1
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Kijowski R, Fritz J, Deniz CM. Deep learning applications in osteoarthritis imaging. Skeletal Radiol 2023; 52:2225-2238. [PMID: 36759367 PMCID: PMC10409879 DOI: 10.1007/s00256-023-04296-6] [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: 10/12/2022] [Revised: 12/22/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023]
Abstract
Deep learning (DL) is one of the most exciting new areas in medical imaging. This article will provide a review of current applications of DL in osteoarthritis (OA) imaging, including methods used for cartilage lesion detection, OA diagnosis, cartilage segmentation, and OA risk assessment. DL techniques have been shown to have similar diagnostic performance as human readers for detecting and grading cartilage lesions within the knee on MRI. A variety of DL methods have been developed for detecting and grading the severity of knee OA and various features of knee OA on X-rays using standardized classification systems with diagnostic performance similar to human readers. Multiple DL approaches have been described for fully automated segmentation of cartilage and other knee tissues and have achieved higher segmentation accuracy than currently used methods with substantial reductions in segmentation times. Various DL models analyzing baseline X-rays and MRI have been developed for OA risk assessment. These models have shown high diagnostic performance for predicting a wide variety of OA outcomes, including the incidence and progression of radiographic knee OA, the presence and progression of knee pain, and future total knee replacement. The preliminary results of DL applications in OA imaging have been encouraging. However, many DL techniques require further technical refinement to maximize diagnostic performance. Furthermore, the generalizability of DL approaches needs to be further investigated in prospective studies using large image datasets acquired at different institutions with different imaging hardware before they can be implemented in clinical practice and research studies.
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Affiliation(s)
- Richard Kijowski
- Department of Radiology, New York University Grossman School of Medicine, 660 First Avenue, 3Rd Floor, New York, NY, 10016, USA.
| | - Jan Fritz
- Department of Radiology, New York University Grossman School of Medicine, 660 First Avenue, 3Rd Floor, New York, NY, 10016, USA
| | - Cem M Deniz
- Department of Radiology, New York University Grossman School of Medicine, 660 First Avenue, 3Rd Floor, New York, NY, 10016, USA
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Rodriguez-Merchan EC. The Current Role of Disease-modifying Osteoarthritis Drugs. THE ARCHIVES OF BONE AND JOINT SURGERY 2023; 11:11-22. [PMID: 36793668 PMCID: PMC9903308 DOI: 10.22038/abjs.2021.56530.2807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/27/2021] [Indexed: 02/17/2023]
Abstract
Contemporary treatments for osteoarthritis (OA) pursue only to alleviate the pain caused by the illness. Discovering disease-modifying osteoarthritis drugs (DMOADs) that can induce the repair and regeneration of articular tissues would be of substantial usefulness. The purpose of this manuscript is to review the contemporary role of DMOADs in managing OA. A narrative literature review on the subject, exploring the Cochrane Library and PubMed (MEDLINE) was performed. It was encountered that many publications have analyzed the impact of several DMOAD methods, including anti-cytokine therapy (tanezumab, AMG 108, adalimumab, etanercept, anakinra), enzyme inhibitors (M6495, doxycycline, cindunistat, PG-116800), growth factors (bone morphogenetic protein-7, sprifermin), gene therapy (micro ribonucleic acids, antisense oligonucleotides), peptides (calcitonin) and others (SM04690, senolitic, transient receptor potential vanilloid 4, neural EGFL-like 1, TPCA-1, tofacitinib, lorecivivint and quercitrin). Tanezumab has been demonstrated to alleviate hip and knee pain in individuals with OA but can cause major adverse events (osteonecrosis of the knee, rapid illness progression, augmented prevalence of total joint arthroplasty of involved joints, particularly when tanezumab is combined with nonsteroidal anti-inflammatory drugs. SM04690 (a Wnt inhibitor) has been demonstrated to be safe and efficacious in alleviating pain and ameliorating function as measured by the Western Ontario and McMaster Universities Arthritis Index. The intraarticular injection of lorecivivint is deemed safe and well tolerated, with no important reported systemic complications. In conclusion, even though DMOADs seem promising, their clinical effectiveness has not yet been demonstrated for managing OA. Until forthcoming studies can proved the medications' capacity to repair and regenerate tissues affected by OA, physicians should keep using treatments that only intend to alleviate pain.
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Okur ME, Kolbaşı B, Şahin M, Karadağ AE, Reis R, Çağlar EŞ, Kaplan AA, Sipahi H, Keskin İ, Demiralp B, Üstündağ Okur N. A novel approach in the treatment of osteoarthritis: In vitro and in vivo evaluation of
Allium sativum
microemulsion. J SURFACTANTS DETERG 2022. [DOI: 10.1002/jsde.12605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Mehmet Evren Okur
- Department of Pharmacology, Faculty of Pharmacy University of Health Sciences Istanbul Turkey
| | - Bircan Kolbaşı
- Department of Histology and Embryology, Faculty of Medicine Istanbul Medipol University Istanbul Turkey
| | - Mustafa Şahin
- Department of Orthopedics and Traumatology School of Medicine, Istanbul Medipol University Istanbul Turkey
| | - Ayşe Esra Karadağ
- Department of Pharmacognosy, School of Pharmacy Istanbul Medipol University Istanbul Turkey
- Department of Pharmacognosy, Graduate School of Health Sciences Anadolu University Eskişehir Turkey
| | - Rengin Reis
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy Acıbadem Mehmet Ali Aydınlar University Istanbul Turkey
| | - Emre Şefik Çağlar
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy University of Health Sciences Istanbul Turkey
| | - Arife Ahsen Kaplan
- Department of Histology and Embryology, Faculty of Medicine Istanbul Medipol University Istanbul Turkey
| | - Hande Sipahi
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy Yeditepe University Istanbul Turkey
| | - İlknur Keskin
- Department of Histology and Embryology, Faculty of Medicine Istanbul Medipol University Istanbul Turkey
| | | | - Neslihan Üstündağ Okur
- Department of Pharmaceutical Technology, Faculty of Pharmacy University of Health Sciences Istanbul Turkey
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Drug delivery in intervertebral disc degeneration and osteoarthritis: Selecting the optimal platform for the delivery of disease-modifying agents. J Control Release 2020; 328:985-999. [PMID: 32860929 DOI: 10.1016/j.jconrel.2020.08.041] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 12/16/2022]
Abstract
Osteoarthritis (OA) and intervertebral disc degeneration (IVDD) as major cause of chronic low back pain represent the most common degenerative joint pathologies and are leading causes of pain and disability in adults. Articular cartilage (AC) and intervertebral discs are cartilaginous tissues with a similar biochemical composition and pathophysiological aspects of degeneration. Although treatments directed at reversing these conditions are yet to be developed, many promising disease-modifying drug candidates are currently under investigation. Given the localized nature of these chronic diseases, drug delivery systems have the potential to enhance therapeutic outcomes by providing controlled and targeted release of bioactives, minimizing the number of injections needed and increasing drug concentration in the affected areas. This review provides a comprehensive overview of the currently most promising disease-modifying drugs as well as potential drug delivery systems for OA and IVDD therapy.
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Chen K, Fang H, Xu N. LncRNA LOXL1-AS1 is transcriptionally activated by JUND and contributes to osteoarthritis progression via targeting the miR-423-5p/KDM5C axis. Life Sci 2020; 258:118095. [PMID: 32679142 DOI: 10.1016/j.lfs.2020.118095] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 06/22/2020] [Accepted: 07/09/2020] [Indexed: 12/25/2022]
Abstract
AIMS This study focused on investigating the potential role of long non-coding RNA (lncRNA) lysyl oxidase like 1 antisense RNA 1 (LOXL1-AS1) in the progression of osteoarthritis (OA). MATERIALS AND METHODS qRT-PCR assay was applied to detect gene expression, while western blot was performed to measure levels of apoptosis-related proteins. CCK-8, colony formation and TUNEL assays were conducted to explore the functional role of LOXL1-AS1 in OA. ChIP assay was utilized to assess the affinity between JunD proto-oncogene, AP-1 transcription factor subunit (JUND) and LOXL1-AS1 promoter. Mechanism experiments were implemented to investigate the underlying molecular mechanism of LOXL1-AS1. KEY FINDINGS LOXL1-AS1 was up-regulated in OA cartilage tissues. Silencing LOXL1-AS1 hampered proliferation and inflammation, yet promoting apoptosis in chondrocytes. LOXL1-AS1 was transcriptionally activated by JUND1. LOXL1-AS1 sequestered miR-423-5p and abolished miR-423-5p-mediated repression on lysine demethylase 5C (KDM5C), thus promoted the development of OA. SIGNIFICANCE LncRNA LOXL1-AS1 is transcriptionally activated by JUND and facilitates the proliferation and inflammation of chondrocytes via elevating miR-423-5p-mediated KDM5C in OA, which may provide potential therapeutic target for OA.
