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Zhong C, Zong X, Hua B, Sun J. Anti-inflammatory effect of a novel piperazino-enaminone delivered by liposomes in a mouse model of hemophilic arthropathy. Int J Pharm 2024; 659:124291. [PMID: 38821434 DOI: 10.1016/j.ijpharm.2024.124291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
Hemophilic arthropathy (HA) is a condition caused by recurrent intra-articular bleeding in patients with hemophilia. Pro-inflammatory cytokines play a crucial role in the pathogenesis of HA. Our previous research demonstrated that a novel compound, piperazino-enaminone (JODI), effectively inhibited pro-inflammatory cytokines, including IL-6, MCP-1, MIP-1α, and MIP-1β, in a mouse model of hemarthrosis. This study aims to enhance the anti-inflammatory effect of JODI by employing nanoparticle delivery systems, which could potentially improve its poor water solubility. Here, we developed liposomes modified with polyethylene glycol (PEG) for the delivery of JODI (JODI-LIP), and found that JODI-LIP exhibited uniform size, morphology, good stability and in vitro release degree. JODI-LIP mitigated cytotoxicity of JODI, and significantly suppressed the production of pro-inflammatory cytokines (TNF-α and IL-1β) and nitric oxide (NO) release in RAW 264.7 cells stimulated by lipopolysaccharide (LPS), as well as the proliferation of human fibroblast-like synovial (HFLS) cells. In a murine model of HA, JODI-LIP demonstrated superior efficacy in ameliorating joint swelling and synovitis, compared to JODI. Importantly, JODI-LIP markedly reduced pro-inflammatory cytokines (TNF-α, IFN-γ, IL-33, and MCP-1) in injured joints. No hepatic or hematological toxicity was observed in mice treated with JODI-LIP. In summary, our results suggest that JODI-LIP holds promise as a therapeutic intervention for HA by attenuating pro-inflammatory cytokine levels.
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Affiliation(s)
- Chen Zhong
- Marine Science Research Institute of Shandong Province, Qingdao, People's Republic of China; School of Bioengineering, East China University of Science and Technology, Shanghai, People's Republic of China
| | - Xiaoying Zong
- School of Bioengineering, East China University of Science and Technology, Shanghai, People's Republic of China
| | - Baolai Hua
- Department of Hematology, Beijing Shijitan Hospital, Capital Medical University, Beijing, People's Republic of China.
| | - Junjiang Sun
- Division of Chemical Biology and Medicinal Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Chen J, Zeng Q, Wang X, Xu R, Wang W, Huang Y, Sun Q, Yuan W, Wang P, Chen D, Tong P, Jin H. Aberrant methylation and expression of TNXB promote chondrocyte apoptosis and extracullar matrix degradation in hemophilic arthropathy via AKT signaling. eLife 2024; 13:RP93087. [PMID: 38819423 PMCID: PMC11142640 DOI: 10.7554/elife.93087] [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] [Indexed: 06/01/2024] Open
Abstract
Recurrent joint bleeding in hemophilia patients frequently causes hemophilic arthropathy (HA). Drastic degradation of cartilage is a major characteristic of HA, but its pathological mechanisms has not yet been clarified. In HA cartilages, we found server matrix degradation and increased expression of DNA methyltransferase proteins. We thus performed genome-wide DNA methylation analysis on human HA (N=5) and osteoarthritis (OA) (N=5) articular cartilages, and identified 1228 differentially methylated regions (DMRs) associated with HA. Functional enrichment analyses revealed the association between DMR genes (DMGs) and extracellular matrix (ECM) organization. Among these DMGs, Tenascin XB (TNXB) expression was down-regulated in human and mouse HA cartilages. The loss of Tnxb in F8-/- mouse cartilage provided a disease-promoting role in HA by augmenting cartilage degeneration and subchondral bone loss. Tnxb knockdown also promoted chondrocyte apoptosis and inhibited phosphorylation of AKT. Importantly, AKT agonist showed chondroprotective effects following Tnxb knockdown. Together, our findings indicate that exposure of cartilage to blood leads to alterations in DNA methylation, which is functionally related to ECM homeostasis, and further demonstrate a critical role of TNXB in HA cartilage degeneration by activating AKT signaling. These mechanistic insights allow development of potentially new strategies for HA cartilage protection.
