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Wei J, Ou Z, Tong B, Liao Z, Yang C. Engineered extracellular vesicles as therapeutics of degenerative orthopedic diseases. Front Bioeng Biotechnol 2023; 11:1162263. [PMID: 37362216 PMCID: PMC10289007 DOI: 10.3389/fbioe.2023.1162263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
Degenerative orthopedic diseases, as a global public health problem, have made serious negative impact on patients' quality of life and socio-economic burden. Traditional treatments, including chemical drugs and surgical treatments, have obvious side effects and unsatisfactory efficacy. Therefore, biological therapy has become the focus of researches on degenerative orthopedic diseases. Extracellular vesicles (EVs), with superior properties of immunoregulatory, growth support, and drug delivery capabilities, have emerged as a new cell-free strategy for the treatment of many diseases, including degenerative orthopedic diseases. An increasing number of studies have shown that EVs can be engineered through cargo loading, surface modification, and chemical synthesis to improve efficiency, specificity, and safety. Herein, a comprehensive overview of recent advances in engineering strategies and applications of engineered EVs as well as related researches in degenerative orthopedic diseases, including osteoarthritis (OA), osteoporosis (OP), intervertebral disc degeneration (IDD) and osteonecrosis of the femoral head (ONFH), is provided. In addition, we analyze the potential and challenges of applying engineered EVs to clinical practice.
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Affiliation(s)
| | | | | | | | - Cao Yang
- *Correspondence: Zhiwei Liao, ; Cao Yang,
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2
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Waugh CM, Scott A. Case Studies in Physiology: Adaptation of Loading-Bearing Tendons during Pregnancy. J Appl Physiol (1985) 2022; 132:1280-1289. [PMID: 35271408 DOI: 10.1152/japplphysiol.00555.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pregnancy is characterized by hormone changes that could alter musculoskeletal (MSK) properties and temporarily increase soft tissue injury risk. Whilst the prevalence of MSK injuries in pregnancy has not yet proven itself to be a widespread problem, indirect evidence indicates an uptake in the prevalence of strength training and vigorous-intensity activity during pregnancy, which may result in increased MSK injury incidence. Combining this evidence with the association between sex hormones and MSK injury risk, we recognize the potential importance of this research area and believe the (prospective) examination of connective tissue properties in relation to hormonal changes in pregnancy are appropriate. Given the dearth of information on MSK adaptations to pregnancy, we present a variety of morphological, mechanical and functional tendon data from two consecutive pregnancies in one woman as a means of highlighting this under-researched topic. This data may be representative of the general pregnant population, or it may be highly individualized - more research is required for a better understanding of MSK adaptation and injury risk during and after pregnancy.
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Affiliation(s)
- Charlie M Waugh
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Alexander Scott
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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3
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Godoy-Santos AL, Schmidt EL, Chaparro F. What Are the Updates on Epidemiology of Progressive Collapsing Foot Deformity? Foot Ankle Clin 2021; 26:407-415. [PMID: 34332726 DOI: 10.1016/j.fcl.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Progressive collapsing foot deformity is one of the most controversial topics in foot and ankle surgery. Much research has been done regarding anatomy, biomechanics, and etiology behind this complex deformity and there is interest in studying metabolic or genetic conditions that could influence the development of this multifactorial disorder. Relevant anatomy includes osseous and soft tissue structures. Several risk factors like obesity, genetics, and flat foot during childhood have been proposed in literature. It occurs 3 times more often in women, the peak incidence happening at age 55, and is more common in white, obese, diabetic, rheumatic, and hypertensive patients.
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Affiliation(s)
- Alexandre Leme Godoy-Santos
- Department of Orthopedic Surgery, Faculdade de Medicina, Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 333, Cerqueira Cesar, Sao Paulo, Sao Paulo 05403-010, Brazil; Hospital Israelita Albert Einstein, São Paulo, Sao Paulo, Brazil.