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Affiliation(s)
- Keng Chen
- Department of Orthopaedics, Shanghai Eighth People's Hospital, 14th Floor, Building2, No.8 Caobao Road, Xuhui District, Shanghai 200235, China.
| | - Hao Fang
- Department of Orthopaedics, Shanghai Eighth People's Hospital, 14th Floor, Building2, No.8 Caobao Road, Xuhui District, Shanghai 200235, China
| | - Ning Xu
- Department of Orthopaedics, Shanghai Eighth People's Hospital, 14th Floor, Building2, No.8 Caobao Road, Xuhui District, Shanghai 200235, China
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Gencoglu H, Orhan C, Sahin E, Sahin K. Undenatured Type II Collagen (UC-II) in Joint Health and Disease: A Review on the Current Knowledge of Companion Animals. Animals (Basel) 2020; 10:E697. [PMID: 32316397 PMCID: PMC7222752 DOI: 10.3390/ani10040697] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 12/14/2022] Open
Abstract
OA is quite common in companion animals, especially in large breed dogs and horses. Collagen, the most abundant protein of mammals, has specific connective tissue types for skin, bones, reticulate, basal lamina, bones, cell surfaces, while type II collagen (UC-II) forms the main structure of cartilage tissue. Even at the smaller dosages, UC-II has also been reported to be more effective than the glucosamine and chondroitin sulfate supplements, which are the supplements most frequently used in the market. In this review, we summarize the effects of UC-II on joint health and function in health and disease conditions in companion animals.
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Affiliation(s)
- Hasan Gencoglu
- Department of Biology, Faculty of Science, Firat University, Elazig (+90) 424, Turkey;
| | - Cemal Orhan
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig (+90) 424, Turkey; (C.O.); (E.S.)
| | - Emre Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig (+90) 424, Turkey; (C.O.); (E.S.)
| | - Kazim Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig (+90) 424, Turkey; (C.O.); (E.S.)
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Ai D, Yu F. LncRNA DNM3OS promotes proliferation and inhibits apoptosis through modulating IGF1 expression by sponging MiR-126 in CHON-001 cells. Diagn Pathol 2019; 14:106. [PMID: 31526393 PMCID: PMC6747757 DOI: 10.1186/s13000-019-0877-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/23/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND As a degenerative disease, osteoarthritis (OA) greatly affects aged population. The human chondrocyte cell line CHON-001, derived from normal human articular cartilage, has been widely used in vitro in osteoarthritis models. In order to better understand the underlying mechanism of OA pathogenesis, this study was conducted to explore the effects of LncRNA dynamin 3 opposite strand (DNM3OS) on CHON-001 cells. METHODS The expression levels of and correlation between DNM3OS and miR-126 that derived from OA and non-OA tissues were determined by quantitative real time (qRT)-PCR and Spearman's correlation analysis. Cell viability, clone, migration, invasion and apoptosis were respectively determined by cell counting kit-8, colony formation, wound healing assay, transwell and flow cytometry. The target genes were predicted by starbase V2 and targetscan 7.2 and confirmed by luciferase reporter assay. The expressions of apoptosis-related factors were detected by Western blot. RESULTS The expression of DNM3OS was down-regulated in OA patients. Functional assays demonstrated that ectopic expression of DNM3OS promoted the proliferation and inhibited apoptosis of CHON-001 cells, and that knocking down DNM3OS suppressed cell proliferation and induced apoptosis. Mechanistic investigation revealed that DNM3OS physically bound to the promoter of miR-126 and suppressed miR-126 expression. Decreased expression of DNM3OS was negatively correlated with miR-126 in OA patients. Furthermore, the effects of siDNM3OS on inhibiting cell proliferation and promoting apoptosis were partially reversed by miR-126 inhibitor. Meanwhile, type insulin-like growth factor-1 (IGF1) was identified as a target gene for miR-126 and was negatively associated with the miR-126 expression. Overexpressed IGF1 restored the effects of miR-126 mimic in suppressing cell proliferation and promoting apoptosis. CONCLUSION Our results showed that DNM3OS could affect the CHON-001 cell proliferation and apoptosis by regulating IGF1 by sponging miR-126.
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Affiliation(s)
- Di Ai
- Department of Joint Surgery, Beijing Shijitan Hospital, CMU, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038 China
| | - Fang Yu
- Department of Joint Surgery, Beijing Shijitan Hospital, CMU, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038 China
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Pirosa A, Gottardi R, Alexander PG, Tuan RS. Engineering in-vitro stem cell-based vascularized bone models for drug screening and predictive toxicology. Stem Cell Res Ther 2018; 9:112. [PMID: 29678192 PMCID: PMC5910611 DOI: 10.1186/s13287-018-0847-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The production of veritable in-vitro models of bone tissue is essential to understand the biology of bone and its surrounding environment, to analyze the pathogenesis of bone diseases (e.g., osteoporosis, osteoarthritis, osteomyelitis, etc.), to develop effective therapeutic drug screening, and to test potential therapeutic strategies. Dysregulated interactions between vasculature and bone cells are often related to the aforementioned pathologies, underscoring the need for a bone model that contains engineered vasculature. Due to ethical restraints and limited prediction power of animal models, human stem cell-based tissue engineering has gained increasing relevance as a candidate approach to overcome the limitations of animals and to serve as preclinical models for drug testing. Since bone is a highly vascularized tissue, the concomitant development of vasculature and mineralized matrix requires a synergistic interaction between osteogenic and endothelial precursors. A number of experimental approaches have been used to achieve this goal, such as the combination of angiogenic factors and three-dimensional scaffolds, prevascularization strategies, and coculture systems. In this review, we present an overview of the current models and approaches to generate in-vitro stem cell-based vascularized bone, with emphasis on the main challenges of vasculature engineering. These challenges are related to the choice of biomaterials, scaffold fabrication techniques, and cells, as well as the type of culturing conditions required, and specifically the application of dynamic culture systems using bioreactors.
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Affiliation(s)
- Alessandro Pirosa
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Pittsburgh, PA 15219 USA
| | - Riccardo Gottardi
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Pittsburgh, PA 15219 USA
- Ri.MED Foundation, Via Bandiera 11, Palermo, 90133 Italy
| | - Peter G. Alexander
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Pittsburgh, PA 15219 USA
| | - Rocky S. Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Pittsburgh, PA 15219 USA
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Bisicchia S, Tudisco C. Hyaluronic acid vs corticosteroids in symptomatic knee osteoarthritis: a mini-review of the literature. ACTA ACUST UNITED AC 2017; 14:182-185. [PMID: 29263730 DOI: 10.11138/ccmbm/2017.14.1.182] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction Although intra-articular injections of hyaluronic acid (HA) are common non-operative measures used in clinical practice in the management of symptomatic osteoarthritis, there is a great controversy on their efficacy and safety compared to corticosteroids (CSs). Efficacy Conflicting results have been reported in clinical trials and meta-analysis due to methodological differences in study design, along with collection, analysis, and interpretation of data. Even if some studies reported small or no differences of HA compared with CSs (or inferred that HA is not more effective than saline as a placebo), in general CSs have shown to be superior in the short term (especially on pain control), while better results have been reported with HA at subsequent evaluations, but with only a moderate effect after 26 weeks. Safety Mild or moderate adverse events have generally been reported after HA injections, the most common being injection site pain. HA is generally considered safe compared to CSs or saline. Furthermore, HA has shown to be safe also after a previous course of injections. Conclusions Conflicting results have been reported on the efficacy and safety of HA. Guidelines are controversial and in most of the cases "uncertain" recommendations are provided due to inconclusive evidence in literature. However, HA does not seem to have significantly higher side effects when compared to saline or CSs injections, and provides better medium-term control of symptoms in patients with mild to moderate knee osteoarthritis.
