1
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Krebs P, Nägele M, Fomina P, Virtanen V, Nippolainen E, Shaikh R, Afara I, Töyräs J, Usenov I, Sakharova T, Artyushenko V, Tafintseva V, Solheim J, Zimmermann B, Kohler A, König O, Saarakkala S, Mizaikoff B. Laser-irradiating infrared attenuated total reflection spectroscopy of articular cartilage: Potential and challenges for diagnosing osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100466. [PMID: 38623306 PMCID: PMC11016904 DOI: 10.1016/j.ocarto.2024.100466] [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: 09/20/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
Objective A prototype infrared attenuated total reflection (IR-ATR) laser spectroscopic system designed for in vivo classification of human cartilage tissue according to its histological health status during arthroscopic surgery is presented. Prior to real-world in vivo applications, this so-called osteoarthritis (OA) scanner has been tested at in vitro conditions revealing the challenges associated with complex sample matrices and the accordingly obtained sparse spectral datasets. Methods In vitro studies on human knee cartilage samples at different contact pressures (i.e., 0.2-0.5 MPa) allowed recording cartilage degeneration characteristic IR signatures comparable to in vivo conditions with high temporal resolution. Afterwards, the cartilage samples were assessed based on the clinically acknowledged osteoarthritis cartilage histopathology assessment (OARSI) system and correlated with the obtained sparse IR data. Results Amide and carbohydrate signal behavior was observed to be almost identical between the obtained sparse IR data and previously measured FTIR data used for sparse partial least squares discriminant analysis (SPLSDA) to identify the spectral regions relevant to cartilage condition. Contact pressures between 0.3 and 0.4 MPa seem to provide the best sparse IR spectra for cylindrical (d = 3 mm) probe tips. Conclusion Laser-irradiating IR-ATR spectroscopy is a promising analytical technique for future arthroscopic applications to differentiate healthy and osteoarthritic cartilage tissue. However, this study also revealed that the flexible connection between the laser-based analyzer and the arthroscopic ATR-probe via IR-transparent fiberoptic cables may affect the robustness of the obtained IR data and requires further improvements.
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Affiliation(s)
- P. Krebs
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Ulm, Germany
| | | | - P. Fomina
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Ulm, Germany
| | - V. Virtanen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - E. Nippolainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - R. Shaikh
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - I.O. Afara
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - J. Töyräs
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
| | | | | | | | - V. Tafintseva
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - J.H. Solheim
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - B. Zimmermann
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - A. Kohler
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - O. König
- Nanoplus Advanced Photonics Gerbrunn GmbH, Gerbrunn, Germany
| | - S. Saarakkala
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - B. Mizaikoff
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Ulm, Germany
- Hahn-Schickard, Ulm, Germany
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Takahashi I, Takeda K, Toyama T, Matsuzaki T, Kuroki H, Hoso M. Histological and immunohistochemical analyses of articular cartilage during onset and progression of pre- and early-stage osteoarthritis in a rodent model. Sci Rep 2024; 14:10568. [PMID: 38719877 PMCID: PMC11079058 DOI: 10.1038/s41598-024-61502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024] Open
Abstract
Early diagnosis and treatment of pre- and early-stage osteoarthritis (OA) is important. However, the cellular and cartilaginous changes occurring during these stages remain unclear. We investigated the histological and immunohistochemical changes over time between pre- and early-stage OA in a rat model of traumatic injury. Thirty-six male rats were divided into two groups, control and OA groups, based on destabilization of the medial meniscus. Histological and immunohistochemical analyses of articular cartilage were performed on days 1, 3, 7, 10, and 14 postoperatively. Cell density of proteins associated with cartilage degradation increased from postoperative day one. On postoperative day three, histological changes, including chondrocyte death, reduced matrix staining, and superficial fibrillation, were observed. Simultaneously, a compensatory increase in matrix staining was observed. The Osteoarthritis Research Society International score increased from postoperative day seven, indicating thinner cartilage. On postoperative day 10, the positive cell density decreased, whereas histological changes progressed with fissuring and matrix loss. The proteoglycan 4-positive cell density increased on postoperative day seven. These findings will help establish an experimental model and clarify the mechanism of the onset and progression of pre- and early-stage traumatic OA.
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Affiliation(s)
- Ikufumi Takahashi
- Section of Rehabilitation, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Keisuke Takeda
- Section of Rehabilitation, Kanazawa University Hospital, 13-1, Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Tadashi Toyama
- Division of Biostatistics, Innovative Clinical Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Taro Matsuzaki
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahiro Hoso
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
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3
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Wang J, Sun Z, Yu C, Zhao H, Yan M, Sun S, Han X, Wang T, Yu T, Zhang Y. Single-cell RNA sequencing reveals the impact of mechanical loading on knee tibial cartilage in osteoarthritis. Int Immunopharmacol 2024; 128:111496. [PMID: 38224628 DOI: 10.1016/j.intimp.2024.111496] [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: 10/27/2023] [Revised: 12/25/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024]
Abstract
Articular cartilage degeneration is one of the major pathogenic alterations observed in knee osteoarthritis (KOA). Mechanical stress has been verified to contribute to KOA development. To gain insight into the pathogenic mechanism of KOA development, we investigated chondrocyte subsets under different mechanical loading conditions via single-cell RNA sequencing (scRNA-seq). Articular cartilage tissues from both high mechanical loading (named the OATL group) and low mechanical loading (named the OATN group) surfaces were obtained from the proximal tibia of KOA patients, and scRNA-seq was conducted. Chondrocyte subtypes, including a new subset, HTC-C (hypertrophic chondrocytes-C), and their functions, development and interactions among cell subsets were identified. Immunohistochemical staining was also conducted to verify the existence and location of each chondrocyte subset. Furthermore, differentially expressed genes (DEGs) and their functions between regions with high and low mechanical loading were identified. Based on Gene Ontology terms for the DEGs in each cell type, the characteristic of cartilage degeneration in the OATL region was clarified. Mitochondrial dysfunction may be involved in the KOA process in the OATN region.
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Affiliation(s)
- Junjie Wang
- Qingdao Medical College, Qingdao University, Qingdao, China; Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zewen Sun
- Qingdao Medical College, Qingdao University, Qingdao, China; Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chenghao Yu
- Qingdao Medical College, Qingdao University, Qingdao, China; Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haibo Zhao
- Qingdao Medical College, Qingdao University, Qingdao, China; Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingyue Yan
- Qingdao Medical College, Qingdao University, Qingdao, China; Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shenjie Sun
- Department of Emergency, Qingdao Municipal Hospital, Qingdao, China
| | - Xu Han
- Qingdao Medical College, Qingdao University, Qingdao, China; Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tianrui Wang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tengbo Yu
- Department of Orthopaedic Surgery, Qingdao Municipal Hospital, Qingdao, China.
| | - Yingze Zhang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Brent M, Brent MB. Sports Participation and Osteoarthritis in Females: A Systematic Review. Sports (Basel) 2023; 12:15. [PMID: 38251289 PMCID: PMC10819498 DOI: 10.3390/sports12010015] [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: 11/29/2023] [Revised: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Sports participation and the risk of osteoarthritis (OA) have been a concern for decades. Few research efforts have been dedicated to clarify this issue for females, although they are considered at greater risk of developing OA than males. In contrast, several reviews have established an association between sports participation and OA for males. The aim of the systematic review was to assess the association between OA and participation in popular sports for females. PubMed, Embase, and Google Scholar were searched and yielded 578 articles. Nine eligible studies were included and covered ballet (age range: 19-54 years), running or tennis (age range: 40-65 years), Olympic sports (age range: not specified), volleyball (age range: 16.0 ± 0.8 to 46.8 ± 5.1 years), and cross-country skiing (age range: 15 to ≥60 years). For females, participating in sports at an elite level was associated with a higher risk of OA and an increased need for surgical treatment. At non-elite level, it was associated with a higher risk of OA, but it did not materialize to an increased risk for surgical treatment. Few studies compared females and males, and these studies suggested that sex did not affect the risk of developing OA from participating in sports. Nevertheless, to isolate the precise effect of sports participation on the development of OA remains difficult as injuries are common among athletes and are independently associated with an increased risk of OA.
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Affiliation(s)
- Magnus Brent
- Department of Health Science and Technology, Aalborg University, 9200 Aalborg Øst, Denmark
| | - Mikkel Bo Brent
- Department of Biomedicine, Health, Aarhus University, 8000 Aarhus, Denmark
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5
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Takahashi I, Matsuzaki T, Kuroki H, Hoso M. Treadmill Exercise Suppresses Histological Progression of Disuse Atrophy in Articular Cartilage in Rat Knee Joints during Hindlimb Suspension. Cartilage 2023; 14:482-491. [PMID: 36802945 PMCID: PMC10807736 DOI: 10.1177/19476035231154510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE The purpose of this study was to determine the preventive effects of treadmill exercise or physiological loading on disuse atrophy in the rat knee joint cartilage and bone during hindlimb suspension. DESIGN Twenty male rats were divided into 4 experimental groups, including the control, hindlimb suspension, physiological loading, and treadmill walking groups. Histological changes in the articular cartilage and bone of the tibia were histomorphometrically and immunohistochemically evaluated 4 weeks after the intervention. RESULTS Compared with the control group, the hindlimb suspension group showed thinning of cartilage thickness, decreased matrix staining, and decreased proportion of noncalcified layers. Cartilage thinning, decreased matrix staining, and decreased noncalcified layers were suppressed in the treadmill walking group. The physiological loading group exhibited no significant suppression of cartilage thinning or decreased noncalcified layers, but the decreased matrix staining was significantly suppressed. No significant prevention of bone mass loss or changes in subchondral bone thickness were detected after physiological loading or treadmill walking. CONCLUSION Disuse atrophy of the articular cartilage caused by unloading conditions could be prevented by treadmill walking in rat knee joints.
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Affiliation(s)
- Ikufumi Takahashi
- Section of Rehabilitation, Kanazawa University Hospital, Ishikawa, Japan
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Taro Matsuzaki
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahiro Hoso
- Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
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6
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Zhao Z, Ito A, Kuroki H, Aoyama T. Analysis of Molecular Changes and Features in Rat Knee Osteoarthritis Cartilage: Progress From Cellular Changes to Structural Damage. Cartilage 2023:19476035231213174. [PMID: 37978830 DOI: 10.1177/19476035231213174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE Although knee osteoarthritis (KOA) is a common disease, there is a lack of specific prevention and early treatment methods. Hence, this study aimed to examine the molecular changes occurring at different stages of KOA to elucidate the dynamic nature of the disease. DESIGN Using a low-force compression model and analyzing RNA sequencing data, we identified molecular changes in the transcriptome of knee joint cartilage, including gene expression and molecular pathways, between the cellular changes and structural damage stages of KOA progression. In addition, we validated hub genes using an external dataset. RESULTS Gene set enrichment analysis (GSEA) identified the following pathways to be associated with KOA: "B-cell receptor signaling pathway," "cytokine-cytokine receptor interaction," and "hematopoietic cell lineage." Expression analysis revealed 585 differentially expressed genes, with 579 downregulated and 6 upregulated genes. Enrichment and clustering analyses revealed that the main molecular clusters were involved in cell cycle regulation and immune responses. Furthermore, the hub genes Csf1r, Cxcr4, Cxcl12, and Ptprc were related to immune responses. CONCLUSIONS Our study provides insights into the dynamic nature of early-stage KOA and offers valuable information to support the development of effective intervention strategies to prevent the irreversible damage associated with KOA, thereby addressing a major clinical challenge.
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Affiliation(s)
- Zixi Zhao
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Ito
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Kuroki
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Motor Function Analysis, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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7
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Maeda T, Kuriyama S, Yoshida S, Nishitani K, Nakamura S, Matsuda S. Decreased Elastic Modulus of Knee Articular Cartilage Based on New Macroscopic Methods Accurately Represents Early Histological Findings of Degeneration. Cartilage 2023:19476035231194770. [PMID: 37655826 DOI: 10.1177/19476035231194770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVE Ex vivo nanoindentation measurement has reported that elastic modulus decreases as cartilage degenerates, but no method has been established to macroscopically evaluate mechanical properties in vivo. The objective of this study was to evaluate the elastic modulus of knee joint cartilage based on macroscopic methods and to compare it with gross and histological findings of degeneration. DESIGN Osteochondral sections were taken from 50 knees with osteoarthritis (average age, 75 years) undergoing total knee arthroplasty. The elastic modulus of the cartilage was measured with a specialized elasticity tester. Gross findings were recorded as International Cartilage Repair Society (ICRS) grade. Histological findings were graded as Mankin score and microscopic cartilage thickness measurement. RESULTS In ICRS grades 0 to 2 knees with normal to moderate cartilage abnormalities, the elastic modulus of cartilage decreased significantly as cartilage degeneration progressed. The elastic modulus of cartilage was 12.2 ± 3.8 N/mm for ICRS grade 0, 6.3 ± 2.6 N/mm for ICRS grade 1, and 3.8 ± 2.4 N/mm for ICRS grade 2. Similarly, elastic modulus was correlated with Mankin score (r = -0.51, P < 0.001). Multiple regression analyses showed that increased Mankin score is the most relevant factor associated with decreased elastic modulus of the cartilage (t-value, -4.53; P < 0.001), followed by increased histological thickness of the cartilage (t-value, -3.15; P = 0.002). CONCLUSIONS Mechanical properties of damaged knee cartilage assessed with new macroscopic methods are strongly correlated with histological findings. The method has potential to become a nondestructive diagnostic modality for early cartilage damage in the clinical setting.
