km. 27+000 s/n, Ranchería Ribera Alta, 86205, Jalpa de Méndez, Tabasco, Mexico
| | - Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Carretera Estatal Libre Villahermosa-Comalcalco Km. 27+000 s/n, Ranchería Ribera Alta, 86205, Jalpa de Méndez, Tabasco, Mexico
| | - María Lilia López-Narváez
- Hospital General of Yajalón "Manuel Velasco Siles", Secretaría de Salud, Calzada Juana Hernández Zarco s/n, Hangares, 29930, Yajalón, Chiapas, Mexico
| | - Antonio Miranda-Duarte
- Departmento of Genética, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Calzada México-Xochimilco No. 289, Col. Arenal Guadalupe, Deleg. Tlalpan, CP 14389, Mexico City, Mexico.
| |
Collapse
|
16
|
Early Morphological and Functional Reorganization of the Articular Cartilage in Rats with Experimental Osteoarthrosis of Different Genesis. Bull Exp Biol Med 2018; 165:497-502. [PMID: 30121928 DOI: 10.1007/s10517-018-4203-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Indexed: 10/28/2022]
Abstract
Peculiarities of the morphology of some phenotypes of experimental osteoarthrosis was studied in experiments on rats. Reorganization of the knee articular cartilage of Wistar rats during aging (age-associated phenotype), obesity (metabolic phenotype), circulatory disturbances (e.g., chronic heart failure), and their combinations (polymorbidity) was studied by hematoxylin and eosin staining, immunohistochemical staining for collagen II and caspase 3, and morphometry. High sensitivity of the cartilage to non-traumatic influence of different anthropomorphic factors was demonstrated; morphological changes in osteoarthrosis of different genesis. The most pronounced pathological changes were observed in polymorbid animals, which allowed developing a new pathogenetically substantiated model of nontraumatic osteoarthrosis.
Collapse
|
17
|
Foster RJ, Damion RA, Ries ME, Smye SW, McGonagle DG, Binks DA, Radjenovic A. Imaging of nuclear magnetic resonance spin-lattice relaxation activation energy in cartilage. ROYAL SOCIETY OPEN SCIENCE 2018; 5:180221. [PMID: 30109078 PMCID: PMC6083713 DOI: 10.1098/rsos.180221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
Samples of human and bovine cartilage have been examined using magnetic resonance imaging to determine the proton nuclear magnetic resonance spin-lattice relaxation time, T1, as a function of depth within through the cartilage tissue. T1 was measured at five to seven temperatures between 8 and 38°C. From this, it is shown that the T1 relaxation time is well described by Arrhenius-type behaviour and the activation energy of the relaxation process is quantified. The activation energy within the cartilage is approximately 11 ± 2 kJ mol-1 with this notably being less than that for both pure water (16.6 ± 0.4 kJ mol-1) and the phosphate-buffered solution in which the cartilage was immersed (14.7 ± 1.0 kJ mol-1). It is shown that this activation energy increases as a function of depth in the cartilage. It is known that cartilage composition varies with depth, and hence, these results have been interpreted in terms of the structure within the cartilage tissue and the association of the water with the macromolecular constituents of the cartilage.
Collapse
Affiliation(s)
- R. J. Foster
- Soft Matter Physics Group, School of Physics and Astronomy, University of Leeds, Leeds LS2 9JT, UK
- Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, University of Leeds, Leeds LS4 7SA, UK
| | - R. A. Damion
- Soft Matter Physics Group, School of Physics and Astronomy, University of Leeds, Leeds LS2 9JT, UK
| | - M. E. Ries
- Soft Matter Physics Group, School of Physics and Astronomy, University of Leeds, Leeds LS2 9JT, UK
| | - S. W. Smye
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK
- Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, University of Leeds, Leeds LS4 7SA, UK
| | - D. G. McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UK
- Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, University of Leeds, Leeds LS4 7SA, UK
| | - D. A. Binks
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UK
- Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, University of Leeds, Leeds LS4 7SA, UK
| | - A. Radjenovic
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UK
- Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, University of Leeds, Leeds LS4 7SA, UK
| |
Collapse
|
18
|
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.
Collapse
Affiliation(s)
- Fred R T Nelson
- Department of Orthopaedics, Henry Ford Hospital, 2799 West Grand Blvd. Detroit Michigan 48202, USA
| |
Collapse
|
19
|
Platelet lysate enhances synovial fluid multipotential stromal cells functions: Implications for therapeutic use. Cytotherapy 2018; 20:375-384. [PMID: 29398623 DOI: 10.1016/j.jcyt.2017.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND AIMS Although intra-articular injection of platelet products is increasingly used for joint regenerative approaches, there are few data on their biological effects on joint-resident multipotential stromal cells (MSCs), which are directly exposed to the effects of these therapeutic strategies. Therefore, this study investigated the effect of platelet lysate (PL) on synovial fluid-derived MSCs (SF-MSCs), which in vivo have direct access to sites of cartilage injury. METHODS SF-MSCs were obtained during knee arthroscopic procedures (N = 7). Colony forming unit-fibroblast (CFU-F), flow-cytometric phenotyping, carboxyfluorescein succinimidyl ester-based immunomodulation for T-cell and trilineage differentiation assays were performed using PL and compared with standard conditions. RESULTS PL-enhanced SF-MSC (PL-MSC) proliferation as CFU-F colonies was 1.4-fold larger, and growing cultures had shorter population-doubling times. PL-MSCs and fetal calf serum (FCS)-MSCs had the same immunophenotype and similar immunomodulation activities. In chondrogenic and osteogenic differentiation assays, PL-MSCs produced 10% more sulfated-glycosaminoglycan (sGAG) and 45% less Ca++ compared with FCS-MSCs, respectively. Replacing chondrogenic medium transforming growth factor-β3 with 20% or 50% PL further increased sGAG production of PL-MSCs by 69% and 95%, respectively, compared with complete chondrogenic medium. Also, Dulbecco's Modified Eagle's Medium high glucose (HG-DMEM) plus 50% PL induced more chondrogenesis compared with HG-DMEM plus 10% FCS and was comparable to complete chondrogenic medium. CONCLUSIONS This is the first study to assess SF-MSC responses to PL and provides biological support to the hypothesis that PL may be capable of modulating multiple functional aspects of joint resident MSCs with direct access to injured cartilage.
Collapse
|
20
|
Lewiecki EM, Bilezikian JP, Carey JJ, Dell RM, Gordon CM, Harris ST, McClung MR, Miller PD, Rosenblatt M. Proceedings of the 2017 Santa Fe Bone Symposium: Insights and Emerging Concepts in the Management of Osteoporosis. J Clin Densitom 2018; 21:3-21. [PMID: 29229501 DOI: 10.1016/j.jocd.2017.10.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 10/31/2017] [Indexed: 11/28/2022]
Abstract
The 18th Annual Santa Fe Bone Symposium was held on August 4-5, 2017, in Santa Fe, New Mexico, USA. The symposium convenes health-care providers and clinical researchers to present and discuss clinical applications of recent advances in research of skeletal diseases. The program includes lectures, oral presentations by endocrinology fellows, case-based panel discussions, and breakout sessions on topics of interest, with emphasis on participation and interaction of all participants. Topics included the evaluation and treatment of adult survivors with pediatric bone diseases, risk assessment and management of atypical femur fractures, nonpharmacologic strategies in the care of osteoporosis, and skeletal effects of parathyroid hormone with opportunities for therapeutic intervention. Management of skeletal complications of rheumatic diseases was discussed. Insights into sequential and combined use of antiresorptive agents were presented. Individualization of patient treatment decisions when clinical practice guidelines may not be applicable was covered. Challenges and opportunities with osteoporosis drug development were discussed. There was an update on progress of Bone Health TeleECHO (Bone Health Extension for Community Healthcare Outcomes), a teleconferencing strategy for sharing knowledge and expanding capacity to deliver best-practice skeletal health care.