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Affiliation(s)
- Salvatore Bisicchia
- Department of Orthopaedic Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Cosimo Tudisco
- Department of Orthopaedic Surgery, University of Rome Tor Vergata, Rome, Italy
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Gumustas SA, Oznam K, Mutlu CA, Kaya YE, Yilmaz I, Isyar M, Guzelant AY, Guler O, Akkaya S, Mahirogullari M. Are We Using Slow-Acting Symptomatic Chondroprotective Drugs Conscious Enough? Open Orthop J 2017; 11:533-540. [PMID: 28694893 PMCID: PMC5470068 DOI: 10.2174/1874325001711010533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 04/20/2017] [Accepted: 05/14/2017] [Indexed: 12/26/2022] Open
Abstract
Background: Osteochondral injuries constitute an entity that is widespread and can be seen in patients of all ages. Actual treatment modalities aim to relieve pain, obtain full range of movement of the joint, and improve the quality of life. There are many slow-acting chondroprotective agents prevalently used in the United States that are classified as nutritional support but not as medicines . This study presents the importance of clinical adverse effect profiles as well as the pharmacological mechanism of action and application of combinations of drugs that are widely prescribed and not subjected to control. Methods: Electronic databases were searched with keywords about the chondroprotective drugs without any language restriction. Evaluations of the descriptive statistics were represented via Microsoft Office Excel 2010 lists in the form of a mean±standard deviation or frequency (%). The first evaluation showed that 1502 studies were potentially relevant. Following exclusion of the 1277 studies which were not clinical, full versions of the remaining 225 studies were subjected to further evaluation. No controlled, blinded, randomized and/or comparative studies met the inclusion criteria of the study, and no studies evaluated the comparative clinical results of the hyaluronan of different molecular weights. Results: The findings of this study concluded that especially when prescribing drugs with ingredients like GS and CS, many patients’ pre-existing conditions must be considered, such as whether the patient has a glucose intolerance or not. Additionally, mineral toxication should be considered since the drugs contain minerals, and after the application of injected hyaluronan, complications should be considered. Conclusion: Clinical, controlled and comparative studies about the use of chondroprotective drugs must be performed to define the benefits of these drugs, if any, in order to determine the most suitable time for operative intervention.
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Affiliation(s)
- Seyit Ali Gumustas
- Department of Orthopaedic and Traumatology, Dr.Lutfi Kirdar Kartal Training and Research Hospital, 34865, Istanbul,Turkey
| | - Kadir Oznam
- Department of Orthopaedic and Traumatology, Istanbul Medipol University School of Medicine, 34214Istanbul, Turkey
| | - Cagri Ata Mutlu
- Department of Medical Sciences, Acibadem Universitiy School of Medicine, 34752Istanbul, Turkey
| | - Yasin Emre Kaya
- Department of Orthopaedic and Traumatology, Republic of Turkey, Ministry of Health, State Hospital, Corlu, 59850Tekirdag, Turkey
| | - Ibrahim Yilmaz
- Department of Medical Pharmacology, Istanbul Medipol University School of Medicine, 34810Istanbul, Turkey
| | - Mehmet Isyar
- Department of Orthopaedic and Traumatology, Acibadem Hospitals Group, Kadikoy, 34718Istanbul, Turkey
| | - Aliye Yıldırım Guzelant
- Department of Physical Medicine and Rehabilitation, Namik Kemal University School of Medicine, 59030Tekirdag, Turkey
| | - Olcay Guler
- Department of Orthopaedic and Traumatology, Istanbul Medipol University School of Medicine, 34214Istanbul, Turkey
| | - Semih Akkaya
- Department of Orthopaedic and Traumatology, Private Denizli Surgery Hospital, 20070Denizli, Turkey
| | - Mahir Mahirogullari
- Department of Orthopaedic and Traumatology, Memorial Health Group, 34750Istanbul, Turkey
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Coccia M. Emerging Technology in Cartilage Repair: Analysis with a Substitution Model of Technological Change. SSRN ELECTRONIC JOURNAL 2017. [DOI: 10.2139/ssrn.2958484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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The NAD-Dependent Deacetylase Sirtuin-1 Regulates the Expression of Osteogenic Transcriptional Activator Runt-Related Transcription Factor 2 (Runx2) and Production of Matrix Metalloproteinase (MMP)-13 in Chondrocytes in Osteoarthritis. Int J Mol Sci 2016; 17:ijms17071019. [PMID: 27367673 PMCID: PMC4964395 DOI: 10.3390/ijms17071019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/17/2016] [Accepted: 06/23/2016] [Indexed: 12/21/2022] Open
Abstract
Aging is one of the major pathologic factors associated with osteoarthritis (OA). Recently, numerous reports have demonstrated the impact of sirtuin-1 (Sirt1), which is the NAD-dependent deacetylase, on human aging. It has been demonstrated that Sirt1 induces osteogenic and chondrogenic differentiation of mesenchymal stem cells. However, the role of Sirt1 in the OA chondrocytes still remains unknown. We postulated that Sirt1 regulates a hypertrophic chondrocyte lineage and degeneration of articular cartilage through the activation of osteogenic transcriptional activator Runx2 and matrix metalloproteinase (MMP)-13 in OA chondrocytes. To verify whether sirtuin-1 (Sirt1) regulates chondrocyte activity in OA, we studied expressions of Sirt1, Runx2 and production of MMP-13, and their associations in human OA chondrocytes. The expression of Sirt1 was ubiquitously observed in osteoarthritic chondrocytes; in contrast, Runx2 expressed in the osteophyte region in patients with OA and OA model mice. OA relating catabolic factor IL-1βincreased the expression of Runx2 in OA chondrocytes. OA chondrocytes, which were pretreated with Sirt1 inhibitor, inhibited the IL-1β-induced expression of Runx2 compared to the control. Since the Runx2 is a promotor of MMP-13 expression, Sirt1 inactivation may inhibit the Runx2 expression and the resultant down-regulation of MMP-13 production in chondrocytes. Our findings suggest thatSirt1 may regulate the expression of Runx2, which is the osteogenic transcription factor, and the production of MMP-13 from chondrocytes in OA. Since Sirt1 activity is known to be affected by several stresses, including inflammation and oxidative stress, as well as aging, SIRT may be involved in the development of OA.