| | - Eli L Schmidt
- Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins drive, Iowa City, IA 52242, USA
| | - Felipe Chaparro
- Hospital San José, Santiago, Chile; Clinica Universidad de los Andes, Avenida Plaza 2501, Las Condes, Santiago 7620157, Chile
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Piraino JA, Theodoulou MH, Ortiz J, Peterson K, Lundquist A, Hollawell S, Scott RT, Joseph R, Mahan KT, Bresnahan PJ, Butto DN, Cain JD, Ford TC, Knight JM, Wobst GM. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Appropriate Clinical Management of Adult-Acquired Flatfoot Deformity. J Foot Ankle Surg 2021; 59:347-355. [PMID: 32131002 DOI: 10.1053/j.jfas.2019.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This clinical consensus statement of the American College of Foot and Ankle Surgeons focuses on the highly debated subject of the management of adult flatfoot (AAFD). In developing this statement, the AAFD consensus statement panel attempted to address the most relevant issues facing the foot and ankle surgeon today, using the best evidence-based literature available. The panel created and researched 16 statements and generated opinions on the appropriateness of the statements. The results of the research on this topic and the opinions of the panel are presented here.
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Affiliation(s)
- Jason A Piraino
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL.
| | - Michael H Theodoulou
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Julio Ortiz
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Kyle Peterson
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Andrew Lundquist
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Shane Hollawell
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Ryan T Scott
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Robert Joseph
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Kieran T Mahan
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Philip J Bresnahan
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Danielle N Butto
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Jarrett D Cain
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Timothy C Ford
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Jessica Marie Knight
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Garrett M Wobst
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
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5
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Nogara PRB, Godoy-Santos AL, Fonseca FCP, Cesar-Netto C, Carvalho KC, Baracat EC, Maffulli N, Pontin PA, Santos MCL. Association of estrogen receptor β polymorphisms with posterior tibial tendon dysfunction. Mol Cell Biochem 2020; 471:63-69. [PMID: 32472323 DOI: 10.1007/s11010-020-03765-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/23/2020] [Indexed: 11/27/2022]
Abstract
Posterior tibial tendon (PTT) dysfunction is three times more common in females, and some patients may have a predisposition without a clinically evident cause, suggesting that individual characteristics play an important role in tendinopathy. The present study investigated the association of rs4986938 (+ 1730G > A; AluI RFLP) and rs1256049 (- 1082G > A; RsaI RFLP) single nucleotide polymorphisms (SNPs) of estrogen receptor-beta (ER-β) gene with PTT dysfunction. A total of 400 participants were recruited. The PTT dysfunction group: these patients underwent surgery, with PTT tendinopathy confirmed by histopathology and magnetic resonance image (MRI). The control group was composed of participants with no clinical or MRI evidence of PTT dysfunction. Each group was composed of 100 postmenopausal women, 50 premenopausal women, and 50 men. Genomic DNA was extracted from saliva samples, and genotypes were obtained by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Concerning the ER-β SNP rs4986938, there were significant differences in the frequencies of alleles between test and control groups of all the cases, only postmenopausal women and only men (p < 0.0001, p = 0.0016 and p = 0.0001). Considering the PTT dysfunction group and comparing postmenopausal women versus premenopausal women adding men, the analysis showed significant differences in the allelic distribution (p = 0.0450): the allele A in postmenopausal women is a risk factor. The ER-β SNP rs1256049 did not show differences in the frequencies of alleles and genotypes between groups. The ER-β SNP rs4986938, but not ER -β SNPs rs1256049, may contribute to PTT insufficiency in the Brazilian population, with additional risk in postmenopausal women. Addition, in men the genetic factor could be more determinant.
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Affiliation(s)
- P R B Nogara
- Department of Cell Biology, University Federal of Paraná, Curitiba, PR, Brazil
| | - A L Godoy-Santos
- Department of Orthopaedics, Foot and Ankle Service, University of São Paulo, São Paulo, SP, Brazil
| | - F C P Fonseca
- Department of Orthopaedics, Foot and Ankle Service, University of São Paulo, São Paulo, SP, Brazil
| | - C Cesar-Netto
- Department of Orthopedic, Medstar Union Memorial Hospital, Baltimore, USA
| | - K C Carvalho
- Department of Gynecology, University of São Paulo, São Paulo, SP, Brazil
| | - E C Baracat
- Department of Gynecology, University of São Paulo, São Paulo, SP, Brazil
| | - N Maffulli
- Centre for Sports and Exercise Medicine Barts and The London, School of Medicine and Dentistry, London, UK
- Department of Musculoskeletal Surgery, School of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
- Institute of Science and Technology in Medicine, Keele University School of Medicine, Stoke on Trent, UK
| | - P A Pontin
- Department of Orthopaedics, Foot and Ankle Service, University of São Paulo, São Paulo, SP, Brazil
| | - M C L Santos
- Department of Cell Biology, University Federal of Paraná, Curitiba, PR, Brazil.
