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Nourmahnad A, Javad Shariyate M, Khak M, Grinstaff MW, Nazarian A, Rodriguez EK. Relaxin as a treatment for musculoskeletal fibrosis: What we know and future directions. Biochem Pharmacol 2024; 225:116273. [PMID: 38729446 PMCID: PMC11179965 DOI: 10.1016/j.bcp.2024.116273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/23/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
Fibrotic changes in musculoskeletal diseases arise from the abnormal buildup of fibrotic tissue around the joints, leading to limited mobility, compromised joint function, and diminished quality of life. Relaxin (RLX) attenuates fibrosis by accelerating collagen degradation and inhibiting excessive extracellular matrix (ECM) production. Further, RLX disrupts myofibroblast activation by modulating the TGF-β/Smads signaling pathways, which reduces connective tissue fibrosis. However, the mechanisms and effects of RLX in musculoskeletal pathologies are emerging as increasing research focuses on relaxin's impact on skin, ligaments, tendons, cartilage, joint capsules, connective tissues, and muscles. This review delineates the actions of relaxin within the musculoskeletal system and the challenges to its clinical application. Relaxin shows significant potential in both in vivo and in vitro studies for broadly managing musculoskeletal fibrosis; however, challenges such as short biological half-life and sex-specific responses may pose hurdles for clinical use.
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Affiliation(s)
| | - Mohammad Javad Shariyate
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mohammad Khak
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia
| | - Edward K Rodriguez
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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2
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Aragón-Herrera A, Feijóo-Bandín S, Vázquez-Abuín X, Anido-Varela L, Moraña-Fernández S, Bravo SB, Tarazón E, Roselló-Lletí E, Portolés M, García-Seara J, Seijas J, Rodríguez-Penas D, Bani D, Gualillo O, González-Juanatey JR, Lago F. Human recombinant relaxin-2 (serelaxin) regulates the proteome, lipidome, lipid metabolism and inflammatory profile of rat visceral adipose tissue. Biochem Pharmacol 2024; 223:116157. [PMID: 38518995 DOI: 10.1016/j.bcp.2024.116157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024]
Abstract
Recombinant human relaxin-2 (serelaxin) has been widely proven as a novel drug with myriad effects at different cardiovascular levels, which support its potential therapeutic efficacy in several cardiovascular diseases (CVD). Considering these effects, together with the influence of relaxin-2 on adipocyte physiology and adipokine secretion, and the connection between visceral adipose tissue (VAT) dysfunction and the development of CVD, we could hypothesize that relaxin-2 may regulate VAT metabolism. Our objective was to evaluate the impact of a 2-week serelaxin treatment on the proteome and lipidome of VAT from Sprague-Dawley rats. We found that serelaxin increased 1 polyunsaturated fatty acid and 6 lysophosphatidylcholines and decreased 4 triglycerides in VAT employing ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) based platforms, and that regulates 47 phosphoproteins using SWATH/MS analysis. Through RT-PCR, we found that serelaxin treatment also caused an effect on VAT lipolysis through an increase in the mRNA expression of hormone-sensitive lipase (HSL) and a decrease in the expression of adipose triglyceride lipase (ATGL), together with a reduction in the VAT expression of the fatty acid transporter cluster of differentiation 36 (Cd36). Serelaxin also caused an anti-inflammatory effect in VAT by the decrease in the mRNA expression of tumor necrosis factor α (TNFα), interleukin-1β (IL-1β), chemerin, and its receptor. In conclusion, our results highlight the regulatory role of serelaxin in the VAT proteome and lipidome, lipolytic function, and inflammatory profile, suggesting the implication of several mechanisms supporting the potential benefit of serelaxin for the prevention of obesity and metabolic disorders.
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Affiliation(s)
- Alana Aragón-Herrera
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain.
| | - Sandra Feijóo-Bandín
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Xocas Vázquez-Abuín
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Laura Anido-Varela
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Sandra Moraña-Fernández
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Cardiology Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Susana B Bravo
- Proteomics Unit, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Estefanía Tarazón
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital, Valencia, Spain
| | - Esther Roselló-Lletí
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital, Valencia, Spain
| | - Manuel Portolés
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiocirculatory Unit, Health Research Institute of La Fe University Hospital, Valencia, Spain
| | - Javier García-Seara
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Arrhytmia Unit, Cardiology Department, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - José Seijas
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiology Department Clinical Trial Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Diego Rodríguez-Penas
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Cardiology Department Clinical Trial Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Daniele Bani
- Research Unit of Histology & Embryology, Department of Experimental & Clinical Medicine, University of Florence, Florence, Italy
| | - Oreste Gualillo
- Laboratory of Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - José Ramón González-Juanatey
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, IDIS, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Cardiology Department, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisca Lago
- Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
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Liu G, Li B, Qin S, Nice EC, Yang J, Yang L, Huang C. Redox signaling-mediated tumor extracellular matrix remodeling: pleiotropic regulatory mechanisms. Cell Oncol (Dordr) 2024; 47:429-445. [PMID: 37792154 DOI: 10.1007/s13402-023-00884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The extracellular matrix (ECM), a fundamental constituent of all tissues and organs, is crucial for shaping the tumor microenvironment. Dysregulation of ECM remodeling has been closely linked to tumor initiation and progression, where specific signaling pathways, including redox signaling, play essential roles. Reactive oxygen species (ROS) are risk factors for carcinogenesis whose excess can facilitate the oxidative damage of biomacromolecules, such as DNA and proteins. Emerging evidence suggests that redox effects can aid the modification, stimulation, and degradation of ECM, thus affecting ECM remodeling. These alterations in both the density and components of the ECM subsequently act as critical drivers for tumorigenesis. In this review, we provide an overview of the functions and primary traits of the ECM, and it delves into our current understanding of how redox reactions participate in ECM remodeling during cancer progression. We also discuss the opportunities and challenges presented by clinical strategies targeting redox-controlled ECM remodeling to overcome cancer. CONCLUSIONS The redox-mediated ECM remodeling contributes importantly to tumor survival, progression, metastasis, and poor prognosis. A comprehensive investigation of the concrete mechanism of redox-mediated tumor ECM remodeling and the combination usage of redox-targeted drugs with existing treatment means may reveal new therapeutic strategy for future antitumor therapies.
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Affiliation(s)
- Guowen Liu
- State Key Laboratory of Biotherapy and Cancer Center, Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, and , Chengdu, 610041, China
| | - Bowen Li
- State Key Laboratory of Biotherapy and Cancer Center, Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, and , Chengdu, 610041, China
| | - Siyuan Qin
- State Key Laboratory of Biotherapy and Cancer Center, Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, and , Chengdu, 610041, China
| | - Edouard C Nice
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC, 3800, Australia
| | - Jinlin Yang
- Department of Gastroenterology & Hepatology, West China Hospital of Sichuan University, Sichuan Province, No.37 Guoxue Alley, Chengdu, 610041, China.