Collapse
Affiliation(s)
- E Michael Lewiecki
- New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA.
| | - John P Bilezikian
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | | | | | - Catherine M Gordon
- Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Steven T Harris
- University of California San Francisco, San Francisco, CA, USA
| | | | - Paul D Miller
- University of Colorado Health Sciences Center, Denver, CO, USA
| | | |
Collapse
|
21
|
McGonagle D, Baboolal TG, Jones E. Native joint-resident mesenchymal stem cells for cartilage repair in osteoarthritis. Nat Rev Rheumatol 2017; 13:719-730. [DOI: 10.1038/nrrheum.2017.182] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
22
|
Targeting subchondral bone mesenchymal stem cell activities for intrinsic joint repair in osteoarthritis. Future Sci OA 2017; 3:FSO228. [PMID: 29134116 PMCID: PMC5674229 DOI: 10.4155/fsoa-2017-0055] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/02/2017] [Indexed: 12/14/2022] Open
Abstract
Osteoarthritis (OA) is a common age-related disease with complex pathophysiology. It is characterized by wide-ranging tissue damage and ultimate biomechanical failure of the whole joint. However, signs of tissue adaptation and attempted repair responses are evident in OA-affected osteochondral tissues. Highlighted in this review article is the role of bone-resident mesenchymal stem cells (MSCs) in these bone remodeling responses, and a proposal that targeting MSC activities in OA subchondral bone could represent a novel approach for intrinsic joint regeneration in OA. The development of these therapies will require better understanding of MSC proliferation, migration and differentiation patterns in relation to OA tissue damage and further clarification of the molecular signaling events in these MSCs during disease progression. Osteoarthritis (OA) is a joint disorder, in which the cartilage, the underlying bone and other joint tissues are affected. Recent evidence demonstrating attempted repair responses in these OA tissues challenges the traditional view of OA as a degenerative disorder. Signs of tissue regeneration are particularly evident in the bone located directly underneath the damaged cartilage, where increased stem cell activity has been observed. Targeting these stem cells could represent a novel approach for intrinsic joint regeneration in OA. To progress with developing these novel therapies, a better understanding of stem cell function in normal and OA joint tissues is needed.
Collapse
|
23
|
Moses MJ, Wang DE, Weinberg M, Strauss EJ. Clinical outcomes following surgically repaired bucket-handle meniscus tears. PHYSICIAN SPORTSMED 2017; 45:329-336. [PMID: 28506133 DOI: 10.1080/00913847.2017.1331688] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Meniscus tears are one of the most common knee injuries. Our goal is to investigate the failure rate for surgically repaired bucket-handle meniscus tears and compare clinical outcomes of repairs that failed versus those that did not, at a minimum 2-year follow-up interval. METHODS 51 patients were identified in this retrospective cohort study who experienced bucket-handle meniscus tears that were isolated or with concomitant ACL injury. Inclusion criteria included age range from 13-55 years, confirmed bucket-handle meniscus tear by MRI and intraoperatively, and at least two-years of post-operative follow-up following index repair. Demographic data and outcome surveys were collected at a minimum of two-years follow-up after repair. RESULTS Of the 51 patients that had a bucket-handle meniscal repair, 12 (23.5%) were defined as failures (return of symptoms alongside re-tear in the same zone of the repaired meniscus within two years of surgery). No demographic variables (age, sex, and BMI smoking status, location of tear, or concomitant ACL tear) significantly correlated with failure. The mean of the Sports and Recreation KOOS was significantly lower between the non-failure (87 ± 14.4) and failure (70 ± 17.2) cohorts (p = 0.0072). The Quality of Life subscale was significantly lower between the non-failure (76 ± 15.8) and failure (57 ± 18.2) groups (p = 0.0058). There was a significant difference in the post-operative Lysholm scores (p = 0.0039) with a mean of 90 ± 9.1 for the entire cohort and means of 92 ± 8.4 and 83 ± 8.6, for non-failure and failure groups, respectively. CONCLUSIONS We found a higher failure rate (23.5%) for bucket-handle meniscus repairs at two-year follow up than has been cited in the literature, which is typically less than 20%, with significantly lower KOOS Quality of Life and Sports and Recreation subscales and Lysholm scores for the failure cohort. This is the first study to report these outcome scores solely for bucket-handle meniscus repairs, shedding light on the post-operative quality of life of patients with repair success or failure.
Collapse
Affiliation(s)
- Michael J Moses
- a Department of Orthopaedic Surgery, Division of Sports Medicine , New York University Langone Medical Center, Hospital for Joint Diseases , New York , NY , USA
| | - David E Wang
- a Department of Orthopaedic Surgery, Division of Sports Medicine , New York University Langone Medical Center, Hospital for Joint Diseases , New York , NY , USA
| | - Maxwell Weinberg
- a Department of Orthopaedic Surgery, Division of Sports Medicine , New York University Langone Medical Center, Hospital for Joint Diseases , New York , NY , USA
| | - Eric J Strauss
- a Department of Orthopaedic Surgery, Division of Sports Medicine , New York University Langone Medical Center, Hospital for Joint Diseases , New York , NY , USA
| |
Collapse
|
24
|
Slobodin G, Rosner I. Enthesis as a target organ in rheumatic diseases: an expanding frontier. Clin Rheumatol 2017; 36:2163-2165. [PMID: 28718044 DOI: 10.1007/s10067-017-3749-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Gleb Slobodin
- Rheumatology Unit, Bnai Zion Medical Center and Ruth and Bruce Rappaport Faculty of Medicine, Technion, 37, Golomb St, 38041, Haifa, Israel.
| | - Itzhak Rosner
- Rheumatology Unit, Bnai Zion Medical Center and Ruth and Bruce Rappaport Faculty of Medicine, Technion, 37, Golomb St, 38041, Haifa, Israel
| |
Collapse
|
25
|
Halstead J, Martín-Hervás C, Hensor EMA, McGonagle D, Keenan AM, Redmond AC, Conaghan PG. Development and Reliability of a Preliminary Foot Osteoarthritis Magnetic Resonance Imaging Score. J Rheumatol 2017; 44:1257-1264. [PMID: 28572462 DOI: 10.3899/jrheum.160617] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Foot osteoarthritis (OA) is very common but underinvestigated musculoskeletal condition and there is little consensus as to common magnetic resonance imaging (MRI) features. The aim of this study was to develop a preliminary foot OA MRI score (FOAMRIS) and evaluate its reliability. METHODS This preliminary semiquantitative score included the hindfoot, midfoot, and metatarsophalangeal joints. Joints were scored for joint space narrowing (JSN; 0-3), osteophytes (0-3), joint effusion/synovitis, and bone cysts (present/absent). Erosions and bone marrow lesions (BML) were scored (0-3) and BML were evaluated adjacent to entheses and at sub-tendon sites (present/absent). Additionally, tenosynovitis (0-3) and midfoot ligament pathology (present/absent) were scored. Reliability was evaluated in 15 people with foot pain and MRI-detected OA using 3.0T MRI multi-sequence protocols, and assessed using ICC as an overall score and per anatomical site. RESULTS Intrareader agreement (ICC) was generally good to excellent across the foot in joint features (JSN 0.90, osteophytes 0.90, effusion/synovitis 0.46, cysts 0.87), bone features (BML 0.83, erosion 0.66, BML entheses 0.66, BML sub-tendon 0.60) and soft tissue features (tenosynovitis 0.83, ligaments 0.77). Interreader agreement was lower for joint features (JSN 0.43, osteophytes 0.27, effusion/synovitis 0.02, cysts 0.48), bone features (BML 0.68, erosion 0.00, BML entheses 0.34, BML sub-tendon 0.13), and soft tissue features (tenosynovitis 0.35, ligaments 0.33). CONCLUSION This preliminary FOAMRIS demonstrated good intrareader reliability and fair interreader reliability when assessing the total feature scores. Further development is required in cohorts with a range of pathologies and to assess the psychometric measurement properties.