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Affiliation(s)
- Takahiro Maeda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichi Kuriyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shigeo Yoshida
- Department of Orthopaedic Surgery, Hayashi Hospital, Fukui, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichiro Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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8
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Sconza C, Di Matteo B, Queirazza P, Dina A, Amenta R, Respizzi S, Massazza G, Ammendolia A, Kon E, de Sire A. Ozone Therapy versus Hyaluronic Acid Injections for Pain Relief in Patients with Knee Osteoarthritis: Preliminary Findings on Molecular and Clinical Outcomes from a Randomized Controlled Trial. Int J Mol Sci 2023; 24:ijms24108788. [PMID: 37240135 DOI: 10.3390/ijms24108788] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Ozone therapy (OT) is used for the treatment of multiple musculoskeletal disorders. In recent years, there has been a growing interest in its use for the treatment of osteoarthritis (OA). The aim of this double-blind randomized controlled trial was to evaluate the efficacy of OT compared with hyaluronic acid (HA) injections for pain relief in patients with knee OA. Patients with knee OA for at least three months were included and randomly assigned to receive three intra-articular injections of ozone or HA (once a week). Patients were assessed at baseline and at 1, 3, and 6 months after the injections for pain, stiffness, and function using the WOMAC LK 3.1, the NRS, and the KOOS questionnaire. Out of 55 patients assessed for eligibility, 52 participants were admitted to the study and randomly assigned into the 2 groups of treatment. During the study, eight patients dropped out. Thus, a total of 44 patients, reached the endpoint of the study at 6 months. Both Group A and B consisted of 22 patients. At 1-month follow-up after injections, both treatment groups improved statistically significantly from baseline in all outcomes measured. At 3 months, improvements remained similarly consistent for Group A and Group B. At 6-month follow-up, the outcomes were comparable between the 2 groups, showing only a worsening trend in pain. No significant differences were found between the two groups in pain scores. Both therapies have proven to be safe, with the few recorded adverse events being mild and self-limiting. OT has demonstrated similar results to HA injections, proving to be a safe approach with significant effects on pain control in patients affected by knee OA. Due to its anti-inflammatory and analgesic effects, ozone might be considered as a potential treatment for OA.
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Affiliation(s)
- Cristiano Sconza
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Berardo Di Matteo
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Paolo Queirazza
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Arianna Dina
- Physical Medicine and Rehabilitation, University of Milan, 20122 Milan, Italy
| | - Roberta Amenta
- Department of Rehabilitation, Casa di Cura Villa Aurelia, 96100 Syracuse, Italy
| | - Stefano Respizzi
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Giuseppe Massazza
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy
| | - Elizaveta Kon
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy
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van Tuijn IM, Emanuel KS, van Hugten PPW, Jeuken R, Emans PJ. Prognostic Factors for the Clinical Outcome after Microfracture Treatment of Chondral and Osteochondral Defects in the Knee Joint: A Systematic Review. Cartilage 2023; 14:5-16. [PMID: 36624991 PMCID: PMC10076892 DOI: 10.1177/19476035221147680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The objective of this study is to establish which patient and lesion characteristics are related to the clinical outcome after microfracture of cartilage defects in the knee. STUDY DESIGN Systematic review. METHODS After preregistration, PubMed, Embase, and Cochrane were searched for studies that analyzed prognostic factors for the outcome of microfracture treatment in the knee. The criteria for inclusion were outcome measured using Patient-Reported Outcome Measures (PROMs), a clinical study with ≥10 participants receiving microfracture, and a minimal follow-up period of 1 year. RESULTS For none of the investigated prognostic factors, effect size reporting was sufficiently homogeneous to conduct a meta-analysis. However, a majority of the included studies identified higher age, larger lesion size, longer preoperative symptom duration, and previous surgery on the ipsilateral knee, especially meniscectomy and anterior cruciate ligament reconstruction, as factors that are reported to be correlated to a less favorable outcome. A lesion location that does not include the trochlea or the patellofemoral joint and is not weightbearing, a nondegenerative mechanism of injury, and a single lesion were reported as factors that predict a favorable outcome. As to gender, body mass index, preoperative activity level, smoking, and concomitant knee surgery, the included articles were inconclusive or no effect was reported. CONCLUSIONS Several factors correlated with the clinical result after microfracture treatment. However, the information on the effect sizes of the influence on clinical outcome is incomplete due to poor reporting. Large-scale registries or pooling of homogeneous, well-reported data is needed to work toward prognostic models. That would be an important step toward personalized treatment.
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Affiliation(s)
- Iris M van Tuijn
- Department of Orthopedic Surgery, Joint Preserving Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Kaj S Emanuel
- Department of Orthopedic Surgery, Joint Preserving Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands
- Department of Orthopedic Surgery and Sports Medicine and Amsterdam Movement Sciences, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Pieter P W van Hugten
- Department of Orthopedic Surgery, Joint Preserving Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ralph Jeuken
- Department of Orthopedic Surgery, Joint Preserving Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Pieter J Emans
- Department of Orthopedic Surgery, Joint Preserving Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands
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Alunni Cardinali M, Govoni M, Tschon M, Brogini S, Vivarelli L, Morresi A, Fioretto D, Rocchi M, Stagni C, Fini M, Dallari D. Brillouin-Raman micro-spectroscopy and machine learning techniques to classify osteoarthritic lesions in the human articular cartilage. Sci Rep 2023; 13:1690. [PMID: 36717645 PMCID: PMC9886972 DOI: 10.1038/s41598-023-28735-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
In this study, Brillouin and Raman micro-Spectroscopy (BRamS) and Machine Learning were used to set-up a new diagnostic tool for Osteoarthritis (OA), potentially extendible to other musculoskeletal diseases. OA is a degenerative pathology, causing the onset of chronic pain due to cartilage disruption. Despite this, it is often diagnosed late and the radiological assessment during the routine examination may fail to recognize the threshold beyond which pharmacological treatment is no longer sufficient and prosthetic replacement is required. Here, femoral head resections of OA-affected patients were analyzed by BRamS, looking for distinctive mechanical and chemical markers of the progressive degeneration degree, and the result was compared to standard assignment via histological staining. The procedure was optimized for diagnostic prediction by using a machine learning algorithm and reducing the time required for measurements, paving the way for possible future in vivo characterization of the articular surface through endoscopic probes during arthroscopy.
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Affiliation(s)
- Martina Alunni Cardinali
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123, Perugia, Italy
| | - Marco Govoni
- Reconstructive Orthopaedic Surgery and Innovative Techniques-Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136, Bologna, Italy.
| | - Matilde Tschon
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136, Bologna, Italy
| | - Silvia Brogini
- Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136, Bologna, Italy
| | - Leonardo Vivarelli
- Reconstructive Orthopaedic Surgery and Innovative Techniques-Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136, Bologna, Italy
| | - Assunta Morresi
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123, Perugia, Italy
| | - Daniele Fioretto
- Department of Physics and Geology, University of Perugia, Via A. Pascoli, 06123, Perugia, Italy.,CEMIN-Center of Excellence for Innovative Nanostructured Material, 06123, Perugia, Italy
| | - Martina Rocchi
- Reconstructive Orthopaedic Surgery and Innovative Techniques-Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136, Bologna, Italy
| | - Cesare Stagni
- Reconstructive Orthopaedic Surgery and Innovative Techniques-Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136, Bologna, Italy
| | - Milena Fini
- Scientific Director, IRCCS Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136, Bologna, Italy
| | - Dante Dallari
- Reconstructive Orthopaedic Surgery and Innovative Techniques-Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136, Bologna, Italy
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Martin S, Rashidifard C, Norris D, Goncalves A, Vercollone C, Brezinski M. Minimally Invasive Polarization Sensitive Optical Coherence Tomography (PS-OCT) for assessing Pre-OA, a pilot study on technical feasibility. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4. [DOI: 10.1016/j.ocarto.2022.100313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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12
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Mills ES, Becerra JA, Yensen K, Bolia IK, Shontz EC, Kebaish KJ, Dobitsch A, Hasan LK, Haratian A, Ong CD, Gross J, Petrigliano FA, Weber AE. Current and Future Advanced Imaging Modalities for the Diagnosis of Early Osteoarthritis of the Hip. Orthop Res Rev 2022; 14:327-338. [PMID: 36131944 PMCID: PMC9482955 DOI: 10.2147/orr.s357498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/16/2022] [Indexed: 12/04/2022] Open
Abstract
Hip osteoarthritis (OA) can be idiopathic or develop secondary to structural joint abnormalities of the hip joint (alteration of normal anatomy) and/or due to a systemic condition with joint involvement. Early osteoarthritic changes to the hip can be completely asymptomatic or may cause the development hip symptomatology without evidence of OA on radiographs. Delaying the progression of hip OA is critical due to the significant impact of this condition on the patient’s quality of life. Pre-OA of the hip is a newly established term that is often described as the development of signs and symptoms of degenerative hip disease but no radiographic evidence of OA. Advanced imaging methods can help to diagnose pre-OA of the hip in patients with hip pain and normal radiographs or aid in the surveillance of asymptomatic patients with an underlying hip diagnosis that is known to increase the risk of early OA of the hip. These methods include the delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC), quantitative magnetic resonance imaging (qMRI- T1rho, T2, and T2* relaxation time mapping), 7-Tesla MRI, computed tomography (CT), and optical coherence tomography (OCT). dGEMRIC proved to be a reliable and accurate modality though it is limited by the significant time necessary for contrast washout between scans. This disadvantage is potentially overcome by T2 weighted MRIs, which do not require contrast. 7-Tesla MRI is a promising development for enhanced imaging resolution compared to 1.5 and 3T MRIs. This technique does require additional optimization and development prior to widespread clinical use. The purpose of this review was to summarize the results of translational and clinical studies investigating the utilization of the above-mentioned imaging modalities to diagnose hip pre-OA, with special focus on recent research evaluating their implementation into clinical practice.
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Affiliation(s)
- Emily S Mills
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jacob A Becerra
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Katie Yensen
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ioanna K Bolia
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Correspondence: Ioanna K Bolia, USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, 1520 San Pablo st #2000, Los Angeles, CA, 90033, USA, Tel +1 9703432813, Fax +8181 658 5920, Email
| | - Edward C Shontz
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kareem J Kebaish
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Andrew Dobitsch
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laith K Hasan
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Aryan Haratian
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Charlton D Ong
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jordan Gross
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Frank A Petrigliano
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alexander E Weber
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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13
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Su X, Zhang Y, Gao Q, Liang Z, Wan L, Zhang L, Tang G. Preliminary study on the assessment of early cartilage degeneration by quantitative ultrashort echo time magnetic resonance imaging in vivo. Quant Imaging Med Surg 2022; 12:3803-3812. [PMID: 35782245 PMCID: PMC9246734 DOI: 10.21037/qims-21-1181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/14/2022] [Indexed: 12/31/2023]
Abstract
BACKGROUND To investigate the feasibility of quantitative ultrashort echo time magnetic resonance imaging (UTE-MRI) techniques for assessing early cartilage degeneration in vivo. METHODS A total of 46 patients with knee pain due to osteoarthritis (OA) as the main complaint were recruited into the study. We performed MRI examinations with different quantitative UTE-MRI techniques, including UTE-based magnetization transfer (MT), UTE-adiabaticT1ρ, and UTE-T2* mapping on a 3.0T clinical magnetic resonance (MR) scanner (MR750; GE Healthcare, Milwaukee, WI, USA). Three regions of interest (ROIs) were manually drawn on the medial and lateral femoral condyles and the corresponding medial and lateral tibial plateaus, respectively. A total of 561 ROIs (12 ROIs for each knee) were finally included and divided into 3 groups according to the MRI Osteoarthritis Knee Score (MOAKS): normal (MOAKS 0, n=175), mild degeneration (MOAKS 1, n=283), and moderate degeneration (MOAKS 2, n=103). One-way analysis of variance (ANOVA) and Tamhane's T2 test were used to compare the differences of quantitative UTE-biomarkers among different groups. The analysis of Spearman's correlation was used to assess the correlation between the UTE-biomarkers and MOAKS grading. The diagnostic efficacy of different quantitative UTE-MRI techniques for detecting mild cartilage degeneration was evaluated using the receiver operating characteristic (ROC) curve. RESULTS The UTE-MT ratio (UTE-MTR) and the UTE-adiabatic T1ρ values had a moderate correlation with the MOAKS grading (r=-0.523, P<0.001; r=0.531, P<0.001, respectively), while the UTE-T2* was weakly correlated with the MOAKS grading (r=-0.396, P<0.001). For the normal group (MOAKS 0) and the mild group (MOAKS 1), the UTE-MTR values were 21.09%±3.03% and 17.30%±3.22%, respectively. The UTE-adiabatic T1ρ values were 30.43±6.26 ms and 35.05±8.78 ms for the normal group (MOAKS 0) and the mild group (MOAKS 1), respectively. With respect to the UTE-T2* values, the normal group (MOAKS 0) values were 21.49±3.96 ms and the mild group (MOAKS 1) values were 19.86±3.08 ms. All the differences between the 2 groups of the 3 UTE-MRI values were significant. The AUCs of the UTE-MTR, UTE-adiabatic T1ρ, and UTE-T2* mapping were 0.794, 0.732, and 0.651, respectively. CONCLUSIONS The quantitative UTE-MRI techniques (UTE-MT, UTE-adiabatic T1ρ, and UTE-T2* mapping) show great promise for assessing the early degeneration of articular cartilage in vivo, and the UTE-MT and UTE-adiabatic T1ρ values show better diagnostic efficacy than UTE-T2* mapping.
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Affiliation(s)
- Xiaolian Su
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yixuan Zhang
- Department of Radiology, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou, China
| | - Qiuming Gao
- Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zonghui Liang
- Department of Radiology, Shanghai Jing’an District Central Hospital, Shanghai, China
| | - Lidi Wan
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lin Zhang
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guangyu Tang
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
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14
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Wrangberg T, Kendall A. Who Is Healthy? A Review of How Equine Control Groups Are Defined in Clinical Orthopaedic Research 1999-2021. Vet Comp Orthop Traumatol 2022; 35:213-219. [PMID: 35512819 DOI: 10.1055/s-0042-1745756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Proper identification of healthy subjects is essential in case-control studies. However, standardized definitions of healthy controls are lacking in equine orthopaedic research. OBJECTIVES The aim of this study was to define the non-invasive methods used for selecting healthy control horses in osteoarthritis (OA), desmitis and tendinitis research. METHODS Systematic review. Case-control studies with a healthy control group and longitudinal studies where horses had to be healthy at the start were included. Studies where joints were visualized by arthroscopy or post-mortem examination were excluded. RESULTS From 2,472 OA papers and 2,746 desmitis/tendinitis papers, 127 and 84 papers met the inclusion criteria respectively. For OA, 11 methods were identified for defining healthy subjects with a median of three methods used per paper. Dynamic examination, radiographic evaluation and clinical examination were the most frequent. Eight different methods were identified in the desmitis/tendinitis papers with a median of three methods per paper; ultrasonography, clinical- and dynamic examination were the most frequent. CONCLUSIONS Overall, the OA and desmitis/tendinitis studies used similar methods for defining subjects as healthy, but the way the examinations were performed and interpreted was inconsistent. In several studies, healthy controls were not examined for lameness. The most common methods have limitations for detecting horses with early OA, which may have implications for interpretation of results. Standardized use of more sensitive and objective methods could be beneficial.