- Department of Gastroenterology & Hepatology, Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
| | - Li Yang
- Department of Gastroenterology & Hepatology, West China Hospital of Sichuan University, Sichuan Province, No.37 Guoxue Alley, Chengdu, 610041, China.
- Department of Gastroenterology & Hepatology, Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
| | - Canhua Huang
- State Key Laboratory of Biotherapy and Cancer Center, Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, and , Chengdu, 610041, China.
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Rauseo ML, Feairheller DL, LaRoche DP, Cook SB. Acute Effect of Dynamic and Gluteal Resistance Exercise Warm-up Protocols on Jump Landing Mechanics in College-Aged Females. J Strength Cond Res 2024; 38:259-265. [PMID: 37815265 DOI: 10.1519/jsc.0000000000004618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Rauseo, ML, Feairheller, DL, LaRoche, DP, and Cook, SB. Acute effect of dynamic and gluteal resistance exercise warm-up protocols on lower-extremity jump landing mechanics in college-aged females. J Strength Cond Res 38(2): 259-265, 2024-Inadequate neuromuscular control of the femur by the gluteal musculature is associated with noncontact and overuse injuries to the knee. Acute bouts of resistance exercises targeting the gluteal musculature can be prescribed as part of a warm-up protocol with the goal of improving subsequent neuromuscular control and performance. The purpose of this study was to determine the effect that a warm-up protocol including moderate-intensity gluteal resistance exercises (GRE) has on single leg jump landing biomechanics. Seventeen healthy, college-aged, recreationally active females (mean ± SD ; age = 21.4 ± 1.9 years; height = 166.9 ± 5.7 cm; body mass = 62.5 ± 7.4 kg) performed 3 single leg hop trials per leg after completing no warm-up (CON), a dynamic warm-up (DWU), and a dynamic warm-up with gluteal resistance exercises (DWU + GRE) across 3 laboratory visits. Lower extremity kinetic and kinematic variables were assessed during single leg hops from the point of initial foot contact to deepest knee flexion. Biomechanical differences between dominant and nondominant limb landings were also assessed. Dominant limb hip internal rotation angle after DWU + GRE (2.03 ± 9.92°) was significantly greater ( p ≤ 0.05) compared with CON (-3.36 ± 7.74°). Peak knee adduction moment (56.8%), peak knee flexion angle (5.7%), and peak knee external rotation angle (17.0%) were significantly greater ( p ≤ 0.017) in the dominant limb, compared with the nondominant limb, across warm-up protocols. The combined DWU + GRE warm-up protocol did not have a substantial impact on landing biomechanics. Clinicians prescribing GRE before activity should not expect significant changes in movement patterns after a single bout.
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Affiliation(s)
- Matthew L Rauseo
- Biomechanics and Motor Control Laboratory, Department of Kinesiology, University of New Hampshire, Durham, New Hampshire
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Berger GK, Rockov ZA, Byrne C, Trentacosta NE, Stone MA. The role of relaxin in anterior cruciate ligament injuries: a systematic review. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:3319-3326. [PMID: 37300589 DOI: 10.1007/s00590-023-03618-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Anterior cruciate ligament (ACL) tears are exceedingly common among the athletic population and are seen with higher incidence in females. Observational studies have noted peak ACL tear rates in the luteal phase of the menstrual cycle, a time in which the hormone relaxin peaks in serum concentration. METHODS A systematic review of the literature was performed. Inclusion criteria specified all prospective and retrospective studies which included the role of relaxin in the pathogenesis of ACL tears. RESULTS Six studies met inclusion criteria yielding 189 subjects from clinical studies and 51 in vitro samples. Included studies found that ACL samples exhibit selective relaxin binding. When pre-treated with estrogen prior to relaxin exposure, female ACL tissue samples exhibit increased expression of collagen degrading receptors. CONCLUSION Relaxin displays binding specificity to the female ACL and increased serum concentrations are correlated with increased ACL tear rates in female athletes. Further research is needed in this area. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Garrett K Berger
- Department of Orthopaedic Surgery, University of California-San Diego, San Diego, CA, 92037, USA.
| | - Zachary A Rockov
- Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Connor Byrne
- Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Natasha E Trentacosta
- Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Michael A Stone
- Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Miro EW, Taylor E, Curtin A, Newman MG, Ose D, Knox J. Cumulative Incidence of All-Cause Knee Injury, Concussion, and Stress Fracture among Transgender Patients on Gender-Affirming Hormone Therapy: An Exploratory Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7060. [PMID: 37998291 PMCID: PMC10671107 DOI: 10.3390/ijerph20227060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
Previous research has shown a discrepancy in incidences of knee injuries, stress fractures, and concussions between cisgender men and women. Little is known regarding the incidence of musculoskeletal injuries among patients on gender-affirming hormone therapy (GAHT). This retrospective cohort study examines cumulative incidence of knee injuries, concussions, and stress fracture injuries among transgender patients on GAHT at one health system from 2011-2020. Using relevant ICD-9 and 10 codes, incidences of knee injury, concussion, and stress fracture were calculated. Cohorts included 1971 transgender and 3964 cisgender patients. Transgender patients had significantly higher incidence of all-cause knee injuries over the study period, 109 (5.5%) versus 175 (4.4%) (p < 0.001; OR: 2.14, 95% CI [1.17-3.92]). Subgroup analysis showed significantly higher incidence of knee injuries among cisgender men (5.6%) versus cisgender women (4.1%) (p = 0.042) and among transgender women (6.6%) versus cisgender women (4.1%) (p = 0.005). There were no significant differences between incidences of concussion and stress fracture between groups. This sample showed that patients on GAHT had increased cumulative incidences of all-cause knee injury compared to controls but similar cumulative incidences of concussion and bone-stress injuries. Transgender women on exogenous estrogen had significantly higher cumulative incidences of all-cause knee injuries compared to cisgender women.
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Affiliation(s)
- Emily W. Miro
- Division of Family Medicine, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
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Preszler JA, McInnis KC, Baute L, Tanaka MJ. Rehabilitation of anterior knee pain in the pregnant athlete: Considerations and modifications by trimester. Phys Ther Sport 2023; 60:34-46. [PMID: 36641951 DOI: 10.1016/j.ptsp.2023.01.001] [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: 09/16/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND Anterior knee pain is a common symptom many females experience during pregnancy. There are several musculoskeletal changes that occur in anatomy and physiology throughout the course of pregnancy that impact the lower extremity kinetic chain. Pregnant athletes, recreational through competitive, who attempt to maintain a high activity level through each trimester may be at increased risk for anterior knee pain due to a greater demand for lumbopelvic and hip stabilization. CLINICAL QUESTION What are the evidence-driven rehabilitation guidelines and specific modifications needed to treat anterior knee pain in the female athlete during each trimester of pregnancy? KEY RESULTS We aim to provide an overview of rehabilitation treatment guidelines for pregnant females with anterior knee pain, presenting specific physiological changes and rationale for modifications, discussed by trimester. We recommend our program be conducted under the supervision of a physical therapist working closely with the athlete's obstetrics and sports medicine team. CLINICAL APPLICATION The number of women who are active during pregnancy is increasing. We provide an overview of the guidelines and considerations for treating women with anterior knee pain during a healthy and uneventful pregnancy.