Collapse
Affiliation(s)
- Jill Halstead
- From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.,J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study
| | - Carmen Martín-Hervás
- From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.,J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study
| | - Elizabeth M A Hensor
- From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.,J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study
| | - Dennis McGonagle
- From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.,J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study
| | - Anne-Maree Keenan
- From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.,J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study
| | - Anthony C Redmond
- From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain. .,J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study.
| | - Philip G Conaghan
- From the Leeds Institute of Rheumatic and Musculoskeletal Medicine, and the School of Healthcare, University of Leeds; UK National Institute for Health Research (NIHR) Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds; Arthritis Research UK Experimental Osteoarthritis Treatment Centre, Leeds; Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, Nottingham/Leeds; Salford Royal Hospital UK National Health Service (NHS) Foundation Trust, Manchester, UK; Department of Musculoskeletal Radiology, La Paz University Hospital, Autonomous University of Madrid; Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.,J. Halstead, PhD, Visiting Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Principal Podiatrist, Salford Royal Hospital NHS Foundation Trust; C. Martín-Hervás, PhD, MD, Consultant Radiologist, Department of Musculoskeletal Radiology, La Paz University Hospital, and Associate Professor of Radiology, School of Medicine, Autonomous University of Madrid, and Biomedical Research Networking Centre on Bioengineering, Biomaterials and Nanomedicine; E.M. Hensor, PhD, Biostatistician, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; D. McGonagle, PhD, Professor of Investigative Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust; A.M. Keenan, PhD, Professor of Allied Health Research, School of Healthcare, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre; A.C. Redmond, PhD, Professor of Clinical Biomechanics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis; P.G. Conaghan, PhD, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, and Arthritis Research UK Experimental Osteoarthritis Treatment Centre, and Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis. P.G. Conaghan and A.C. Redmond contributed equally to this study
| |
Collapse
|
26
|
Steineman BD, LaPrade RF, Santangelo KS, Warner BT, Goodrich LR, Haut Donahue TL. Early Osteoarthritis After Untreated Anterior Meniscal Root Tears: An In Vivo Animal Study. Orthop J Sports Med 2017; 5:2325967117702452. [PMID: 28508006 PMCID: PMC5415046 DOI: 10.1177/2325967117702452] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Meniscal root tears cause menisci and their insertions to inadequately distribute loads and potentially leave underlying articular cartilage unprotected. Untreated meniscal root tears are becoming increasingly recognized to induce joint degradation; however, little information is known about anterior meniscal root tears and how they affect joint tissue. Purpose: To observe the early degenerative changes within the synovial fluid, menisci, tibial articular cartilage, and subchondral bone after arthroscopic creation of untreated anterior meniscal root tears. Study Design: Controlled laboratory study. Methods: Anterolateral meniscal root tears were created in 1 knee joint of 5 adult Flemish Giant rabbits, and anteromedial meniscal root tears were created in 4 additional rabbits. The contralateral limbs were used as nonoperated controls. The animals were euthanized at 8 weeks postoperatively; synovial fluid was aspirated, and tissue samples of menisci and tibial articular cartilage were collected and processed for multiple analyses to detect signs of early degeneration. Results: Significant changes were found within the synovial fluid, meniscal tissue, and tibial subchondral bone of the knees with anterior meniscal root tears when compared with controls. There were no significant changes identified in the tibial articular cartilage when comparing the tear groups with controls. Conclusion: This study demonstrated early degenerative changes within the synovial fluid, menisci, and tibial subchondral bone when leaving anterior meniscal root tears untreated for 8 weeks. The results suggest that meniscal tissue presents measurable, degenerative changes prior to changes within the articular cartilage after anterior meniscal root tears. Anterior destabilization of the meniscus arthroscopically may lead to measurable degenerative changes and be useful for future in vivo natural history and animal repair studies. Clinical Relevance: The present study is the first to investigate various tissue changes after anterior meniscal root tears of both the medial and lateral menisci. The results from this study suggest that degenerative changes occur within the synovial fluid, meniscus, and tibial subchondral bone prior to any measurable changes to the tibial articular cartilage. Further studies should expand on this study to evaluate how these components continue to progress when left untreated for long periods.
Collapse
Affiliation(s)
- Brett D Steineman
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado, USA
| | - Robert F LaPrade
- The Steadman Clinic, Vail, Colorado, USA.,Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Kelly S Santangelo
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA.,Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | | | - Laurie R Goodrich
- Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, Colorado, USA
| | - Tammy L Haut Donahue
- School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado, USA.,Department of Mechanical Engineering, Colorado State University, Fort Collins, Colorado, USA
| |
Collapse
|
27
|
Blaker CL, Clarke EC, Little CB. Using mouse models to investigate the pathophysiology, treatment, and prevention of post-traumatic osteoarthritis. J Orthop Res 2017; 35:424-439. [PMID: 27312470 DOI: 10.1002/jor.23343] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
Post-traumatic osteoarthritis (PTOA) is defined by its development after joint injury. Factors contributing to the risk of PTOA occurring, the rate of progression, and degree of associated disability in any individual, remain incompletely understood. What constitutes an "OA-inducing injury" is not defined. In line with advances in the traumatic brain injury field, we propose the scope of PTOA-inducing injuries be expanded to include not only those causing immediate structural damage and instability (Type I), but also those without initial instability/damage from moderate (Type II) or minor (Type III) loading severity. A review of the literature revealed this full spectrum of potential PTOA subtypes can be modeled in mice, with 27 Type I, 6 Type II, and 4 Type III models identified. Despite limitations due to cartilage anatomy, joint size, and bio-fluid availability, mice offer advantages as preclinical models to study PTOA, particularly genetically modified strains. Histopathology was the most common disease outcome, cartilage more frequently studied than bone or synovium, and meniscus and ligaments rarely evaluated. Other methods used to examine PTOA included gene expression, protein analysis, and imaging. Despite the major issues reported by patients being pain and biomechanical dysfunction, these were the least commonly measured outcomes in mouse models. Informative correlations of simultaneously measured disease outcomes in individual animals, was rarely done in any mouse PTOA model. This review has identified knowledge gaps that need to be addressed to increase understanding and improve prevention and management of PTOA. Preclinical mouse models play a critical role in these endeavors. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:424-439, 2017.