- Universidade Federal Do Paraná, Centro Politécnico, Rua Francisco H. Dos Santos, Jd. das Américas, Curitiba PR, 81531-990, Brazil.
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Steinmann S, Pfeifer CG, Brochhausen C, Docheva D. Spectrum of Tendon Pathologies: Triggers, Trails and End-State. Int J Mol Sci 2020; 21:ijms21030844. [PMID: 32013018 PMCID: PMC7037288 DOI: 10.3390/ijms21030844] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/18/2020] [Accepted: 01/24/2020] [Indexed: 12/31/2022] Open
Abstract
The biggest compartment of the musculoskeletal system is the tendons and ligaments. In particular, tendons are dense tissues connecting muscle to bone that are critical for the integrity, function and locomotion of this system. Due to the increasing age of our society and the overall rise in engagement in extreme and overuse sports, there is a growing prevalence of tendinopathies. Despite the recent advances in tendon research and due to difficult early diagnosis, a multitude of risk factors and vague understanding of the underlying biological mechanisms involved in the progression of tendon injuries, the toolbox of treatment strategies remains limited and non-satisfactory. This review is designed to summarize the current knowledge of triggers, trails and end state of tendinopathies.
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Affiliation(s)
- Sara Steinmann
- Experimental Trauma Surgery, Department of Trauma Surgery, University Medical Center Regensburg, Am Biopark 9, 93053 Regensburg, Germany; (S.S.); (C.G.P.)
| | - Christian G. Pfeifer
- Experimental Trauma Surgery, Department of Trauma Surgery, University Medical Center Regensburg, Am Biopark 9, 93053 Regensburg, Germany; (S.S.); (C.G.P.)
- Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Christoph Brochhausen
- Institute of Pathology, University Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany;
| | - Denitsa Docheva
- Experimental Trauma Surgery, Department of Trauma Surgery, University Medical Center Regensburg, Am Biopark 9, 93053 Regensburg, Germany; (S.S.); (C.G.P.)
- Department of Medical Biology, Medical University-Plovdiv, 15A Vassil Aprilov Blvd., 4002 Plovdiv, Bulgaria
- Correspondence: ; Tel.: +49 941 943-1605
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He Y, Feng Z, Wang W, Chen Y, Cheng J, Meng J, Yang H, Wang Y, Yao X, Feng Q, Chen L, Zhang H, Wang MHT, Zee BCY, Wang X, He ML. Global cytokine/chemokine profile identifies potential progression prediction indicators in hand-foot-and-mouth disease patients with Enterovirus A71 infections. Cytokine 2019; 123:154765. [PMID: 31255913 DOI: 10.1016/j.cyto.2019.154765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/27/2019] [Accepted: 06/18/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE New clinical indicators are urgently needed for predicting the progression and complications of hand-foot-and-mouth disease (HFMD) caused by EV-A71 infections. MATERIALS AND METHODS Serum specimens from 132 EV-A71 HFMD patients and 73 health children were collected during 2012-2014 in Shenzhen, China. The specific cytokines/chemokines were detected with a 274-human cytokine antibody array, followed by a 38-inflammation cytokine array, and further validated by ELISA. RESULTS Cytokines varied in different severity of EV-A71 HFMD patients. The ROC curve analysis revealed 5 serum cytokines with high sensitivity and specificity in predicting the disease progression. Eotaxin, IL-8 and IP-10 have showed high AUC values (0.90-0.95) for discrimination between the health controls and the patient group. The three cytokines showed high sensitivity (80-91%) and specificity (88-95%). MMP-8 had a high sensitivity and specificity to predict mild HFMD (100%, 100%). IL-1b and leptin discriminated the severe/critical group from the mild group (79% and 69% in sensitivity, 73% and 63% in specificity). CONCLUSIONS Eotaxin, IP-10 and IL-8 could be potential indicators for predicting HFMD progression with EV-A71 infection. MMP-8 is a specific indicator for mild infection, while IL-1b and leptin display potential for predicting the severity and criticality.