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Intra-Articular Injection of Cross-Linked Hyaluronic Acid-Dexamethasone Hydrogel Attenuates Osteoarthritis: An Experimental Study in a Rat Model of Osteoarthritis. Int J Mol Sci 2016; 17:411. [PMID: 27092487 PMCID: PMC4848885 DOI: 10.3390/ijms17040411] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/07/2016] [Accepted: 03/09/2016] [Indexed: 01/28/2023] Open
Abstract
Cross-linked hyaluronic acid hydrogel (cHA gel) and dexamethasone (Dex) have been used to treat knee osteoarthritis (OA) in clinical practice owing to their chondroprotective and anti-inflammatory effects, respectively. The aim of the present study was to compare the treatment effects of the cHA gel pre-mixed with/without Dex in a surgery-induced osteoarthritis model in rats. Anterior cruciate ligament transection (ACLT) surgery was performed on the right knee of rats to induce OA. Male 2-month-old Sprague-Dawley rats were randomly divided into five groups (n = 10/per group): (1) ACLT + saline; (2) ACLT + cHA gel; (3) ACLT + cHA-Dex (0.2 mg/mL) gel; (4) ACLT + cHA-Dex (0.5 mg/mL) gel; (5) Sham + saline. Intra-joint injections were performed four weeks after ACLT in the right knee. All animals were euthanized at 12 weeks post-surgery. Cartilage damage and changes in the synovial membrane were assessed by micro X-ray, Indian ink articular surface staining, Safranin-O/Fast Green staining, immunohistochemistry, hematoxylin and eosin staining of the synovial membrane, and quantitative reverse transcription-polymerase chain reaction for changes in gene expression. Micro X-ray revealed that the knee joint treated with the cHA-Dex gel was wider than those treated with cHA gel alone or saline. The cHA-Dex gel group had less Indian ink staining (indicator of cartilage fibrillation) than the cHA gel or saline injection groups. Safranin-O/Fast Green staining indicated that increased proteoglycan staining and less cartilage damage were found in the cHA-Dex gel group compared with the cHA gel or saline injection groups. Quantification of histology findings from saline, cHA gel, cHA-Dex (0.2 mg/mL) gel, cHA-Dex (0.5 mg/mL) gel, and sham groups were 5.84 ± 0.29, 4.50 ± 0.87, 3.00 ± 1.00, 2.00 ± 0.48, and 0.30 ± 0.58 (p < 0.05), respectively. A strong staining of type II collagen was found in both the cHA-Dex gel groups compared with saline group or cHA alone group. Similar result was found for the mRNA level of aggrecan and opposite result for type X collagen. Hematoxylin and eosin staining in the synovial membrane showed less synovial lining cell layers and reduced inflammatory cell infiltration in cHA-Dex gel-treated animals compared with saline or cHA only groups. Altogether, cHA-Dex gel has better chondroprotective and anti-inflammatory effects in rat surgery-induced osteoarthritis than cHA alone.
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Wu G, Zhu S, Sun X, Hu J. Subchondral bone changes and chondrogenic capacity of progenitor cells from subchondral bone in the collagenase-induced temporomandibular joints osteoarthritis rabbit model. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:9782-9789. [PMID: 26617688 PMCID: PMC4637773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 08/21/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE The goals of this study were to characterize subchondral bone changes, and to determine biological activity characteristics of progenitor cell populations from subchondral bone in the collagenase-induced temporomandibular joint osteoarthritis (TMJOA) rabbit model. Greater understanding of such pathological changes occurring in TMJOA samples is critical in the future treatment modalities regarding cartilage protection and repair. Furthermore, the use of progenitor cell populations in various cartilage regeneration strategies proves to be a fruitful avenue for research and clinical applications. MATERIALS AND METHODS Bone remodeling and anabolic activity of subchondral bone was evaluated by hematoxylin-eosin (H&E), Alcian blue-periodic acid-Schiff (AB-PAS) staining and immuohistochemical staining. The biological activity characteristics of progenitor cells were assessed by expressions of collagen type II, CD44, SOX-9 and MMP-9 by immunohistochemistry and Western blot analysis. RESULTS In most of the specimens, cartilage of the digested area displayed a reaction characterized by thickening of the cartilage cellular structure with retraction structure formation in the subchondral bone. Most of the specimens focuses on chondroid metaplasia were observed in the subchondral bone, promoting its remodeling, which could develop to endochondral ossification and increasing subchondral bone size. Meanwhile, immunohistochemistry analysis revealed that CD44 expressions in subchondral bone were most significantly increased in TMJOA at 2 weeks group (P < 0.01). And, at 4, 6 and 8 weeks groups, the osteochondral junction had completely disappeared by active subchondral bone remodeling, and collagen type II, CD44, SOX-9 and MMP-9 expressions in active subchondral bone region were significantly increased in TMJOA (P < 0.05). In addition, western blot analysis revealed that CD44 expression significantly emerged in subchondral bone region at 2 weeks group (P < 0.01). Meanwhile, SOX-9 expression emerged in all group, and the intensity was increased in the experimental groups (P < 0.05). CONCLUSION Our results suggest that the beneficial activation of progenitor cells and bone marrow stem cells in subchondral bone at early stage of TMJOA played an important role on renovation and remodeling of subchondral bone.
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Affiliation(s)
- Guomin Wu
- West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan UniversityChengdu 610041, Sichuan, China
| | - Songsong Zhu
- West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan UniversityChengdu 610041, Sichuan, China
| | - Xiumei Sun
- Department of Orthodontics, Hospital of Stomatology, Jilin UniversityChangchun, Jilin Province, China
| | - Jing Hu
- West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan UniversityChengdu 610041, Sichuan, China
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15
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Lu HT, Hsieh MS, Cheng CW, Yao LF, Hsu TY, Lan J, Kim KY, Oh SJ, Chang YH, Lee CH, Lin YF, Chen CH. Alterative effects of an oral alginate extract on experimental rabbit osteoarthritis. J Biomed Sci 2015; 22:64. [PMID: 26239837 PMCID: PMC4524359 DOI: 10.1186/s12929-015-0169-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 07/21/2015] [Indexed: 11/25/2022] Open
Abstract
Background Osteoarthritis (OA) is a common joint disease that causes disabilities in elderly. However, few agents with high efficacy and low side effects have been developed to treat OA. In this study, we evaluated the effects of the alginate extract named CTX in OA cell and rabbit models. Results CTX was formulated by hydrolyzing sodium alginate polymers with alginate lyase and then mixing with pectin. HPLC was used to analyze the CTX content. Human chondrosarcoma SW1353 cells treated with interleukin-1β were used as OA model cells to investigate the effects of CTX on chondrocyte inflammation and anabolism. CTX at concentrations up to 1000 μg/ml exerted low cytotoxicity. It inhibited the gene expression of proinflammatory matrix metalloproteinases (MMPs) including MMP1, MMP3 and MMP13 in a dose-dependent manner and increased the mRNA level of aggrecan, the major proteoglycan in articular cartilage, at 1000 μg/ml. Thirteen-week-old New Zealand White rabbits underwent a surgical anterior cruciate ligament transection and were orally treated with normal saline, glucosamine or CTX for up to 7 weeks. Examinations of the rabbit femur and tibia samples demonstrated that the rabbits taking oral CTX at a dosage of 30 mg/kg/day suffered lesser degrees of articular stiffness and histological cartilage damage than the control rabbits. Conclusions The gene expression profiles in the cell and the examinations done on the rabbit cartilage suggest that the alginate extract CTX is a pharmaco-therapeutic agent applicable for OA therapy.
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Affiliation(s)
- Hsien-Tseng Lu
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Orthopedics, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ming-Shium Hsieh
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Orthopedics, En Chu Kong Hospital, New Taipei, Taiwan
| | - Chao-Wen Cheng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Li-Fan Yao
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, 250 Wu Xing St., Taipei, 110, Taiwan
| | - Tsuey-Ying Hsu
- Mastervet International Marketing Limited, Taipei, Taiwan
| | - Jai Lan
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, 250 Wu Xing St., Taipei, 110, Taiwan.,Mastervet International Marketing Limited, Taipei, Taiwan
| | | | | | - Yung-Hsiang Chang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chian-Her Lee
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Orthopedics, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yung-Feng Lin
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, 250 Wu Xing St., Taipei, 110, Taiwan.
| | - Chien-Ho Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, 250 Wu Xing St., Taipei, 110, Taiwan.
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16
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Murakami K, Nakagawa H, Nishimura K, Matsuo S. Changes in peptidergic fiber density in the synovium of mice with collagenase-induced acute arthritis. Can J Physiol Pharmacol 2015; 93:435-41. [PMID: 25909759 DOI: 10.1139/cjpp-2014-0446] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The effect of acute osteoarthritis (OA) on peripheral nerve fibers (NFs) in synovial tissue, and their association with histological changes were investigated in collagenase-induced OA mice. Collagenase (10 U in 5 μL saline) was injected into the right knee, and the same volume of saline was injected into the left knee as the control. Mice were sacrificed 1, 2, 3, and 4 weeks after the collagenase injection. Histopathological changes in the knee joints were evaluated. The numbers of protein gene product (PGP) 9.5-, calcitonin-gene-related peptide (CGRP)-, and substance P (SP)-positive NFs in the synovial tissue were determined, and their densities in the tissue were calculated. The densities of PGP 9.5- and CGRP-positive NFs in the synovium were drastically decreased 1 week after the collagenase injection. However, by week 4, the density of PGP 9.5- and CGRP-positive NFs had recovered to 84% and 79% of their normal levels, respectively. Despite the poor correlation between the synovitis score and the density of CGRP- or SP-positive NFs in the synovium, the ossification rate of chondrophytes in chondro/osteophyte lesions correlated strongly with the density of CGRP-positive NFs (R = 0.855). These results suggest that the ossification of chondrophytes occurred in parallel with the increase in CGRP-positive fiber density in the synovium during the acute phase of collagenase-induced OA.
