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Buchanan WW, Kean CA, Kean WF, Rainsford KD. Osteoarthritis. Inflammopharmacology 2024; 32:13-22. [PMID: 37195499 DOI: 10.1007/s10787-023-01223-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/27/2023] [Indexed: 05/18/2023]
Abstract
The clinical appearance and radiological pattern of osteoarthritis have been identified in the skeletons of dinosaurs some 50-70 million years old, and in Egyptian mummies, and in ancient skeletons in England. Osteoarthritis patterns of joint involvement, often referred to as primary osteoarthritis, can be seen in the hands, spinal facet joints, hips, knees and feet, but can also be termed secondary osteoarthritis when seen in any joint that has had trauma, sepsis, surgery or metabolic insult. The prevalence of osteoarthritis increases with age. The histology and pathophysiology both demonstrate an inflammatory process. While there have been studies of genetic predisposition, the basic cause of primary osteoarthritis has not been determined.
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Affiliation(s)
- W Watson Buchanan
- Department of Medicine, McMaster University, Hamilton, ON, L8N 3Z5, Canada
| | - Colin A Kean
- Haldimand War Memorial Hospital, 400 Broad Street, Dunnville, ON, N1A 2P7, Canada
| | - Walter F Kean
- Department of Medicine, McMaster University, Hamilton, ON, L8N 3Z5, Canada.
- Haldimand War Memorial Hospital, 400 Broad Street, Dunnville, ON, N1A 2P7, Canada.
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Ylitalo T, Finnilä MA, Gahunia HK, Karhula SS, Suhonen H, Valkealahti M, Lehenkari P, Hæggström E, Pritzker KP, Saarakkala S, Nieminen HJ. Quantifying Complex Micro-Topography of Degenerated Articular Cartilage Surface by Contrast-Enhanced Micro-Computed Tomography and Parametric Analyses. J Orthop Res 2019; 37:855-866. [PMID: 30737811 PMCID: PMC6518937 DOI: 10.1002/jor.24245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 01/29/2019] [Indexed: 02/04/2023]
Abstract
One of the earliest changes in osteoarthritis (OA) is a surface discontinuity of the articular cartilage (AC), and these surface changes become gradually more complex with OA progression. We recently developed a contrast enhanced micro-computed tomography (μCT) method for visualizing AC surface in detail. The present study aims to introduce a μCT analysis technique to parameterize these complex AC surface features and to demonstrate the feasibility of using these parameters to quantify degenerated AC surface. Osteochondral plugs (n = 35) extracted from 19 patients undergoing joint surgery were stained with phosphotungstic acid and imaged using μCT. The surface micro-topography of AC was analyzed with developed method. Standard root mean square roughness (Rq ) was calculated as a reference, and the Area Under Curve (AUC) for receiver operating characteristic analysis was used to compare the acquired quantitative parameters with semi-quantitative visual grading of μCT image stacks. The parameters quantifying the complex micro-topography of AC surface exhibited good sensitivity and specificity in identifying surface continuity (AUC: 0.93, [0.80 0.99]), fissures (AUC: 0.94, [0.83 0.99]) and fibrillation (AUC: 0.98, [0.88 1.0]). Standard Rq was significantly smaller compared with the complex roughness (CRq ) already with mild surface changes with all surface reference parameters - continuity, fibrillation, and fissure sum. Furthermore, only CRq showed a significant difference when comparing the intact surface with lowest fissure sum score. These results indicate that the presented method for evaluating complex AC surfaces exhibit potential to identify early OA changes in superficial AC and is dynamic throughout OA progression. © 2019 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. Society. 9999:1-12, 2019.