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Affiliation(s)
- Jamie A Preszler
- Department of Sports Physical Therapy, Massachusetts General Hospital, Boston, MA, USA.
| | - Kelly C McInnis
- Division of Sports Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Lisa Baute
- Department of Obstetrics & Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Etiopathogenesis of Canine Cruciate Ligament Disease: A Scoping Review. Animals (Basel) 2023; 13:ani13020187. [PMID: 36670727 PMCID: PMC9855089 DOI: 10.3390/ani13020187] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
The spontaneous rupture of the cranial cruciate ligament in dogs remains a pathoetiologic puzzle. Despite much progress in research over the past years, the systemic and local mechanisms leading to ligament degeneration and structural failure remain largely obscure. This scoping review focuses on pathogenesis and aims at summarizing and interpreting today's knowledge on causes of canine cruciate ligament rupture, i.e., the multifactorial mechanisms leading to degenerative stifle joint disease with collagen matrix degeneration and structural failures. Thus, the initial view of traumatic ligament rupture, fostered by "wear and tear", has clearly been replaced by a new concept of systemic processes linked to progressive degenerative joint disease and ligament failure; thus, the term "cranial cruciate ligament disease" has been coined and is generally accepted. In addition, cruciate ligament rupture in people shares some similarities with the lesion in dogs; therefore, the review also includes comparative studies. The methods used were based on the PRISMA-ScR model (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews).
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Lulic-Kuryllo T, Greig Inglis J. Sex differences in motor unit behaviour: A review. J Electromyogr Kinesiol 2022; 66:102689. [DOI: 10.1016/j.jelekin.2022.102689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 10/15/2022] Open
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Cohn MR, DeFroda SF, Huddleston HP, Williams BT, Singh H, Vadhera A, Garrigues GE, Nicholson GP, Yanke AB, Verma NN. Does native glenoid anatomy predispose to shoulder instability? An MRI analysis. J Shoulder Elbow Surg 2022; 31:S110-S116. [PMID: 35378313 DOI: 10.1016/j.jse.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND It is unclear if native glenohumeral anatomic features predispose young patients to instability and if such anatomic risk factors differ between males and females. The purpose of this study was to compare glenoid and humeral head dimensions between patients with a documented instability event without bone loss to matched controls and to evaluate for sex-based differences across measurements. The authors hypothesized that a smaller glenoid width and glenoid surface area would be significant risk factors for instability, whereas humeral head width would not. METHODS A prospectively maintained database was queried for patients aged <21 years who underwent magnetic resonance imaging (MRI) for shoulder instability. Patients with prior shoulder surgery, bony Bankart, or glenoid or humeral bone loss were excluded. Patients were matched by sex and age to control patients who had no history of shoulder instability. Two blinded independent raters measured glenoid height, glenoid width, and humeral head width on sagittal MRI. Glenoid surface area, glenoid index (ratio of glenoid height to width), and glenohumeral mismatch ratio (ratio of humeral head width to glenoid width) were calculated. RESULTS A total of 107 instability patients and 107 controls were included (150 males and 64 females). Among the entire cohort, there were no differences in glenoid height, glenoid width, glenoid surface area, humeral head width, or glenoid index between patients with instability and controls. Overall, those with instability had a greater glenohumeral mismatch ratio (P = .029) compared with controls. When stratified by sex, female controls and instability patients showed no differences in any of the glenoid or humerus dimensions. However, males with instability had a smaller glenoid width by 3.5% (P = .017), smaller glenoid surface area by 5.2% (P = .015), and a greater glenohumeral mismatch ratio (P = .027) compared with controls. CONCLUSION Compared with controls, males with instability were found to have smaller glenoid width and surface area, and a glenoid width that was proportionally smaller relative to humeral width. In contrast, bony glenohumeral morphology did not appear to be a significant risk factor for instability among females. These sex-based differences suggest that anatomic factors may influence risk of instability for male and female patients differently.
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Affiliation(s)
- Matthew R Cohn
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Steven F DeFroda
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Hailey P Huddleston
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Brady T Williams
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Harsh Singh
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Amar Vadhera
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Grant E Garrigues
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Gregory P Nicholson
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Adam B Yanke
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Nikhil N Verma
- Division of Sports Medicine and Shoulder Surgery, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
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Tanaka MJ, Forman JM, Otwell AG, Frischmann LD, Jones LC, Szymanski LM. Characterization of knee dysfunction and related risk factors during pregnancy. PHYSICIAN SPORTSMED 2022; 50:78-83. [PMID: 33507121 DOI: 10.1080/00913847.2021.1882277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Knee pain can be a common complaint during pregnancy; however, the severity of symptoms and their associated risk factors have not been described. QUESTIONS/PURPOSES The aim of this study was to characterize knee-related dysfunction and describe risk factors in a general obstetric population. PATIENTS AND METHODS Patients in obstetric clinics completed the International Knee Documentation Committee (IKDC) questionnaire to assess their knee function, as well as the Pregnancy Physical Activity Questionnaire (PPAQ), a validated tool to assess physical activity. Age, weeks gestation, height, weight, and history of knee problems prior to pregnancy were analyzed to identify independent associations with IKDC score and determine predictors of knee dysfunction. RESULTS 310 patients were included in this study, of which 68, 111 and 131 were in their first, second and trimesters, respectively. Mean age of the total study group was 30.3 ± 5.5 years. Knee function decreased with each trimester, from a mean IKDC score of 88.9 ± 13.0 in the first trimester, 84.5 ± 16.8 in the second, and 82.0 ± 20.0 in the third, with corresponding decreases in activity levels of 258.5 ± 141.7, 254.0 ± 141.5, and 246.1 ± 156.6 MET-h/wk. Of the total study group, 26.1% had IKDC scores <75, including 13.2%, 25.2%, and 33.6% in the first, second and third trimesters. Risk factors for knee dysfunction included high activity levels of PPAQ ≥ 500 MET-h/wk (OR 2.8), history of knee problems (OR 2.7), age <25 years (OR 2.6), and BMI ≥ 30 kg/m2 (OR 1.9). CONCLUSION In our cohort, 26.1% of pregnant women reported severe knee dysfunction, and this was associated with high levels of activity, younger age, greater BMI, and history of knee problems. These findings may have implications for women who wish to maintain training and fitness during pregnancy. Future studies are recommended to assess the need for intervention, as well as to identify optimal methods to prevent and address symptoms in this population. LEVEL OF EVIDENCE IV, Case Series.