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Affiliation(s)
- Kohei Murakami
- Laboratory of Toxicology, Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-ourai-kita, Izumisano-shi, Osaka 598-8531, Japan., Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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17
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Celecoxib Combined with Diacerein Effectively Alleviates Osteoarthritis in Rats via Regulating JNK and p38MAPK Signaling Pathways. Inflammation 2015; 38:1563-72. [DOI: 10.1007/s10753-015-0131-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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18
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Huh JE, Koh PS, Seo BK, Park YC, Baek YH, Lee JD, Park DS. Mangiferin reduces the inhibition of chondrogenic differentiation by IL-1β in mesenchymal stem cells from subchondral bone and targets multiple aspects of the Smad and SOX9 pathways. Int J Mol Sci 2014; 15:16025-42. [PMID: 25216336 PMCID: PMC4200868 DOI: 10.3390/ijms150916025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/30/2014] [Accepted: 08/21/2014] [Indexed: 02/06/2023] Open
Abstract
Mangiferin is a natural immunomodulator found in plants including mango trees. The effects of mangiferin on chondrogenesis and cartilage repair have not yet been reported. This study was designed to determine the effect of mangiferin on chondrogenic differentiation in IL-1β-stimulated mesenchymal stem cells (MSCs) from subchondral bone and to explore the mechanisms underlying these effects. MSCs were isolated from the subchondral bone of rabbit and treated with mangiferin alone and/or interleukin-1β (IL-1β). Mangiferin induced chondrogenic differentiation in MSCs by upregulating transforming growth factor (TGF)-β, bone morphogenetic protein (BMP)-2, and BMP-4 and several key markers of chondrogenesis, including sex-determining region Y-box (SRY-box) containing gene 9 (SOX9), type 2α1 collagen (Col2α1), cartilage link protein, and aggrecan. In IL-1β-stimulated MSCs, mangiferin significantly reversed the production of TGF-β, BMP-2, BMP-4, SOX9, Col2α1, cartilage link protein, and aggrecan, as well as matrix metalloproteinase (MMP)-1, MMP-13, and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS5). Mangiferin upregulated the phosphorylation of Smad 2, Smad 3, Smad 1/5/8, and SOX9 in IL-1β-stimulated MSCs. In the presence of mangiferin, SOX9 siRNA suppressed the activation of Smad 2, Smad 3, Smad 1/5/8, aggrecan, and Col2α1 expression. In conclusion, mangiferin exhibits both chondrogenic and chondroprotective effects on damaged MSCs and mediates these effects by targeting multiple aspects of the Smad and SOX9 signaling pathways.
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Affiliation(s)
- Jeong-Eun Huh
- East-West Bone & Joint Research Institute, Kyung Hee University, 149, Sangil-dong, Gangdong-gu, Seoul 134-727, Korea.
| | - Pil-Seong Koh
- Department of Acupuncture and Moxibustion, College of Oriental Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Korea.
| | - Byung-Kwan Seo
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Kangdong, 149, Sangil-dong, Gangdong-gu, Seoul 134-727, Korea.
| | - Yeon-Chul Park
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Kangdong, 149, Sangil-dong, Gangdong-gu, Seoul 134-727, Korea.
| | - Yong-Hyun Baek
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Kangdong, 149, Sangil-dong, Gangdong-gu, Seoul 134-727, Korea.
| | - Jae-Dong Lee
- Department of Acupuncture and Moxibustion, College of Oriental Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Korea.
| | - Dong-Suk Park
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Kangdong, 149, Sangil-dong, Gangdong-gu, Seoul 134-727, Korea.
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19
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MacKay C, Badley EM, Jaglal SB, Sale J, Davis AM. "We're all looking for solutions": a qualitative study of the management of knee symptoms. Arthritis Care Res (Hoboken) 2014; 66:1033-40. [PMID: 24403242 PMCID: PMC4657457 DOI: 10.1002/acr.22278] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 12/27/2013] [Indexed: 12/28/2022]
Abstract
OBJECTIVE While the prevalence of osteoarthritis (OA) increases with age, the first signs begin in the fourth or fifth decade. Little is known about how younger adults respond to OA. This study explores how people ages 35-65 years manage knee symptoms. METHODS Six focus groups were conducted with 41 participants (mean age 50.9 years, 63% women) who self-reported a diagnosis of OA or reported knee symptoms (i.e., pain, aching, or stiffness) on most days of the past month. Purposive sampling was used, seeking variation in age and sex. The principles of constructivist grounded theory guided data collection and analysis. Data were analyzed using a constant comparative method. RESULTS Participants engaged in a process of proactively trying to find ways to control knee symptoms and disease progression. Their approach to management was not linear, but rather a process that moved back and forth between searching for "solutions" and active management (ongoing use of strategies). During the process, participants consulted health care providers, but often perceived that medical care offered limited options and guidance. Management was constructed as a "never-ending" process that entailed effort and personal resources. CONCLUSION Participants were proactive in seeking ways to manage knee OA symptoms. There is a mismatch between participants' proactive approach and the reactive approach of the health care system that has focused on late-stage disease. Programs and supports within the formal and informal health care system are required to enable people to successfully manage knee symptoms across their lifespan.
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Affiliation(s)
- Crystal MacKay
- Toronto Western Research Institute and University of TorontoToronto, Ontario, Canada
| | - Elizabeth M Badley
- Toronto Western Research Institute and University of TorontoToronto, Ontario, Canada
| | - Susan B Jaglal
- University of Toronto and Toronto Rehab, University Health NetworkToronto, Ontario, Canada
| | - Joanna Sale
- University of Toronto and Li Ka Shing Knowledge Institute, St. Michael’s HospitalToronto, Ontario, Canada
| | - Aileen M Davis
- Toronto Western Research Institute and University of TorontoToronto, Ontario, Canada
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20
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Housman L, Arden N, Schnitzer TJ, Birbara C, Conrozier T, Skrepnik N, Wei N, Bockow B, Waddell D, Tahir H, Hammond A, Goupille P, Sanson BJ, Elkins C, Bailleul F. Intra-articular hylastan versus steroid for knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2014; 22:1684-92. [PMID: 23417236 DOI: 10.1007/s00167-013-2438-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 01/29/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE To assess the efficacy and safety of one and two intra-articular (IA) injections of the new viscosupplement, hylastan, compared with a single IA corticosteroid injection for pain due to knee osteoarthritis (OA). Hylastan is a high-molecular-weight hyaluronan derivative prepared from bacterial fermented sodium hyaluronate that was developed to remain in the joint for longer than most other viscosupplements. METHODS This 6-month, double-blind, randomized, parallel group, multicenter trial enrolled patients aged ≥40 years who met American College of Rheumatology criteria for knee OA and had continued pain despite conservative treatment. Patients were randomized 1:1:1 to one of three arms: 2 × 4 mL hylastan (n = 129; arthrocentesis then IA hylastan Day 0, same treatment Week 2); 1 × 4 mL hylastan (n = 130; arthrocentesis then IA hylastan Day 0, arthrocentesis only Week 2); steroid (n = 132; arthrocentesis then IA methylprednisolone acetate 40 mg Day 0, arthrocentesis only Week 2). Participants and evaluators were blinded to treatment. The primary clinical outcome measure was change from baseline in WOMAC A pain score over all postbaseline visits to Week 26. RESULTS Statistically significant pain reduction was observed in all three arms, with similar mean (95 % CI) changes in WOMAC A: 2 × 4 mL hylastan -0.9 (-1.0, -0.7); 1 × 4 mL hylastan -0.8 (-0.9, -0.7); steroid -0.9 (-1.0, -0.8); all P < 0.0001 versus baseline. Changes in secondary outcomes (OMERACT-OARSI and WOMAC A responder rates, patient/clinical observer global assessments, and WOMAC A1 walking pain) were similar in all three arms. Target knee adverse events were comparable for all treatments. CONCLUSIONS Both IA hylastan injection regimens were effective in relieving pain with an acceptable safety profile. IA hylastan did not show a difference versus IA corticosteroid; therefore, the hypothesis of superior pain relief was not met. Further research is needed to compare the efficacy and safety of hylastan with other viscosupplements.