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Affiliation(s)
- Jiali Chen
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese MedicineHangzhouChina
- The First College of Clinical Medicine, Zhejiang Chinese Medical UniversityHangzhouChina
| | - Qinghe Zeng
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese MedicineHangzhouChina
- The First College of Clinical Medicine, Zhejiang Chinese Medical UniversityHangzhouChina
| | - Xu Wang
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese MedicineHangzhouChina
- The First College of Clinical Medicine, Zhejiang Chinese Medical UniversityHangzhouChina
| | - Rui Xu
- Department of Orthopaedics, Affiliated Hospital of Jiangxi University of Traditional Chinese MedicineNanchangChina
| | - Weidong Wang
- Department of Osteology, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Yuliang Huang
- Department of Osteology, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Qi Sun
- Department of Orthopaedic Surgery, Fuyang Orthopaedics and Traumatology Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Wenhua Yuan
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese MedicineHangzhouChina
| | - Pinger Wang
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese MedicineHangzhouChina
| | - Di Chen
- Research Center for Computer-aided Drug Discovery, Shenzhen Institute of Advanced Technology, Chinese Academy of SciencesShenzhenChina
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of SciencesShenzhenChina
| | - Peijian Tong
- Department of Orthopaedic Surgery, the First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese MedicineHangzhouChina
| | - Hongting Jin
- Institute of Orthopaedics and Traumatology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Chinese MedicineHangzhouChina
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Srivastava A. Defining success in haemophilia care - Are we doing it right? Haemophilia 2024; 30 Suppl 3:52-59. [PMID: 38498584 DOI: 10.1111/hae.14958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Transformational advances have occurred in the management of haemophilia in the last decade leading to much better outcomes. However, a detailed and critical examination of its assessment and reporting show gaps in many aspects. These are discussed in this review. METHODS The relevant literature related to different aspects of management of haemophilia was reviewed to identify gaps which need to be addressed. These include detection and diagnosis of haemophilia, documentation and reporting of joint bleeding, its management and methods of reporting in clinical trials and practice, aspects of personalizing care as well as access to therapeutic products and the need for and organization of comprehensive care. RESULTS Current diagnostic approaches have more than doubled the identified number of persons with haemophilia (PWH) over the last 25 years but still constitute only ∼30% of the expected number. Joint bleeding is the primary indicator of disease severity and treatment efficacy, but there is lack of consistency and standardization in the way it is recorded and reported. Its continued use as an efficacy measure of modern treatments which maintain steady state factor levels or equivalence of >5% will lack sensitivity. The treatment of acute haemarthrosis has focussed on haemostasis and pain control, ignoring the role of inflammation in joint damage. Phenotypic heterogeneity of severe haemophilia has recognized clinical and laboratory variations based on haemostasis but not differences in local response to blood in the joint. At the organizational level, IU/capita provides a relevant measure of access to therapeutic products when the detection rate is ∼100% but is fallaciously low when detection rates are very low. With highly effective modern therapies for haemophilia and nearly no bleeding, the concept of comprehensive care team will need modifications. CONCLUSION As haemophilia care advances, a deeper dive is needed into the details of various aspects its management to ensure consistency and contemporary relevance.
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Affiliation(s)
- Alok Srivastava
- Department of Haematology, Christian Medical College Vellore, Vellore, Tamil Nadu, India
- Centre for Stem Cell Research, a Unit of inStem, Bengaluru, CMC Campus, Vellore, Tamil Nadu, India
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Zheng L, Han Z, Luo D, Li J, Pang N, Ding M, Ye H, Zhu K, Yao Y. IL-6, IL-1β and TNF-α regulation of the chondrocyte phenotype: a possible mechanism of haemophilic cartilage destruction. Hematology 2023; 28:2179867. [PMID: 36799502 DOI: 10.1080/16078454.2023.2179867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Proinflammatory cytokines are considered to be one of the key causes of haemophilic cartilage destruction by inducing chondrocyte apoptosis and extracellular matrix degradation. However, few studies have focused on how proinflammatory cytokines regulate the phenotypic changes of chondrocytes, which may be an important factor in haemophilic cartilage degradation pathogenesis. More understanding is needed about the effect of proinflammatory cytokines on phenotypic changes of the chondrocyte. The objective of this study was to examine how IL-6, TNF-α and IL-1β regulate the chondrocyte phenotype, which may be an important factor in haemophilic cartilage degradation pathogenesis. METHODS HUM-iCell-s018 chondrocytes were treated with increasing concentrations of TNF-α, IL-6 or IL-1β (0, 1, 5, 10 ng/ml) for 24 h, then FGF23 and SOX9 expression was determined by qRT-PCR and WB, respectively. RESULTS We found that TNF-α, IL-6 and IL-1β induced FGF23 and suppressed SOX9 expression in chondrocytes in a dose-dependent manner. IL-1β had a stronger regulatory effect on FGF23, while TNF-α and IL-6 had stronger regulatory effects on SOX9. CONCLUSIONS These findings suggest that IL-6, IL-1β and TNF-α may be involved in haemophilic cartilage destruction pathogenesis by altering the chondrocyte phenotype through modulation of FGF23 and SOX9 gene expression.
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Affiliation(s)
- Liujie Zheng
- Department of Orthopaedic Surgery, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zhiwei Han
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Dasheng Luo
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Jiale Li
- Department of Orthopaedic Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, People's Republic of China
| | - Nanyu Pang
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Mingyang Ding
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Houlong Ye
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Keyan Zhu
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Yunfeng Yao
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
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Tseng SH, Lee CJ, Chen SH, Chen CH, Tsai PW, Hsieh MS, Chu JS, Wang CC. Cinnamic aldehyde, an anti-inflammatory component in Du-Huo-Ji-Sheng-Tang, ameliorates arthritis in II collagenase and monosodium iodoacetate induced osteoarthritis rat models. J Tradit Complement Med 2022; 13:51-61. [PMID: 36685080 PMCID: PMC9845653 DOI: 10.1016/j.jtcme.2022.10.003] [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: 12/24/2021] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022] Open
Abstract
Background and aim Du-Huo-Ji-Sheng-Tang (DHJST) is a Chinese herbal formula used for arthralgia and arthritis treatment clinically. This study aims to evaluate the joint-protecting efficacy of DHJST and to identify the active constituents as the evaluation marker. Experimental procedure DHJST can be categorized into three recipes: Blood-tonifying-herbs Si-Wu-Tang (SWT), Wind-dampness-dispelling-herbs (WDH) and Qi-tonifying-herbs (TH). All formulas were used to explore the joint-protecting efficacies. Results and conclusion s: Firstly, DHJST could decrease the arthritis progression in the monosodium-iodoacetate-induced rat and cure arthritis in the type II collagenase-induced rat. Further, in lipopolysaccharide-stimulated RAW 264.7 cells, DHJST, TH and Cinnamomum cassia (CC), an ingredient in TH, were the most potent nitric oxide (NO) and prostaglandin E2 (PGE2) inhibitors. The major components, cinnamic aldehyde, showed the strongest NO and PGE2 inhibition. Up-regulated inducible NO synthase (iNOS) and cyclooxygenase-2 were inhibited by DHJST, TH, CC, and cinnamic aldehyde. In interleukin-1β-stimulated primary chondrocytes, upregulated iNOS was inhibited by DHJST, TH, Cinnamomum cassia, and cinnamic aldehyde. Upregulated matrix metalloprotease-13 was only inhibited by DHJST and TH and Eucommia ulmoides (EU) extract. Results suggest that DHJST presented joint-protective and cure arthritis effects. TH presented equal joint-protective effects as DHJST. The major anti-inflammatory ingredient in TH was Cinnamomum cassia in TH. And cinnamic aldehyde was the potent anti-inflammatory active compound in Cinnamomum cassia. Therefore, this study may facilitate the modern use of DHJST with TH as a simplified version but equally effective anti-osteoarthritic agents with cinnamic aldehyde as a quality control marker of DHJST and TH in osteoarthritis prevention or treatment.