Collapse
Affiliation(s)
- Carina L Blaker
- Murray Maxwell Biomechanics Laboratory, Institute of Bone and Joint Research, Level 10, Kolling Institute B6, Northern Sydney Local Health District, Sydney Medical School Northern, University of Sydney, The Royal North Shore Hospital, St. Leonards, New South Wales, 2065, Australia.,Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Sydney Medical School Northern, University of Sydney, St. Leonards, New South Wales, 2065, Australia
| | - Elizabeth C Clarke
- Murray Maxwell Biomechanics Laboratory, Institute of Bone and Joint Research, Level 10, Kolling Institute B6, Northern Sydney Local Health District, Sydney Medical School Northern, University of Sydney, The Royal North Shore Hospital, St. Leonards, New South Wales, 2065, Australia
| | - Christopher B Little
- Raymond Purves Bone and Joint Research Laboratories, Institute of Bone and Joint Research, Kolling Institute, Northern Sydney Local Health District, Sydney Medical School Northern, University of Sydney, St. Leonards, New South Wales, 2065, Australia
| |
Collapse
|
28
|
Yumusakhuylu Y, Kasapoglu-Gunal E, Murat S, Kurum E, Keskin H, Icagasioglu A, McGonagle D, Zehra Aydin S. A preliminary study showing that ultrasonography cannot differentiate between psoriatic arthritis and nodal osteoarthritis based on enthesopathy scores: Table 1. Rheumatology (Oxford) 2016; 55:1703-4. [DOI: 10.1093/rheumatology/kew218] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2016] [Indexed: 01/30/2023] Open
|
29
|
Kreinest M, Reisig G, Ströbel P, Fickert S, Brade J, Wennemuth G, Lipp P, Schwarz ML. Analysis of Gene Expression and Ultrastructure of Stifle Menisci from Juvenile and Adult Pigs. Comp Med 2016; 66:30-40. [PMID: 26884408 PMCID: PMC4752034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/19/2015] [Accepted: 08/05/2015] [Indexed: 06/05/2023]
Abstract
The origin of the age-associated degenerative processes in meniscal tissue is poorly understood and may be related to an imbalance of anabolic and catabolic metabolism. The aim of the current study was to compare medial menisci isolated from juvenile pigs and degenerated medial menisci from adult pigs in terms of gene expression profile and ultrastructure. Medial menisci were isolated from the knee joints of juvenile and adult pigs (n = 8 for each group). Degeneration was determined histologically according to a scoring system. In addition, the gene expression profiles of 14 genes encoding extracellular matrix proteins, catabolic matrix metalloproteinases and mediators of inflammation were analyzed. Changes in the ultrastructure of the collagen network of the meniscal tissue were analyzed by using transmission electron microscopy. The histologic analysis of menisci showed significantly higher grade of degeneration in tissue isolated from adult porcine knee joints compared with menisci isolated from juvenile knee joints. In particular, destruction of the collagen network was greater in adult menisci than in juvenile menisci. Degenerated menisci showed significantly decreased gene expression of COL1A1 and increased expression of MMP2, MMP13, and IL8. The menisci from adult porcine knee joints can serve as a model for meniscal degeneration. Degenerative changes were manifested as differences in histopathology, gene expression and ultrastructure of collagen network.
Collapse
Affiliation(s)
- Michael Kreinest
- Department of Experimental Orthopaedics, Trauma Surgery and Orthopaedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
| | - Gregor Reisig
- Department of Experimental Orthopaedics, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany
| | - Philipp Ströbel
- Department of Pathology, University Medical Centre Göttingen, Göttingen, Germany
| | - Stefan Fickert
- Department of Experimental Orthopaedics, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany
| | - Joachim Brade
- Department of Medical Statistics and Biometry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Peter Lipp
- Department of Molecular Cell Biology, University Medical Centre Homburg, Saarland University, Homburg-Saar, Germany
| | - Markus L Schwarz
- Department of Experimental Orthopaedics, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany
| |
Collapse
|
30
|
Pauly HM, Larson BE, Coatney GA, Button KD, DeCamp CE, Fajardo RS, Haut RC, Donahue TLH. Assessment of cortical and trabecular bone changes in two models of post-traumatic osteoarthritis. J Orthop Res 2015; 33:1835-45. [PMID: 26147652 PMCID: PMC4628602 DOI: 10.1002/jor.22975] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 06/29/2015] [Indexed: 02/04/2023]
Abstract
Subchondral bone is thought to play a significant role in the initiation and progression of the post-traumatic osteoarthritis. The goal of this study was to document changes in tibial and femoral subchondral bone that occur as a result of two lapine models of anterior cruciate ligament injury, a modified ACL transection model and a closed-joint traumatic compressive impact model. Twelve weeks post-injury bones were scanned via micro-computed tomography. The subchondral bone of injured limbs from both models showed decreases in bone volume and bone mineral density. Surgical transection animals showed significant bone changes primarily in the medial hemijoint of femurs and tibias, while significant changes were noted in both the medial and lateral hemijoints of both bones for traumatic impact animals. It is believed that subchondral bone changes in the medial hemijoint were likely caused by compromised soft tissue structures seen in both models. Subchondral bone changes in the lateral hemijoint of traumatic impact animals are thought to be due to transmission of the compressive impact force through the joint. The joint-wide bone changes shown in the traumatic impact model were similar to clinical findings from studies investigating the progression of osteoarthritis in humans.
Collapse
Affiliation(s)
- Hannah M Pauly
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO USA
| | - Blair E Larson
- Department of Chemical and Biological Engineering, Colorado State University, Fort Collins, CO USA
| | - Garrett A Coatney
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO USA,Department of Mechanical Engineering, Colorado State University, Fort Collins, CO USA
| | - Keith D. Button
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI USA
| | - Charlie E DeCamp
- Small Animal Clinical Sciences, College of Veterinary, Michigan State University, East Lansing, MI USA
| | - Ryan S Fajardo
- Department of Radiology, Michigan State University, East Lansing, MI USA
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, College of Osteopathic Medicine, Michigan State University, East Lansing, MI USA,Department of Radiology, Michigan State University, East Lansing, MI USA
| | - Tammy L Haut Donahue
- School of Biomedical Engineering, Colorado State University, Fort Collins, CO USA,Department of Mechanical Engineering, Colorado State University, Fort Collins, CO USA
| |
Collapse
|
31
|
MacKay JW, Murray PJ, Low SBL, Kasmai B, Johnson G, Donell ST, Toms AP. Quantitative analysis of tibial subchondral bone: Texture analysis outperforms conventional trabecular microarchitecture analysis. J Magn Reson Imaging 2015; 43:1159-70. [PMID: 26606692 DOI: 10.1002/jmri.25088] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 10/26/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The aim of this study was to compare two different methods of quantitative assessment of tibial subchondral bone in osteoarthritis (OA): statistical texture analysis (sTA) and trabecular microarchitecture analysis (tMA). METHODS Asymptomatic controls aged 20-30 (n = 10), patients aged 40-50 with chronic knee pain but without established OA (n = 10) and patients aged 55-85 with advanced OA scheduled for knee replacement (n = 10) underwent knee MR imaging at 3 Tesla with a three-dimensional gradient echo sequence to allow sTA and tMA. tMA and sTA features were calculated using region of interest creation in the medial (MT) and lateral (LT) tibial subchondral bone. Features were compared between groups using one-way analysis of variance. The two most discriminating tMA and sTA features were used to construct exploratory discriminant functions to assess the ability of the two methods to classify participants. RESULTS No tMA features were significantly different between groups at either MT or LT. 17/20 and 11/20 sTA features were significantly different between groups at the MT/LT, respectively (P < 0.001). Discriminant functions created using tMA features classified 12/30 participants correctly (40% accuracy; 95% confidence interval [CI], 22-58%) based on MT data and 9/30 correctly (30%,; 95% CI, 14-46) based on LT data. Discriminant functions using sTA features classified 16/30 participants correctly (53%; 95% CI, 35-71) based on MT data and 14/30 correctly (47%; 95% CI, 29-65) based on LT data. CONCLUSION sTA features showed more significant differences between the three study groups and improved classification accuracy compared with tMA features.