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Affiliation(s)
- Lawrence Housman
- Tucson Orthopaedic Institute, 2424 N Wyatt Dr, Tucson, AZ, 85712, USA
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21
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Zhang Y, Pizzute T, Pei M. Anti-inflammatory strategies in cartilage repair. TISSUE ENGINEERING PART B-REVIEWS 2014; 20:655-68. [PMID: 24846478 DOI: 10.1089/ten.teb.2014.0014] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cartilage defects are normally concomitant with posttraumatic inflammation and pose a major challenge in cartilage repair. Due to the avascular nature of cartilage and its inability to surmount an inflammatory response, the cartilage is easily attacked by proinflammatory factors and oxidative stress; if left untreated, osteoarthritis may develop. Suppression of inflammation has always been a crux for cartilage repair. Pharmacological drugs have been successfully applied in cartilage repair; however, they cannot optimally work alone. This review article will summarize current pharmacological drugs and their application in cartilage repair. The development of extracellular matrix-based scaffolds and preconditioned tissue-specific stem cells will be emphasized because both of these tissue engineering components could contribute to an enhanced ability not only for cartilage regeneration but also for anti-inflammation. These strategies could be combined to boost cartilage repair under inflammatory conditions.
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Affiliation(s)
- Ying Zhang
- 1 Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University , Morgantown, West Virginia
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22
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Drugs and Polymers for Delivery Systems in OA Joints: Clinical Needs and Opportunities. Polymers (Basel) 2014. [DOI: 10.3390/polym6030799] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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23
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Kijowski R, Blankenbaker DG, Munoz Del Rio A, Baer GS, Graf BK. Evaluation of the Articular Cartilage of the Knee Joint: Value of Adding a T2 Mapping Sequence to a Routine MR Imaging Protocol. Radiology 2013; 267:503-13. [PMID: 23297335 DOI: 10.1148/radiol.12121413] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Richard Kijowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Clinical Science Center-E3/311, Madison, WI 53792-3252, USA.
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Lu HT, Sheu MT, Lin YF, Lan J, Chin YP, Hsieh MS, Cheng CW, Chen CH. Injectable hyaluronic-acid-doxycycline hydrogel therapy in experimental rabbit osteoarthritis. BMC Vet Res 2013; 9:68. [PMID: 23574696 PMCID: PMC3637605 DOI: 10.1186/1746-6148-9-68] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 03/26/2013] [Indexed: 12/16/2022] Open
Abstract
Background Osteoarthritis (OA) is a common joint disease that causes disabilities in elderly adults. However, few long-lasting pharmacotherapeutic agents with low side effects have been developed to treat OA. We evaluated the therapeutic effects of intra-articular injections of hydrogels containing hyaluronic acid (HA) and doxycycline (DOX) in a rabbit OA model. Results Thirteen week old New Zealand White rabbits undergone a partial meniscectomy and unilateral fibular ligament transection were administered with either normal saline (NT), HA, DOX or HA-DOX hydrogels on day 0, 3, 6, 9 and 12; animals were also examined the pain assessment in every three days. The joint samples were taken at day 14 post-surgery for further histopathological evaluation. The degree of pain was significantly attenuated after day 7 post-treatment with both HA and HA-DOX hydrogels. In macroscopic appearance, HA-DOX hydrogel group showed a smoother cartilage surface, no or minimal signs of ulceration, smaller osteophytes, and less fissure formation in compare to HA or DOX treatment alone. In the areas with slight OA changes, HA-DOX hydrogel group exhibited normal distribution of chondrocytes, indicating the existence of cartilage regeneration. In addition, HA-DOX hydrogels also ameliorated the progression of OA by protecting the injury of articular cartilage layer and restoring the elastoviscosity. Conclusion Overall, from both macroscopic and microscopic data of this study indicate the injectable HA-DOX hydrogels presented as a long-lasting pharmacotherapeutic agent to apply for OA therapy.
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Affiliation(s)
- Hsien-Tsung Lu
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, No. 250 Wu-Hsing Street, Xinyi District, Taipei City 110, Taiwan
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Boyan BD, Tosi LL, Coutts RD, Enoka RM, Hart DA, Nicolella DP, Berkley KJ, Sluka KA, Kwoh CK, O’Connor MI, Kohrt WM, Resnick E. Addressing the gaps: sex differences in osteoarthritis of the knee. Biol Sex Differ 2013; 4:4. [PMID: 23374401 PMCID: PMC3571922 DOI: 10.1186/2042-6410-4-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 12/10/2012] [Indexed: 01/10/2023] Open
Abstract
An introduction to the accompanying three papers.
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Affiliation(s)
- Barbara D Boyan
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, 315 Ferst Drive NW, Atlanta, GA, 30332-0363, USA
| | - Laura L Tosi
- Division of Orthopaedic Surgery and Sports Medicine, Children's National Medical Center, Washington, DC, 20010
| | - Richard D Coutts
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
| | - Roger M Enoka
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
| | - David A Hart
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
| | - Daniel P Nicolella
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
| | - Karen J Berkley
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
- Program in Neuroscience, Florida State University, Tallahassee, FL, 32306-4301, USA
| | - Kathleen A Sluka
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
| | - C Kent Kwoh
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
| | - Mary I O’Connor
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, USA
| | - Wendy M Kohrt
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
| | - Eileen Resnick
- ISIS Research Network on Musculoskeletal Health, Society for Women’s Health Research, Washington, DC, USA
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Coccia M. Cartilage tissue engineering with chondrogeneic cells versus artificial joint replacement: the insurgence of new technological paradigms. HEALTH AND TECHNOLOGY 2012. [DOI: 10.1007/s12553-012-0032-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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27
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Hielm-Björkman A, Roine J, Elo K, Lappalainen A, Junnila J, Laitinen-Vapaavuori O. An un-commissioned randomized, placebo-controlled double-blind study to test the effect of deep sea fish oil as a pain reliever for dogs suffering from canine OA. BMC Vet Res 2012; 8:157. [PMID: 22950577 PMCID: PMC3514349 DOI: 10.1186/1746-6148-8-157] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 07/23/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND An un-commissioned randomized, double-blinded, placebo controlled clinical study was planned using a deep sea fish oil product for pets. Seventy-seven client-owned dogs with osteoarthritis were randomly assigned to supplement the food with either the fish oil product or corn (=placebo) oil. Our main outcome variables were force platform variables peak vertical force (PVF) and impulse, the validated Helsinki Chronic Pain Index (HCPI) and the use of rescue NSAIDs. Secondary outcome variables were a locomotion visual analog scale (VAS), a Quality of life VAS, a comparative questionnaire, a veterinary assessment, owners' final assessment of outcome and guessing the product given. RESULTS When comparing the two test groups at the end of the trial (16 weeks) there was no significant difference in any of the main outcome variables but owners of dogs that had taken fish oil were significantly happier with the treatment at the end visit and did significantly better at guessing what group their dogs had been in, compared to the placebo group. When comparing variables within the fish oil group as change from baseline to trial end, there were significant positive changes in PVF, HCPI, NSAID use, Quality of life VAS, as well as in all three scores in the comparative questionnaire (locomotion, every-day situations, and skin & coat). There were similar positive trends in force platform impulse and in the veterinary assessment variables, although they did not reach significance. Within the placebo group there were significant positive changes only in the HCPI and a significant deterioration according to veterinary assessment. CONCLUSIONS When compared to placebo, there was not a major statistically significant benefit in using deep sea fish oil as a pain reliever in our study population of dogs suffering from osteoarthritis. However, the fish oil treated patients improved significantly in many of the variables, when comparing baseline values to the study-end values within the group, indicating a true but small relief in symptoms. Deep sea fish oil supplementation could be considered a part of the multimodal pain relieving approach currently recommended for dogs suffering from OA, especially for individuals that do not tolerate anti-inflammatory drugs.