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Affiliation(s)
- Sung-Hui Tseng
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chia-Jung Lee
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Pharmacognosy Science, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Shih-Han Chen
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Chao-Hsin Chen
- Pharmaceutical and Biotechnology Management, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Po-Wei Tsai
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Medical Science Industry, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Ming-Shium Hsieh
- Orthopedics Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- En Chu Kong Hospital, New Taipei City, Taiwan
| | - Jan-Show Chu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ching-Chiung Wang
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Pharmacognosy Science, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Pharmaceutical and Biotechnology Management, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Orthopedics Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Corresponding author. School of Pharmacy, College of Pharmacy, Taipei Medical University 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
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Zheng L, Han Z, Luo D, Li J, Ye H, Feng R, Zhong Q, Jing J, Yao Y. FGF23 and SOX9 expression in hemophilic cartilage: In vitro studies of the effects of iron. Haemophilia 2022; 28:1062-1068. [PMID: 35802007 DOI: 10.1111/hae.14623] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/07/2022] [Accepted: 06/24/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Clarifying the links between iron and FGF23, SOX9 expression in chondrocytes would be helpful for comprehending articular cartilage degradation pathogenesis in blood-induced arthritis and exploring new protective methods. AIM The purpose of this study was to determine iron regulation of fibroblast growth factor 23 (FGF23) and SRY-box 9 (SOX9) in human chondrocytes, an area which is unexplored in blood-induced arthritis cartilage degradation pathogenesis. METHODS Expression of FGF23, SOX9, MMP13 and collagen Ⅱ in articular cartilage of patients with osteoarthritis (OA) or haemophilic arthritis (HA) was determined by western blot (WB). Iron induced FGF23 and SOX9 mRNA and protein expression in primary human normal chondrocyte cells (HUM-iCell-s018) was quantifified by qRT-PCR and WB, respectively. RESULTS We found that compared with OA patients, the expression of FGF23, MMP13 in articular cartilage of patients with HA was up-regulated, while the expression of SOX9, collagen Ⅱ was down-regulated. Iron induced FGF23 and suppressed SOX9 expression in chondrocytes in a dose-dependent manner. CONCLUSIONS These findings demonstrated that iron were involved in hemophilic cartilage lesion directly via changing cartilage phenotype through regulation of FGF23 and SOX9 expression in chondrocytes.
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Affiliation(s)
- Liujie Zheng
- Department of Orthopaedic Surgery, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Zhiwei Han
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Dasheng Luo
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Jiale Li
- Department of Orthopaedic Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, People's Republic of China
| | - Houlong Ye
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Ru Feng
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Qigang Zhong
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Juehua Jing
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yunfeng Yao
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
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The Application of Focused Medium-Energy Extracorporeal Shockwave Therapy in Hemophilic A Arthropathy. Healthcare (Basel) 2022; 10:healthcare10020352. [PMID: 35206968 PMCID: PMC8871785 DOI: 10.3390/healthcare10020352] [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: 01/02/2022] [Revised: 02/01/2022] [Accepted: 02/08/2022] [Indexed: 12/04/2022] Open
Abstract
Hemophilic arthropathy causes the damage of synovium, cartilage, and subchondral bone. The present study evaluated the safety and the effect of extracorporeal shockwave therapy (ESWT), a safe treatment widely used in musculoskeletal conditions in patients with hemophilic arthropathy. Between 1 August 2019 and 31 July 2020, seven hemophilia A patients were enrolled and treated with medium-energy ESWT on the knee joint in the first two months after prophylactic coagulation factor administration. At the beginning of the study and at 1-, 2-, 3-, and 6-month follow-ups, the Hemophilia Joint Health Score (HJHS), visual analog scale score (VAS), and Hemophilia Early Arthropathy Detection with Ultrasound score (HEAD-US) were evaluated for therapeutic effectiveness and safety, while serum bone morphogenetic protein 2 (BMP-2) and von Willebrand factor (vWF) levels were analyzed for assessing chondroprotection and bone healing. Magnetic resonance imaging (MRI) of the knee was performed at the beginning of the study and the 6-month follow-ups. As a result, a non-significant decrease in VAS scores (p = 0.151) but not HJHS after treatment was noticed. At the 3-month follow-up, there was a non-significant increase in BMP2 levels (p = 0.171) but not vWF. Ultrasonography showed no disease activity score elevation in five patients and no further disease damage in all patients. Repeated MRI examinations in three patients showed no structural progression during the 6-month follow-up. As to adverse events, redness, local heat, and mild swelling were noted in five patients without breakthrough bleeding. We concluded that medium-energy ESWT might be safe for hemophilic arthropathy once prophylactic coagulation factors are administered.