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Affiliation(s)
- Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jared M Forman
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Alexandra G Otwell
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Leah D Frischmann
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Lynne C Jones
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Linda M Szymanski
- Division of Maternal-Fetal Medicine, Mayo Clinic, Rochester, MD, USA
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Nédélec E, Foli E, Shultz SJ, Swinton PA, Dolan E, Enright K, Piasecki J, Matthews JJ, Sale C, Elliott-Sale KJ. Effect of menstrual cycle phase, menstrual irregularities and hormonal contraceptive use on anterior knee laxity and non-contact anterior cruciate ligament injury occurrence in women: a protocol for a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2021; 7:e001170. [PMID: 34745647 PMCID: PMC8559120 DOI: 10.1136/bmjsem-2021-001170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 11/16/2022] Open
Abstract
Exercising women report three to six times more ACL tears than men, which happen, in the majority of cases, with a non-contact mechanism. This sex disparity has, in part, been attributed to the differences in reproductive hormone profiles between men and women. Many studies have shown that anterior knee (AK) laxity and the rate of non-contact ACL injuries vary across the menstrual cycle, but these data are inconsistent. Similarly, several studies have investigated the potential protective effect of hormonal contraceptives on non-contact ACL injuries, but their conclusions are also variable. The purpose of this systematic review and meta-analysis is to, identify, evaluate and summarise the effects of endogenous and exogenous ovarian hormones on AK laxity (primary outcome) and the occurrence of non-contact ACL injuries (secondary outcome) in women. We will perform a systematic search for all observational studies conducted on this topic. Studies will be retrieved by searching electronic databases, clinical trial registers, author's personal files and cross-referencing selected studies. Risk of bias will be assessed using the Newcastle Ottawa Quality Assessment Scale for Cohort and Case-Control Studies. Certainty in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. The meta-analyses will use a Bayesian approach to address specific research questions in a more intuitive and probabilistic manner. This review is registered on the international database of prospectively registered systematic reviews (PROSPERO; CRD42021252365).
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Affiliation(s)
- Elisa Nédélec
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Elvis Foli
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Sandra J Shultz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Paul A Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Eimear Dolan
- Applied Physiology and Nutrition Research Group, Escola de Educação Física e Esporte, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | - Kevin Enright
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jessica Piasecki
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Joseph J Matthews
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Kirsty Jayne Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
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Idota M, Ishizuka S, Hiraiwa H, Yamashita S, Oba H, Kawamura Y, Sakaguchi T, Haga T, Mizuno T, Kawashima I, Kuriyama K, Imagama S. 4-Methylumbelliferone suppresses catabolic activation in anterior cruciate ligament-derived cells via a mechanism independent of hyaluronan inhibition. J Orthop Surg Res 2021; 16:507. [PMID: 34404442 PMCID: PMC8369759 DOI: 10.1186/s13018-021-02637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The anterior cruciate ligament (ACL) has a key role as a dynamic stabilizer of the knee joints, and ACL dysfunction caused by traumatic or degenerative rupture accelerates osteoarthritis progression. Thus, it is important to prevent the degenerative rupture of the ACL. 4-Methylumbelliferone (4-MU), a pre-approved drug, exerts anti-inflammatory effects in osteoarthritis chondrocytes. It was originally used as an inhibitor of hyaluronan synthesis in chondrocytes. METHODS In this study, we investigated whether 4-MU affects the expression of catabolic factors, such as matrix metalloproteinase (MMP)-1, MMP-3, and interleukin (IL)-6, in ACL-derived cells and ACL explant cultures using immunohistochemistry, real-time RT-qPCR, and capillary western immunoassay. Furthermore, the hyaluronan concentration was evaluated using a colorimetric assay. Statistical analyses were conducted using analysis of variance for multi-group comparisons, followed by Tukey or Tukey-Kramer post hoc test. RESULTS Our results revealed, for the first time, that 4-MU suppressed the IL-β-induced upregulation of pro-catabolic factors, such as MMP-1, MMP-3, and IL-6, in ACL-derived cells. This suppressive effect was also observed in the cultured ligament tissues in ex vivo experiments. 4-MU also reversed an enhanced dependence on glycolysis in IL-1β-activated ACL-derived cells. Furthermore, we found that the suppressive effects of 4-MU were exerted directly and not through the inhibition of hyaluronan synthesis. CONCLUSIONS We conclude that 4-MU could be an effective and useful treatment for knee osteoarthritis, owing to its anti-inflammatory effect on, not only chondrocytes but also on ligament cells.
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Affiliation(s)
- Masaru Idota
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Shinya Ishizuka
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan.
| | - Hideki Hiraiwa
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Satoshi Yamashita
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Hiroki Oba
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Yusuke Kawamura
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Takefumi Sakaguchi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Takahiro Haga
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Takafumi Mizuno
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Itaru Kawashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Kanae Kuriyama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
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14
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Current Concept Review: Inclusion and Analysis of Diverse Study Populations in Orthopaedic Research. J Am Acad Orthop Surg 2021; 29:e479-e487. [PMID: 33443389 DOI: 10.5435/jaaos-d-20-01087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/17/2020] [Indexed: 02/01/2023] Open
Abstract
As disparities in healthcare access and outcomes have been increasingly identified across medical specialties, the importance of recognizing and understanding the diversity of our patient populations and the influence of individual characteristics such as age, sex, gender, race, and ethnicity on clinical outcomes has been emphasized. Orthopaedic literature has advanced dramatically in the quality and quantity of research generated over the past 25 years, yet a consistent, sustained focus on studying musculoskeletal health in the context of these unique patient-specific variables has not been maintained. The result of this inattention may be the provision of orthopaedic care that is ill-suited for the individual patient whose biologic characteristics, life experiences, and cultural constructs differ from that of the typical research subject. The recent proliferation of meta-analyses-whose intention is to optimize statistical power-likely compounds the problem because improper, inconsistent, or absent categorization of patients in research articles precludes meaningful subgroup analysis. This article describes the current variability in demographic reporting in the orthopaedic literature, highlights the importance of complete, consistent demographic reporting and subgroup analysis, and reviews specific examples of orthopaedic conditions that illustrate how clinical outcomes may be affected by patient-specific variables such as age, sex, gender, race, and ethnicity.