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Affiliation(s)
- Anna Hielm-Björkman
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, P.O.Box 57, Helsinki, FI-00014, Finland
| | - Johanna Roine
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, P.O.Box 57, Helsinki, FI-00014, Finland
- Faculty of Agriculture and Forestry. Department of Animal sciences, University of Helsinki, P.O.Box 28, Helsinki, FI-00014, Finland
| | - Kari Elo
- Faculty of Agriculture and Forestry. Department of Animal sciences, University of Helsinki, P.O.Box 28, Helsinki, FI-00014, Finland
| | - Anu Lappalainen
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, P.O.Box 57, Helsinki, FI-00014, Finland
| | - Jouni Junnila
- 4Pharma Ltd., Metsänneidonkuja 6, Espoo, FI-02130, Finland
| | - Outi Laitinen-Vapaavuori
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, P.O.Box 57, Helsinki, FI-00014, Finland
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Dinc M, Bilgen MS, Kucukalp A, Bilgen OF. An assessment of the chondroprotective effects of intra-articular application of statin and tetracycline on early-stage experimental osteoarthritis. ISRN ORTHOPEDICS 2012; 2012:182097. [PMID: 24977073 PMCID: PMC4063183 DOI: 10.5402/2012/182097] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 03/28/2012] [Indexed: 11/23/2022]
Abstract
Objectives. To compare the effects of intra-articular application of statin and tetracyclines on cartilage and synovial tissue on experimental osteoarthritis.
Methods. Osteoarthritis was created in 30 rabbits of 3 groups. The control group received saline intra-articularly, statin group, atorvastatin and the tetracycline group, doxycycline once a week for 3 weeks. Chondral and synovial tissues were evaluated macroscopically and histopathologically.
Results. Macroscopic evaluation determined mean values of control group 3.0, statin group 0.56, and tetracycline group 2.5. Histopathological evaluations determined mean values; femoral medial condyle cartilage tissue, control group, 14.60 ± 1.00, statin group 2.20 ± 1.30, tetracycline group 12.7 ± 5.39: tibia medial plateau, control group, 14.33 ± 8.68, statin group 2.89 ± 1.96, tetracycline group, 15.90 ± 7.03: synovial tissue, control group 12.22 ± 3.63, statin group 4.33 ± 2.69, tetracycline group 10.70 ± 2.62. Average values of synovial tissue cell layer thickness were control group 14.46 ± 2.35 μm, statin group 10.56 ± 1.01 μm, tetracycline group 12.80 ± 0.79 μm. All measurements showed statistically significant differences between statin and control groups (P < 0.05) but not between tetracycline and control groups (P > 0.05).
Conclusions. Tetracycline has little effect due to chemical modification requirement, and the effect is dose dependent. Statins have chondroprotective effects, so may become a novel therapeutic agent in osteoarthritis management after chemical processing.
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Affiliation(s)
- Mustafa Dinc
- Department of Orthopaedics and Traumatology, Nizip State Hospital, Gaziantep, Turkey
| | - Muhammed Sadik Bilgen
- Ortopedi ve Travmatoloji Bölümü, Tıp Fakültesi, Uludağ Üniversitesi, 16059, Görükle Kampüsü, Bursa, Turkey
| | - Abdullah Kucukalp
- Ortopedi ve Travmatoloji Bölümü, Tıp Fakültesi, Uludağ Üniversitesi, 16059, Görükle Kampüsü, Bursa, Turkey
| | - Omer Faruk Bilgen
- Ortopedi ve Travmatoloji Bölümü, Tıp Fakültesi, Uludağ Üniversitesi, 16059, Görükle Kampüsü, Bursa, Turkey
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Jotanovic Z, Mihelic R, Sestan B, Dembic Z. Role of Interleukin-1 Inhibitors in Osteoarthritis. Drugs Aging 2012; 29:343-58. [DOI: 10.2165/11599350-000000000-00000] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Vainio O. Translational animal models using veterinary patients - An example of canine osteoarthritis (OA). Scand J Pain 2012; 3:84-89. [PMID: 29913782 DOI: 10.1016/j.sjpain.2011.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 11/18/2011] [Indexed: 10/28/2022]
Abstract
Background and purpose The use of laboratory animals in pain research has powerfully contributed to our detailed understanding of the physiological mechanisms of pain. Animal models also represent an essential tool to screen and select novel drug molecules with potentially analgesic properties. Despite of the inevitable input of laboratory animal trials, recent studies have shown that animal pain models have repeatedly failed to predict clinical analgesic efficacy and adverse side effects of potential drug molecules in human pain patients. This paper provides a review of the laboratory animal models of OA, which have been developed to test efficacy of novel analgesics. The paper also presents spontaneous OA in canine veterinary patients, and methods to observe chronic pain in nonverbal dogs. Methods PubMed data base was searched as a reference list to locate most relevant articles. A number of 118 articles including 4 reviews were located. Web pages of 4 establishments and 2 private organizations were also accessed. Results The clinical expression and pathogenesis of naturally occurring OA in dogs is considered an analogous disease that occurs in humans, including pain and lameness. OA may occur in any joint in dogs as well as in humans. Primary idiopathic OA in dogs is rare, but certain breeds may be predisposed to it. For the most part, canine OA is considered secondary to acquired or congenital musculoskeletal disorders. Concomitant factors, such as aging and obesity, likely accelerate progression. However, mechanical factors appear to predominate in the etiopathogenesis of canine spontaneous OA. Both subjective (validated questionnaire) and objective (gait analysis) tools are available to measure OA related pain in dogs. Information on the prevalence of canine OA is limited, but rough surveys suggest that 11 million dogs in the United States and 5 million in Europe could suffer from OA. Ethical considerations concerning the use of privately owned dogs can be resolved by a careful experimental design. Conclusion Canine spontaneous OA could serve as a translational animal model that would more closely mimick clinical OA related pain conditions in humans. Privately owned dogs would make a solution to fix the gap between animal pain models and clinical trials when testing potential analgesic drug molecules. Close interdisciplinary cooperation would guarantee that both scientific and ethical intentions would be achieved. Implications The predictability of translational pain research would improve by using privately owned dogs as chronic pain models when testing novel analgesics.
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Affiliation(s)
- Outi Vainio
- Faculty of Veterinary Medicine, POB 57, 00014 University of Helsinki, Helsinki, Finland
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Robbins SMK, Birmingham TB, Maly MR, Chesworth BM, Giffin JR. Comparative diagnostic accuracy of knee adduction moments in knee osteoarthritis: a case for not normalizing to body size. J Biomech 2011; 44:968-71. [PMID: 21296354 DOI: 10.1016/j.jbiomech.2010.12.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 12/13/2010] [Accepted: 12/24/2010] [Indexed: 11/27/2022]
Abstract
Previous authors have questioned the practice of normalizing the external knee adduction moment during gait to body size when investigating dynamic joint loading in knee osteoarthritis (OA). The purpose of this study was to compare the abilities of non-normalized and normalized external knee adduction moments during gait in discriminating between patients with least and greatest severity of radiographic medial compartment knee OA. Subjects with mild (n=118) and severe (n=115) medial compartment knee OA underwent three-dimensional gait analysis. The peak external knee adduction moment was calculated and kept in its original units (Nm), normalized to body mass (Nm/kg) and normalized to body weight and height (%BW × Ht). Receiver Operating Characteristic (ROC) curve analysis indicated that non-normalized values better discriminated between patients with mild and severe knee OA. The area under the ROC curve for non-normalized peak knee adduction moments (0.63) was significantly (p<0.05) greater than when normalized to body mass (0.58), or to body weight times height (0.57). Post-hoc analysis of covariance indicated the mean difference in peak knee adduction moment between OA severity groups (7.23 Nm, p=0.003) was reduced by approximately 50% (3.60 Nm, p=0.09) when adjusted for mass. These findings are consistent with the suggestion that non-normalized values are more sensitive to radiographic disease progression. We suggest including knee adduction moment values that are not normalized to body size when investigating knee OA.