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Affiliation(s)
| | - A Kendall
- Division of Pathology, Pharmacology and Toxicology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
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15
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Tossetta G, Fantone S, Licini C, Marzioni D, Mattioli-Belmonte M. The multifaced role of HtrA1 in the development of joint and skeletal disorders. Bone 2022; 157:116350. [PMID: 35131488 DOI: 10.1016/j.bone.2022.116350] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 02/01/2022] [Indexed: 12/15/2022]
Abstract
HtrA1 (High temperature requirement A1) family proteins include four members, widely conserved from prokaryotes to eukaryotes, named HtrA1, HtrA2, HtrA3 and HtrA4. HtrA1 is a serine protease involved in a variety of biological functions regulating many signaling pathways degrading specific components and playing key roles in many human diseases such as neurodegenerative disorders, pregnancy complications and cancer. Due to its role in the breakdown of many ExtraCellular Matrix (ECM) components of articular cartilage such as fibronectin, decorin and aggrecan, HtrA1 encouraged many researches on studying its role in several skeletal diseases (SDs). These studies were further inspired by the fact that HtrA1 is able to regulate the signaling of one of the most important cytokines involved in SDs, the TGFβ-1. This review aims to summarize the data currently available on the role of HtrA1 in skeletal diseases such as Osteoporosis, Rheumatoid Arthritis, Osteoarthritis and Intervertebral Disc Degeneration (IDD). The use of HtrA1 as a marker of frailty in geriatric medicine would represent a powerful tool for identifying older individuals at risk of developing skeletal disorders, evaluating an appropriate intervention to improve quality care in these people avoiding or improving age-related SDs in the elderly population.
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Affiliation(s)
- Giovanni Tossetta
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, 60126 Ancona, Italy; Clinic of Obstetrics and Gynaecology, Department of Clinical Sciences, Università Politecnica delle Marche, Salesi Hospital, Azienda Ospedaliero Universitaria, Ancona, Italy.
| | - Sonia Fantone
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Caterina Licini
- Department of Clinical and Molecular Sciences (DISCLIMO), Università Politecnica delle Marche, Via Tronto 10/a, Ancona 60126, Italy
| | - Daniela Marzioni
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Monica Mattioli-Belmonte
- Department of Clinical and Molecular Sciences (DISCLIMO), Università Politecnica delle Marche, Via Tronto 10/a, Ancona 60126, Italy
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16
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Teoh YX, Lai KW, Usman J, Goh SL, Mohafez H, Hasikin K, Qian P, Jiang Y, Zhang Y, Dhanalakshmi S. Discovering Knee Osteoarthritis Imaging Features for Diagnosis and Prognosis: Review of Manual Imaging Grading and Machine Learning Approaches. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4138666. [PMID: 35222885 PMCID: PMC8881170 DOI: 10.1155/2022/4138666] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 12/30/2022]
Abstract
Knee osteoarthritis (OA) is a deliberating joint disorder characterized by cartilage loss that can be captured by imaging modalities and translated into imaging features. Observing imaging features is a well-known objective assessment for knee OA disorder. However, the variety of imaging features is rarely discussed. This study reviews knee OA imaging features with respect to different imaging modalities for traditional OA diagnosis and updates recent image-based machine learning approaches for knee OA diagnosis and prognosis. Although most studies recognized X-ray as standard imaging option for knee OA diagnosis, the imaging features are limited to bony changes and less sensitive to short-term OA changes. Researchers have recommended the usage of MRI to study the hidden OA-related radiomic features in soft tissues and bony structures. Furthermore, ultrasound imaging features should be explored to make it more feasible for point-of-care diagnosis. Traditional knee OA diagnosis mainly relies on manual interpretation of medical images based on the Kellgren-Lawrence (KL) grading scheme, but this approach is consistently prone to human resource and time constraints and less effective for OA prevention. Recent studies revealed the capability of machine learning approaches in automating knee OA diagnosis and prognosis, through three major tasks: knee joint localization (detection and segmentation), classification of OA severity, and prediction of disease progression. AI-aided diagnostic models improved the quality of knee OA diagnosis significantly in terms of time taken, reproducibility, and accuracy. Prognostic ability was demonstrated by several prediction models in terms of estimating possible OA onset, OA deterioration, progressive pain, progressive structural change, progressive structural change with pain, and time to total knee replacement (TKR) incidence. Despite research gaps, machine learning techniques still manifest huge potential to work on demanding tasks such as early knee OA detection and estimation of future disease events, as well as fundamental tasks such as discovering the new imaging features and establishment of novel OA status measure. Continuous machine learning model enhancement may favour the discovery of new OA treatment in future.
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Affiliation(s)
- Yun Xin Teoh
- Department of Biomedical Engineering, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Khin Wee Lai
- Department of Biomedical Engineering, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Juliana Usman
- Department of Biomedical Engineering, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Siew Li Goh
- Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Hamidreza Mohafez
- Department of Biomedical Engineering, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Khairunnisa Hasikin
- Department of Biomedical Engineering, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Pengjiang Qian
- School of Artificial Intelligence and Computer Sciences, Jiangnan University, Wuxi 214122, China
| | - Yizhang Jiang
- School of Artificial Intelligence and Computer Sciences, Jiangnan University, Wuxi 214122, China
| | - Yuanpeng Zhang
- Department of Medical Informatics of Medical (Nursing) School, Nantong University, Nantong 226001, China
| | - Samiappan Dhanalakshmi
- Department of Electronics and Communication Engineering, SRM Institute of Science and Technology, Kattankulathur 603203, India
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17
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Zeng CY, Zhang ZR, Tang ZM, Hua FZ. Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Front Physiol 2022; 12:794062. [PMID: 34975542 PMCID: PMC8716769 DOI: 10.3389/fphys.2021.794062] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/19/2021] [Indexed: 01/09/2023] Open
Abstract
Knee osteoarthritis is a chronic degenerative disease. Cartilage and subchondral bone degeneration, as well as synovitis, are the main pathological changes associated with knee osteoarthritis. Mechanical overload, inflammation, metabolic factors, hormonal changes, and aging play a vital role in aggravating the progression of knee osteoarthritis. The main treatments for knee osteoarthritis include pharmacotherapy, physiotherapy, and surgery. However, pharmacotherapy has many side effects, and surgery is only suitable for patients with end-stage knee osteoarthritis. Exercise training, as a complementary and adjunctive physiotherapy, can prevent cartilage degeneration, inhibit inflammation, and prevent loss of the subchondral bone and metaphyseal bone trabeculae. Increasing evidence indicates that exercise training can improve pain, stiffness, joint dysfunction, and muscle weakness in patients with knee osteoarthritis. There are several exercise trainings options for the treatment of knee osteoarthritis, including aerobic exercise, strength training, neuromuscular exercise, balance training, proprioception training, aquatic exercise, and traditional exercise. For Knee osteoarthritis (KOA) experimental animals, those exercise trainings can reduce inflammation, delay cartilage and bone degeneration, change tendon, and muscle structure. In this review, we summarize the main symptoms of knee osteoarthritis, the mechanisms of exercise training, and the therapeutic effects of different exercise training methods on patients with knee osteoarthritis. We hope this review will allow patients in different situations to receive appropriate exercise therapy for knee osteoarthritis, and provide a reference for further research and clinical application of exercise training for knee osteoarthritis.
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Affiliation(s)
- Chu-Yang Zeng
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhen-Rong Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
| | - Zhi-Ming Tang
- Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Fu-Zhou Hua
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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18
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Ali N, Turkiewicz A, Hughes V, Folkesson E, Tjörnstand J, Neuman P, Önnerfjord P, Englund M. Proteomics profiling of human synovial fluid suggests increased protein interplay in early-osteoarthritis (OA) that is lost in late-stage OA. Mol Cell Proteomics 2022; 21:100200. [PMID: 35074580 PMCID: PMC8941261 DOI: 10.1016/j.mcpro.2022.100200] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 11/04/2021] [Accepted: 01/15/2022] [Indexed: 11/28/2022] Open
Abstract
The underlying molecular mechanisms in osteoarthritis (OA) development are largely unknown. This study explores the proteome and the pairwise interplay of proteins in synovial fluid from patients with late-stage knee OA (arthroplasty), early knee OA (arthroscopy due to degenerative meniscal tear), and from deceased controls without knee OA. Synovial fluid samples were analyzed using state-of-the-art mass spectrometry with data-independent acquisition. The differential expression of the proteins detected was clustered and evaluated with data mining strategies and a multilevel model. Group-specific slopes of associations were estimated between expressions of each pair of identified proteins to assess the co-expression (i.e., interplay) between the proteins in each group. More proteins were increased in early-OA versus controls than late-stage OA versus controls. For most of these proteins, the fold changes between late-stage OA versus controls and early-stage OA versus controls were remarkably similar suggesting potential involvement in the OA process. Further, for the first time, this study illustrated distinct patterns in protein co-expression suggesting that the interplay between the protein machinery is increased in early-OA and lost in late-stage OA. Further efforts should focus on earlier stages of the disease than previously considered. Synovial fluid proteomics study of different stages of osteoarthritis (OA). Higher catabolic activity is found in both early- and late-stage OA. Imbalance of the metabolic homeostasis in late-stage OA. Understanding early-stage OA may lead to finding better effective therapies.
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19
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Changoor A, Garon M, Quenneville E, Bull SB, Gordon K, Savard P, Buschmann MD, Hurtig MB. Non-invasive Electroarthrography Measures Load-Induced Cartilage Streaming Potentials via Electrodes Placed on Skin Surrounding an Articular Joint. Cartilage 2021; 13:375S-385S. [PMID: 32500724 PMCID: PMC8804767 DOI: 10.1177/1947603520928583] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We aimed to demonstrate that electroarthrography (EAG) measures streaming potentials originating in the cartilage extracellular matrix during load bearing through electrodes adhered to skin surrounding an articular joint. DESIGN Equine metacarpophalangeal joints were subjected to simulated physiological loads while (1) replacing synovial fluid with immersion buffers of different electrolyte concentrations and (2) directly degrading cartilage with trypsin. RESULTS An inverse relationship between ionic strength and EAG coefficient was detected. Compared to native synovial fluid, EAG coefficients increased (P < 0.05) for 5 of 6 electrodes immersed in 0.1X phosphate-buffered saline (PBS) (0.014 M NaCl), decreased (P < 0.05) for 4 of 6 electrodes in 1X PBS (0.14 M NaCl), and decreased (P < 0.05) for all 6 electrodes in 10X PBS (1.4 M NaCl). This relationship corresponds to similar studies where streaming potentials were directly measured on cartilage. EAG coefficients, obtained after trypsin degradation, were reduced (P < 0.05) in 6 of 8, and 7 of 8 electrodes, during simulated standing and walking, respectively. Trypsin degradation was confirmed by direct cartilage assessments. Streaming potentials, measured by directly contacting cartilage, indicated lower cartilage stiffness (P < 10-5). Unconfined compression data revealed reduced Em, representing proteoglycan matrix stiffness (P = 0.005), no change in Ef, representing collagen network stiffness (P = 0.15), and no change in permeability (P = 0.24). Trypsin depleted proteoglycan as observed by both dimethylmethylene blue assay (P = 0.0005) and safranin-O stained histological sections. CONCLUSION These data show that non-invasive EAG detects streaming potentials produced by cartilage during joint compression and has potential to become a diagnostic tool capable of detecting early cartilage degeneration.
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Affiliation(s)
- Adele Changoor
- Lunenfeld-Tanenbaum Research Institute,
Sinai Health System, Toronto, Ontario, Canada
- Department of Surgery and Department of
Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario,
Canada
| | | | | | - Shelley B. Bull
- Lunenfeld-Tanenbaum Research Institute,
Sinai Health System, Toronto, Ontario, Canada
| | - Karen Gordon
- College of Engineering and Physical
Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Pierre Savard
- Biomedical and Electrical Engineering,
École Polytechnique, Montréal, Quebec, Canada
| | | | - Mark B. Hurtig
- Comparative Orthopaedic Research
Laboratory, Department of Clinical Studies, University of Guelph, Guelph, Ontario,
Canada
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20
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Safa A, Bagherifard A, Hadi Al-Baseesee H, Amini Kadijani A, Yahyazadeh H, Azizi M, Akbari A, Mirzaei A. Serum Calprotectin as a Blood-Based Biomarker for Monitoring Knee Osteoarthritis at Early but Not Late Stages. Cartilage 2021; 13:1566S-1571S. [PMID: 33000650 PMCID: PMC8808838 DOI: 10.1177/1947603520961161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The identification of early-stage osteoarthritis (OA) is crucial for the deceleration of its progression; however, no reliable biomarker is available for this purpose. The current study aimed to determine the role of serum calprotectin in the detection of early-stage knee OA. DESIGN In a case-control study, serum samples were collected from 84 patients with primary bilateral knee OA and 52 healthy controls. The radiographic grading of knee OA was performed using the Kellgren-Lawrence classification system. Serum concentrations of calprotectin were measured using an enzyme-linked immunosorbent assay. RESULTS The mean serum calprotectin level was 2908 ± 2516 ng/mL in OA patients and 901 ± 875 ng/mL in healthy control subjects (P < 0.001). Mean serum calprotectin levels were significantly higher in the lower stages of OA: 3740 ± 2728 ng/mL in OA grade I, 3100 ± 2084 ng/mL in OA grade II, 2246 ± 1418 ng/mL in OA grade III, and 2035 ± 765 ng/mL in OA grade IV (P = 0.047). Serum calprotectin levels were significantly higher in patients with a disease duration <42 months compared with those with a disease duration >42 months (P = 0.043). CONCLUSION Serum calprotectin level increases significantly in the early stages of OA and shows a reverse association with disease severity. Therefore, it could be suggested as a promising blood-based marker for early-stage knee OA.