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15
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Fung AK, Shetye SS, Li Y, Zhou Y, Sherry Liu X, Soslowsky LJ. Pregnancy and Lactation Impair Subchondral Bone Leading to Reduced Rat Supraspinatus Tendon-to-Bone Insertion Site Failure Properties. J Biomech Eng 2020; 142:111003. [PMID: 32577720 PMCID: PMC7580662 DOI: 10.1115/1.4047629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/16/2020] [Indexed: 12/12/2022]
Abstract
Pregnant women experience weight gain, gait changes, and biochemical fluctuations that impair joint function and alter the maternal skeleton. Hormonal changes increase pelvic ligament laxity in preparation for childbirth and affect peripheral joint laxity. Calcium demands also rise during pregnancy and lactation, resulting in reduced bone mineral density (BMD) and maternal bone loss. Altered tendon properties and bone loss during pregnancy and lactation may impact tendon insertion sites, such as rotator cuff tendons where insertion site ruptures are common. However, the effects of pregnancy and lactation at the tendon-to-bone interface have not been investigated. Therefore, the objective of this study was to evaluate supraspinatus tendon mechanical properties and insertion site microstructure during pregnancy, lactation, and postweaning recovery in female rats. We hypothesized that pregnancy and lactation would compromise supraspinatus tendon mechanical properties and subchondral bone microstructure. Female rats were divided into virgin, pregnancy, lactation, and recovery groups, and supraspinatus tendons were mechanically evaluated. Surprisingly, tendon mechanics was unaffected by pregnancy and lactation. However, tendon modulus decreased two-weeks postweaning. Additionally, tendons failed by bony avulsion at the insertion site, and the lactation group exhibited reduced failure properties corresponding to decreased subchondral bone mineralization. Lactation also resulted in dramatic bone loss at the epiphysis, but trabecular bone microarchitecture recovered postweaning. In conclusion, lactation following pregnancy impaired trabecular bone microstructure and subchondral bone mineralization, leading to reduced supraspinatus tendon-to-bone insertion site failure properties. These findings will contribute toward understanding the pathogenesis of tendon-to-bone disorders.
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Affiliation(s)
- Ashley K. Fung
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA 19104-6081
| | - Snehal S. Shetye
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA 19104-6081
| | - Yihan Li
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA 19104-6081
| | - Yilu Zhou
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA 19104-6081
| | - X. Sherry Liu
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA 19104-6081
| | - Louis J. Soslowsky
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA 19104-6081
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16
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Herzog MM, Young JC, Lund JL, Pate V, Mack CD, Marshall SW. Oral contraceptive use and anterior cruciate ligament injury: comparison of active comparator new user cohort and case-control study designs. Inj Epidemiol 2020; 7:53. [PMID: 33070772 PMCID: PMC7570098 DOI: 10.1186/s40621-020-00282-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study further investigates a protective association between oral contraceptive (OC) use and anterior cruciate ligament (ACL) injury noted in prior case-control studies. METHODS Active comparator new user cohort analysis of women aged 13-45 years in the United States from the IBM MarketScan Commercial Claims and Encounters database who newly-initiated low-dose OCs (exposed) or underwent intrauterine device (IUD) insertion (comparison group) from 2000 to 2014. Women were followed for ACL injury starting 90 days after OC initiation or IUD insertion until OC or IUD discontinuation or end of continuous enrollment. Adjusted hazard ratios (adjHR) and 95% confidence intervals (CI) were estimated controlling for age. Secondary analysis replicated previously-published case-control studies assessing "ever" versus "never" OC use over 1- and 5-year periods among women who underwent ACL reconstruction compared to age-matched controls. RESULTS In the cohort analysis, 2,370,286 women initiated OCs and 621,798 underwent IUD insertion. There were 3571 (0.15%) ACL injuries during an average 370.6 days of continuous OC use and 1620 (0.26%) during an average 590.5 days of IUD use. No difference in risk of ACL injury was observed between OC initiators and IUD users (adjHR = 0.95; 95%CI 0.89, 1.01). The case-control analysis replicated the slight protective association observed in prior studies over a 5-year period (OR = 0.90; 95%CI 0.85, 0.94). CONCLUSIONS This cohort study suggests no association between OC use and ACL injury, while the case-control study suggested bias from uncontrolled confounding and selection factors may have influenced previous findings that suggested a protective association between OC use and ACL injury.
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Affiliation(s)
- Mackenzie M Herzog
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA. .,University of North Carolina Injury Prevention Research Center, Chapel HIll, USA. .,Injury Surveillance and Analytics, Real-World Analytics Solutions, IQVIA, Durham, USA. .,Department of Exercise and Sport Science, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - Jessica C Young
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA
| | - Jennifer L Lund
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA
| | - Virginia Pate
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA
| | - Christina D Mack
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA.,Injury Surveillance and Analytics, Real-World Analytics Solutions, IQVIA, Durham, USA
| | - Stephen W Marshall
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA.,University of North Carolina Injury Prevention Research Center, Chapel HIll, USA.,Department of Exercise and Sport Science, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, USA
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17
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DeFroda SF, Donnelly JC, Mulcahey MK, Perez L, Owens BD. Shoulder Instability in Women Compared with Men: Epidemiology, Pathophysiology, and Special Considerations. JBJS Rev 2020; 7:e10. [PMID: 31567718 DOI: 10.2106/jbjs.rvw.19.00007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Steven F DeFroda
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Joseph C Donnelly
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery (M.K.M.), Tulane University School of Medicine (L.P.), New Orleans, Louisiana
| | - Lizbeth Perez
- Department of Orthopaedic Surgery (M.K.M.), Tulane University School of Medicine (L.P.), New Orleans, Louisiana
| | - Brett D Owens
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
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18
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Raeeszadeh-Sarmazdeh M, Do LD, Hritz BG. Metalloproteinases and Their Inhibitors: Potential for the Development of New Therapeutics. Cells 2020; 9:E1313. [PMID: 32466129 PMCID: PMC7290391 DOI: 10.3390/cells9051313] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 02/06/2023] Open
Abstract
The metalloproteinase (MP) family of zinc-dependent proteases, including matrix metalloproteinases (MMPs), a disintegrin and metalloproteases (ADAMs), and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTSs) plays a crucial role in the extracellular matrix (ECM) remodeling and degradation activities. A wide range of substrates of the MP family includes ECM components, chemokines, cell receptors, and growth factors. Metalloproteinases activities are tightly regulated by proteolytic activation and inhibition via their natural inhibitors, tissue inhibitors of metalloproteinases (TIMPs), and the imbalance of the activation and inhibition is responsible in progression or inhibition of several diseases, e.g., cancer, neurological disorders, and cardiovascular diseases. We provide an overview of the structure, function, and the multifaceted role of MMPs, ADAMs, and TIMPs in several diseases via their cellular functions such as proteolysis of other cell signaling factors, degradation and remodeling of the ECM, and other essential protease-independent interactions in the ECM. The significance of MP inhibitors targeting specific MMP or ADAMs with high selectivity is also discussed. Recent advances and techniques used in developing novel MP inhibitors and MP responsive drug delivery tools are also reviewed.
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Affiliation(s)
- Maryam Raeeszadeh-Sarmazdeh
- Chemical and Materials Engineering Department, University of Nevada, Reno, NV 89557, USA; (L.D.D.); (B.G.H.)