Collapse
Affiliation(s)
- James W MacKay
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, United Kingdom
| | - Philip J Murray
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, United Kingdom
| | - Samantha B L Low
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, United Kingdom
| | - Bahman Kasmai
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, United Kingdom
| | - Glyn Johnson
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Simon T Donell
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Department of Trauma & Orthopaedics, Norfolk & Norwich University Hospital, Norwich, United Kingdom
| | - Andoni P Toms
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| |
Collapse
|
32
|
Sharma L, Nevitt M, Hochberg M, Guermazi A, Roemer FW, Crema M, Eaton C, Jackson R, Kwoh K, Cauley J, Almagor O, Chmiel JS. Clinical significance of worsening versus stable preradiographic MRI lesions in a cohort study of persons at higher risk for knee osteoarthritis. Ann Rheum Dis 2015; 75:1630-6. [PMID: 26467570 DOI: 10.1136/annrheumdis-2015-208129] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 09/20/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Whether preradiographic lesions in knees at risk for osteoarthritis are incidental versus disease is unclear. We hypothesised, in persons without but at higher risk for knee osteoarthritis, that: 12-48 month MRI lesion status worsening is associated with 12-48 month incident radiographic osteoarthritis (objective component of clinical definition of knee osteoarthritis) and 48-84 month persistent symptoms. METHODS In 849 Osteoarthritis Initiative participants Kellgren/Lawrence (KL) 0 in both knees, we assessed cartilage damage, bone marrow lesions (BMLs), and menisci on 12 month (baseline) and 48 month MRIs. Multivariable logistic regression was used to evaluate associations between 12-48 month worsening versus stable status and outcome (12-48 month incident KL ≥1 and KL ≥2, and 48-84 month persistent symptoms defined as frequent symptoms or medication use most days of ≥1 month in past 12 month, at consecutive visits 48-84 months), adjusting for age, gender, body mass index (BMI), injury and surgery. RESULTS Mean age was 59.6 (8.8), BMI 26.7 (4.2) and 55.9% were women. 12-48 month status worsening of cartilage damage, meniscal tear, meniscal extrusion, and BMLs was associated with 12-48 month incident radiographic outcomes, and worsening of cartilage damage and BMLs with 48-84 month persistent symptoms. There was a dose-response association for magnitude of worsening of cartilage damage, meniscal tear, meniscal extrusion, and BMLs and radiographic outcomes, and cartilage damage and BMLs and persistent symptoms. CONCLUSIONS In persons at higher risk, worsening MRI lesion status was associated with concurrent incident radiographic osteoarthritis and subsequent persistent symptoms. These findings suggest that such lesions represent early osteoarthritis, and add support for a paradigm shift towards investigation of intervention effectiveness at this stage.
Collapse
Affiliation(s)
- Leena Sharma
- Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael Nevitt
- Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California, USA
| | - Marc Hochberg
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Ali Guermazi
- Department of Radiology, Boston University, Boston, Massachusetts, USA
| | - Frank W Roemer
- Department of Radiology, Boston University, Boston, Massachusetts, USA University of Erlangen-Nuremberg, Erlangen, Germany
| | - Michel Crema
- Department of Radiology, Boston University, Boston, Massachusetts, USA
| | | | | | - Kent Kwoh
- Division of Rheumatology, University of Arizona Arthritis Center, University of Arizona, Tucson, Arizona, USA
| | - Jane Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Orit Almagor
- Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Joan S Chmiel
- Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
33
|
McAlindon TE. Toward a new paradigm of knee osteoarthritis. Arthritis Rheumatol 2015; 67:1987-9. [PMID: 25940432 DOI: 10.1002/art.39177] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 04/23/2015] [Indexed: 11/10/2022]
|
34
|
Abstract
Animal models of osteoarthritis are extensively used for investigating disease pathways and for preclinical testing of novel therapies. Their predictive utility, however, has often been questioned, mainly because preclinical efficacy of novel therapeutics is poorly translated in clinical trials. In the current narrative review, we consider the preclinical models that were used to support undertaking clinical trials for disease-modifying osteoarthritis drugs, and compare outcomes between clinical and preclinical studies. We discuss this in light of the 1999 Food and Drug Administration draft guidelines for industry for use in the development of drugs, devices, and biological products intended for the treatment of osteoarthritis, which raised five considerations on the usefulness of osteoarthritis models. We systematically discuss what has been learnt regarding these five points since 1999, with emphasis on replicating distinct risk factors and subtypes of human osteoarthritis, and on comprehensive evaluation of the disease in animals, including pathology of all joint tissues, biomarker analysis, and assessment of pain and joint function. Finally, we discuss lessons learnt and propose some recommendations for how the evidence from preclinical research might be strengthened with a view to improving success in clinical translation.
Collapse
Affiliation(s)
- Anne-Marie Malfait
- Department of Medicine, Division of Rheumatology, and Department of Biochemistry, Rush University Medical Center, Chicago, IL, 60612, USA.
| | - Christopher B Little
- Raymond Purves Bone and Joint Research Laboratories, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney at Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
| |
Collapse
|
35
|
Dyment NA, Breidenbach AP, Schwartz AG, Russell RP, Aschbacher-Smith L, Liu H, Hagiwara Y, Jiang R, Thomopoulos S, Butler DL, Rowe DW. Gdf5 progenitors give rise to fibrocartilage cells that mineralize via hedgehog signaling to form the zonal enthesis. Dev Biol 2015; 405:96-107. [PMID: 26141957 DOI: 10.1016/j.ydbio.2015.06.020] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/03/2015] [Accepted: 06/24/2015] [Indexed: 02/01/2023]
Abstract
The sequence of events that leads to the formation of a functionally graded enthesis is not clearly defined. The current study demonstrates that clonal expansion of Gdf5 progenitors contributes to linear growth of the enthesis. Prior to mineralization, Col1+ cells in the enthesis appose Col2+ cells of the underlying primary cartilage. At the onset of enthesis mineralization, cells at the base of the enthesis express alkaline phosphatase, Indian hedgehog, and ColX as they mineralize. The mineralization front then extends towards the tendon midsubstance as cells above the front become encapsulated in mineralized fibrocartilage over time. The hedgehog (Hh) pathway regulates this process, as Hh-responsive Gli1+ cells within the developing enthesis mature from unmineralized to mineralized fibrochondrocytes in response to activated signaling. Hh signaling is required for mineralization, as tissue-specific deletion of its obligate transducer Smoothened in the developing tendon and enthesis cells leads to significant reductions in the apposition of mineralized fibrocartilage. Together, these findings provide a spatiotemporal map of events - from expansion of the embryonic progenitor pool to synthesis of the collagen template and finally mineralization of this template - that leads to the formation of the mature zonal enthesis. These results can inform future tendon-to-bone repair strategies to create a mechanically functional enthesis in which tendon collagen fibers are anchored to bone through mineralized fibrocartilage.