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Zheng L, Luo D, Li J, Ye H, Han Z, Feng R, Zhong Q, Jing J, Yao Y. Pathological changes and expression of lysine oxidases and matrix metalloproteinases -1, -2, and -3 in ligaments of patients with haemophilic arthritis. Haemophilia 2021; 28:145-150. [PMID: 34697874 DOI: 10.1111/hae.14443] [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: 05/03/2021] [Revised: 09/17/2021] [Accepted: 10/12/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Studying the pathological changes of ligaments in patients with haemophilic arthritis (HA) has important significance for guiding the release of ligaments during total knee arthroplasty (TKA) and exploring interventions to prevent ligament lesions. AIM This study was conducted to show the pathological changes and investigate the lysine oxidase (LOX) and matrix metalloproteinase (MMP)-1, -2, and -3 levels in the ligaments of patients with HA compared with those of patients with osteoarthritis (OA). METHODS Ligaments obtained during the TKA were stained with Masson trichrome, Verhoeff-Van Gieson and haematoxylin and eosin to show the basic pathological changes. Collagen I, elastin, LOXs and MMP-1, -2, and -3 expression levels were detected via western blot. LOX and MMP-1, -2, and -3 mRNA expression levels were analysed via quantitative real-time PCR. RESULTS Compared with OA ligaments, HA ligaments were constructed more loosely with wider gaps, more breaks, haemocytodeposition and local hypertrophy among the fibres. LOXs and MMP mRNA expression levels were upregulated in the HA tissues, which was consistent with the western blot results. Collagen I and elastin levels were also higher in patients with HA. CONCLUSIONS The metabolism of the ligaments in patients with HA is more complex than in those with OA, and the ligaments of patients with HA have stronger healing and destruction processes. This pathology is related to iron overload and imbalanced inflammatory factors due to repeated intra-articular bleeding.
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Affiliation(s)
- Liujie Zheng
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Dasheng Luo
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jiale Li
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Houlong Ye
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhiwei Han
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ru Feng
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qigang Zhong
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Juehua Jing
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yunfeng Yao
- Department of Orthopaedic Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
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EPCR deficiency or function-blocking antibody protects against joint bleeding-induced pathology in hemophilia mice. Blood 2021; 135:2211-2223. [PMID: 32294155 DOI: 10.1182/blood.2019003824] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 03/18/2020] [Indexed: 02/06/2023] Open
Abstract
We recently showed that clotting factor VIIa (FVIIa) binding to endothelial cell protein C receptor (EPCR) induces anti-inflammatory signaling and protects vascular barrier integrity. Inflammation and vascular permeability are thought to be major contributors to the development of hemophilic arthropathy following hemarthrosis. The present study was designed to investigate the potential influence of FVIIa interaction with EPCR in the pathogenesis of hemophilic arthropathy and its treatment with recombinant FVIIa (rFVIIa). For this, we first generated hemophilia A (FVIII-/-) mice lacking EPCR (EPCR-/-FVIII-/-) or overexpressing EPCR (EPCR++ FVIII-/-). Joint bleeding was induced in FVIII-/-, EPCR-/-FVIII-/-, and EPCR++FVIII-/- mice by needle puncture injury. Hemophilic synovitis was evaluated by monitoring joint bleeding, change in joint diameter, and histopathological analysis of joint tissue sections. EPCR deficiency in FVIII-/- mice significantly reduced the severity of hemophilic synovitis. EPCR deficiency attenuated the elaboration of interleukin-6, infiltration of macrophages, and neoangiogenesis in the synovium following hemarthrosis. A single dose of rFVIIa was sufficient to fully prevent the development of milder hemophilic synovitis in EPCR-/-FVIII-/- mice. The development of hemophilic arthropathy in EPCR-overexpressing FVIII-/- mice did not significantly differ from that of FVIII-/- mice, and 3 doses of rFVIIa partly protected against hemophilic synovitis in these mice. Consistent with the data that EPCR deficiency protects against developing hemophilic arthropathy, administration of a single dose of EPCR-blocking monoclonal antibodies markedly reduced hemophilic synovitis in FVIII-/- mice subjected to joint bleeding. The present data indicate that EPCR could be an attractive new target to prevent joint damage in hemophilia patients.
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Zhu H, Meng Y, Tong P, Zhang S. Pathological mechanism of joint destruction in haemophilic arthropathy. Mol Biol Rep 2020; 48:969-974. [PMID: 33289909 DOI: 10.1007/s11033-020-06052-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/30/2020] [Indexed: 01/08/2023]
Abstract
Haemophilic arthropathy (HA), caused by intra-articular haemorrhage, is one of the most common complications in patients with haemophilia. Factor replacement therapy provides missing coagulation factors to prevent children with haemophilia from joint bleeding and decreases their risk for HA. However, haemophilia patients in developing countries are still suffering from HA due to insufficient replacement therapy. Symptoms such as pain and activity limitations caused by HA seriously affect the functional abilities and quality of life of patients with HA, causing a high disability rate in the haemophilia cohort. The pathological mechanism of HA is complicated because the whole pathological mainly involves hypertrophic synovitis, osteopenia, cartilage and bone destruction, and these pathological changes occur in parallel and interact with each other. Inflammation plays an important role in the whole complex pathological process, and iron, cytokines, growth factors and other factors are involved. This review summarizes the pathological mechanism of HA to provide background for clinical and basic research.