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Konopka JA, Hsue L, Chang W, Thio T, Dragoo JL. The Effect of Oral Contraceptive Hormones on Anterior Cruciate Ligament Strength. Am J Sports Med 2020; 48:85-92. [PMID: 31765227 DOI: 10.1177/0363546519887167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Women are 2 to 9 times more likely to experience an anterior cruciate ligament (ACL) injury than men. Various hormones including relaxin, progesterone, and estrogen influence ACL strength. Oral contraceptives (OCs) alter these hormone levels; however, studies have yet to comprehensively compare different OCs' effects on the ACL. HYPOTHESIS OCs with increased progestin-to-estrogen ratios will (1) increase ACL collagen expression, (2) decrease ACL matrix metalloproteinase expression, and (3) increase ACL strength. STUDY DESIGN Controlled laboratory study. METHODS Untreated female rats were compared with rats treated with 1 of 5 clinically used OCs: norethindrone (NE) only, NE plus ethinylestradiol (EE), etynodiol diacetate (ED) plus EE, norgestimate (NG) plus EE, and drospirenone (DS) plus EE. Doses were scaled from human doses to account for differences in bioavailability and body weight, and OCs were administered daily via oral gavage for 4 rat estrous cycles (20 days). A total of 36 rats were then sacrificed (6 rats/group). ACLs underwent biomechanical testing to assess ACL strength, stiffness, and maximum load before failure. ACL specimens were also isolated for quantitative real-time polymerase chain reaction analysis to assess collagen, matrix metalloproteinase, and relaxin receptor-1 expression. RESULTS While the primary structural property of interest (ACL maximum load before failure) was not significantly improved by OC treatment, the main material property of interest (ACL strength) in rats treated with NE only, DS + EE, ED + EE, and NE + EE was significantly increased compared with untreated controls (P = .001, P = .004, P = .004, and P = .04, respectively). The order from strongest to weakest ACLs, which was also the same order as the highest to lowest progestin-to-estrogen ratios, was groups treated with NE only, DS + EE, ED + EE, NE + EE, and lastly NG + EE. Higher ratio formulations also increased the expression of type I collagen (P = .02) and decreased the expression of matrix metalloproteinase-1 (P = .04). CONCLUSION OC formulations with higher progestin-to-estrogen ratios may be more protective for the ACL than formulations with lower ratios. CLINICAL RELEVANCE OC formulations with high progestin-to-estrogen ratios may benefit female athletes by reducing their ACL injury risk by decreasing the effects of relaxin on the ACL.
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Affiliation(s)
- Jaclyn A Konopka
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Lauren Hsue
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Wenteh Chang
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Timothy Thio
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Jason L Dragoo
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
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20
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DeFroda SF, Bokshan SL, Worobey S, Ready L, Daniels AH, Owens BD. Oral contraceptives provide protection against anterior cruciate ligament tears: a national database study of 165,748 female patients. PHYSICIAN SPORTSMED 2019; 47:416-420. [PMID: 30913940 DOI: 10.1080/00913847.2019.1600334] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Anterior cruciate ligament (ACL) tears are more prevalent in females than males. One of the factors responsible for this may be the variation in levels of estrogen and progesterone. The purpose of this study was to determine the potentially protective effects of oral contraceptive pills (OCPs) on ACL tears.Methods: The PearlDiver database (www.pearldiverinc.com, Fort Wayne, IN) was queried for all OCP users amongst females aged 15-49. Female experiencing an ACL tear and undergoing surgery (CPT 29,888) were compared to a control group of females undergoing surgery for an ACL tear, but not on OCPs. Chi-squared testing was used to assess for significant differences in the rate of ACL reconstruction for the OCP and non-OCP users, according to age groups broken down into age intervals of 5 years.Results: There were a total 82,874 patients in both the OCP and non-OCP groups. There was a total of 569 (0.69%) ACL reconstructions in the non-OCP group and 465 (0.56%) in the OCP group (p< 0.001). In the non-OCP group, patients aged 15-19 accounted for 29.35% of all ACL reconstructions, whereas, in the OCP group, this same age group only accounted for 13.33%. Among all age groups, the odds ratios for experiencing an ACL reconstruction while on OCP was 0.82 (χ2 = 0.001, 95% CI 0.72-0.92) compared to not using OCP. This protective effect was driven primarily by the 15-19 age group (odds ratio 0.37 (χ2 < 0.001, 95% CI 0.27-0.50)). The number need to treat for OCP usage in the 15-19 age group was six patients.Conclusions: OCPs have a protective effect on ACL tear, especially in the 15-19 age group, which exhibited a 63% reduction in the rate of tear. Consideration should be given to prescribing OCPs to younger athletes, after careful assessment of the risks of these commonly prescribed medications.Level of evidence: III.
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Affiliation(s)
- Steven F DeFroda
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI, USA
| | - Steven L Bokshan
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI, USA
| | - Samantha Worobey
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI, USA
| | - Lauren Ready
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI, USA
| | - Alan H Daniels
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI, USA
| | - Brett D Owens
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI, USA
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21
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Fede C, Pirri C, Fan C, Albertin G, Porzionato A, Macchi V, De Caro R, Stecco C. Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PLoS One 2019; 14:e0223195. [PMID: 31557257 PMCID: PMC6762168 DOI: 10.1371/journal.pone.0223195] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/15/2019] [Indexed: 12/12/2022] Open
Abstract
Although it is now recognized that women suffer from myofascial pain to a greater extent than men, and that the muscular fasciae can respond to hormonal stimuli, thanks to the expression of sex hormone receptors, how the fasciae can modify their structure under hormonal stimulation is not clear. In this work, an immunocytochemical analysis of collagen-I, collagen-III and fibrillin were carried out on fibroblasts isolated from human fascia lata after in vitro treatment with various levels of sex hormones β-estradiol and/or relaxin-1, according to the phases of a woman's period (follicular, periovulatory, luteal, post-menopausal phases and pregnancy). This study demonstrates for the first time that fascial cells can modulate the production of some components of the extracellular matrix according to hormone levels, when treated with β-estradiol: collagen-I falls from 6% of positivity in the follicular phase to 1.9 in the periovulatory phase. However, after the addition of relaxin-1 to the cell culture, the production of extracellular matrix decreased and remained at the same level (1.7% of collagen-I, at both follicular and periovulatory levels of hormones). These results confirm the antifibrotic function of relaxin-1, thanks to its ability to reduce matrix synthesis. They are also a first step in our understanding of how some hormonal dysfunctions in women can cause a dysregulation of extracellular matrix production in fasciae.