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Affiliation(s)
- Yaqing He
- Major Infectious Disease Control Key Laboratory, The Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
| | - Zhuoying Feng
- Department of Biomedical Science, The City University of Hong Kong, China
| | - Wei Wang
- Department of Biomedical Science, The City University of Hong Kong, China
| | - Ying Chen
- Department of Biomedical Science, The City University of Hong Kong, China
| | - Jinquan Cheng
- Major Infectious Disease Control Key Laboratory, The Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
| | - Jun Meng
- Major Infectious Disease Control Key Laboratory, The Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
| | - Hong Yang
- Major Infectious Disease Control Key Laboratory, The Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
| | - Yujie Wang
- The Zhenzhou Hospital of Traditional Chinese Medicine, Zhenzhou, Henan Province, China
| | - Xiangjie Yao
- Major Infectious Disease Control Key Laboratory, The Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
| | - Qianjin Feng
- The Cancer Institute, Zhongshan People's Hospital, Zhongshan, Guangdong Province, China
| | - Long Chen
- Major Infectious Disease Control Key Laboratory, The Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
| | - Hailong Zhang
- Major Infectious Disease Control Key Laboratory, The Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
| | - Maggie H T Wang
- The Cancer Institute, Zhongshan People's Hospital, Zhongshan, Guangdong Province, China; Division of Biostatistics, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; The CUHK Shenzhen Research Institute, Shenzhen, China
| | - Benny C Y Zee
- The Cancer Institute, Zhongshan People's Hospital, Zhongshan, Guangdong Province, China; Division of Biostatistics, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; The CUHK Shenzhen Research Institute, Shenzhen, China
| | - Xin Wang
- The CityU Shenzhen Research Institute, Shenzhen, Guangdong Province, China
| | - Ming-Liang He
- Department of Biomedical Science, The City University of Hong Kong, China; The CityU Shenzhen Research Institute, Shenzhen, Guangdong Province, China.
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Lulińska-Kuklik E, Rahim M, Moska W, Maculewicz E, Kaczmarczyk M, Maciejewska-Skrendo A, Ficek K, Cieszczyk P, September AV, Sawczuk M. Are MMP3, MMP8 and TIMP2 gene variants associated with anterior cruciate ligament rupture susceptibility? J Sci Med Sport 2019; 22:753-757. [PMID: 30755371 DOI: 10.1016/j.jsams.2019.01.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Anterior cruciate ligament rupture (ACLR) is a common and severe knee injury which typically occurs as a result of sports participation, primarily via a non-contact mechanism. A number of extrinsic and intrinsic risk factors, including genetics, have been identified thus far. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteases (TIMPs) play a crucial role in extracellular matrix remodeling of ligaments and therefore the genes encoding MMPs and TIMPs are plausible candidates for investigation with ACL rupture risk. DESIGN A case-control genetic association study was conducted on 229 (158 male) individuals with surgically diagnosed primary ACLR, ruptured through non-contact mechanisms and 192 (107 male) apparently healthy participants (CON) without any history of ACLR. All participants were physically active, unrelated, self-reported Caucasians. METHODS All participants were genotyped for four single nucleotide polymorphisms (SNP): MMP3 (rs591058C/T, rs679620 G/A), MMP8 (rs11225395C/T), and TIMP2 (rs4789932 G/A) using standard PCR assays. Gene-gene interactions were inferred. Single-locus association analysis was conducted using the Chi-square test. SNP-SNP interaction effects were analysed using multifactor dimensionality reduction (MDR) method. RESULTS Genotype frequencies did not significantly differ between cases and controls, however, the MMP3 rs679620 G and rs591058C alleles were significantly overrepresented in cases compared to controls (p=0.021, OR=1.38, 95% CI: 1.05-1.81). CONCLUSIONS These results support the hypothesis that genetic variation within MMP3 contributes to inter-individual susceptibility to non-contact ACLR. However, these results need to be explored further in larger, independent sample sets.