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Affiliation(s)
- Haijia Zhu
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Yilin Meng
- The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Peijian Tong
- Department of Orthopedic Surgery, The First Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Shanxing Zhang
- Department of Orthopedic Surgery, The First Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
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Toenges R, Wittenbrink A, Miesbach W. Biomarkers and immunological parameters in haemophilia and rheumatoid arthritis patients: a comparative multiplexing laboratory study. Haemophilia 2020; 27:e119-e126. [PMID: 33210410 DOI: 10.1111/hae.14200] [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: 06/10/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Haemophilia (HA) and rheumatoid arthritis (RA) patients may develop joint damage caused by recurrent joint bleedings in HA or by chronic inflammation in RA. Only few data exist for biomarker studies in these patients. AIM The objective of the present study is to assess a large array of biomarkers in peripheral blood samples obtained from HA patients without or with arthropathy and to compare pattern to RA patients and healthy controls. METHODS A panel of biomarkers was assessed in 129 men (40 HA patients without arthropathy, 23 HA patients with arthropathy, 23 RA patients and 43 control subjects). 37 different biomarkers (cytokines, angiogenesis-related proteins) were analysed using a multiple analyte profiling technology and supplemented by acute phase proteins, coagulation and immunological parameters. RESULTS Evidence for systemic inflammation was obtained by increased acute phase reactants in all patient groups. 13 or 14 from 42 soluble parameters demonstrated significant differences (p < .05) between HA patients without arthropathy and healthy controls, or between HA patients with arthropathy and healthy controls, respectively. Largely overlapping patterns were obtained except for interleukin-7 being increased in HA patients without arthropathy and being decreased in HA in the presence of arthropathy. CONCLUSIONS In addition to data supporting systemic inflammation, we provide evidence for a common biomarker profile in HA patients and RA patients compared to healthy controls. A distinctive biomarker profile for HA patients with arthropathy did not appear except for interleukin-7 demonstrating specific changes depending on the absence or presence of arthropathy in HA patients.
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Affiliation(s)
- Rosa Toenges
- Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany.,Department of Medicine, Hemostaseology, Goethe University, Frankfurt, Germany
| | - Anna Wittenbrink
- Department of Medicine, Hemostaseology, Goethe University, Frankfurt, Germany
| | - Wolfgang Miesbach
- Department of Medicine, Hemostaseology, Goethe University, Frankfurt, Germany
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12
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Comparative Analysis of the Occurrence and Role of CX3CL1 (Fractalkine) and Its Receptor CX3CR1 in Hemophilic Arthropathy and Osteoarthritis. J Immunol Res 2020; 2020:2932696. [PMID: 32884948 PMCID: PMC7455839 DOI: 10.1155/2020/2932696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 02/06/2023] Open
Abstract
Objective Hemophilic arthropathy is characterized by recurrent bleeding episodes in patients with hemophilia leading to irreversible joint degeneration. The involvement of CX3CL1 (fractalkine) and its receptor CX3CR1 was observed in the pathogenesis of numerous arthritis-associated diseases. Taking this into account, we have presented a study investigating the role of the CX3CL1/CX3XR1 axis in the course of hemophilic arthropathy, including the CX3CL1-dependent expression of CD56+, CD68+, and CD31+ cells along with evaluation of articular cartilage and synovial membrane morphology. Methods The study was carried out using cases (n = 20) of end-stage hemophilic arthropathy with a severe type of hemophilia A and control cases (n = 20) diagnosed with osteoarthritis. The biofluids including blood serum and synovial fluid were obtained intraoperatively for the evaluation of CX3CL1 using the ELISA test. Tissue specimens including articular cartilage and synovial membrane were similarly collected during surgery and stained immunohistologically using selected antibodies including anti-CX3CR1, anti-CD56, anti-CD68, and anti-CD31. Additionally, the analysis included the assessment of articular cartilage, synovial membrane, and blood vessel morphology. Results In our study, we have documented increased average concentration of CX3CL1 in the blood serum of the study group (7.16 ± 0.53 ng/ml) compared to the control group (5.85 ± 0.70 ng/ml) without statistically significant difference in synovial fluid concentration at the same time. We have observed an increased macrophage presence with more marked proliferation and fibrosis of the synovial membrane in the study group. Remaining results such as expression of CX3CR1 presence of NK cells and larger surface area of blood vessels within the synovial membrane were noted also without statistical significance. Conclusions This study has demonstrated collective CX3CL1/CX3CR1 axis involvement in hemophilic arthropathy pathogenesis introducing new interesting diagnostics and a therapeutic target.