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Affiliation(s)
- Caterina Fede
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carmelo Pirri
- Physical and Rehabilitation Medicine, University of Rome “Tor Vergata”, Roma, Italy
| | - Chenglei Fan
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Giovanna Albertin
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy
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Xu T, Bai J, Xu M, Yu B, Lin J, Guo X, Liu Y, Zhang D, Yan K, Hu D, Hao Y, Geng D. Relaxin inhibits patellar tendon healing in rats: a histological and biochemical evaluation. BMC Musculoskelet Disord 2019; 20:349. [PMID: 31351472 PMCID: PMC6661089 DOI: 10.1186/s12891-019-2729-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 07/18/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Female patients are more likely to have tendon injuries than males, especially those who has a higher concentration of relaxin. Previous studies have demonstrated that relaxin attenuates extracellular matrix (ECM) formation. However, the mechanism of relaxin on tendon repair remains unclear. We hypothesize that relaxin inhibits tendon healing by disrupting collagen synthesis. METHODS A patellar tendon window defect model was established using Sprague-Dawley rats. The center of the patellar tendon was removed from the patella distal apex and inserted to the tibia tuberosity in width of 1 mm. Then, the rats were injected with saline (0.2 μg/kg/day) or relaxin (0.2 μg/kg/day) for two and four weeks, which was followed by biomechanical analysis and histological and histochemical examination. RESULTS Mechanical results indicated that relaxin induces a significant decrease in tear resistance, stiffness, and Young's modulus compared to those rats without relaxin treatment. In addition, it was shown that relaxin activates relaxin family peptide receptor 1(RXFP1), disturbs the balance between matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteases (TIMPs), and reduces the deposition of collagen in injury areas. CONCLUSIONS Relaxin impairs tendon healing in rats. Also, relaxin might lead to tendon injury more commonly for females than males.
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Affiliation(s)
- Tianpeng Xu
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, 242, Guangji Road, Suzhou, 215006 People’s Republic of China
| | - Jiaxiang Bai
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006 People’s Republic of China
| | - Menglei Xu
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, 242, Guangji Road, Suzhou, 215006 People’s Republic of China
| | - Binqing Yu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006 People’s Republic of China
| | - Jiayi Lin
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006 People’s Republic of China
| | - Xiaobin Guo
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006 People’s Republic of China
| | - Yu Liu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006 People’s Republic of China
| | - Di Zhang
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, 242, Guangji Road, Suzhou, 215006 People’s Republic of China
| | - Kai Yan
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, 242, Guangji Road, Suzhou, 215006 People’s Republic of China
| | - Dan Hu
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, 242, Guangji Road, Suzhou, 215006 People’s Republic of China
| | - Yuefeng Hao
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, 242, Guangji Road, Suzhou, 215006 People’s Republic of China
| | - Dechun Geng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, shi zi Road, Suzhou, 215006 People’s Republic of China
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Liu Z, Li Y, Ren Y, Jin Y, Yang J, Wang S, Zhu X, Xiong H, Zou G, Liu Y, Huang W. Enhancement of in vitro proliferation and bioactivity of human anterior cruciate ligament fibroblasts using an in situ tissue isolation method and basic fibroblast growth factor culture conditions: A pilot analysis. Medicine (Baltimore) 2019; 98:e15907. [PMID: 31145353 PMCID: PMC6708876 DOI: 10.1097/md.0000000000015907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Previous studies have reported poor proliferation and bioactivity of human anterior cruciate ligament fibroblasts (hACLFs) after injury. As hACLFs are one of the most significant and indispensable source of seed cells in constructing tissue-engineered ligament, enhancing hACLF proliferation would offer favorable cellular-biological ability and induce the extracellular matrix secretion of hACLFs after loading on multiple types of scaffolds. Enhancing the bioactivity of hACLFs would improve tissue repair and functional recovery after tissue-engineered ligament transplantation. This study compared cells prepared by collagenase digestion and the in situ culture of tissue pieces and investigated the effect of basic fibroblast growth factor (bFGF) on hACLFs. METHODS Six adult patients participated in this study. Of these patients, tissues from three were compared after culture establishment through collagenase digestion or in situ tissue isolation. hACLF phenotypic characteristics were assessed, and the effect of bFGF on hACLF cultures was observed. hACLFs cultured with and without bFGF served as the experimental and control groups, respectively. Cell Counting Kit-8 was used to detect proliferation. The expression of ligament-related genes and proteins was evaluated by immunofluorescence staining, real-time polymerase chain reaction (PCR) assays, and Western blot assays. RESULTS The morphology of hACLFs isolated using the two methods differed after the 2nd passage. The proliferation of cells obtained by in situ culture was higher than that of cells obtained by collagenase digestion. hACLFs cultured with bFGF after the 3rd passage exhibited a higher proliferation rate than the controls. Immunofluorescence staining, real-time PCR, and Western blot analysis showed a significant increase in ligament-related gene and protein expression in the hACLFs cultured with bFGF. CONCLUSIONS The in situ isolation of tissue pieces enhanced hACLF proliferation in vitro, and the hACLFs exhibited phenotypic characteristics of fibroblasts. hACLFs cultured with bFGF exhibited increased hACLF bioactivity.
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Affiliation(s)
- Ziming Liu
- Department of Orthopaedic Surgery, the First Affiliated Hospital of Chongqing Medical University
| | - Yuwan Li
- Department of Orthopaedic Surgery, the First Affiliated Hospital of Chongqing Medical University
| | - Youliang Ren
- Department of Orthopaedic Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Ying Jin
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, P.R. China
| | - Jibin Yang
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, P.R. China
| | - Shengmin Wang
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, P.R. China
| | - Xizhong Zhu
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, P.R. China
| | - Huazhang Xiong
- Department of Orthopaedic Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Gang Zou
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, P.R. China
| | - Yi Liu
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, P.R. China
| | - Wei Huang
- Department of Orthopaedic Surgery, the First Affiliated Hospital of Chongqing Medical University
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24
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Konopka JA, Hsue LJ, Dragoo JL. Effect of Oral Contraceptives on Soft Tissue Injury Risk, Soft Tissue Laxity, and Muscle Strength: A Systematic Review of the Literature. Orthop J Sports Med 2019; 7:2325967119831061. [PMID: 30923726 PMCID: PMC6431771 DOI: 10.1177/2325967119831061] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Female patients are more likely than male patients to experience various musculoskeletal (MSK) injuries. Because MSK tissues are sensitive to the female hormones relaxin, estrogen, and progesterone, studies have examined whether hormonal contraceptives, which change female hormone levels, can alter the female MSK injury risk. These studies have reached contradictory conclusions, leaving unclear the influence of hormonal contraception on female MSK injury risk. HYPOTHESIS Hormonal contraceptives act to decrease female soft tissue injury risk and soft tissue laxity. STUDY DESIGN Systematic review; Level of evidence, 3. METHODS Reviewers searched for clinically relevant studies evaluating the relationship between hormonal contraceptive use and soft tissue injuries, soft tissue laxity, muscle injuries, and muscle strength in the PubMed, Cochrane, Scopus, CINAHL, and Embase databases. Studies meeting inclusion criteria were scored by 2 independent researchers for risk of bias, imprecision, inconsistency, and indirectness with a template designed using the British Medical Journal Clinical Evidence GRADE (Grades of Recommendation Assessment, Development and Evaluation) scoring system and GRADEPro guidelines. Scores were uploaded into the GRADEPro scoring system software, which calculated each study's final GRADE score (very low, low, moderate, or high quality). RESULTS A total of 29 studies met inclusion criteria. Of the 7 studies evaluating oral contraceptive (OC) use and soft tissue injury risk, only 2 received a high quality-of-evidence score; all other studies received a very low score. The high-quality studies concluded that OC use decreases anterior cruciate ligament (ACL) injury risk. Only 1 of the 10 studies evaluating OC use and soft tissue laxity was found to have a high quality of evidence; this study determined that OC use decreases ACL laxity. CONCLUSION Higher quality studies suggest that OCs decrease a female patient's risk of ACL injuries and ACL laxity. The strength of these findings, however, is weak. Female patients are up to 8 times more likely to tear their ACLs than male patients. OCs may serve a therapeutic role in decreasing the sex disparity in ACL injury rates.