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Affiliation(s)
- Ewelina Lulińska-Kuklik
- Faculty of Tourism and Recreation, Gdansk University of Physical Education and Sport, Poland
| | - Masouda Rahim
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Waldemar Moska
- Faculty of Tourism and Recreation, Gdansk University of Physical Education and Sport, Poland
| | - Ewelina Maculewicz
- Applied Physiology Unit, Military Institute of Hygiene and Epidemiology, Poland
| | - Mariusz Kaczmarczyk
- Faculty of Tourism and Recreation, Gdansk University of Physical Education and Sport, Poland
| | | | - Krzysztof Ficek
- Faculty of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland
| | - Pawel Cieszczyk
- Applied Physiology Unit, Military Institute of Hygiene and Epidemiology, Poland; Faculty of Physical Education, Gdansk University of Physical Education and Sport, Poland
| | - Alison V September
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Marek Sawczuk
- Faculty of Tourism and Recreation, Gdansk University of Physical Education and Sport, Poland
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Abstract
Adult-acquired flatfoot deformity (AAFD) comprises a wide spectrum of ligament and tendon failure that may result in significant deformity and disability. It is often associated with posterior tibial tendon deficiency (PTTD), which has been linked to multiple demographic factors, medical comorbidities, and genetic processes. AAFD is classified using stages I through IV. Nonoperative treatment modalities should always be attempted first and often provide resolution in stages I and II. Stage II, consisting of a wide range of flexible deformities, is typically treated operatively with a combination of soft tissue procedures and osteotomies. Stage III, which is characterized by a rigid flatfoot, typically warrants triple arthrodesis. Stage IV, where the flatfoot deformity involves the ankle joint, is treated with ankle arthrodesis or ankle arthroplasty with or without deltoid ligament reconstruction along with procedures to restore alignment of the foot. There is limited evidence as to the optimal procedure; thus, the surgical indications and techniques continue to be researched.
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Affiliation(s)
- Jensen K. Henry
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Rachel Shakked
- Department of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, USA
| | - Scott J. Ellis
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA
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10
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Pontin PA, Nogara PRB, Fonseca FCP, Cesar Netto C, Carvalho KC, Soares Junior JM, Baracat EC, Fernandes TD, Maffulli N, Santos MCL, Godoy-Santos AL. ERα PvuII and XbaI polymorphisms in postmenopausal women with posterior tibial tendon dysfunction: a case control study. J Orthop Surg Res 2018; 13:316. [PMID: 30537990 PMCID: PMC6290490 DOI: 10.1186/s13018-018-1020-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/26/2018] [Indexed: 02/05/2023] Open
Abstract
Background Posterior tibial tendon (PTT) insufficiency is considered as the main cause of adult acquired flat foot and is three times more frequent in females. High estrogen levels exert a positive effect on the overall collagen synthesis in tendons. We have previously demonstrated the association between some genetic single-nucleotide polymorphism (SNP) and tendinopathy. In the present study, we investigated the association of PvuII c454-397T>C (NCBI ID: rs2234693) and XbaI c454-351A>G (NCBI ID: rs9340799) SNPs in estrogen receptor alfa (ER-α) gene with PPT dysfunction. Methods A total of 92 female subjects with PTT dysfunction, with histopathological examination of the tendon and magnetic resonance image (MRI) evidence of tendinopathy, were compared to 92 asymptomatic females who presented an intact PPT at MRI for PvuII and XbaI SNPs in the ER-α gene. Genomic DNA was extracted from saliva and genotypes were obtained by polymerase chain reaction restriction fragment length polymorphism. Results The analysis of PvuII SNPs showed no significant differences in the frequency of alleles and genotypes between control and PTT dysfunction groups. The XbaI SNPs in the ER-α gene showed significant differences in the frequency of genotypes between control and test groups (p = 0.01; OR 95% 1.14 (0.55–2.33). Conclusions The XbaI SNP in the ERα gene may contribute to tendinopathy, and the A/A genotype could be a risk factor for PTT tendinopathy in this population. The PvuII SNP studied was not associated with PTT tendinopathy.
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Affiliation(s)
- P A Pontin
- Department of Orthopaedic and Traumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - P R B Nogara
- Department of Cell Biology, University Federal of Paraná, Curitiba, PR, Brazil
| | - F C P Fonseca
- Department of Orthopaedic and Traumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - C Cesar Netto
- Department of Orthopedic, Hospital for Special Surgery, New York, USA
| | - K C Carvalho
- Department of Gynecology, University of São Paulo, São Paulo, SP, Brazil
| | - J M Soares Junior
- Department of Gynecology, University of São Paulo, São Paulo, SP, Brazil
| | - E C Baracat
- Department of Gynecology, University of São Paulo, São Paulo, SP, Brazil
| | - T D Fernandes
- Department of Orthopaedic and Traumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - N Maffulli
- Department of Orthopaedics, School of Medicine, Surgery and Dentistry, Salerno, Italy. .,Institute of Science and Technology in Medicine, Keele University School of Medicine, Stoke-on-Trent, UK. .,Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Road, London, E1 4NS, UK.