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Affiliation(s)
- Amin Safa
- Institute of Research and Development,
Duy Tan University, Da Nang, Viet Nam,Department of Immunology, Ophthalmology
and ENT, School of Medicine, Complutense University, Madrid, Spain
| | - Abolfazl Bagherifard
- Bone and Joint Reconstruction Research
Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran,
Iran
| | | | - Azade Amini Kadijani
- Basic and Molecular Epidemiology of
Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology
and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Hooman Yahyazadeh
- Bone and Joint Reconstruction Research
Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran,
Iran
| | - Masoumeh Azizi
- Molecular Medicine Department,
Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Abolfazl Akbari
- Colorectal Research Center, Iran
University of Medical Sciences, Tehran, Iran
| | - Alireza Mirzaei
- Bone and Joint Reconstruction Research
Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran,
Iran,Alireza Mirzaei, Shafa Orthopedic Hospital,
Baharestan Square, Tehran, Iran.
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21
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Lawler D, Tangredi B, Becker J, Widga C, Etnier M, Martin T, Schulz K, Kohn L. The nature of coxofemoral joint pathology across family Canidae. Anat Rec (Hoboken) 2021; 305:2119-2136. [PMID: 34837349 DOI: 10.1002/ar.24846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 01/26/2023]
Abstract
We evaluated coxofemoral joints from museum specimens of: Vulpes lagopus; Vulpes vulpes; Vulpes velox; Nyctereutes procyonoides; Urocyon cinereoargenteus; Aenocyon [Canis] dirus; Canis latrans; Canis lupus lupus; Canis lupus familiaris; C. l. familiaris × latrans; and Canis dingo. Acetabular components included: fossa; articular surface; medial and lateral articular margins; and periarticular surfaces. Acetabular components variably revealed: osteophyte-like features; varying appearance of articular margin rims (especially contour changes); rough bone surfaces (especially fossa and articular surface); and surface wear. Proximal femoral components included: articular surface; articular margin; periarticular surfaces; and joint capsule attachment. Femoral components variably revealed: rough bone surface; bone loss; articular margin osteophyte-like features; caudal post-developmental mineralized prominence; and enthesophytes along the joint capsule attachment. Non-metric multidimensional scaling was used to analyze right-left asymmetric relationships between observed traits, across taxa. Significantly different acetabular trait asymmetry involved only C. latrans-C. l. familiaris; V. vulpes-N. procyonoides, and U. cinereoargenteus-N. procyonoides. There were no significant lateralized differences in proximal femoral traits involving modern canids, ancient and modern C. l. familiaris, or modern vulpines. Thus, the observations were strongly bilateral. We hypothesized high similarity of traits across taxa. The data confirm the hypothesis and strongly suggest broad and deep morphological and mechanistic conservation that almost certainly pre-existed (at least) all modern canids. Further zoological studies are needed to evaluate phylogenic implications in greater detail.
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Affiliation(s)
- Dennis Lawler
- Center for American Archaeology, Kampsville, Illinois, USA.,Pacific Marine Mammal Center, Laguna Beach, California, USA.,Department of Landscape History, Illinois State Museum, Springfield, Illinois, USA
| | - Basil Tangredi
- Pacific Marine Mammal Center, Laguna Beach, California, USA.,Green Mountain College, Poultney, Vermont, USA.,Vermont Institute of Natural Sciences, Quechee, Vermont, USA
| | - Julia Becker
- Tippecanoe Animal Hospital, Lafayette, Indiana, USA
| | - Christopher Widga
- Don Sunquist Center for Excellence in Paleontology, East Tennessee State University, Gray, Tennessee, USA
| | - Michael Etnier
- Department of Anthropology, Western Washington University, Bellingham, Washington, USA
| | - Terrance Martin
- Department of Landscape History, Illinois State Museum, Springfield, Illinois, USA
| | - Kurt Schulz
- Department of Biological Sciences, Southern Illinois University, Edwardsville, Illinois, USA
| | - Luci Kohn
- Department of Biological Sciences, Southern Illinois University, Edwardsville, Illinois, USA
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22
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Wang J, Fan Q, Yu T, Zhang Y. Identifying the hub genes and immune cell infiltration in synovial tissue between osteoarthritic and rheumatoid arthritic patients by bioinformatic approach. Curr Pharm Des 2021; 28:497-509. [PMID: 34736376 DOI: 10.2174/1381612827666211104154459] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Osteoarthritis (OA) and rheumatoid arthritis (RA) are two common diseases that result in limb disability and a decrease in quality of life. The major symptoms of OA and RA are pain, swelling, stiffness, and malformation of joints, and each disease also has unique characteristics. OBJECTIVE To compare the pathological mechanisms of OA and RA via weighted correlation network analysis (WGCNA) and immune infiltration analysis and find potential diagnostic and pharmaceutical targets for the treatment of OA and RA. METHODS The gene expression profiles of ten OA and ten RA synovial tissue samples were downloaded from the Gene Expression Omnibus (GEO) database (GSE55235). After obtaining differentially expressed genes (DEGs) via GEO2R, WGCNA was conducted using an R package, and modules and genes that were highly correlated with OA and RA were identified. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and protein-protein interaction (PPI) network analyses were also conducted. Hub genes were identified using the Search Tool for the Retrieval of Interacting Genes (STRING) and Cytoscape software. Immune infiltration analysis was conducted using the Perl program and CIBERSORT software. RESULTS Two hundred ninety-nine DEGs, 24 modules, 16 GO enrichment terms, 6 KEGG pathway enrichment terms, 10 hub genes (CXCL9, CXCL10, CXCR4, CD27, CD69, CD3D, IL7R, STAT1, RGS1, and ISG20), and 8 kinds of different infiltrating immune cells (plasma cells, CD8 T cells, activated memory CD4 T cells, T helper follicular cells, M1 macrophages, Tregs, resting mast cells, and neutrophils) were found to be involved in the different pathological mechanisms of OA and RA. CONCLUSION Inflammation-associated genes were the top differentially expressed hub genes between OA and RA, and their expression was downregulated in OA. Genes associated with lipid metabolism may have upregulated expression in OA. In addition, immune cells that participate in the adaptive immune response play an important role in RA. OA mainly involves immune cells that are associated with the innate immune response.
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Affiliation(s)
- Junjie Wang
- Qingdao University, Qingdao, Shandong 266000. China
| | - Qin Fan
- Qingdao University, Qingdao, Shandong 266000. China
| | - Tengbo Yu
- Qingdao University, Qingdao, Shandong 266000. China
| | - Yingze Zhang
- Qingdao University, Qingdao, Shandong 266000. China
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23
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Pei W, Huang X, Ni B, Zhang R, Niu G, You H. Selective STAT3 Inhibitor Alantolactone Ameliorates Osteoarthritis via Regulating Chondrocyte Autophagy and Cartilage Homeostasis. Front Pharmacol 2021; 12:730312. [PMID: 34650433 PMCID: PMC8505527 DOI: 10.3389/fphar.2021.730312] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/10/2021] [Indexed: 01/05/2023] Open
Abstract
Osteoarthritis (OA), which is identified by chronic pain, impacts the quality of life. Cartilage degradation and inflammation are the most relevant aspects involved in its development. Signal transducer and activator of transcription 3(STAT3), a member of the STATs protein family, is associated with inflammation. Alantolactone (ALT), a sesquiterpene lactone compound, can selectively suppress the phosphorylation of STAT3. However, the pharmacological effect of ALT on OA is still imprecise. In this study, IL-1β (10 ng/ml) was applied to cartilage chondrocytes, which were treated with different concentrations of Alantolactone for 24 h. The expression of inducible nitric oxide synthase (iNOS), cyclooxygenase-2(COX2), matrix metalloproteinases (MMPs) and thrombospondin motifs-5 (ADAMTS5) were detected by western blot. Protein expression of Collagen Ⅱ was observed by western blot, safranin O staining and immunofluorescence. Manifestation of autophagy related proteins such as autophagy-related gene-5 (ATG5), P62, LC3Ⅱ/Ⅰ and PI3K/AKT/mTOR-related signaling molecules were measured by western blot and autophagic flux monitored by confocal microscopy. Expression of STAT3 and NF-κB-related signaling molecules were evaluated by western blot and immunofluorescence. In vivo, 2 mg/kg ALT or equal bulk of vehicle was engaged in the destabilization of medial meniscus (DMM) mouse models by intra-articular injection, the degree of cartilage destruction was classified by Safranin O/Fast green staining. Our findings reported that the enhance of inflammatory factors containing iNOS, COX2, MMPs and ADAMTS5 induced by IL-1β could be ameliorated by ALT. Additionally, the diminish of Collagen Ⅱ and autophagy which was stimulated by IL-1β could be alleviated by ALT. Mechanistically, STAT3, NF-κB and PI3K/AKT/mTOR signal pathways might be involved in the effect of ALT on IL-1β-induced mouse chondrocytes. In vivo, ALT protected cartilage in the DMM mouse model. Overall, this study illustrated that ALT attenuated IL-1β-induced inflammatory responses, relieved cartilage degeneration and promoted impaired autophagy via restraining of STAT3 and NF-κB signal pathways, implying its auspicious therapeutical effect for OA.
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Affiliation(s)
- Wenbin Pei
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojian Huang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bowei Ni
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Zhang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangyi Niu
- Rhode Island School of Design, Providence, RI, United States
| | - Hongbo You
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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24
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Moewis P, Kaiser R, Trepczynski A, von Tycowicz C, Krahl L, Ilg A, Holz J, Duda GN. Patient-specific resurfacing implant knee surgery in subjects with early osteoarthritis results in medial pivot and lateral femoral rollback during flexion: a retrospective pilot study. Knee Surg Sports Traumatol Arthrosc 2021; 31:1247-1266. [PMID: 34601628 PMCID: PMC10050034 DOI: 10.1007/s00167-021-06749-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Metallic resurfacing implants have been developed for the treatment of early, small, condylar and trochlear osteoarthritis (OA) lesions. They represent an option for patients who do not fulfill the criteria for unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA) or are too old for biological treatment. Although clinical evidence has been collected for different resurfacing types, the in vivo post-operative knee kinematics remain unknown. The present study aims to analyze the knee kinematics in subjects with patient-specific episealer implants. This study hypothesized that patient-specific resurfacing implants would lead to knee kinematics close to healthy knees, resulting in medial pivot and a high degree of femoral rollback during flexion. METHODS Retrospective study design. Fluoroscopic analysis during unloaded flexion-extension and loaded lunge was conducted at > 12 months post-surgery in ten episealer knees, and compared to ten healthy knees. Pre- and post-operative clinical data of the episealer knees were collected using a visual analog scale (VAS), the EQ 5d Health, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaires. RESULTS A consistent medial pivot was observed in both episealer and healthy knees. Non-significant differences were found in the unloaded (p = 0.15) and loaded (p = 0.51) activities. Although lateral rollback was observed in both groups, it was significantly higher for the episealer knees in both the unloaded (p = 0.02) and loaded (p = 0.01) activities. Coupled axial rotation was significantly higher in the unloaded (p = 0.001) but not in the loaded (p = 0.06) activity in the episealer knees. Improved scores were observed at 1-year post-surgery in the episealer subjects for the VAS (p = 0.001), KOOS (p = 0.001) and EQ Health (p = 0.004). CONCLUSION At 12 month follow-up, a clear physiological knee kinematics pattern of medial pivot, lateral femoral rollback and coupled axial external femoral rotation during flexion was observed in patients treated with an episealer resurfacing procedure. However, higher femoral rollback and axial external rotation in comparison to healthy knees was observed, suggesting possible post-operative muscle weakness and consequent insufficient stabilization at high flexion.
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Affiliation(s)
- Philippe Moewis
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - René Kaiser
- OrthoCentrum Hamburg, Hansastrasse 1-3, 20149, Hamburg, Germany
| | - Adam Trepczynski
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353, Berlin, Germany
| | | | - Leonie Krahl
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Ansgar Ilg
- OrthoCentrum Hamburg, Hansastrasse 1-3, 20149, Hamburg, Germany
| | - Johannes Holz
- OrthoCentrum Hamburg, Hansastrasse 1-3, 20149, Hamburg, Germany
| | - Georg N Duda
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Julius Wolff Institute, Augustenburger Platz 1, 13353, Berlin, Germany
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25
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Quarterman JC, Naguib YW, Chakka JL, Seol D, Martin JA, Salem AK. HPLC-UV Method Validation for Amobarbital and Pharmaceutical Stability Evaluation When Dispersed in a Hyaluronic Acid Hydrogel: A New Concept for Post-Traumatic Osteoarthritis Prevention. J Pharm Sci 2021; 111:1379-1390. [PMID: 34563533 DOI: 10.1016/j.xphs.2021.09.025] [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: 06/30/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/17/2022]
Abstract
A mitochondrial electron transport chain member complex I inhibitor, amobarbital, can reduce oxidative damage and chondrocyte death, eventually preventing post-traumatic osteoarthritis (PTOA). Viscosupplementation using a crosslinked hyaluronic acid (HA) hydrogel is currently applied clinically for knee OA pain relief. In this work, we utilized the HA hydrogel as a drug delivery vehicle to improve the long-term efficacy of amobarbital. Here we evaluated the pharmaceutic stability of amobarbital when dispersed in a crosslinked HA hydrogel formulated in proportions intended for clinical use. We validated a high-performance liquid chromatography with an ultraviolet detector (HPLC-UV) method following International Conference for Harmonization Q2(R1) guidelines to ensure its suitability for amobarbital detection. The feasibility of this formulation's drug delivery capability was proven by measuring the release, solubility, and drug uniformity. The amobarbital/HA hydrogel showed comparable amobarbital stability in different biological fluids compared to amobarbital solution. In addition, the amobarbital/HA hydrogel imparted significantly greater drug stability when stored at 70°C for 24 hours. In conclusion, we confirmed the pharmaceutical stability of the amobarbital/HA hydrogel in various conditions and biological fluids using a validated HPLC-UV method. This data provides essential evidence in support of the use of this amobarbital/HA formulation in future clinical trials for PTOA treatment.
