Healthcare and Scientific Treatment of Knee Osteoarthritis

Knee osteoarthritis: A review of animal models and intervention of traditional Chinese medicine

BACKGROUND

Knee osteoarthritis (KOA) characterized by degeneration of knee cartilage and subsequent bone hyperplasia is a prevalent joint condition primarily affecting aging adults. The pathophysiology of KOA remains poorly understood, as it involves complex mechanisms that result in the same outcome. Consequently, researchers are interested in studying KOA and require appropriate animal models for basic research. Chinese herbal compounds, which consist of multiple herbs with diverse pharmacological properties, possess characteristics such as multicomponent, multipathway, and multitarget effects. The potential benefits in the treatment of KOA continue to attract attention.

PURPOSE

This study aims to provide a comprehensive overview of the advantages, limitations, and specific considerations in selecting different species and methods for KOA animal models. This will help researchers make informed decisions when choosing an animal model.

METHODS

Online academic databases (e.g., PubMed, Google Scholar, Web of Science, and CNKI) were searched using the search terms "knee osteoarthritis," "animal models," "traditional Chinese medicine," and their combinations, primarily including KOA studies published from 2010 to 2023.

RESULTS

Based on literature retrieval, this review provides a comprehensive overview of the methods of establishing KOA animal models; introduces the current status of advantages and disadvantages of various animal models, including mice, rats, rabbits, dogs, and sheep/goats; and presents the current status of methods used to establish KOA animal models.

CONCLUSION

This study provides a review of the animal models used in recent KOA research, discusses the common modeling methods, and emphasizes the role of traditional Chinese medicine compounds in the treatment of KOA.

Plasma microRNA-320c as a Potential Biomarker for the Severity of Knee Osteoarthritis and Regulates cAMP Responsive Element Binding Protein 5 (CREB5) in Chondrocytes

Objective

Osteoarthritis (OA) is a commonly known prevalent joint disease, with limited therapeutic methods. This study aimed to investigate the expression of plasma microRNA-320c (miR-320c) in patients with knee OA and to explore the clinical value and potential mechanism of miR-320c in knee OA.

Methods

Forty knee OA patients and 20 healthy controls were enrolled. The levels of plasma miR-320c and plasma inflammatory cytokines were measured by real-time PCR or ELISA. Correlations of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and cytokine levels with the miR-320c expression level were evaluated by Pearson correlation analysis. Then, a receiver operating characteristic (ROC) curve was drawn to analyse the diagnostic value of miR-320c in OA. Finally, the interaction of miR-320c and cAMP responsive element binding protein 5 (CREB5) was determined using a luciferase reporter assay, and the effect of CREB5 on the cAMP pathway was assessed.

Results

The expression level of plasma miR-320c was significantly higher in OA patients than in healthy controls (p  < 0.05). The increased plasma miR-320c level was positively correlated with the WOMAC score (r = 0.796, p  < 0.001) and the plasma interleukin (IL)-1β (r = 0.814, p  < 0.001) and IL-6 (r = 0.695, p  < 0.001) levels in patients with OA. ROC curve analysis demonstrated the relatively high diagnostic accuracy of plasma miR-320c for OA. Furthermore, the luciferase reporter assay results showed that miR-320c regulates CREB5 expression by binding to the CREB5 3'-untranslated region. Moreover, suppression of CREB5 significantly reduced the expression levels of c-fos and c-jun.

Conclusion

Our results indicate that plasma miR-320c may serve as a potential novel predictor of the severity of knee OA and that miR-320c may play an important role in the pathogenesis of OA through inhibiting the cAMP pathway by targeting CREB5.

Diacerein plus glucosamine hydrochloride improves the safety and efficacy and inhibit inflammatory factors in the treatment of knee osteoarthritis

OBJECTIVES

The aim of this study is to elucidate the safety and efficacy of diacerein (DIA) plus glucosamine hydrochloride (GlcN·HCl) in the treatment of knee osteoarthritis (KOA) and their effect on inflammatory factors (IFs).

METHODS

Retrospectively, 116 KOA patients admitted between August 2018 and August 2021 were selected. Among them, 55 cases received DIA monotherapy (control group, Con) and 61 cases received DIA + GlcN·HCl (observation group, Obs). The efficacy, safety, scores of Lequesne Index, and Visual Analogue Scale (VAS), as well as the levels of IFs of the two groups were observed and compared. Further, Cox regression was used to perform an in-depth analysis of factors influencing the occurrence of complications in patients with KOA.