| | - M C L Santos
- Department of Cell Biology, University Federal of Paraná, Curitiba, PR, Brazil
| | - A L Godoy-Santos
- Department of Orthopaedic and Traumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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12
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de Araujo Munhoz FB, Baroneza JE, Godoy-Santos A, Fernandes TD, Branco FP, Alle LF, de Souza RL, dos Santos MCLG. Posterior tibial tendinopathy associated with matrix metalloproteinase 13 promoter genotype and haplotype. J Gene Med 2016; 18:325-330. [DOI: 10.1002/jgm.2934] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 11/16/2016] [Accepted: 11/20/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - José Eduardo Baroneza
- Department of Cell Biology; University Federal of Paraná; Curitiba Puerto Rico Brazil
| | - Alexandre Godoy-Santos
- Department of Orthopedics and Traumatology; University of São Paulo; São Paulo SP Brazil
| | - Túlio Diniz Fernandes
- Department of Orthopedics and Traumatology; University of São Paulo; São Paulo SP Brazil
| | | | - Lupe Furtado Alle
- Department of Genetic; University Federal of Paraná; Curitiba Puerto Rico Brazil
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13
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September A, Rahim M, Collins M. Towards an Understanding of the Genetics of Tendinopathy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 920:109-16. [PMID: 27535252 DOI: 10.1007/978-3-319-33943-6_9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
To date, more than 18 genomic intervals, which underpin the complex myriad of extracellular matrix interactions of tendons, have been implicated in risk models for tendinopathy. It is these relationships that most likely regulate the tissue's response to loading and unloading, thereby dictating the overall capacity of tendons and influencing injury susceptibility. The evidence suggesting a genetic contribution to the susceptibility of sustaining a tendon injury is growing. However, only a few of the loci have been repeated in independent studies, of which some have included a range of musculoskeletal soft tissues injuries. Case-control study designs can be effective in capturing risk, provided that the cases and controls are equally well-defined and carefully considered. The genome consists of 3.6 × 10(9) sequences and therefore we realise that we are far from decoding all the genomic signatures. We are indeed fortunate to be living in such exciting times where high-throughput technologies are at our disposal. Through collaboration, our chances of harnessing these "omics" technologies to further our clinical understanding of tendinopathy will increase.
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Affiliation(s)
- Alison September
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, 115, Newlands, 7725, South Africa.
| | - Masouda Rahim
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, 115, Newlands, 7725, South Africa
| | - Malcolm Collins
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, 115, Newlands, 7725, South Africa
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Burger MC, De Wet H, Collins M. Matrix metalloproteinase genes on chromosome 11q22 and risk of carpal tunnel syndrome. Rheumatol Int 2015; 36:413-9. [DOI: 10.1007/s00296-015-3385-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022]
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Baroneza JE, Godoy-Santos A, Ferreira Massa B, Boçon de Araujo Munhoz F, Diniz Fernandes T, Leme Godoy dos Santos MC. MMP-1 promoter genotype and haplotype association with posterior tibial tendinopathy. Gene 2014; 547:334-7. [PMID: 24995609 DOI: 10.1016/j.gene.2014.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 06/16/2014] [Accepted: 07/01/2014] [Indexed: 01/22/2023]
Abstract
PURPOSE Posterior tibial tendon (PTT) is particularly vulnerable and its insufficiency is recognized as the main cause of adult acquired flatfoot. Some patients have a predisposition without clinically recognized cause, suggesting that individual characteristics play an important role in tendinopathy. The objective of the present study is to investigate the association of -519 (rs1144393) matrix metalloproteinase-1 (MMP-1) polymorphism and the -1607 (rs1799750) and -519 MMP-1 haplotypes and risk of PTT dysfunction. METHODS The test group included 50 females who presented PTT dysfunction Grade 2 or 3, and who were submitted to surgical treatment, with histopathological examination of the tendon and magnetic resonance image (MRI) confirming tendinopathy, while the control group was 100 asymptomatic women who present intact PTT at MRI. We analyzed functional polymorphisms MMP-1 and their haplotypes using polymerase chain reaction and restriction fragment length analysis. RESULTS There was a significant difference in the presence of the different alleles and genotypes between the control group and test group for the MMP-1 gene (p≤0.01). The G allele of the -519 MMP-1 polymorphism increased susceptibility to degeneration in the PTT tendon and seems to be a genetic risk factor. Global haplotype analysis indicated a significant difference between both groups (p<0.0001). Haplotypes G-2G and A-2G had statistically significant risk effect on PTT insufficiency. G-2G, p<0.001; OR=5.72 (CI, 2.84-11.52) and A-2G p=0.002, OR=3.95 (CI, 1.65-9.44). CONCLUSION According to our results, -519 MMP-1 isolated and -1607/-519 MMP-1 haplotypes are associated to tendinopathy in posterior tibial tendon.