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Affiliation(s)
- Juliana C Quarterman
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, 115 S Grand Avenue, 201 Pharmacy Building, Iowa City, IA 52242, USA
| | - Youssef W Naguib
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, 115 S Grand Avenue, 201 Pharmacy Building, Iowa City, IA 52242, USA; Department of Pharmaceutics, Faculty of Pharmacy, Minia University, Minia 61519, Egypt
| | - Jaidev L Chakka
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, 115 S Grand Avenue, 201 Pharmacy Building, Iowa City, IA 52242, USA
| | - Dongrim Seol
- Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - James A Martin
- Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Aliasger K Salem
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, 115 S Grand Avenue, 201 Pharmacy Building, Iowa City, IA 52242, USA.
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26
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Lv Z, Yang YX, Li J, Fei Y, Guo H, Sun Z, Lu J, Xu X, Jiang Q, Ikegawa S, Shi D. Molecular Classification of Knee Osteoarthritis. Front Cell Dev Biol 2021; 9:725568. [PMID: 34513847 PMCID: PMC8429960 DOI: 10.3389/fcell.2021.725568] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/09/2021] [Indexed: 01/15/2023] Open
Abstract
Knee osteoarthritis (KOA) is the most common form of joint degeneration with increasing prevalence and incidence in recent decades. KOA is a molecular disorder characterized by the interplay of numerous molecules, a considerable number of which can be detected in body fluids, including synovial fluid, urine, and blood. However, the current diagnosis and treatment of KOA mainly rely on clinical and imaging manifestations, neglecting its molecular pathophysiology. The mismatch between participants' molecular characteristics and drug therapeutic mechanisms might explain the failure of some disease-modifying drugs in clinical trials. Hence, according to the temporal alteration of representative molecules, we propose a novel molecular classification of KOA divided into pre-KOA, early KOA, progressive KOA, and end-stage KOA. Then, progressive KOA is furtherly divided into four subtypes as cartilage degradation-driven, bone remodeling-driven, inflammation-driven, and pain-driven subtype, based on the major pathophysiology in patient clusters. Multiple clinical findings of representatively investigated molecules in recent years will be reviewed and categorized. This molecular classification allows for the prediction of high-risk KOA individuals, the diagnosis of early KOA patients, the assessment of therapeutic efficacy, and in particular, the selection of homogenous patients who may benefit most from the appropriate therapeutic agents.
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Affiliation(s)
- Zhongyang Lv
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yannick Xiaofan Yang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiawei Li
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yuxiang Fei
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Hu Guo
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Ziying Sun
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jun Lu
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xingquan Xu
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Qing Jiang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Science (IMS, RIKEN), Tokyo, Japan
| | - Dongquan Shi
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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27
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Szwedowski D, Szczepanek J, Paczesny Ł, Zabrzyński J, Gagat M, Mobasheri A, Jeka S. The Effect of Platelet-Rich Plasma on the Intra-Articular Microenvironment in Knee Osteoarthritis. Int J Mol Sci 2021; 22:5492. [PMID: 34071037 PMCID: PMC8197096 DOI: 10.3390/ijms22115492] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 02/07/2023] Open
Abstract
Knee osteoarthritis (KOA) represents a clinical challenge due to poor potential for spontaneous healing of cartilage lesions. Several treatment options are available for KOA, including oral nonsteroidal anti-inflammatory drugs, physical therapy, braces, activity modification, and finally operative treatment. Intra-articular (IA) injections are usually used when the non-operative treatment is not effective, and when the surgery is not yet indicated. More and more studies suggesting that IA injections are as or even more efficient and safe than NSAIDs. Recently, research to improve intra-articular homeostasis has focused on biologic adjuncts, such as platelet-rich plasma (PRP). The catabolic and inflammatory intra-articular processes that exists in knee osteoarthritis (KOA) may be influenced by the administration of PRP and its derivatives. PRP can induce a regenerative response and lead to the improvement of metabolic functions of damaged structures. However, the positive effect on chondrogenesis and proliferation of mesenchymal stem cells (MSC) is still highly controversial. Recommendations from in vitro and animal research often lead to different clinical outcomes because it is difficult to translate non-clinical study outcomes and methodology recommendations to human clinical treatment protocols. In recent years, significant progress has been made in understanding the mechanism of PRP action. In this review, we will discuss mechanisms related to inflammation and chondrogenesis in cartilage repair and regenerative processes after PRP administration in in vitro and animal studies. Furthermore, we review clinical trials of PRP efficiency in changing the OA biomarkers in knee joint.
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Affiliation(s)
- Dawid Szwedowski
- Orthopedic Arthroscopic Surgery International (O.A.S.I.) Bioresearch Foundation, Gobbi N.P.O., 20133 Milan, Italy
- Department of Orthopaedics and Trauma Surgery, Provincial Polyclinical Hospital, 87100 Torun, Poland
| | - Joanna Szczepanek
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, 87100 Torun, Poland;
| | - Łukasz Paczesny
- Orvit Clinic, Citomed Healthcare Center, 87100 Torun, Poland; (Ł.P.); (J.Z.)
| | - Jan Zabrzyński
- Orvit Clinic, Citomed Healthcare Center, 87100 Torun, Poland; (Ł.P.); (J.Z.)
| | - Maciej Gagat
- Department of Histology and Embryology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85067 Bydgoszcz, Poland;
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, FI-90014 Oulu, Finland;
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Santariskiu 5, LT-08406 Vilnius, Lithuania
- Departments of Orthopedics, Rheumatology and Clinical Immunology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
- Department of Joint Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Sławomir Jeka
- Department and Clinic of Rheumatology and Connective Tissue Diseases, University Hospital No. 2, Collegium Medicum UMK, 85168 Bydgoszcz, Poland;
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28
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Seitz AM, Osthaus F, Schwer J, Warnecke D, Faschingbauer M, Sgroi M, Ignatius A, Dürselen L. Osteoarthritis-Related Degeneration Alters the Biomechanical Properties of Human Menisci Before the Articular Cartilage. Front Bioeng Biotechnol 2021; 9:659989. [PMID: 34026741 PMCID: PMC8134692 DOI: 10.3389/fbioe.2021.659989] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022] Open
Abstract
An exact understanding of the interplay between the articulating tissues of the knee joint in relation to the osteoarthritis (OA)-related degeneration process is of considerable interest. Therefore, the aim of the present study was to characterize the biomechanical properties of mildly and severely degenerated human knee joints, including their menisci and tibial and femoral articular cartilage (AC) surfaces. A spatial biomechanical mapping of the articulating knee joint surfaces of 12 mildly and 12 severely degenerated human cadaveric knee joints was assessed using a multiaxial mechanical testing machine. To do so, indentation stress relaxation tests were combined with thickness and water content measurements at the lateral and medial menisci and the AC of the tibial plateau and femoral condyles to calculate the instantaneous modulus (IM), relaxation modulus, relaxation percentage, maximum applied force during the indentation, and the water content. With progressing joint degeneration, we found an increase in the lateral and the medial meniscal instantaneous moduli (p < 0.02), relaxation moduli (p < 0.01), and maximum applied forces (p < 0.01), while for the underlying tibial AC, the IM (p = 0.01) and maximum applied force (p < 0.01) decreased only at the medial compartment. Degeneration had no influence on the relaxation percentage of the soft tissues. While the water content of the menisci did not change with progressing degeneration, the severely degenerated tibial AC contained more water (p < 0.04) compared to the mildly degenerated tibial cartilage. The results of this study indicate that degeneration-related (bio-)mechanical changes seem likely to be first detectable in the menisci before the articular knee joint cartilage is affected. Should these findings be further reinforced by structural and imaging analyses, the treatment and diagnostic paradigms of OA might be modified, focusing on the early detection of meniscal degeneration and its respective treatment, with the final aim to delay osteoarthritis onset.
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Affiliation(s)
- Andreas M Seitz
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Felix Osthaus
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Jonas Schwer
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Daniela Warnecke
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Martin Faschingbauer
- Department of Orthopedic Surgery, Universitäts- und Rehabilitationskliniken Ulm (RKU), Ulm University Medical Center, Ulm, Germany
| | - Mirco Sgroi
- Department of Orthopedic Surgery, Universitäts- und Rehabilitationskliniken Ulm (RKU), Ulm University Medical Center, Ulm, Germany
| | - Anita Ignatius
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
| | - Lutz Dürselen
- Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, Ulm University Medical Center, Ulm, Germany
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29
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Yamada ALM, Pinheiro M, Marsiglia MF, Hagen SCF, Baccarin RYA, da Silva LCLC. Ultrasound and clinical findings in the metacarpophalangeal joint assessment of show jumping horses in training. J Vet Sci 2020; 21:e21. [PMID: 32476309 PMCID: PMC7263911 DOI: 10.4142/jvs.2020.21.e21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/19/2019] [Accepted: 12/16/2019] [Indexed: 01/01/2023] Open
Abstract
Background Physical exercise is known to cause significant joint changes. Thus, monitoring joint behavior of athletic horses is essential in early disorders recognition, allowing the proper management. Objectives The aims of this study were to determine the morphological patterns, physical examination characteristics and ultrasound findings of show jumping horses in training and to establish a score-based examination model for physical and ultrasound follow-ups of metacarpophalangeal joint changes in these animals. Methods A total of 52 metacarpophalangeal joints from 26 horses who were initially in the taming stage were evaluated, and the horses' athletic progression was monitored. The horses were evaluated by a physical examination and by B-mode and Doppler-mode ultrasound examinations, starting at time zero (T0), which occurred concomitantly with the beginning of training, and every 3 months thereafter for a follow-up period of 18 months. Results The standardized examination model revealed an increase in the maximum joint flexion angles and higher scores on the physical and ultrasound examinations after scoring was performed by predefined assessment tools, especially between 3 and 6 months of evaluation, which was immediately after the horses started more intense training. The lameness score and the ultrasound examination score were slightly higher at the end of the study. Conclusions The observed results were probably caused by the implementation of a training regimen and joint adaptation to physical conditioning. The joints most likely undergo a pre-osteoarthritic period due to work overload, which can manifest in a consistent or adaptive manner, as observed during this study. Thus, continuous monitoring of young athlete horses by physical and ultrasound examinations that can be scored is essential.
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Affiliation(s)
- Ana Lúcia M Yamada
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP 05508 270, Brazil.
| | - Marcelo Pinheiro
- Independant Veterinarian, Alameda do Parque 400, Jd Plaza Athene, Itu, SP 13302 225, Brazil
| | - Marília F Marsiglia
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP 05508 270, Brazil
| | - Stefano Carlo F Hagen
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP 05508 270, Brazil
| | - Raquel Yvonne A Baccarin
- Department of Clinical Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP 05508 270, Brazil
| | - Luís Cláudio L C da Silva
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP 05508 270, Brazil
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Mennan C, Hopkins T, Channon A, Elliott M, Johnstone B, Kadir T, Loughlin J, Peffers M, Pitsillides A, Sofat N, Stewart C, Watt FE, Zeggini E, Holt C, Roberts S. The use of technology in the subcategorisation of osteoarthritis: a Delphi study approach. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100081. [PMID: 36474678 PMCID: PMC9718088 DOI: 10.1016/j.ocarto.2020.100081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/28/2020] [Indexed: 01/19/2023] Open
Abstract
Objective This UK-wide OATech Network + consensus study utilised a Delphi approach to discern levels of awareness across an expert panel regarding the role of existing and novel technologies in osteoarthritis research. To direct future cross-disciplinary research it aimed to identify which could be adopted to subcategorise patients with osteoarthritis (OA). Design An online questionnaire was formulated based on technologies which might aid OA research and subcategorisation. During a two-day face-to-face meeting concordance of expert opinion was established with surveys (23 questions) before, during and at the end of the meeting (Rounds 1, 2 and 3, respectively). Experts spoke on current evidence for imaging, genomics, epigenomics, proteomics, metabolomics, biomarkers, activity monitoring, clinical engineering and machine learning relating to subcategorisation. For each round of voting, ≥80% votes led to consensus and ≤20% to exclusion of a statement. Results Panel members were unanimous that a combination of novel technological advances have potential to improve OA diagnostics and treatment through subcategorisation, agreeing in Rounds 1 and 2 that epigenetics, genetics, MRI, proteomics, wet biomarkers and machine learning could aid subcategorisation. Expert presentations changed participants' opinions on the value of metabolomics, activity monitoring and clinical engineering, all reaching consensus in Round 2. X-rays lost consensus between Rounds 1 and 2; clinical X-rays reached consensus in Round 3. Conclusion Consensus identified that 9 of the 11 technologies should be targeted towards OA subcategorisation to address existing OA research technology and knowledge gaps. These novel, rapidly evolving technologies are recommended as a focus for emergent, cross-disciplinary osteoarthritis research programmes.