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Affiliation(s)
- Jaclyn A. Konopka
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Lauren J. Hsue
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Jason L. Dragoo
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, USA
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25
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Frank RM, Romeo AA, Bush-Joseph CA, Bach BR. Injuries to the Female Athlete in 2017: Part II: Upper and Lower-Extremity Injuries. JBJS Rev 2019; 5:e5. [PMID: 29028751 DOI: 10.2106/jbjs.rvw.17.00031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Rachel M Frank
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado
| | - Anthony A Romeo
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Charles A Bush-Joseph
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Bernard R Bach
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
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26
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Tanaka MJ, Szymanski LM, Dale JL, Dixit S, Jones LC. Team Approach: Treatment of Injuries in the Female Athlete: Multidisciplinary Considerations for Women's Sports Medicine Programs. JBJS Rev 2019; 7:e7. [PMID: 30672778 DOI: 10.2106/jbjs.rvw.18.00011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Miho J Tanaka
- Departments of Orthopaedic Surgery (M.J.T., S.D., and L.C.J.), Gynecology and Obstetrics (L.M.S.), and Physical Medicine and Rehabilitation (J.L.D.), Johns Hopkins University, Baltimore, Maryland
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27
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Current topics in women’s sports medicine: evaluation and treatment of the female athlete. CURRENT ORTHOPAEDIC PRACTICE 2019. [DOI: 10.1097/bco.0000000000000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Mirza F, Lorenzo J, Drissi H, Lee FY, Soung DY. Dried plum alleviates symptoms of inflammatory arthritis in TNF transgenic mice. J Nutr Biochem 2017; 52:54-61. [PMID: 29149648 DOI: 10.1016/j.jnutbio.2017.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 07/24/2017] [Accepted: 10/14/2017] [Indexed: 12/20/2022]
Abstract
Dried plum (DP), a rich source of polyphenols has been shown to have bone-preserving properties in both animal models of osteoporosis and postmenopausal women. We evaluated if DP alleviated the destruction of joints in transgenic mice (TG) that overexpress human tumor necrosis factor (TNF), a genetic model of rheumatoid arthritis (RA). A four-week treatment of 20% DP diet in TG slowed the onset of arthritis and reduced bone erosions in the joints compared to TG on a regular diet. This was associated with fewer tartrate-resistant acid phosphatase (TRAP) positive cells, suggesting decreased osteoclastogenesis. A DP diet also produced significant protection of articular cartilage and reduction of synovitis. Cultures of human synovial fibroblast in the presence of TNF showed a significant increase in inflammatory interleukin (IL)-1β, chemokines (monocyte chemoattractant protein-1: MCP1 & macrophage inflammatory protein-1 alpha: MIP1α), cartilage matrix metalloproteinases (MMP1&3), and an osteoclastogenic cytokine (receptor activator of nuclear factor-κB ligand: RANKL) compared to controls. Addition of neochlorogenic acid (NC), a major polyphenol in DP to these cultures resulted in down-regulation of these genes. In the cultures of mouse bone marrow macrophage, NC also repressed TNF-induced formation of osteoclasts and mRNA levels of cathepsin K and MMP9 through inhibition of nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1) expression and nuclear factor kappa B (NF-κB) activation. Our data suggested that dietary supplementation with DP inhibited TNF singling; leading to decreased erosions of bone and articular cartilage as well as synovitis.
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Affiliation(s)
- Faryal Mirza
- Department of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT 06030, USA
| | - Joseph Lorenzo
- Department of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT 06030, USA; Orthopaedic Surgery, UConn Health, 263 Farmington Avenue, Farmington, CT 06030, USA
| | - Hicham Drissi
- Genetics and Genome Sciences, UConn Health, 263 Farmington Avenue, Farmington, CT 06030, USA; Orthopaedic Surgery, UConn Health, 263 Farmington Avenue, Farmington, CT 06030, USA
| | - Francis Y Lee
- Department of Orthopaedics and Rehabilitation, Yale University, 800 Howard Avenue, New Haven, CT 06519, USA
| | - Do Y Soung
- Department of Orthpaedic Surgery, Columbia University, 650 W. 168th Street, Black Building 14-1410, New York, NY 10032, USA.
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29
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Whole grape alleviates inflammatory arthritis through inhibition of tumor necrosis factor. J Funct Foods 2017. [DOI: 10.1016/j.jff.2017.06.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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30
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Fede C, Albertin G, Petrelli L, Sfriso MM, Biz C, De Caro R, Stecco C. Hormone receptor expression in human fascial tissue. Eur J Histochem 2016; 60:2710. [PMID: 28076930 PMCID: PMC5134680 DOI: 10.4081/ejh.2016.2710] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/18/2016] [Accepted: 10/21/2016] [Indexed: 01/06/2023] Open
Abstract
Many epidemiologic, clinical, and experimental findings point to sex differences in myofascial pain in view of the fact that adult women tend to have more myofascial problems with respect to men. It is possible that one of the stimuli to sensitization of fascial nociceptors could come from hormonal factors such as estrogen and relaxin, that are involved in extracellular matrix and collagen remodeling and thus contribute to functions of myofascial tissue. Immunohistochemical and molecular investigations (real-time PCR analysis) of relaxin receptor 1 (RXFP1) and estrogen receptor-alpha (ERα) localization were carried out on samples of human fascia collected from 8 volunteers patients during orthopedic surgery (all females, between 42 and 70 yrs, divided into pre- and post-menopausal groups), and in fibroblasts isolated from deep fascia, to examine both protein and RNA expression levels. We can assume that the two sex hormone receptors analyzed are expressed in all the human fascial districts examined and in fascial fibroblasts culture cells, to a lesser degree in the post-menopausal with respect to the pre-menopausal women. Hormone receptor expression was concentrated in the fibroblasts, and RXFP1 was also evident in blood vessels and nerves. Our results are the first demonstrating that the fibroblasts located within different districts of the muscular fasciae express sex hormone receptors and can help to explain the link between hormonal factors and myofascial pain. It is known, in fact, that estrogen and relaxin play a key role in extracellular matrix remodeling by inhibiting fibrosis and inflammatory activities, both important factors affecting fascial stiffness and sensitization of fascial nociceptors.
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Affiliation(s)
- C Fede
- University of Padua, Department of Neuroscience.
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