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Affiliation(s)
- Tuomo Ylitalo
- Research Unit of Medical Imaging, Physics and Technology, Faculty of MedicineUniversity of OuluOuluFinland,Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - Mikko A.J. Finnilä
- Research Unit of Medical Imaging, Physics and Technology, Faculty of MedicineUniversity of OuluOuluFinland,Department of Applied Physics University of Eastern FinlandKuopioFinland,Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
| | | | - Sakari S. Karhula
- Research Unit of Medical Imaging, Physics and Technology, Faculty of MedicineUniversity of OuluOuluFinland,Infotech OuluUniversity of OuluOuluFinland
| | - Heikki Suhonen
- Department of PhysicsUniversity of HelsinkiHelsinkiFinland
| | - Maarit Valkealahti
- Department of Surgery and Intensive CareUniversity of Oulu and Oulu University HospitalOuluFinland
| | - Petri Lehenkari
- Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland,Department of Surgery and Intensive CareUniversity of Oulu and Oulu University HospitalOuluFinland,Institute of Cancer Research and Translational Medicine, Department of Anatomy and Cell Biology, Faculty of MedicineUniversity of OuluOuluFinland
| | | | - Kenneth P.H. Pritzker
- Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada,Mount Sinai HospitalTorontoCanada
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of MedicineUniversity of OuluOuluFinland,Infotech OuluUniversity of OuluOuluFinland,Department of Diagnostic RadiologyOulu University HospitalOuluFinland
| | - Heikki J. Nieminen
- Research Unit of Medical Imaging, Physics and Technology, Faculty of MedicineUniversity of OuluOuluFinland,Department of PhysicsUniversity of HelsinkiHelsinkiFinland,Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada,Department of Neuroscience and Biomedical EngineeringAalto UniversityEspooFinland
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Therapeutic Effects of Ribunucleinate (Ribonucleotides) in Immuno-Inflammatory and Arthritic Diseases. ACTA ACUST UNITED AC 2015; 70:35-89. [PMID: 26462364 DOI: 10.1007/978-3-0348-0927-6_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Ribonucleic acids from different organs and from yeast have been used for the treatment of chronic and degenerative diseases in the context of naturopathic medicine in the last 60 years. This chapter provides general information about ribonucleinates as therapeutic agents. Past and present pharmacological and clinical investigations are discussed in the field of the central nervous system, sensory organs, cancer and degenerative diseases of joints and vertebra.
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Lach M, Trzeciak T, Richter M, Pawlicz J, Suchorska WM. Directed differentiation of induced pluripotent stem cells into chondrogenic lineages for articular cartilage treatment. J Tissue Eng 2014; 5:2041731414552701. [PMID: 25383175 PMCID: PMC4221915 DOI: 10.1177/2041731414552701] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/02/2014] [Indexed: 12/12/2022] Open
Abstract
In recent years, increases in the number of articular cartilage injuries caused by environmental factors or pathological conditions have led to a notable rise in the incidence of premature osteoarthritis. Osteoarthritis, considered a disease of civilization, is the leading cause of disability. At present, standard methods for treating damaged articular cartilage, including autologous chondrocyte implantation or microfracture, are short-term solutions with important side effects. Emerging treatments include the use of induced pluripotent stem cells, a technique that could provide a new tool for treatment of joint damage. However, research in this area is still early, and no optimal protocol for transforming induced pluripotent stem cells into chondrocytes has yet been established. Developments in our understanding of cartilage developmental biology, together with the use of modern technologies in the field of tissue engineering, provide an opportunity to create a complete functional model of articular cartilage.
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Affiliation(s)
- Michał Lach
- Radiobiology Laboratory, Greater Poland Cancer Centre, Poznan, Poland
| | - Tomasz Trzeciak
- Department of Orthopedics and Traumatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Richter
- Department of Orthopedics and Traumatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jarosław Pawlicz
- Department of Orthopedics and Traumatology, Poznan University of Medical Sciences, Poznan, Poland
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Scherer J, Rainsford KD, Kean CA, Kean WF. Pharmacology of intra-articular triamcinolone. Inflammopharmacology 2014; 22:201-17. [DOI: 10.1007/s10787-014-0205-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 04/15/2014] [Indexed: 12/16/2022]
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Adatia A, Rainsford KD, Kean WF. Osteoarthritis of the knee and hip. Part I: aetiology and pathogenesis as a basis for pharmacotherapy. ACTA ACUST UNITED AC 2012; 64:617-25. [PMID: 22471357 DOI: 10.1111/j.2042-7158.2012.01458.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Osteoarthritis (OA) of the knee and hip is among the most frequent and debilitating arthritic conditions. Aside from surgical intervention in severe cases, conventional treatment involves relieving painful symptoms with non-steroidal anti-inflammatory drugs (NSAIDs), narcotic and non-narcotic (weak) analgesics and physical therapy. To obtain insight into the extent of pathological changes in hip and knee OA we reviewed current literature on the pathogenesis of this state as a basis for current pharmacotherapy options. KEY FINDINGS Key features of the pathological joint changes in OA include: cartilage destruction by pro-inflammatory cytokines, matrix metalloproteinases and prostaglandins, which promote a catabolic environment; subchondral bone remodelling and resorption; hypertrophic differentiation of chondrocytes; neovascularisation of synovial tissue; and focal calcification of joint cartilage. Despite the central involvement of hyaline cartilage in OA pathogenesis, the source of pain likely stems from the richly innervated synovium, subchondral bone and periosteum components of the joint. Tissue damage during joint degeneration generates nociceptive stimuli. The presence of inflammatory mediators, including bradykinin, prostaglandins and leukotrienes, lowers the threshold of the Aδ and C pain fibres, resulting in a heightened response to painful stimuli. SUMMARY It is our opinion that it is important to base and centre the management of OA patients on the severity of patient-important outcomes, rather than purely an assessment of damage to the joint. The joint damage, as interpreted from radiographs, is not necessarily representative of the symptoms experienced. The management of OA primarily comprises pharmacological therapy, surgical interventions and various non-pharmacological interventions.