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Affiliation(s)
- Claire Mennan
- The Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust & School of Pharmacy & Bioengineering, Keele University, Oswestry, Shropshire, SY10 7AG, UK
| | - Timothy Hopkins
- The Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust & School of Pharmacy & Bioengineering, Keele University, Oswestry, Shropshire, SY10 7AG, UK
| | - Alastair Channon
- School of Computing & Mathematics, Keele University, Staffordshire, ST5 5BG, UK
| | - Mark Elliott
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, CV4 7AL, UK
| | - Brian Johnstone
- Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Timor Kadir
- Optellum Ltd, Oxford Centre for Innovation, Oxford, OX1 1BY, UK
| | - John Loughlin
- Biosciences Institute, International Centre for Life, Newcastle University, Newcastle upon Tyne, NE1 3BX, UK
| | - Mandy Peffers
- Institute of Ageing and Chronic Disease, The University of Liverpool, L69 7ZX, UK
| | - Andrew Pitsillides
- Comparative Biomedical Sciences, The Royal Veterinary College, London, NW1 0TU, UK
| | - Nidhi Sofat
- Institute of Infection and Immunity, St Georges University of London, SW17 0RE, UK
| | - Caroline Stewart
- The Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust & School of Pharmacy & Bioengineering, Keele University, Oswestry, Shropshire, SY10 7AG, UK
| | - Fiona E. Watt
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, OX3 7FY, UK
| | - Eleftheria Zeggini
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute for Translational Genomics, Ingolstädter Landstr., 185764, Neuherberg, Germany
| | - Cathy Holt
- Cardiff University, Queen's Buildings, The Parade, Cardiff, CF24 3AA, UK
| | - Sally Roberts
- The Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust & School of Pharmacy & Bioengineering, Keele University, Oswestry, Shropshire, SY10 7AG, UK
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Torgomyan A, Saroyan M. Molecular Mechanisms of Chondro- and Osteogenesis Disturbance in Osteoarthritis and Ways of Their Correction. CYTOL GENET+ 2020. [DOI: 10.3103/s0095452720040118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vangeneugden J, Verlaan L, Oomen P, Liu WY, Peters M, Natour N, Emans P, Meijer K. Signatures of knee osteoarthritis in women in the temporal and fractal dynamics of human gait. Clin Biomech (Bristol, Avon) 2020; 76:105016. [PMID: 32438265 DOI: 10.1016/j.clinbiomech.2020.105016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 02/06/2020] [Accepted: 04/21/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Osteoarthritis of the knee is characterized by progressive cartilage deterioration causing pain and function loss. Symptoms develop late with limited disease-modifying opportunities. Osteoarthritis is a major cause of immobility, with a higher prevalence above 60 years. This age-related increase in prevalence is further amplified by the female gender. Imaging and biochemical analyses for detection of osteoarthritis of the knee are expensive and labor-intensive. Continuous movement tracking could aid in detecting onset and/or worsening of symptoms. METHODS We used portable technology to investigate kinematic differences in female patients with knee osteoarthritis, weight-matched healthy female volunteers and obese female patients with osteoarthritis of the knee. Knee osteoarthritis was established radiographically and corroborated using magnetic resonance imaging. FINDINGS The total amount, type and level of activity did not differ significantly between groups. The temporal activity pattern during the day was however significantly different with a bimodal signature in healthy volunteers only. Sequence analyses revealed more time to recuperate after dynamic activity in both patient groups. Analysis of walking bouts revealed significant differences in stride interval dynamics, indicative of gait naturalness, only in healthy volunteers. Temporal activity, sequence and walking patterns were independent of body weight. INTERPRETATION We thus provide for the first-time evidence of temporal specific kinematic signatures in amount and quality of movement also in stride interval dynamics between people with and without osteoarthritis of the knee independent of body weight. These findings could allow early and non-intrusive diagnosis of osteoarthritis enabling concordant treatment.
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Affiliation(s)
- Joris Vangeneugden
- Department of Orthopedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands; Department of Psychiatry & Neuropsychology, Division of Translational Neuroscience, Maastricht University, the Netherlands
| | - Loek Verlaan
- Department of Orthopedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands.
| | - Pieter Oomen
- Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and metabolism, Maastricht University Medical Center, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Wai-Yan Liu
- Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and metabolism, Maastricht University Medical Center, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Marloes Peters
- Department of Orthopedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands
| | - Nicole Natour
- Department of Nuclear Medicine and Radiology, Maastricht University Medical Center, the Netherlands
| | - Pieter Emans
- Department of Orthopedic Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands
| | - Kenneth Meijer
- Department of Human Movement Sciences, NUTRIM School for Nutrition, Toxicology and metabolism, Maastricht University Medical Center, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
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Kaur T, Dumoga S, Koul V, Singh N. Modulating neutrophil extracellular traps for wound healing. Biomater Sci 2020; 8:3212-3223. [PMID: 32374321 DOI: 10.1039/d0bm00355g] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A diabetic microenvironment primes neutrophils for NETosis, a process of formation of neutrophil extracellular traps (NETs) that further degrades the neutrophils and makes them unavailable for the early-stage inflammatory processes. Mechanistically, simple modification of arginine residues of histones to citrulline by peptidylarginine deiminase (PAD4) enzyme is considered to be a prerequisite for NETosis. In fact, under diabetic conditions, an increase in PAD4-mediated NET formation is considered as one of the reasons for impaired wound healing. Therefore, in the present work, an alginate-GelMa (generally recognized as safe category by FDA, USA) based hydrogel scaffold containing a tripeptide (Thr-Asp-F-amidine) that inhibits PAD4 is developed, based on the hypothesis that inhibiting PAD4 enzyme might offer a way to enhance wound healing under diabetic conditions. The scaffolds are thoroughly characterized for their physicochemical and biological properties. Furthermore, neutrophil-scaffold interactions in terms of NETosis ability and release of other related biomarkers are studied. The wound healing ability is evaluated by a cell migration assay. In vivo wound healing efficacy of the developed scaffolds is demonstrated using a diabetic rat model. The results suggest a reduction in NETosis in the presence of a PAD4 inhibitor. Thus, the study demonstrates a novel scaffold system to deliver the PAD4 inhibitor that can be used to modulate NETosis and improve wound healing.
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Affiliation(s)
- Tejinder Kaur
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India.
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Jiang A, Xu P, Zhao Z, Tan Q, Sun S, Song C, Leng H. Identification of Candidate Genetic Markers and a Novel 4-genes Diagnostic Model in Osteoarthritis through Integrating Multiple Microarray Data. Comb Chem High Throughput Screen 2020; 23:805-813. [PMID: 32342805 DOI: 10.2174/1386207323666200428120310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/19/2020] [Accepted: 03/19/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Osteoarthritis (OA) is a joint disease that leads to a high disability rate and a low quality of life. With the development of modern molecular biology techniques, some key genes and diagnostic markers have been reported. However, the etiology and pathogenesis of OA are still unknown. OBJECTIVE To develop a gene signature in OA. METHOD In this study, five microarray data sets were integrated to conduct a comprehensive network and pathway analysis of the biological functions of OA related genes, which can provide valuable information and further explore the etiology and pathogenesis of OA. RESULTS AND DISCUSSION Differential expression analysis identified 180 genes with significantly expressed expression in OA. Functional enrichment analysis showed that the up-regulated genes were associated with rheumatoid arthritis (p < 0.01). Down-regulated genes regulate the biological processes of negative regulation of kinase activity and some signaling pathways such as MAPK signaling pathway (p < 0.001) and IL-17 signaling pathway (p < 0.001). In addition, the OA specific protein-protein interaction (PPI) network was constructed based on the differentially expressed genes. The analysis of network topological attributes showed that differentially upregulated VEGFA, MYC, ATF3 and JUN genes were hub genes of the network, which may influence the occurrence and development of OA through regulating cell cycle or apoptosis, and were potential biomarkers of OA. Finally, the support vector machine (SVM) method was used to establish the diagnosis model of OA, which not only had excellent predictive power in internal and external data sets (AUC > 0.9), but also had high predictive performance in different chip platforms (AUC > 0.9) and also had effective ability in blood samples (AUC > 0.8). CONCLUSION The 4-genes diagnostic model may be of great help to the early diagnosis and prediction of OA.
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Affiliation(s)
- Ai Jiang
- Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Peng Xu
- University of Chinese Academy of Sciences, Beijing 100049, P.R. China
| | - Zhenda Zhao
- Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Qizhao Tan
- Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Shang Sun
- Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, P.R. China
| | - Chunli Song
- Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, P.R. China,Department of Orthopaedics, Beijing Key Lab of Spine Diseases, Beijing 100191, P.R. China
| | - Huijie Leng
- Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, P.R. China
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Chawla D, Kaur T, Joshi A, Singh N. 3D bioprinted alginate-gelatin based scaffolds for soft tissue engineering. Int J Biol Macromol 2020; 144:560-567. [DOI: 10.1016/j.ijbiomac.2019.12.127] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/04/2019] [Accepted: 12/14/2019] [Indexed: 01/07/2023]
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Hernandez PA, Wells J, Usheva E, Nakonezny PA, Barati Z, Gonzalez R, Kassem L, Henson FMD. Early-Onset Osteoarthritis originates at the chondrocyte level in Hip Dysplasia. Sci Rep 2020; 10:627. [PMID: 31953438 PMCID: PMC6969105 DOI: 10.1038/s41598-020-57431-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/31/2019] [Indexed: 01/05/2023] Open
Abstract
Subjects with developmental dysplasia of the hip (DDH) often show early-onset osteoarthritis (OA); however, the molecular mechanisms underlying this pathology are not known. We investigated whether cellular changes in chondrocytes from OA cartilage can be detected in chondrocytes from DDH cartilage before histological manifestations of degeneration. We characterized undamaged and damaged articular cartilage from 22 participants having hip replacement surgery with and without DDH (9 DDH-OA, 12 OA-only, one femoral fracture). Tissue immunostaining revealed changes in damaged OA-only cartilage that was also found in undamaged DDH-OA cartilage. Chondrocytes in situ from both groups show: (i) thicker fibers of vimentin intermediate filaments, (ii) clusters of integrin α5β1, (iii) positive MMP13 staining and (iv) a higher percentage of cells expressing the serine protease HtrA1. Further characterization of the extracellular matrix showed strong aggrecan and collagen II immunostaining in undamaged DDH cartilage, with no evidence of augmented cell death by activation of caspase 3. These findings suggest that early events in DDH cartilage originate at the chondrocyte level and that DDH cartilage may provide a novel opportunity to study these early changes for the development of therapeutic targets for OA.
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Affiliation(s)
- Paula A Hernandez
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
| | - Joel Wells
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Emiliya Usheva
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Paul A Nakonezny
- Department of Population and Data Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Zahra Barati
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Roberto Gonzalez
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Layla Kassem
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Frances M D Henson
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, CB2 2QQ, UK
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Bäumlein M, Hanke A, Gueorguiev B, Nerlich M, Liodakis E, Perren T, Rillmann P, Ryf C, Loibl M. Long-term outcome after surgical treatment of intra-articular tibial plateau fractures in skiers. Arch Orthop Trauma Surg 2019; 139:951-959. [PMID: 30864087 DOI: 10.1007/s00402-019-03150-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Tibial plateau fractures occur frequently during downhill skiing. There is a lack of information about the outcome and development of posttraumatic osteoarthritis after internal fixation of such fractures at long-term follow-up in skiers. MATERIALS AND METHODS A population of 83 skiers was followed up in a case series after internal fixation of intra-articular tibial plateau fractures AO-OTA 41 B1-B3 and C1-C3. Functional outcomes Visual Analog Scale, Tegner Activity Scale, Modified Lysholm Score, Hospital for Special Surgery (HSS) Knee Score and X-ray images of the affected knees (preoperative, postoperative and at time of follow-up) were obtained. Radiological evaluation focused on severity of osteoarthritis according to the Kellgren and Lawrence score of the lateral, medial and retropatellar knee compartments separately. Subgroup analyses for fracture type and age were performed separately. RESULTS Patients age was 49.8 ± 12.9 years (range 19-74 years) at the time of surgery, with a mean follow-up period of 10.3 ± 1.9 years (range 6-14 years). All tibial plateau fractures affected the lateral compartment, while the medial compartment was affected in addition as part of bicondylar fractures in two cases. Both the Tegener Activity Scale and Lysholm Score decreased significantly during the follow-up period and their median values dropped from 6 (range 3-7) to 5 (range 2-7) and from 100 (range 90-100) to 95 (range 58-100), respectively (both p < .01). The median clinical knee function at the time of follow-up revealed an HSS Knee Score of 96.5 points (range 74-100). Among the whole patient population, the radiological evaluation at follow-up revealed a significantly higher grade of osteoarthritis in all compartments of the knee joint compared to the time of the operation (p < .01). The grade of osteoarthritis in the lateral compartment was significantly higher than that in the medial and retropatellar compartments (p < .01). CONCLUSIONS In addition to physiologic aging, progression of radiologic signs of osteoarthritis following internal fixation of intra-articular tibial plateau fractures in an athletic population of skiers is most severe in the lateral knee compartment corresponding to fracture location. However, the long-term functional outcomes seem to be very satisfactory.