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13
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Lin PC, Chiou SS, Hsu WY, Liao YM, Tsai SP, Su HL, Lu PT, Tseng YH. Plasma levels of IL-1β and IL-37 in patients with severe haemophilia. J Int Med Res 2020; 48:300060520940512. [PMID: 32691667 PMCID: PMC7375719 DOI: 10.1177/0300060520940512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective Haemophilia A and B are disorders caused by the lack of clotting factors VIII and IX, respectively. Repeated bleeding into the same joint leads to haemophilic arthropathy (HA). Interleukin (IL)-1β is responsible for the pro-inflammatory response and IL-37 is induced by IL-1β stimuli to have an anti-inflammatory response and prevent uncontrolled inflammation and tissue damage. Our objective was to investigate plasma levels of IL-1β and IL-37 in patients with severe haemophilia with different severities of HA. Methods Peripheral blood samples were collected from 14 patients with severe haemophilia A and 6 with severe haemophilia B, and 18 healthy individuals. Plasma levels of IL-1β and IL-37 were detected by immunoassay, and severity of HA was evaluated using the Pettersson scoring system. Plasma levels of IL-1β and IL-37 were analysed in patients with severe haemophilia grouped by Pettersson score and in healthy individuals. Results Plasma levels of IL-1β and IL-37 were significantly higher in patients with severe haemophilia compared with healthy individuals and significantly lower in those with moderate to severe HA than in those with no or mild HA. Conclusions Plasma levels of IL-1β and IL-37 may be useful to track HA progression in patients with severe haemophilia.
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Affiliation(s)
- Pei-Chin Lin
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shyh-Shin Chiou
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Yi Hsu
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Mei Liao
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Hematology and Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Pien Tsai
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiu-Lan Su
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ping-Tao Lu
- Special Hematologic Disease Service Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Hsin Tseng
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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14
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Andrawes NG, Saker HM, Salah El-Din NY, Abd Elhakim Hussain M. Tissue-inhibitors of metalloproteinase-1 and vascular-endothelial growth-factor in severe haemophilia A children on low dose prophylactic recombinant factor VIII: Relation to subclinical arthropathy. Haemophilia 2020; 26:607-614. [PMID: 32445517 DOI: 10.1111/hae.14041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/22/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Subclinical synovitis occur long before clinical haemophilic arthropathy (HA). New biomarkers are needed for early detection of HA. AIM To compare the levels of tissue inhibitors of metalloproteinase-1 (TIMP-1) and vascular endothelial growth factor (VEGF)in severe haemophilia A boys on prophylaxis and on-demand therapy to healthy boys and correlate them with the haemophilia joint health score (HJHS) & the Denver magnetic resonance imaging (MRI) scale; hence, determine their values in early detection of HA. METHODS Haemophilia joint health score, serum TIMP-1, VEGF and Denver MRI score were assessed in 50 boys with severe haemophilia A (31 on prophylactic factor VIII therapy (62%) with a dose of 15 IU/kg/twice weekly) and 50 age-matched healthy boys. RESULTS Boys with severe haemophilia A had significantly higher TIMP-1 240 ng/mL, SD200-350 (P < .001) and VEGF 600 pg/mL, SD400-1100 (P < .001). Their mean HJHS was 4.5 ± 3.0 (0-11) and their mean Denver MRI score was 5.55 ± 1.6 (2.00-8.00). A significant positive correlation was found between TIMP-1 and VEGF (P < .001), BMI Z-score (P = .029), HJHS (P = .041)and total MRI score (<.001). Significant correlations were found between VEGF and age (P < .001), HJHS (P = .003) and total MRI score (P < .001). Boys with severe haemophilia A on prophylaxis therapy had significantly lower HJHS (P = .021), VEGF (P < .001), TIMP-1 (P = .002) and total MRI score (P = .021) than those on on-demand therapy. Receiver operating characteristic curve, defined a cut-off value of 160 ng/mL for TIMP-1 with a sensitivity of 90% and specificity of 60% and that of 350 pg/mL for VEGF with a sensitivity of 78% and specificity of 88% for discrimination between severe haemophilia A and healthy boys. CONCLUSION Vascular endothelial growth factor and TIMP-1 can be used for early detection of HA. Further prospective studies should include larger study populations. In addition, studies should address the role of various anti-VEGFs as potential therapy for HA and their impact on prevention and treatment of HA.
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Affiliation(s)
| | - Hossam Mousa Saker
- Radiology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
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15
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Calcaterra I, Iannuzzo G, Dell'Aquila F, Di Minno MND. Pathophysiological Role of Synovitis in Hemophilic Arthropathy Development: A Two-Hit Hypothesis. Front Physiol 2020; 11:541. [PMID: 32581836 PMCID: PMC7296047 DOI: 10.3389/fphys.2020.00541] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/30/2020] [Indexed: 12/13/2022] Open
Abstract
Despite an increasing access to prophylaxis with clotting factor concentrates, arthropathy still represents the main chronic complication of hemophilia. Whereas previous studies described hemophilic arthropathy (HA) as a degenerative arthropathy, somehow resembling osteoarthritis (OA), most recent evidence suggests that complex inflammatory and immunologic mechanisms are also involved in the pathophysiology of HA. In the present review, we described available data on major mechanisms leading to arthropathic changes in patients with hemophilia, with a specific focus on the role of synovium. The presence of hemosiderin in the joint space induces synovium proliferation, thus leading to formation of several lytic enzymes determining chondrocytes apoptosis and proteoglycans levels reduction. This leads to a direct joint “chemical” damage representing early damages in the pathogenesis of HA (first hit). In parallel, synovial membrane and synovial endothelial cells become a dynamic reservoir of inflammatory cells and mediators, and propagate the inflammatory response (second hit), switching the process from a chemical damage to an inflammatory damage. Overall, consistent data pointed out synovitis as the keystone in HA pathophysiology. This opens novel potential therapeutic targets in this clinical setting.