Collapse
Affiliation(s)
- Nathaniel A Dyment
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, University of Connecticut Health Center, United States.
| | - Andrew P Breidenbach
- Biomedical Engineering Program, College of Engineering and Applied Science, University of Cincinnati, United States
| | - Andrea G Schwartz
- Department of Orthopaedic Surgery, Washington University in St. Louis, United States
| | - Ryan P Russell
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, University of Connecticut Health Center, United States
| | | | - Han Liu
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, United States
| | - Yusuke Hagiwara
- Department of Orthopaedic Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Rulang Jiang
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, United States
| | - Stavros Thomopoulos
- Department of Orthopaedic Surgery, Washington University in St. Louis, United States
| | - David L Butler
- Biomedical Engineering Program, College of Engineering and Applied Science, University of Cincinnati, United States
| | - David W Rowe
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, University of Connecticut Health Center, United States
| |
Collapse
|
36
|
Dyment NA, Hagiwara Y, Jiang X, Huang J, Adams DJ, Rowe DW. Response of knee fibrocartilage to joint destabilization. Osteoarthritis Cartilage 2015; 23:996-1006. [PMID: 25680653 PMCID: PMC4757847 DOI: 10.1016/j.joca.2015.01.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 01/16/2015] [Accepted: 01/28/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A major challenge to understanding osteoarthritis (OA) pathology is identifying the cellular events that precede the onset of cartilage damage. The objective of this study is to determine the effect of joint destabilization on early changes to fibrocartilage in the joint. DESIGN/METHODS The anterior cruciate ligament was transected in collagen reporter mice (Col1CFP and ColXRFP). Mineralization labels were given every 2 weeks to measure new mineralized cartilage apposition. Novel fluorescent histology of mineralized tissue was used to characterize the changes in fibrocartilage at 2 and 4 weeks post-injury. RESULTS Changes in fibrocartilaginous structures of the joint occur as early as 2 weeks after injury and are well developed by 4 weeks. The alterations are seen in multiple entheses and in the medial surface of the femoral and tibial condyles. In the responding entheses, mineral apposition towards the ligament midsubstance results in thickening of the mineralize fibrocartilage. These changes are associated with increases in ColX-RFP, Col1-CFP reporter activity and alkaline phosphatase enzyme activity. Mineral apposition also occurs in the fibrocartilage of the non-articular regions of the medial condyles by 2 weeks and develops into osteophytes by 4 weeks post-injury. An unexpected observation is punctate expression of tartrate resistant acid phosphatase activity in unmineralized fibrochondrocytes adjacent to active appositional mineralization. DISCUSSION These observations suggest that fibrocartilage activates prior to degradation of the articular cartilage. Thus clinical and histological imaging of fibrocartilage may be an earlier indicator of disease initiation and may indicate a more appropriate time to start preventative treatment.
Collapse
Affiliation(s)
- N A Dyment
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine and Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032, USA.
| | - Y Hagiwara
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine and Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032, USA; Department of Orthopedic Surgery, Nippon Medical School Hospital, Tokyo 113, Japan.
| | - X Jiang
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine and Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032, USA.
| | - J Huang
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine and Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032, USA.
| | - D J Adams
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine and Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032, USA.
| | - D W Rowe
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine and Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032, USA.
| |
Collapse
|
37
|
Fischenich KM, Lewis J, Kindsfater KA, Bailey TS, Haut Donahue TL. Effects of degeneration on the compressive and tensile properties of human meniscus. J Biomech 2015; 48:1407-11. [DOI: 10.1016/j.jbiomech.2015.02.042] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 01/03/2023]
|
38
|
Fermor HL, Russell SL, Williams S, Fisher J, Ingham E. Development and characterisation of a decellularised bovine osteochondral biomaterial for cartilage repair. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:186. [PMID: 25893393 PMCID: PMC4412724 DOI: 10.1007/s10856-015-5517-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 03/19/2015] [Indexed: 06/04/2023]
Abstract
It is proposed that an acellular natural osteochondral scaffold will provide a successful repair material for the early intervention treatment of cartilage lesions, to prevent or slow the progression of cartilage deterioration to osteoarthritis. Here, we investigated the efficacy of methods for the decellularisation of bovine osteochondral plugs. The plugs were subject to four freeze/thaw cycles followed by two cycles of washes in hypotonic solution and low concentration (0.1% w/v) sodium dodecyl sulphate with protease inhibitors. Plugs were treated with nuclease (DNase and RNase) treatment followed by sterilization in peracetic acid. Full tissue decellularisation was achieved as confirmed by histological analysis and DNA quantification, however the resultant acellular matrix had reduced glycosaminoglycan content which led to an increased percent deformation of cartilage. Furthermore, the acellular scaffold was not reproducibly biocompatible. Additional terminal washes were included in the process to improve biocompatibility, however, this led to visible structural damage to the cartilage. This damage was found to be minimised by reducing the cut edge to cartilage area ratio through decellularisation of larger cuts of osteochondral tissue.
Collapse
Affiliation(s)
- Hazel L Fermor
- Faculty of Biological Sciences, University of Leeds, Leeds, UK,
| | | | | | | | | |
Collapse
|
39
|
Fischenich KM, Coatney GA, Haverkamp JH, Button KD, DeCamp C, Haut RC, Haut Donahue TL. Evaluation of meniscal mechanics and proteoglycan content in a modified anterior cruciate ligament transection model. J Biomech Eng 2014; 136:1864206. [PMID: 24749144 DOI: 10.1115/1.4027468] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 04/22/2014] [Indexed: 01/14/2023]
Abstract
Post-traumatic osteoarthritis (PTOA) develops as a result of traumatic loading that causes tears of the soft tissues in the knee. A modified transection model, where the anterior cruciate ligament (ACL) and both menisci were transected, was used on skeletally mature Flemish Giant rabbits. Gross morphological assessments, elastic moduli, and glycosaminoglycan (GAG) coverage of the menisci were determined to quantify the amount of tissue damage 12 weeks post injury. This study is one of the first to monitor meniscal changes after inducing combined meniscal and ACL transections. A decrease in elastic moduli as well as a decrease in GAG coverage was seen.
Collapse
|
40
|
Conconi M, Halilaj E, Parenti Castelli V, Crisco JJ. Is early osteoarthritis associated with differences in joint congruence? J Biomech 2014; 47:3787-93. [PMID: 25468667 DOI: 10.1016/j.jbiomech.2014.10.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 10/20/2014] [Accepted: 10/24/2014] [Indexed: 02/03/2023]
Abstract
Previous studies suggest that osteoarthritis (OA) is related to abnormal or excessive articular contact stress. The peak pressure resulting from an applied load is determined by many factors, among which is shape and relative position and orientation of the articulating surfaces or, referring to a more common nomenclature, joint congruence. It has been hypothesized that anatomical differences may be among the causes of OA. Individuals with less congruent joints would likely develop higher peak pressure and thus would be more exposed to the risk of OA onset. The aim of this work was to determine if the congruence of the first carpometacarpal (CMC) joint differs with the early onset of OA or with sex, as the female population has a higher incidence of OA. 59 without and 38 with early OA were CT-scanned with their dominant or arthritic hand in a neutral configuration. The proposed measure of joint congruence is both shape and size dependent. The correlation of joint congruence with pathology and sex was analyzed both before and after normalization for joint size. We found a significant correlation between joint congruence and sex due to the sex-related differences in size. The observed correlation disappeared after normalization. Although joint congruence increased with size, it did not correlate significantly with the onset of early OA. Differences in joint congruence in this population may not be a primary cause of OA onset or predisposition, at least for the CMC joint.
Collapse
Affiliation(s)
- Michele Conconi
- Health Sciences and Technologies, Interdepartmental Center for Industrial Research (HST-ICIR), Alma Mater Studiorum-University of Bologna, Bologna, Italy.