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Affiliation(s)
- Martin Bäumlein
- Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Baldinger Str., 35043, Marburg, Germany. .,Department of Trauma Surgery, Davos Hospital, Davos, Switzerland.
| | - Alexander Hanke
- Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany
| | | | - Michael Nerlich
- Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany
| | | | - Thomas Perren
- Department of Trauma Surgery, Davos Hospital, Davos, Switzerland
| | - Paavo Rillmann
- Department of Trauma Surgery, Davos Hospital, Davos, Switzerland
| | - Christian Ryf
- Department of Trauma Surgery, Davos Hospital, Davos, Switzerland
| | - Markus Loibl
- Department of Trauma Surgery, Davos Hospital, Davos, Switzerland.,Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany
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Arias-Vázquez PI, Tovilla-Zárate CA, Hernández-Díaz Y, González-Castro TB, Juárez-Rojop IE, López-Narváez ML, Bermudez-Ocaña DY, Barjau-Madrígal HA, Legorreta-Ramírez G. Short-Term Therapeutic Effects of Ozone in the Management of Pain in Knee Osteoarthritis: A Meta-Analysis. PM R 2019; 11:879-887. [PMID: 30689297 DOI: 10.1002/pmrj.12088] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 12/16/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Ozone therapy has been used widely to decrease pain related to osteoarthritis, but the effectiveness of this treatment has not been evaluated. OBJECTIVE To evaluate the effectiveness of ozone therapy in the reduction of pain in patients with knee osteoarthritis, according to the type of intervention and duration of the effect. TYPE: Meta-analysis. LITERATURE SURVEY We performed an online search using PUBMED, DIALNET, SCIELO, MEDIGRAPHIC, and ISCO3 databases. We searched for articles published up to January 2018. PARTICIPANTS We selected eight studies including a total of 355 patients and 363 controls. METHODOLOGY Only randomized-controlled trials that assessed the efficacy of intraarticular or periarticular infiltrations with ozone to treat knee osteoarthritis in humans were included in the analysis. The results are expressed as standardized mean difference and 95% confidence intervals. The meta-analysis was performed in accordance with the statement of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. SYNTHESIS We observed that ozone treatment had a therapeutic effect when compared with placebo (d = -0.81, 95% CI -1.06 to -0.55, I2 = 34.79, P(Q) = .47) or other noninvasive treatments. No significant effects were found in favor of the ozone treatment when compared with the use of hyaluronic acid or platelet-rich plasma. However, the use of ozone had a significant short-term benefit reducing knee pain (d = -2.26, 95% CI -2.26 to -3.72, I2 = 97, P(Q) < .001). Pain relief benefits lasted between 3 and 6 months. CONCLUSION Our results indicate that intraarticular infiltrations of ozone can be used as an optional effective treatment for the management of pain related to knee osteoarthritis. There are short-term effect benefits that peak at around 1 month of treatment, with a gradual decline in efficacy after 3 to 6 months of treatment. More studies are needed to improve our understanding of the efficacy of this interventional treatment. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Pedro Iván Arias-Vázquez
- Multidisciplinary Academic Division of Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, México
| | - Carlos Alfonso Tovilla-Zárate
- Multidisciplinary Academic Division of Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, México
| | - Yazmín Hernández-Díaz
- Multidisciplinary Academic Division of Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, Mexico
| | - Thelma Beatriz González-Castro
- Multidisciplinary Academic Division of Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, Mexico
| | - Isela Esther Juárez-Rojop
- Academic Division of Health Sciences, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, México
| | | | - Deysi Yadira Bermudez-Ocaña
- Multidisciplinary Academic Division of Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, México
| | - Hugo Adrián Barjau-Madrígal
- Multidisciplinary Academic Division of Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, México
| | - Gabriela Legorreta-Ramírez
- Subdirección Medical Clinic, Rehabilitation Center Children Telethon, Tlanepantla, Estado de México, MéxicoDisclosures: none
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Sauerschnig M, Berninger MT, Kaltenhauser T, Plecko M, Wexel G, Schönfelder M, Wienerroither V, Imhoff AB, Schöttle PB, Rosado Balmayor E, Salzmann GM. Chondrocyte Culture Parameters for Matrix-Assisted Autologous Chondrocyte Implantation Affect Catabolism and Inflammation in a Rabbit Model. Int J Mol Sci 2019; 20:ijms20071545. [PMID: 30934789 PMCID: PMC6479589 DOI: 10.3390/ijms20071545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 11/16/2022] Open
Abstract
Cartilage defects represent an increasing pathology among active individuals that affects the ability to contribute to sports and daily life. Cell therapy, such as autologous chondrocyte implantation (ACI), is a widespread option to treat larger cartilage defects still lacking standardization of in vitro cell culture parameters. We hypothesize that mRNA expression of cytokines and proteases before and after ACI is influenced by in vitro parameters: cell-passage, cell-density and membrane-holding time. Knee joint articular chondrocytes, harvested from rabbits (n = 60), were cultured/processed under varying conditions: after three different cell-passages (P1, P3, and P5), cells were seeded on 3D collagen matrices (approximately 25 mm³) at three different densities (2 × 10⁵/matrix, 1 × 10⁶/matrix, and 3 × 10⁶/matrix) combined with two different membrane-holding times (5 h and two weeks) prior autologous transplantation. Those combinations resulted in 18 different in vivo experimental groups. Two defects/knee/animal were created in the trochlear groove (defect dimension: ∅ 4 mm × 2 mm). Four identical cell-seeded matrices (CSM) were assembled and grouped in two pairs: One pair giving pre-operative in vitro data (CSM-i), the other pair was implanted in vivo and harvested 12 weeks post-implantation (CSM-e). CSMs were analyzed for TNF-α, IL-1β, MMP-1, and MMP-3 via qPCR. CSM-i showed higher expression of IL-1β, MMP-1, and MMP-3 compared to CSM-e. TNF-α expression was higher in CSM-e. Linearity between CSM-i and CSM-e values was found, except for TNF-α. IL-1β expression was higher in CSM-i at higher passage and longer membrane-holding time. IL-1β expression decreased with prolonged membrane-holding time in CSM-e. For TNF-α, the reverse was true. Lower cell-passages and lower membrane-holding time resulted in stronger TNF-α expression. Prolonged membrane-holding time resulted in increased MMP levels among CSM-i and CSM-e. Cellular density was of no significant effect. We demonstrated cytokine and MMP expression levels to be directly influenced by in vitro culture settings in ACI. Linearity of expression-patterns between CSM-i and CSM-e may predict ACI regeneration outcome in vivo. Cytokine/protease interaction within the regenerate tissue could be guided via adjusting in vitro culture parameters, of which membrane-holding time resulted the most relevant one.
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Affiliation(s)
- Martin Sauerschnig
- Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich 81675, Germany.
- Trauma Hospital Graz, Unfallkrankenhaus der Allgemeinen Unfallversicherungsanstalt (AUVA), Teaching Hospital Medical University Graz, Graz 8010, Austria.
| | - Markus T Berninger
- Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich 81675, Germany.
- Department of Trauma Surgery, Trauma Center (BGU) Murnau, Murnau 82418, Germany.
| | - Theresa Kaltenhauser
- Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich 81675, Germany.
| | - Michael Plecko
- Trauma Hospital Graz, Unfallkrankenhaus der Allgemeinen Unfallversicherungsanstalt (AUVA), Teaching Hospital Medical University Graz, Graz 8010, Austria.
| | - Gabriele Wexel
- Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich 81675, Germany.
| | - Martin Schönfelder
- Exercise Biology, Technical University of Munich, 80809 Munich, Germany.
| | - Valerie Wienerroither
- Trauma Hospital Graz, Unfallkrankenhaus der Allgemeinen Unfallversicherungsanstalt (AUVA), Teaching Hospital Medical University Graz, Graz 8010, Austria.
- Department of General Surgery, Medical University of Graz, Graz 8036, Austria.
| | - Andreas B Imhoff
- Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich 81675, Germany.
| | - Philip B Schöttle
- Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich 81675, Germany.
| | - Elizabeth Rosado Balmayor
- Experimental Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich 81675, Germany.
| | - Gian M Salzmann
- Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich 81675, Germany.
- Gelenkzentrum Rhein-Main, Wiesbaden 65183, Germany.
- Musculoskeletal Centre, Schulthess Klinik Zurich, Zurich 8008, Switzerland.
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40
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Gu HY, Yang M, Guo J, Zhang C, Lin LL, Liu Y, Wei RX. Identification of the Biomarkers and Pathological Process of Osteoarthritis: Weighted Gene Co-expression Network Analysis. Front Physiol 2019; 10:275. [PMID: 30941059 PMCID: PMC6433881 DOI: 10.3389/fphys.2019.00275] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/28/2019] [Indexed: 11/29/2022] Open
Abstract
Osteoarthritis (OA) is a joint disease resulting in high rates of disability and low quality of life. The initial site of OA (bone or cartilage) is uncertain. The aim of the current study was to explore biomarkers and pathological processes in subchondral bone samples. The gene expression profile GSE51588 was downloaded from the Gene Expression Omnibus database. Fifty subchondral bone [knee lateral tibial (LT) and medial tibial (MT)] samples from 40 OA and 10 non-OA subjects were analyzed. After data preprocessing, 5439 genes were obtained for weighted gene co-expression network analysis. Highly correlated genes were divided into 19 modules. The yellow module was found to be highly correlated with OA (r = 0.71, p = 1e-08) and the brown module was most associated with the differences between the LT and MT regions (r = 0.77, p = 1e-10). Gene ontology functional annotation and Kyoto Encyclopedia of Genes and Genomes pathway enrichment indicated that the yellow module was enriched in a variety of components including proteinaceous extracellular matrix and collagen trimers, involved in protein digestion and absorption, axon guidance, ECM-receptor interaction, and the PI3K-Akt signaling pathway. In addition, the brown module suggests that the differences between the early (LT) and end (MT) stage of OA are associated with extracellular processes and lipid metabolism. Finally, 45 hub genes in the yellow module (COL24A1, COL5A2, COL3A1, MMP2, COL6A1, etc.) and 72 hub genes in the brown module (LIPE, LPL, LEP, SLC2A4, FABP4, ADH1B, ALDH4A1, ADIPOQ, etc.) were identified. Hub genes were validated using samples from cartilage (GSE57218). In summary, 45 hub genes and 72 hub genes in two modules are associated with OA. These hub genes could provide new biomarkers and drug targets in OA. Further studies focusing on subchondral bone are required to validate these hub genes and better understand the pathological process of OA.
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Affiliation(s)
- Hui-Yun Gu
- Department of Orthopedic, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Min Yang
- Department of Orthopedic, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jia Guo
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chao Zhang
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Lu-Lu Lin
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yang Liu
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Ren-Xiong Wei
- Department of Orthopedic, Zhongnan Hospital of Wuhan University, Wuhan, China
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Zupan J, Vrtačnik P, Cör A, Haring G, Weryha G, Visvikis-Siest S, Marc J. VEGF-A is associated with early degenerative changes in cartilage and subchondral bone. Growth Factors 2018; 36:263-273. [PMID: 30764675 DOI: 10.1080/08977194.2019.1570926] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Paired cartilage and subchondral bone of subjects with no clinical history of joint disorders were analyzed to determine whether antioxidant enzymes, inflammatory cytokines and growth factors can be linked to a pre-osteoarthritis. Tissue explants were phenotyped according to Osteoarthritis Research Society International grading and micro-computed tomography, and also screened for the expression of several markers using quantitative polymerase chain reaction. The expression of these same genes was measured in SW1353 cells treated with hydrogen peroxide, to gain insight into the pathways involved with oxidative stress responses. Vascular endothelial growth factor A (VEGF-A) was up-regulated in the cartilage samples that showed early cartilage or bone degeneration. Oxidative stress in chondrocytes provoked up-regulation of interleukin-1β, interleukin-6, aggrecan, and SRY-box containing gene 9. Our results confirm the hitherto evidence of the deteriorating effects of the oxidative stress on cartilage and suggest the link between VEGF-A and pre-osteoarthritis.
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Affiliation(s)
- Janja Zupan
- a University of Ljubljana, Faculty of Pharmacy , Department of Clinical Biochemistry
| | - Peter Vrtačnik
- a University of Ljubljana, Faculty of Pharmacy , Department of Clinical Biochemistry
| | - Andrej Cör
- b Valdoltra Orthopaedic Hospital , Ankaran , Slovenia
| | - Gregor Haring
- c University of Ljubljana , Faculty of Medicine, Institute of Forensic Medicine
| | - Georges Weryha
- d Université de Lorraine , Inserm, IGE-PCV , Nancy , France
| | | | - Janja Marc
- a University of Ljubljana, Faculty of Pharmacy , Department of Clinical Biochemistry
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42
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Demehri S, Shakoor D. Structural changes in aging-knee vs early-knee osteoarthritis: review of current evidence and future challenges. Osteoarthritis Cartilage 2018; 26:1412-1414. [PMID: 30041053 DOI: 10.1016/j.joca.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/05/2018] [Accepted: 07/12/2018] [Indexed: 02/02/2023]
Affiliation(s)
- S Demehri
- Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University, Baltimore, MD, USA.
| | - D Shakoor
- Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins University, Baltimore, MD, USA.