RESULTS

The analyses revealed a higher overall response rate and a lower adverse event rate in the Obs group compared with the Con group, with statistical significance. Decreased scores of Lequesne Index and VAS and levels of IFs were determined in the Obs after treatment, which were all significantly lower compared with those of the Con. Cox regression analysis identified that TNF-α, IL-1β, hs-CRP, and treatment mode affected the occurrence of complications in KOA patients.

CONCLUSIONS

DIA + GlcN·HCl can significantly inhibit the inflammation level in KOA, with definite curative effects and a favorable safety profile.

A Simple Nomogram for Predicting Osteoarthritis Severity in Patients with Knee Osteoarthritis

Objective

To explore the influencing factors of knee osteoarthritis (KOA) severity and establish a KOA nomogram model.

Methods

Inpatient data collected in the Department of Joint Surgery, Chengde Medical University Affiliated Hospital from January 2020 to January 2022 were used as the training cohort. Patients with knee osteoarthritis who were admitted to the Third Hospital of Hebei Medical University from February 2022 to May 2022 were taken as the external validation group of the model. In the training group, the least absolute shrinkage and selection operator (LASSO) method was used to screen the factors of KOA severity to determine the best prediction index. Then, after combining the significant factors from the LASSO and multivariate logistic regressions, a prediction model was established. All potential prediction factors were included in the KOA severity prediction model, and the corresponding nomogram was drawn. The consistency index (C-index), area under the receiver operating characteristic (ROC) curve (AUC), GiViTi calibration band, net classification improvement (NRI) index, and integrated discrimination improvement (IDI) index evaluation of a model predicted KOA severity. Decision curve analysis (DCA) and clinical influence curves were used to study the model's potential clinical value. The validation group also used the above evaluation indexes to measure the diagnostic efficiency of the model. Spearman correlation was used to investigate the relationship between nomogram-related markers and osteoarthritis severity.

Results

The total sample included 572 patients with knee osteoarthritis, including 400 patients in the training cohort and 172 patients in the validation cohort. The nomogram's predictive factors were age, pulse, absolute value of lymphocytes, mean corpuscular haemoglobin concentration (MCHC), and blood urea nitrogen (BUN). The C-index and AUC of the model were 0.802. The GiViTi calibration band (P = 0.065), NRI (0.091), and IDI (0.033) showed that the modified model can distinguish between severe KOA and nonsevere KOA. DCA showed that the KOA severity nomogram has clinical application value with threshold probabilities between 0.01 and 0.78. The external verification results also show the stability and diagnosis of the model. Age, pulse, MCHC, and BUN are correlated with osteoarthritis severity.

Conclusions

A nomogram model for predicting KOA severity was established for the first time that can visually identify patients with severe KOA and is novel for indirectly evaluating KOA severity by nonimaging means.

Colchicine versus Physical Therapy in Knee Osteoarthritis

Background: The treatment of osteoarthritis remains a major challenge due to the unavailability of a disease-modifying medication and the limitations of current therapeutic perspectives, which mainly target the symptoms, not the disease itself. The purpose of our study is to compare the efficacy of colchicine treatment versus physical therapy. Methods: The study included 62 patients diagnosed with knee osteoarthritis (KOA) according to the American College of Rheumatology (ACR) criteria, hospitalized within the time frame of October 2020−March 2022 in the Department of Rehabilitation Medicine and Physical Therapy of the Emergency Clinical County Hospital of Craiova. The participants were randomly divided into two groups. The observation period was 16 weeks long. The first group (31 patients) received colchicine at a dosage of 1 mg/day together with analgesics (acetaminophen < 2 g/day), while the second group (31 patients) received analgesics (acetaminophen < 2 g/day) together with a 16-week plan of physiotherapy. Results: Group II, in which patients underwent physical therapy, demonstrated a statistically significant decrease in both left (p < 0.001) and right (p = 0.012) knee VAS and WOMAC (p = 0.038) scores at 16 weeks, compared to the group treated with colchicine. Regarding the MSUS examination at 16 weeks, there were no significant changes in the structural abnormalities and no improvement in cartilage aspect or thickness. Higher BMI was associated with higher WOMAC score (p = 0.012), but not with higher VAS score (p = 0.062). Cholesterol and triglyceride levels were associated with high WOMAC (p < 0.001; p = 0.021) and high VAS (p = 0.023; p < 0.001) scores. Conclusions: Our study monitored VAS and WOMAC scores in two groups of patients with KOA, showing that physical therapy is more effective than colchicine in reducing symptoms. We found no statistically significant difference in musculoskeletal ultrasound (MSUS) feature improvement during the 16-week study.