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Affiliation(s)
| | - Alexandre Godoy-Santos
- Department of Orthopedics and Traumatology, University of São Paulo, São Paulo, SP, Brazil
| | - Bruno Ferreira Massa
- Department of Orthopedics and Traumatology, University of São Paulo, São Paulo, SP, Brazil
| | | | - Túlio Diniz Fernandes
- Department of Orthopedics and Traumatology, University of São Paulo, São Paulo, SP, Brazil
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Sanhudo JAV, Gomes JLE. Association between leg length discrepancy and posterior tibial tendon dysfunction. Foot Ankle Spec 2014; 7:119-26. [PMID: 24525616 DOI: 10.1177/1938640014522096] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Leg length discrepancy (LLD) is associated with a variety of orthopaedic disorders and biomechanical gait changes that involve possible overload of the posterior tibial tendon (PTT). In view of the biomechanical disturbances induced by LLD, an association may exist between LLD and PTT dysfunction (PTTD). PURPOSE To compare the frequency and magnitude of LLD between subjects with and without PTTD and ascertain whether associations exist between clinical features and presence of dysfunction. STUDY DESIGN Case-control study. METHODS A total of 118 patients with a diagnosis of PTTD were seen between January 2009 and September 2012 and compared with 118 gender-matched and race-matched volunteers. The frequency of LLD, the mean absolute LLD, and the mean relative LLD were measured by conventional (radiographic) or computed tomography scanography and compared between cases and controls. RESULTS The prevalence of LLD and mean absolute and relative LLD values were significantly greater in the case group (94.9%, 5.64 mm and 7.36%, respectively) than in the control group (79.7%, 3.28 mm and 4.18%, respectively) (P < .001). CONCLUSION The findings of this study demonstrate a relationship between LLD and PTTD. In light of the major biomechanical changes it induces, LLD may be a predisposing factor for development of PTTD.
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Godoy-Santos A, Cunha MV, Ortiz RT, Fernandes TD, Mattar R, dos Santos MCLG. MMP-1 promoter polymorphism is associated with primary tendinopathy of the posterior tibial tendon. J Orthop Res 2013; 31:1103-7. [PMID: 23389922 DOI: 10.1002/jor.22321] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 01/10/2013] [Indexed: 02/04/2023]
Abstract
Posterior tibial tendon (PTT) dysfunction is recognized as an etiology leading to acquired flatfoot in adults, causing significant functional loss. Many risk factors and systemic conditions have been proposed in literature. However, many patients present PTT dysfunction without any of these characteristics. This suggests that there could be a genetic influence associated with posterior tibial tendinopathy. The purpose of the present study is to investigate the association of the -1607 polymorphism in the promoter gene of MMP-1 and posterior tibial tendinopathy. The test group included 50 women, who presented PTT dysfunction grade 2 or 3, and who were submitted to surgical treatment, with histopathological examination of the tendon and magnetic resonance image (MRI) confirming tendinopathy, while the control group was 100 asymptomatic women who presented intact PTT at MRI. The results were analyzed using the chi-square test. The data showed a 75% incidence of the allele 1G and 62% of the genotype 1G/1G at the control group while, at the test group, they showed a 78% incidence of the allele 2G and 72% of the genotype 2G/2G (p < 0.001). The -1607 polymorphism of promoter gene of MMP-1 is associated with the posterior tibial tendinopathy in the studied population.
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Affiliation(s)
- Alexandre Godoy-Santos
- Department of Orthopedics and Traumatology, University of São Paulo, Rua Ovídio Pires de Campos, 333, Cerqueira Cesar, São Paulo, SP 05403-010, Brazil.
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