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Affiliation(s)
- Ilenia Calcaterra
- Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesco Dell'Aquila
- Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
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16
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Vøls KK, Kjelgaard‐Hansen M, Ley CD, Hansen AK, Petersen M. Initial joint bleed volume in a delayed on-demand treatment setup correlates with subsequent synovial changes in hemophilic mice. Animal Model Exp Med 2020; 3:160-168. [PMID: 32613175 PMCID: PMC7323705 DOI: 10.1002/ame2.12118] [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: 01/20/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Hemophilic arthropathy is a debilitating morbidity of hemophilia caused by recurrent joint bleeds. We investigated if the joint bleed volume, before initiation of treatment, was linked to the subsequent degree of histopathological changes and the development of bone pathology in a mouse model of hemophilic arthropathy. METHODS FVIII knock-out (F8-KO) mice were dosed with a micro-CT blood pool agent prior to induction of hemarthrosis. Eight hours after induction, the bleed volume was quantified with micro computed tomography (micro-CT) and recombinant FVIII treatment initiated. On Day 8, inflammation in the knees was characterized by fluorescence molecular tomography. On Day 14, knee pathology was characterized by micro-CT and histopathology. In a second study, contrast agent was injected into the knee of wild-type (WT) mice, followed by histopathological evaluation on Day 14. RESULTS The average joint bleed volume before treatment was 3.9 mm3. The inflammation-related fluorescent intensities in the injured knees were significantly increased on Day 8. The injured knees had significantly increased synovitis scores, vessel counts, and areas of hemosiderin compared to un-injured knees. However, no cartilage- or bone pathology was observed. The bleed volume before initiation of treatment correlated with the degree of synovitis and was associated with high fluorescent intensity on Day 8. In F8-KO and WT mice, persistence of contrast agent in the joint elicited morphological changes. CONCLUSION When applying a delayed on-demand treatment regimen to hemophilic mice subjected to an induced knee hemarthrosis, the degree of histopathological changes on Day 14 reflected the bleed volume prior to initiation of treatment.
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Affiliation(s)
- Kåre Kryger Vøls
- Global Drug DiscoveryNovo Nordisk A/SMaaloevDenmark
- Veterinary and Animal SciencesUniversity of CopenhagenFrederiksbergDenmark
| | | | | | | | - Maj Petersen
- Global Drug DiscoveryNovo Nordisk A/SMaaloevDenmark
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17
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Kotela A, Wojdasiewicz P, Łęgosz P, Sarzyńska S, Drela K, Pulik Ł, Kaleta B, Kniotek M, Borysowski J, Poniatowski ŁA, Kotela I. Increased serum levels of progranulin (PGRN) in patients with haemophilic arthropathy. Clin Exp Pharmacol Physiol 2018; 46:373-379. [PMID: 30488982 DOI: 10.1111/1440-1681.13054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/17/2018] [Accepted: 11/23/2018] [Indexed: 11/29/2022]
Abstract
Haemophilia A and B are rarely occurring X chromosome-linked congenital coagulation disorders dominated by spontaneous joint bleedings and chronic synovitis, leading to development of haemophilic arthropathy (HA). Progranulin (PGRN) is a growth factor with anti-inflammatory and immunomodulatory properties. PGRN is an important molecule in the pathogenesis of osteoarthritis (OA) and rheumatological disorders. This study was aimed at investigating the potential role of PGRN in the mechanisms underlying the pathogenesis of HA. The serum levels of PGRN were measured by enzyme-linked immunosorbent assay (ELISA) in patients with end-stage knee joint HA (n = 20) and end-stage primary knee joint OA (n = 20) who met the inclusion and exclusion criteria. The clinical and radiological assessment of disease severity was evaluated by the Knee Society Score (KSS) and Kellgren-Lawrence scale. Median PGRN levels in HA patients was 349.1 ng/mL (232.8-415.6 ng/mL) and in OA patients 148.3 ng/mL (112.1-275.3 ng/mL) with statistically significant differences between both groups (P < 0.015). Further analysis revealed no correlation between PGRN levels and any of the patient demographics and clinical parameters. This study demonstrates increased PGRN serum levels in patients with HA and provides new insights into the mechanisms underlying the pathogenesis of HA indicating a new potential target for therapeutic intervention.