| | - Eni Halilaj
- Center for Biomedical Engineering, Brown University, Providence, RI, USA
| | - Vincenzo Parenti Castelli
- Health Sciences and Technologies, Interdepartmental Center for Industrial Research (HST-ICIR), Alma Mater Studiorum-University of Bologna, Bologna, Italy; Department of Industrial Engineering (DIN), Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Joseph J Crisco
- Center for Biomedical Engineering, Brown University, Providence, RI, USA; Department of Orthopaedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI, USA
| |
Collapse
|
41
|
MRI signal-based quantification of subchondral bone at the tibial plateau: a population study. Skeletal Radiol 2014; 43:1567-75. [PMID: 24986652 DOI: 10.1007/s00256-014-1943-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/18/2014] [Accepted: 06/08/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether differences in subchondral sclerosis at the tibial plateau could be detected with magnetic resonance (MR) imaging in two different age groups. MATERIALS AND METHODS This was a retrospective hypothesis-testing study. Thirty-two knees in group A (25-30 year olds) and 32 knees in group B (45-50 years old) were included. Participants had no MR features of osteoarthritis (OA). On coronal images, tibial articular cartilage thickness was measured, and regions of interest were created in the medial and lateral tibial plateau subchondral bone and in the tibial metaphysis. The measure of heterogeneity at the tibial plateaux was the ratio of the standard deviation of the signal in the medial/lateral compartment to the standard deviation of the signal in the metaphysis (ratio of standard deviations--RSS(medial)/RSS(lateral)). Differences between groups were assessed using unpaired Student's t-tests. RESULTS Mean RSS(medial) was 2.61 (standard deviation, SD = 0.77) in group A and 2.97 (SD = 0.59) in group B. Mean RSS(lateral) in group A was 1.86 (SD = 0.63) and 1.89 (SD = 0.43) in group B. Mean total cartilage thickness (in mm) in group A was 3.38 (SD = 0.90) for the medial and 3.90 (SD = 1.09) for the lateral compartment and 3.44 (SD = 0.74) for the medial and 3.96 (SD = 0.96) for the lateral compartment in group B. The only parameter to show a statistically significant difference between groups was RSS(medial) (p = 0.04). CONCLUSION A difference in medial subchondral bone sclerosis between two age groups was demonstrated in the absence of MR features of OA. This may represent the earliest OA change detectable on MR imaging.
Collapse
|
42
|
Hardcastle SA, Dieppe P, Gregson CL, Arden NK, Spector TD, Hart DJ, Edwards MH, Dennison EM, Cooper C, Williams M, Davey Smith G, Tobias JH. Osteophytes, enthesophytes, and high bone mass: a bone-forming triad with potential relevance in osteoarthritis. Arthritis Rheumatol 2014; 66:2429-39. [PMID: 24910132 PMCID: PMC4288267 DOI: 10.1002/art.38729] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/28/2014] [Indexed: 11/14/2022]
Abstract
Objective Previous studies of skeletal remains have suggested that both enthesophytes and osteophytes are manifestations of an underlying bone-forming tendency. A greater prevalence of osteophytes has been observed among individuals with high bone mass (HBM) compared with controls. This study was undertaken to examine the possible interrelationships between bone mass, enthesophytes, and osteophytes in a population of individuals with extreme HBM. Methods Cases of HBM (defined according to bone mineral density [BMD] Z scores on dual x-ray absorptiometry) from the UK-based HBM study were compared with a control group comprising unaffected family members and general population controls from the Chingford and Hertfordshire cohort studies. Pelvic radiographs from cases and controls were pooled and evaluated, in a blinded manner, by a single observer, who performed semiquantitative grading of the radiographs for the presence and severity of osteophytes and enthesophytes (score range 0–3 for each). Logistic regression analysis was used to identify significant associations, with a priori adjustment for age, sex, and body mass index. Results In this study, 226 radiographs from HBM cases and 437 radiographs from control subjects were included. Enthesophytes (grade ≥1) and moderate enthesophytes (grade ≥2) were more prevalent in HBM cases compared with controls (adjusted odds ratio [OR] 3.00 [95% confidence interval (95% CI) 1.96–4.58], P < 0.001 for any enthesophyte; adjusted OR 4.33 [95% CI 2.67–7.02], P < 0.001 for moderate enthesophytes). In the combined population of cases and controls, the enthesophyte grade was positively associated with BMD at both the total hip and lumbar spine (adjusted P for trend < 0.001). In addition, a positive association between osteophytes and enthesophytes was observed; for each unit increase in enthesophyte grade, the odds of any osteophyte being present were increased >2-fold (P < 0.001). Conclusion Strong interrelationships were observed between osteophytes, enthesophytes, and HBM, which may be helpful in defining a distinct subset of patients with osteoarthritis characterized by excess bone formation.
Collapse
|
43
|
McGonagle D, Hermann KGA, Tan AL. Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era. Rheumatology (Oxford) 2014; 54:29-38. [PMID: 25231177 DOI: 10.1093/rheumatology/keu328] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Rheumatologists have long considered OA and PsA as two completely distinct arthropathies. This review highlights how some forms of generalized OA and PsA may afflict the same entheseal-associated anatomical territories. While degeneration or inflammation may be clearly discernible at the two extremes, there may be a group of patients where differentiation is impossible. Misdiagnosis of a primary degeneration-related pathology as being part of the PsA spectrum could lead to apparent failure of disease-modifying agents, including apparent anti-TNF and apparent IL23/17 axis therapy failure. This is not a reflection of poor clinical acumen, but rather a failure to appreciate that the pathological process overlaps in the two diseases. Whether the category of OA-PsA overlap disease exists or whether it represents the co-occurrence of two common arthropathies that afflict the same anatomical territories has implications for the optimal diagnosis and management of both OA and PsA.
Collapse
Affiliation(s)
- Dennis McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK and Department of Radiology, Charité Medical School, Berlin, Germany. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK and Department of Radiology, Charité Medical School, Berlin, Germany.
| | - Kay-Geert A Hermann
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK and Department of Radiology, Charité Medical School, Berlin, Germany
| | - Ai Lyn Tan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK and Department of Radiology, Charité Medical School, Berlin, Germany. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK and Department of Radiology, Charité Medical School, Berlin, Germany
| |
Collapse
|
44
|
Mhlanga JC, Carrino JA, Lodge M, Wang H, Wahl RL. 18F-FDG PET of the hands with a dedicated high-resolution PEM system (arthro-PET): correlation with PET/CT, radiography and clinical parameters. Eur J Nucl Med Mol Imaging 2014; 41:2337-45. [PMID: 25134669 DOI: 10.1007/s00259-014-2856-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 07/03/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to prospectively determine the feasibility and compare the novel use of a positron emission mammography (PEM) scanner with standard PET/CT for evaluating hand osteoarthritis (OA) with (18)F-FDG. METHODS Institutional review board approval and written informed consent were obtained for this HIPAA-compliant prospective study in which 14 adults referred for oncological (18)F-FDG PET/CT underwent dedicated hand PET/CT followed by arthro-PET using the PEM device. Hand radiographs were obtained and scored for the presence and severity of OA. Summed qualitative and quantitative joint glycolytic scores for each modality were compared with the findings on plain radiography and clinical features. RESULTS Eight patients with clinical and/or radiographic evidence of OA comprised the OA group (mean age 73 ± 7.7 years). Six patients served as the control group (53.7 ± 9.3 years). Arthro-PET quantitative and qualitative joint glycolytic scores were highly correlated with PET/CT findings in the OA patients (r = 0.86. p = 0.007; r = 0.94, p = 0.001). Qualitative arthro-PET and PET/CT joint scores were significantly higher in the OA patients than in controls (38.7 ± 6.6 vs. 32.2 ± 0.4, p = 0.02; 37.5 ± 5.4 vs. 32.2 ± 0.4, p = 0.03, respectively). Quantitative arthro-PET and PET/CT maximum SUV-lean joint scores were higher in the OA patients, although they did not reach statistical significance (20.8 ± 4.2 vs. 18 ± 1.8, p = 0.13; 22.8 ± 5.38 vs. 20.1 ± 1.54, p = 0.21). By definition, OA patients had higher radiographic joint scores than controls (30.9 ± 31.3 vs. 0, p = 0.03). CONCLUSION Hand imaging using a small field of view PEM system (arthro-PET) with FDG is feasible, performing comparably to PET/CT in assessing metabolic joint activity. Arthro-PET and PET/CT showed higher joint FDG uptake in OA. Further exploration of arthro-PET in arthritis management is warranted.