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Legrand C, Ahmed U, Anwar A, Rajpoot K, Pasha S, Lambert C, Davidson RK, Clark IM, Thornalley PJ, Henrotin Y, Rabbani N. Glycation marker glucosepane increases with the progression of osteoarthritis and correlates with morphological and functional changes of cartilage in vivo. Arthritis Res Ther 2018; 20:131. [PMID: 29929535 PMCID: PMC6013878 DOI: 10.1186/s13075-018-1636-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/29/2018] [Indexed: 12/17/2022] Open
Abstract
Background Changes of serum concentrations of glycated, oxidized, and nitrated amino acids and hydroxyproline and anticyclic citrullinated peptide antibody status combined by machine learning techniques in algorithms have recently been found to provide improved diagnosis and typing of early-stage arthritis of the knee, including osteoarthritis (OA), in patients. The association of glycated, oxidized, and nitrated amino acids released from the joint with development and progression of knee OA is unknown. We studied this in an OA animal model as well as interleukin-1β-activated human chondrocytes in vitro and translated key findings to patients with OA. Methods Sixty male 3-week-old Dunkin-Hartley guinea pigs were studied. Separate groups of 12 animals were killed at age 4, 12, 20, 28 and 36 weeks, and histological severity of knee OA was evaluated, and cartilage rheological properties were assessed. Human chondrocytes cultured in multilayers were treated for 10 days with interleukin-1β. Human patients with early and advanced OA and healthy controls were recruited, blood samples were collected, and serum or plasma was prepared. Serum, plasma, and culture medium were analyzed for glycated, oxidized, and nitrated amino acids. Results Severity of OA increased progressively in guinea pigs with age. Glycated, oxidized, and nitrated amino acids were increased markedly at week 36, with glucosepane and dityrosine increasing progressively from weeks 20 and 28, respectively. Glucosepane correlated positively with OA histological severity (r = 0.58, p < 0.0001) and instantaneous modulus (r = 0.52–0.56; p < 0.0001), oxidation free adducts correlated positively with OA severity (p < 0.0009–0.0062), and hydroxyproline correlated positively with cartilage thickness (p < 0.0003–0.003). Interleukin-1β increased the release of glycated and nitrated amino acids from chondrocytes in vitro. In clinical translation, plasma glucosepane was increased 38% in early-stage OA (p < 0.05) and sixfold in patients with advanced OA (p < 0.001) compared with healthy controls. Conclusions These studies further advance the prospective role of glycated, oxidized, and nitrated amino acids as serum biomarkers in diagnostic algorithms for early-stage detection of OA and other arthritic disease. Plasma glucosepane, reported here for the first time to our knowledge, may improve early-stage diagnosis and progression of clinical OA. Electronic supplementary material The online version of this article (10.1186/s13075-018-1636-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catherine Legrand
- Bone and Cartilage Research Unit, Arthropôle Liège, Institute of Pathology, Level 5, CHU Sart-Tilman, 4000, Liège, Belgium
| | - Usman Ahmed
- Warwick Systems Biology, University of Warwick, Clinical Sciences Research Laboratories, University Hospital, Coventry, CV2 2DX, UK.,Warwick Medical School, Clinical Sciences Research Laboratories, University of Warwick, University Hospital, Coventry, CV2 2DX, UK
| | - Attia Anwar
- Warwick Systems Biology, University of Warwick, Clinical Sciences Research Laboratories, University Hospital, Coventry, CV2 2DX, UK
| | - Kashif Rajpoot
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - Sabah Pasha
- Warwick Systems Biology, University of Warwick, Clinical Sciences Research Laboratories, University Hospital, Coventry, CV2 2DX, UK
| | - Cécile Lambert
- Bone and Cartilage Research Unit, Arthropôle Liège, Institute of Pathology, Level 5, CHU Sart-Tilman, 4000, Liège, Belgium
| | - Rose K Davidson
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - Ian M Clark
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - Paul J Thornalley
- Warwick Systems Biology, University of Warwick, Clinical Sciences Research Laboratories, University Hospital, Coventry, CV2 2DX, UK.,Warwick Medical School, Clinical Sciences Research Laboratories, University of Warwick, University Hospital, Coventry, CV2 2DX, UK
| | - Yves Henrotin
- Bone and Cartilage Research Unit, Arthropôle Liège, Institute of Pathology, Level 5, CHU Sart-Tilman, 4000, Liège, Belgium.,Department of Physical Therapy and Rehabilitation, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
| | - Naila Rabbani
- Warwick Systems Biology, University of Warwick, Clinical Sciences Research Laboratories, University Hospital, Coventry, CV2 2DX, UK. .,Warwick Medical School, Clinical Sciences Research Laboratories, University of Warwick, University Hospital, Coventry, CV2 2DX, UK.
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Celecoxib-mediated reduction of prostanoid release in Hoffa's fat pad from donors with cartilage pathology results in an attenuated inflammatory phenotype. Osteoarthritis Cartilage 2018; 26:697-706. [PMID: 29426013 DOI: 10.1016/j.joca.2018.01.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/07/2018] [Accepted: 01/30/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The Hoffa's fat pad (HFP) is an intra-articular adipose tissue which is situated under and behind the patella. It contains immune cells next to adipocytes and secretes inflammatory factors during osteoarthritis (OA). In this study, we compared the release profile of prostanoids, which are involved in inflammation, of HFP from OA patients vs patients with a focal cartilage defect (CD) without evidence for OA on MRI and investigated the prostanoid modulatory anti-inflammatory action of celecoxib on HFP. DESIGN Prostanoid release was analyzed in conditioned medium of HFP explant cultures from 17 osteoarthritic patients and 12 CD patients, in the presence or absence of celecoxib. Furthermore, gene expression of COX enzymes and expression of genes indicative of a pro-inflammatory or anti-inflammatory phenotype of HFP was analyzed. RESULTS Prostanoid release by HFP from knee OA patients clustered in two subgroups with high and low prostanoid producers. HFP from high prostanoid producers released higher amounts of PGE2, PGF2α and PGD2 compared to HFP from CD patients. PGE2 release by OA HFP was positively associated with expression of genes known to be expressed by M1 macrophages, indicating a role for macrophages. Celecoxib modulated prostanoid release by HFP, and also modulated the inflammation ratio towards a more favorable anti-inflammatory M2 phenotype, most effectively in patients with higher prostanoid release profiles. CONCLUSION In knee OA patients with inflamed HFP's, celecoxib may exert positive effects in the knee joint via decreasing the release of prostanoids produced by the HFP and by favorably modulating the anti-inflammatory marker expression in HFP.
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Thulborn KR. Quantitative sodium MR imaging: A review of its evolving role in medicine. Neuroimage 2018; 168:250-268. [PMID: 27890804 PMCID: PMC5443706 DOI: 10.1016/j.neuroimage.2016.11.056] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/23/2016] [Accepted: 11/22/2016] [Indexed: 12/26/2022] Open
Abstract
Sodium magnetic resonance (MR) imaging in humans has promised metabolic information that can improve medical management in important diseases. This technology has yet to find a role in clinical practice, lagging proton MR imaging by decades. This review covers the literature that demonstrates that this delay is explained by initial challenges of low sensitivity at low magnetic fields and the limited performance of gradients and electronics available in the 1980s. These constraints were removed by the introduction of 3T and now ultrahigh (≥7T) magnetic field scanners with superior gradients and electronics for proton MR imaging. New projection pulse sequence designs have greatly improved sodium acquisition efficiency. The increased field strength has provided the expected increased sensitivity to achieve resolutions acceptable for metabolic interpretation even in small target tissues. Consistency of quantification of the sodium MR image to provide metabolic parametric maps has been demonstrated by several different pulse sequences and calibration procedures. The vital roles of sodium ion in membrane transport and the extracellular matrix will be reviewed to indicate the broad opportunities that now exist for clinical sodium MR imaging. The final challenge is for the technology to be supplied on clinical ≥3T scanners.
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Affiliation(s)
- Keith R Thulborn
- Center for Magnetic Resonance Research, University of Illinois at Chicago, 1801 West Taylor Street, Chicago, IL 60612, United States.
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46
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Ondrésik M, Oliveira JM, Reis RL. Advances for Treatment of Knee OC Defects. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1059:3-24. [PMID: 29736567 DOI: 10.1007/978-3-319-76735-2_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Osteochondral (OC) defects are prevalent among young adults and are notorious for being unable to heal. Although they are traumatic in nature, they often develop silently. Detection of many OC defects is challenging, despite the criticality of early care. Current repair approaches face limitations and cannot provide regenerative or long-standing solution. Clinicians and researchers are working together in order to develop approaches that can regenerate the damaged tissues and protect the joint from developing osteoarthritis. The current concepts of tissue engineering and regenerative medicine, which have brought many promising applications to OC management, are overviewed herein. We will also review the types of stem cells that aim to provide sustainable cell sources overcoming the limitation of autologous chondrocyte-based applications. The various scaffolding materials that can be used as extracellular matrix mimetic and having functional properties similar to the OC unit are also discussed.
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Affiliation(s)
- Marta Ondrésik
- 3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal.
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
| | - J Miguel Oliveira
- 3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Barco, Guimarães, Portugal
| | - Rui L Reis
- 3B's Research Group - Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
- The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Barco, Guimarães, Portugal
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Abstract
INTRODUCTION Osteoarthritis (OA), a chronic, debilitating and degenerative disease of the joints, is the most common form of arthritis. The seriousness of this prevalent and chronic disease is often overlooked. Disease modifying OA drug development is hindered by the lack of soluble biomarkers to detect OA early. The objective of OA biomarker research is to identify early OA prior to the appearance of radiographic signs and the development of pain. Areas covered: This review has focused on extracellular genomic material that could serve as biomarkers of OA. Recent studies have examined the expression of extracellular genomic material such as miRNA, lncRNA, snoRNA, mRNA and cell-free DNA, which are aberrantly expressed in the body fluids of OA patients. Changes in genomic content of peripheral blood mononuclear cells in OA could also function as biomarkers of OA. Expert commentary: There is an unmet need for soluble biomarkers for detecting and then monitoring OA disease progression. Extracellular genomic material research may also reveal more about the underlying pathophysiology of OA. Minimally-invasive liquid biopsies such as synovial fluid and blood sampling of genomic material may be more sensitive over radiography in the detection, diagnosis and monitoring of OA in the future.
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Affiliation(s)
- Emma Budd
- a The D-BOARD European Consortium for Biomarker Discovery, School of Veterinary Medicine , University of Surrey , Guildford , UK.,b Department of Veterinary Pre-Clinical Sciences, School of Veterinary Medicine, Faculty of Health and Medical Sciences , University of Surrey , Guildford , UK
| | - Giovanna Nalesso
- b Department of Veterinary Pre-Clinical Sciences, School of Veterinary Medicine, Faculty of Health and Medical Sciences , University of Surrey , Guildford , UK
| | - Ali Mobasheri
- a The D-BOARD European Consortium for Biomarker Discovery, School of Veterinary Medicine , University of Surrey , Guildford , UK.,b Department of Veterinary Pre-Clinical Sciences, School of Veterinary Medicine, Faculty of Health and Medical Sciences , University of Surrey , Guildford , UK.,c Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis , Queen's Medical Centre , Nottingham , UK
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Rodriguez-Fontan F, Payne KA, Chahla J, Mei-Dan O, Richards A, Uchida S, Pascual-Garrido C. Viability and Tissue Quality of Cartilage Flaps From Patients With Femoroacetabular Hip Impingement: A Matched-Control Comparison. Orthop J Sports Med 2017; 5:2325967117723608. [PMID: 28868322 PMCID: PMC5562333 DOI: 10.1177/2325967117723608] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Chondrolabral damage is commonly observed in patients with cam-type femoroacetabular impingement (FAI). Chondral flap reattachment has recently been proposed as a possible preservation technique. Purpose/Hypothesis: The purpose of this study was to determine the viability and tissue quality of chondral flaps from patients with FAI at the time of arthroscopy. It was hypothesized that chondral flaps from patients with cam lesions of the hip would exhibit less viability and greater tissue degeneration than would those of a matched control group. Study Design: Cohort study; Level of evidence, 2. Methods: Patients with cam-type FAI who were treated with hip arthroscopy between 2014 and 2016 were asked to participate in this study. The cartilage lesions were localized and classified intraoperatively according to Beck classification. A chondral flap (study group) and a cartilage sample (control group) were obtained from each patient for histologic evaluation. Cellular viability and tissue quality were examined and compared in both groups. Cellular viability was determined with live/dead staining, and tissue quality was evaluated using safranin O/fast green, hematoxylin and eosin (H&E) staining, and immunohistochemistry for collagen II. Osteoarthritis Research Society International (OARSI) grading was used for quality assessment, and Image J software was used to calculate the percentage of tissue viability and Col II stain. Results: A total of 10 male patients with a mean age of 38.4 years (range, 30-55 years) were enrolled. All chondral flaps were classified as Beck grade 4. The mean cellular viability of the chondral flaps was reduced (54.6% ± 25.6%), and they were found to be degenerated (OARSI grade, 4 ± 1.27). Control samples also had reduced viability (38.8% ± 30.3%) and were degenerative (OARSI grade, 3.5 ± 1.38). There was no statistically significant intergroup difference for viability (P = .203) or OARSI grade (P = .645), nor was there an intragroup correlation between viability and OARSI grade (P > .05). A significant negative correlation (r = −0.9, P = .035) was found between OARSI grade and collagen II percentage scale in 5 selected samples. Conclusion: Despite appearing normal macroscopically, the chondral flaps from patients with cam-type FAI displayed loss of viability and tissue degeneration. In addition, control samples obtained away from the injury area also displayed cartilage damage and degeneration. Careful consideration should be taken when attempting to reattach the chondral flap.
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Affiliation(s)
- Francisco Rodriguez-Fontan
- Regenerative Orthopedics Laboratory, Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Karin A Payne
- Regenerative Orthopedics Laboratory, Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jorge Chahla
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Omer Mei-Dan
- Sports Medicine, Hip Preservation, Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Abigail Richards
- Regenerative Orthopedics Laboratory, Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Soshi Uchida
- Department of Orthopaedic Surgery, Wakamatsu Hospital for the University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Cecilia Pascual-Garrido
- Adult Reconstruction, Adolescent and Young Adult Hip Service, Orthopaedics Department, Washington University, St Louis, Missouri, USA
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Richardson JB, Wright KT, Wales J, Kuiper JH, McCarthy HS, Gallacher P, Harrison PE, Roberts S. Efficacy and safety of autologous cell therapies for knee cartilage defects (autologous stem cells, chondrocytes or the two): randomized controlled trial design. Regen Med 2017. [PMID: 28635368 DOI: 10.2217/rme-2017-0032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AIM The main aim of this trial is to test the safety and efficacy of autologous stromal/stem cells, chondrocytes or the two combined in the treatment of knee cartilage defects. PATIENTS & METHODS Patients with symptomatic chondral/osteochondral defects will be randomized to cell therapy treatment with one of three cell populations (1:1:1). The primary efficacy outcome is a functional knee score (Lysholm) at 15 months post-treatment and the primary safety outcome is the incidence of adverse events. Secondary objectives are to analyze repair tissues, quality of life and cost-utility assessments. Exploratory objectives are to identify predictors for success/potency and dose-response relationships. RESULTS & CONCLUSION This trial has been carefully designed so that valuable scientific and clinical information can be gathered throughout and in the final analysis.
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Affiliation(s)
- James B Richardson
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.,Institute for Science & Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Karina T Wright
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.,Institute for Science & Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Johanna Wales
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK
| | - Jan Herman Kuiper
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.,Institute for Science & Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Helen S McCarthy
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.,Institute for Science & Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Peter Gallacher
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK
| | - Paul E Harrison
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK
| | - Sally Roberts
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK.,Institute for Science & Technology in Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
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Lahm A, Dabravolski D, Spank H, Merk H, Esser J, Kasch R. Regional differences of tibial and femoral cartilage in the chondrocyte gene expression, immunhistochemistry and composite in different stages of osteoarthritis. Tissue Cell 2017; 49:249-256. [DOI: 10.1016/j.tice.2017.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 01/18/2023]
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