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Affiliation(s)
- Andrzej Kotela
- Department of Orthopaedics and Traumatology, 1st Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Department of Orthopaedics and Traumatology, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Piotr Wojdasiewicz
- Department of General and Experimental Pathology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland.,Department of Rehabilitation, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Paweł Łęgosz
- Department of Orthopaedics and Traumatology, 1st Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Sylwia Sarzyńska
- Department of Orthopaedics and Traumatology, 1st Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Drela
- NeuroRepair Department, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Łukasz Pulik
- Department of Orthopaedics and Traumatology, 1st Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Beata Kaleta
- Department of Clinical Immunology, 1st Faculty of Medicine, Tadeusz Orłowski Transplantation Institute, Medical University of Warsaw, Warsaw, Poland
| | - Monika Kniotek
- Department of Clinical Immunology, 1st Faculty of Medicine, Tadeusz Orłowski Transplantation Institute, Medical University of Warsaw, Warsaw, Poland
| | - Jan Borysowski
- Department of Clinical Immunology, 1st Faculty of Medicine, Tadeusz Orłowski Transplantation Institute, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz A Poniatowski
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland.,Department of Neurosurgery, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Ireneusz Kotela
- Department of Orthopaedics and Traumatology, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.,Department of Rehabilitation in Disease of the Locomotor System, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
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18
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Wojdasiewicz P, Poniatowski ŁA, Nauman P, Mandat T, Paradowska-Gorycka A, Romanowska-Próchnicka K, Szukiewicz D, Kotela A, Kubaszewski Ł, Kotela I, Kurkowska-Jastrzębska I, Gasik R. Cytokines in the pathogenesis of hemophilic arthropathy. Cytokine Growth Factor Rev 2018; 39:71-91. [DOI: 10.1016/j.cytogfr.2017.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 11/09/2017] [Indexed: 01/26/2023]
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19
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Poonnoose P, Carneiro JDA, Cruickshank AL, El Ekiaby M, Perez Bianco RP, Ozelo MC, De Bosch N, Baghaipour M, Tien SL, Chuansumrit A, D'Amico EA, van Zyl A, Sabour A, Candela M, Ricciardi JBS, Ruiz-Sàez A, Ravanbod R, Lam JCL, Jaovisidha S, Kavitha ML, Gibikote S, Shyamkumar N, Srivastava A. Episodic replacement of clotting factor concentrates does not prevent bleeding or musculoskeletal damage - the MUSFIH study. Haemophilia 2017; 23:538-546. [DOI: 10.1111/hae.13242] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 12/01/2022]
Affiliation(s)
| | - J. D. A. Carneiro
- Hospital das Clinicas da Faculdade de Medicina USP; Sao Paulo Brazil
| | | | | | - R. P. Perez Bianco
- Instituto de Investigaciones Hematológicas; National Academy of Medicine; Buenos Aires Argentina
| | - M. C. Ozelo
- INCT do Sangue Hemocentro UNICAMP; University of Campinas; Campinas SP Brazil
| | - N. De Bosch
- Banco Municipal de Sangre; Caracas Venezuela
| | | | - S. L. Tien
- Singapore General Hospital; Singapore Singapore
| | | | - E. A. D'Amico
- Hospital das Clinicas da Faculdade de Medicina USP; Sao Paulo Brazil
| | - A. van Zyl
- Stellenbosch University and Tygerberg Hospital; Capetown South Africa
| | | | - M. Candela
- Instituto de Investigaciones Hematológicas; National Academy of Medicine; Buenos Aires Argentina
| | - J. B. S. Ricciardi
- INCT do Sangue Hemocentro UNICAMP; University of Campinas; Campinas SP Brazil
| | | | | | - J. C. L. Lam
- KK Women's and Children's Hospital; Singapore Singapore
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20
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van Vulpen LFD, Mastbergen SC, Lafeber FPJG, Schutgens REG. Differential effects of bleeds on the development of arthropathy - basic and applied issues. Haemophilia 2017; 23:521-527. [DOI: 10.1111/hae.13236] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 01/12/2023]
Affiliation(s)
- L. F. D. van Vulpen
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
- Department of Rheumatology & Clinical Immunology; University Medical Center Utrecht; Utrecht The Netherlands
| | - S. C. Mastbergen
- Department of Rheumatology & Clinical Immunology; University Medical Center Utrecht; Utrecht The Netherlands
| | - F. P. J. G. Lafeber
- Department of Rheumatology & Clinical Immunology; University Medical Center Utrecht; Utrecht The Netherlands
| | - R. E. G. Schutgens
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
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21
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Affiliation(s)
| | - Alexander D. Liddle
- NIHR Clinical Lecturer, University College London Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
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22
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Pathophysiology of hemophilic arthropathy and potential targets for therapy. Pharmacol Res 2017; 115:192-199. [DOI: 10.1016/j.phrs.2016.11.032] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/04/2016] [Accepted: 11/23/2016] [Indexed: 01/14/2023]
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23
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Martin EJ, Cooke EJ, Ceponis A, Barnes RFW, Moran CM, Holle S, Hughes TH, Moore RE, von Drygalski A. Efficacy and safety of point-of-care ultrasound-guided intra-articular corticosteroid joint injections in patients with haemophilic arthropathy. Haemophilia 2016; 23:135-143. [DOI: 10.1111/hae.13057] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 12/20/2022]
Affiliation(s)
- E. J. Martin
- Division of Hematology/Oncology; Department of Medicine; University of California San Diego; San Diego CA USA
| | - E. J. Cooke
- Division of Hematology/Oncology; Department of Medicine; University of California San Diego; San Diego CA USA
- Department of Molecular and Experimental Medicine; The Scripps Research Institute; La Jolla CA USA
| | - A. Ceponis
- Division of Rheumatology; Allergy and Immunology; Department of Medicine; University of California San Diego; La Jolla CA USA
| | - R. F. W. Barnes
- Division of Hematology/Oncology; Department of Medicine; University of California San Diego; San Diego CA USA
| | - C. M. Moran
- Division of Hematology/Oncology; Department of Medicine; University of California San Diego; San Diego CA USA
| | - S. Holle
- Division of Hematology/Oncology; Department of Medicine; University of California San Diego; San Diego CA USA
| | - T. H. Hughes
- Department of Radiology; University of California San Diego; San Diego CA USA
| | - R. E. Moore
- General Musculoskeletal Imaging Inc; Cincinnati OH USA
| | - A. von Drygalski
- Division of Hematology/Oncology; Department of Medicine; University of California San Diego; San Diego CA USA
- Department of Molecular and Experimental Medicine; The Scripps Research Institute; La Jolla CA USA
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