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Affiliation(s)
- Aleem Adatia
- Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
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The effect of hyaluronan injections into human knees on the number of bone and cartilage wear particles captured by bio-ferrography. Acta Biomater 2011; 7:848-57. [PMID: 20826234 DOI: 10.1016/j.actbio.2010.08.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 08/29/2010] [Accepted: 08/31/2010] [Indexed: 02/03/2023]
Abstract
Osteoarthritis is characterized by degradation of cartilage and subchondral bone, releasing wear particles into the synovial fluid. Intra-articular injections of exogenous hyaluronan are often given to patients suffering from osteoarthritis in order to compensate for the reduction in the level of endogenous hyaluronan and to restore the rheological properties of the synovial fluid. The exact effect of these injections is still ambiguous. In this work bio-ferrography was used to capture magnetically labeled cartilage and bone debris from the synovial fluid in human knees before each of four injections (Euflexxa). The wear particles were counted and characterized microscopically and chemically. WOMAC, VAS, SF-36 and KS questionnaires indicated significant pain relief during the treatment, but suffered from inconsistency. Bio-ferrography showed a reduction in the concentration of both cartilage and bone particles, with a minimum after the third hyaluronan injection. The advantages of bio-ferrography as a primary assessment tool are discussed. The results indicate that while hyaluronan treatment may temporarily slow the wear rate to an extent beyond a placebo effect, it does not prevent joint degradation altogether.
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Combe R, Bramwell S, Field MJ. The monosodium iodoacetate model of osteoarthritis: a model of chronic nociceptive pain in rats? Neurosci Lett 2005; 370:236-40. [PMID: 15488329 DOI: 10.1016/j.neulet.2004.08.023] [Citation(s) in RCA: 157] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Revised: 08/13/2004] [Accepted: 08/13/2004] [Indexed: 11/26/2022]
Abstract
Osteoarthritis (OA) is a widespread condition affecting the elderly population. One of the most prominent features but least studied symptoms is chronic pain associated with OA. The study objective was to determine pain endpoints in rats with monosodium iodoacetate (MIA) induced OA, and to investigate the efficacy of common nociceptive agents. Sprague-Dawley rats received an intraarticular injection of either 25 microl 80 mg/ml MIA or 25 microl 0.9% sterile saline into the right knee joint. Changes in von Frey thresholds and latencies to stroking with a cotton bud (punctate and dynamic allodynia, respectively) were measured pre- and for up to 10 weeks post-intraarticular injection. Changes in hind paw weight distribution were also determined. Both punctate allodynia and a weight bearing deficit were observed in MIA-treated rats for up to 10 weeks. Interestingly, dynamic allodynia was not detected at any time point tested. Morphine (0.3-3 mg/kg, s.c.) and tramadol (3-100 mg/kg, p.o.) dose-dependently inhibited punctate allodynia and partially reversed weight bearing deficit. In conclusion, the MIA model of OA is reproducible and mimics OA pain in humans. Analgesic drug studies indicate this model may be useful for investigating chronic nociceptive pain.
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Affiliation(s)
- Rachel Combe
- Pain Therapeutics, Pfizer Global Research and Development, Ramsgate Road, Sandwich, Kent CT139NJ, UK.
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Programme and Abstracts. Inflammopharmacology 2003. [DOI: 10.1163/156856003322699654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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