Collapse
Affiliation(s)
- Joyce C Mhlanga
- Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | | |
Collapse
|
45
|
Mobargha N, Ludwig C, Ladd AL, Hagert E. Ultrastructure and innervation of thumb carpometacarpal ligaments in surgical patients with osteoarthritis. Clin Orthop Relat Res 2014; 472:1146-54. [PMID: 23761171 PMCID: PMC3940730 DOI: 10.1007/s11999-013-3083-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The complex configuration of the thumb carpometacarpal (CMC-1) joint relies on musculotendinous and ligamentous support for precise circumduction. Ligament innervation contributes to joint stability and proprioception. Evidence suggests abnormal ligament innervation is associated with osteoarthritis (OA) in large joints; however, little is known about CMC-1 ligament innervation characteristics in patients with OA. We studied the dorsal radial ligament (DRL) and the anterior oblique ligament (AOL), ligaments with a reported divergent presence of mechanoreceptors in nonosteoarthritic joints. QUESTIONS/PURPOSES This study's purposes were (1) to examine the ultrastructural architecture of CMC-1 ligaments in surgical patients with OA; (2) to describe innervation, specifically looking at mechanoreceptors, of these ligaments using immunohistochemical techniques and compare the AOL and DRL in terms of innervation; and (3) to determine whether there is a correlation between age and mechanoreceptor density. METHODS The AOL and DRL were harvested from 11 patients with OA during trapeziectomy (10 women, one man; mean age, 67 years). The 22 ligaments were sectioned in paraffin and analyzed using immunoflourescent triple staining microscopy. RESULTS In contrast to the organized collagen bundles of the DRL, the AOL appeared to be composed of disorganized connective tissue with few collagen fibers and little innervation. Mechanoreceptors were identified in CMC-1 ligaments of all patients with OA. The DRL was significantly more innervated than the AOL. There was no significant correlation between innervation of the DRL and AOL and patient age. CONCLUSIONS The dense collagen structure and rich innervation of the DRL in patients with OA suggest that the DRL has an important proprioceptive and stabilizing role. CLINICAL RELEVANCE Ligament innervation may correlate with proprioceptive and neuromuscular changes in OA pathophysiology and consequently support further investigation of innervation in disease prevention and treatment strategies.
Collapse
Affiliation(s)
- Nathalie Mobargha
- Department of Clinical Science and Education, Karolinska Institute, Sjukhusbacken 10, 118 83, Stockholm, Sweden,
| | | | | | | |
Collapse
|
46
|
Castañeda S, Roman-Blas JA, Largo R, Herrero-Beaumont G. Osteoarthritis: a progressive disease with changing phenotypes. Rheumatology (Oxford) 2013; 53:1-3. [PMID: 23878311 DOI: 10.1093/rheumatology/ket247] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Santos Castañeda
- Bone and Joint Research Unit, Fundación Jiménez Díaz, Av. Reyes Católicos 2, 28040 Madrid, Spain.
| | | | | | | |
Collapse
|
47
|
Little CB, Hunter DJ. Post-traumatic osteoarthritis: from mouse models to clinical trials. Nat Rev Rheumatol 2013; 9:485-97. [PMID: 23689231 DOI: 10.1038/nrrheum.2013.72] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Osteoarthritis (OA), the most common of all arthropathies, is a leading cause of disability and has a large (and growing) worldwide socioeconomic cost. Despite its burgeoning importance, translation of disease-modifying OA therapies from the laboratory into clinical practice has slowed. Differences between the OA models studied preclinically and the disease evaluated in human clinical trials contribute to this failure. Most animal models of OA induce disease through surgical or mechanical disruption of joint biomechanics in young individuals rather than the spontaneous development of age-associated disease. This instability-induced joint disease in animals best models the arthritis that develops in humans after an injurious event, known as post-traumatic OA (PTOA). Studies in genetically modified mice suggest that PTOA has a distinct molecular pathophysiology compared with that of spontaneous OA, which might explain the poor translation from preclinical to clinical OA therapeutic trials. This Review summarizes the latest data on potential molecular targets for PTOA prevention and modification derived from studies in genetically modified mice, and describes their validation in preclinical therapeutic trials. This article focuses on how these findings might best be translated to humans, and identifies the potential challenges to successful implementation of clinical trials of disease-modifying drugs for PTOA.
Collapse
Affiliation(s)
- Christopher B Little
- Raymond Purves Bone and Joint Research Laboratories, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney at Royal North Shore Hospital, St Leonards, NSW 2065, Australia. christopher.little@ sydney.edu.au
| | | |
Collapse
|
48
|
Walker AE, Khanna M, Kinderlerer AR. Imaging in rheumatology. IMAGING 2013. [DOI: 10.1259/imaging.20120008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
|
49
|
Abraham AC, Donahue TLH. From meniscus to bone: a quantitative evaluation of structure and function of the human meniscal attachments. Acta Biomater 2013; 9:6322-9. [PMID: 23385217 DOI: 10.1016/j.actbio.2013.01.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 01/16/2013] [Accepted: 01/28/2013] [Indexed: 12/01/2022]
Abstract
Meniscus efficacy at promoting joint congruity and preventing osteoarthritis hinges on enthesis integrity. Gross-scale tensile testing, histomorphometry and magnetic resonance imaging reveal significant differences between the four attachments, implying that each must endure a unique mechanical environment, which dictates their structure. However, little data exists to elucidate how these interfaces have adapted to their complex loading environment, particularly on a relevant scale, as the enthesis transitions through several unique zones in less than a millimeter. In our study we leveraged nanoindentation to determine viscoelastic material properties through the transition zones. Additionally, we employed histological techniques to evaluate the enthesis structure, including collagen organization and interdigitation morphometry. Mechanical evaluation revealed the medial posterior insertion site to be significantly more compliant than others. Collagen fiber orientation and dispersion as well as interdigitation morphometry were significantly different between attachments sites. These findings are clinically relevant as a disproportionate amount of enthesis failure occurs in the medial posterior attachment. Also, meniscal enthesis structure and function will need to be considered in future reparative and replacement strategies in order to recreate native meniscus mechanics and prevent osteoarthritis propagation.
Collapse
Affiliation(s)
- Adam C Abraham
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA
| | | |
Collapse
|
50
|
Binks DA, Hodgson RJ, Ries ME, Foster RJ, Smye SW, McGonagle D, Radjenovic A. Quantitative parametric MRI of articular cartilage: a review of progress and open challenges. Br J Radiol 2013; 86:20120163. [PMID: 23407427 DOI: 10.1259/bjr.20120163] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
With increasing life expectancies and the desire to maintain active lifestyles well into old age, the impact of the debilitating disease osteoarthritis (OA) and its burden on healthcare services is mounting. Emerging regenerative therapies could deliver significant advances in the effective treatment of OA but rely upon the ability to identify the initial signs of tissue damage and will also benefit from quantitative assessment of tissue repair in vivo. Continued development in the field of quantitative MRI in recent years has seen the emergence of techniques able to probe the earliest biochemical changes linked with the onset of OA. Quantitative MRI measurements including T(1), T(2) and T(1ρ) relaxometry, diffusion weighted imaging and magnetisation transfer have been studied and linked to the macromolecular structure of cartilage. Delayed gadolinium-enhanced MRI of cartilage, sodium MRI and glycosaminoglycan chemical exchange saturation transfer techniques are sensitive to depletion of cartilage glycosaminoglycans and may allow detection of the earliest stages of OA. We review these current and emerging techniques for the diagnosis of early OA, evaluate the progress that has been made towards their implementation in the clinic and identify future challenges in the field.
Collapse
Affiliation(s)
- D A Binks
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
| | | | | | | | | | | | | |
Collapse
|