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Affiliation(s)
- Shawn M K Robbins
- Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, ON, Canada
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Farkas B, Kvell K, Czömpöly T, Illés T, Bárdos T. Increased chondrocyte death after steroid and local anesthetic combination. Clin Orthop Relat Res 2010; 468:3112-20. [PMID: 20700677 PMCID: PMC2947661 DOI: 10.1007/s11999-010-1443-0] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Accepted: 06/08/2010] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hyaline articular cartilage has limited repair and regeneration capacity. Intraarticular administration of glucocorticoid and local anesthetic injections play an important role in the therapy of osteoarthritis. Glucocorticoids and anesthetics reportedly enhance apoptosis in chondrocytes, but effects of the combined use of glucocorticoids and local anesthetics are unknown. QUESTIONS/PURPOSES We asked whether glucocorticoid and local anesthetic agents combined had any synergistic effects on chondrocyte apoptosis. METHODS Cell viability and apoptosis/necrosis assessment of human articular chondrocytes were performed in vitro (chondrocyte cell cultures) and ex vivo (osteochondral specimens) using flow cytometry and TUNEL analysis, respectively. RESULTS Glucocorticoids and local anesthetics induce apoptosis in chondrocytes at various rates. When used in combination, the percentage of dead chondrocytes was increased in in vitro chondrocyte cell cultures and osteochondral ex vivo specimens. CONCLUSIONS We observed a time-dependent decrease in chondrocyte viability after concurrent steroid and local anesthetic exposure. CLINICAL RELEVANCE The combination of glucocorticoids and local anesthetics has an adverse effect on articular chondrocytes, and it raises a question regarding whether concomitant administration should be used in treating osteoarthritis.
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Affiliation(s)
- Boglárka Farkas
- Department of Orthopaedics, University of Pécs, Ifjúság u. 13, 7624 Pécs, Hungary ,Department of Anatomy, University of Pécs, Pécs, Hungary
| | - Krisztián Kvell
- Department of Immunology and Biotechnology, University of Pécs, Pécs, Hungary
| | - Tamás Czömpöly
- Department of Immunology and Biotechnology, University of Pécs, Pécs, Hungary
| | - Tamás Illés
- Department of Orthopaedics, University of Pécs, Ifjúság u. 13, 7624 Pécs, Hungary
| | - Tamás Bárdos
- Department of Orthopaedics, University of Pécs, Ifjúság u. 13, 7624 Pécs, Hungary
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PELLETIER JEANPIERRE, TRONCY ÉRIC, BERTAIM THIERRY, THIBAUD DOMINIQUE, GOULET ANNECHRISTINE, ABRAM FRANÇOIS, CARON JUDITH, BOILEAU CHRISTELLE, d’ANJOU MARCANDRÉ, MOREAU MAXIM, LUSSIER BERTRAND, MARTEL-PELLETIER JOHANNE. Treatment with Tiludronic Acid Helps Reduce the Development of Experimental Osteoarthritis Lesions in Dogs with Anterior Cruciate Ligament Transection Followed by Reconstructive Surgery: A 1-Year Study with Quantitative Magnetic Resonance Imaging. J Rheumatol 2010; 38:118-28. [DOI: 10.3899/jrheum.100642] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective.To investigate over a 1-year period in dogs that underwent extracapsular stabilization surgery (ECS) following anterior cruciate ligament (ACL) transection: whether reconstructive surgery could prevent osteoarthritis (OA) progression and whether treatment with the bisphosphonate tiludronic acid (TA) could improve the chronic evolution of OA structural changes.Methods.ACL transection was performed on dogs on Day 0 and ECS on Day 28. Dogs were randomly divided into 2 groups: 15 received placebo and 16 were treated with TA (2 mg/kg subcutaneous injection) on Days 14, 28, 56, and 84. Magnetic resonance images were acquired on Days −10, 26, 91, 210, and 357, and cartilage volume was quantified. At sacrifice (Day 364), cartilage from femoral condyles and tibial plateaus was macroscopically and histologically evaluated. Expression levels of MMP-1, -3, -13, ADAMTS-4, -5, BMP-2, FGF-2, IGF-1, TGF-ß1, collagen type II, and aggrecan were determined using real-time RT-PCR.Results.The loss of cartilage volume observed after ACL transection stabilized following ECS. Thereafter, a gradual gain occurred, with the cartilage volume loss on the tibial plateaus reduced at Day 91 (p < 0.02) and Day 210 (p < 0.001) in the TA-treated dogs. At sacrifice, TA-treated dogs presented a reduction in the severity of macroscopic (p = 0.03 for plateaus) and histologic (p = 0.07 for plateaus) cartilage lesions, had a better preserved collagen network, and showed decreased MMP-13 (p = 0.04), MMP-1 and MMP-3 levels.Conclusion.Our findings indicate that in dogs with ACL transection, ECS greatly prevents development of cartilage volume loss. Treatment with TA provided an additional benefit of reducing the development of OA lesions.
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Levy RM, Khokhlov A, Kopenkin S, Bart B, Ermolova T, Kantemirova R, Mazurov V, Bell M, Caldron P, Pillai L, Burnett BP. Efficacy and safety of flavocoxid, a novel therapeutic, compared with naproxen: a randomized multicenter controlled trial in subjects with osteoarthritis of the knee. Adv Ther 2010; 27:731-42. [PMID: 20845002 DOI: 10.1007/s12325-010-0064-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Flavocoxid is a novel flavonoid-based "dual inhibitor" of the 5-lipoxygenase (5-LOX) enzyme and the cyclooxygenase (COX) enzymes. This study was designed to compare the effectiveness and safety of flavocoxid to naproxen in subjects with moderate to severe osteoarthritis (OA) of the knee. METHODS In this randomized, multicenter, double-blind study, 220 subjects were assigned to receive either flavocoxid (500 mg twice daily) or naproxen (500 mg twice daily) for 12 weeks. The trial was structured to show noninferiority of flavocoxid to naproxen. Primary outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and subscales and a timed walk. RESULTS More than 90% of the subjects in both groups noted significant reduction in the signs and symptoms of knee OA. There were no statistically significant differences in efficacy between the flavocoxid and naproxen groups when the entire intent-to-treat population was analyzed. The flavocoxid group had significantly fewer upper gastrointestinal (UGI) and renal (edema) adverse events (AEs) as well as a strong trend toward fewer respiratory AEs. CONCLUSION Flavocoxid, a first-in-class flavonoid-based therapeutic that inhibits COX-1 and COX-2 as well as 5-LOX, was as effective as naproxen in managing the signs and symptoms of OA of the knee. Flavocoxid demonstrated better UGI, renal (edema), and respiratory safety profiles than naproxen.
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Affiliation(s)
- Robert M Levy
- Primus Pharmaceuticals, Inc., Scottsdale, AZ 85251, USA.
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Abstract
Osteoarthritis (OA) is the most common form of arthritis and the leading cause of chronic disability among older people. The burden of the disease is expected to rise with an aging population and the increasing prevalence of obesity. Despite this, there is as yet no cure for OA. However, in recent years, a number of potential therapeutic advances have been made, in part due to improved understanding of the underlying pathophysiology. This review provides the current evidence for symptomatic management of OA including nonpharmacological, pharmacological and surgical approaches. The current state of evidence for disease-modifying therapy in OA is also reviewed.
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Affiliation(s)
- Ananthila Anandacoomarasamy
- Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Australia
- Department of Rheumatology, Concord Hospital Sydney, Australia
| | - Lyn March
- Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney Sydney, Australia
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Boulocher CB, Viguier ER, Cararo RDR, Fau DJ, Arnault F, Collard F, Maitre PA, Roualdes O, Duclos ME, Vignon EP, Roger TW. Radiographic assessment of the femorotibial joint of the CCLT rabbit experimental model of osteoarthritis. BMC Med Imaging 2010; 10:3. [PMID: 20089151 PMCID: PMC2828401 DOI: 10.1186/1471-2342-10-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 01/20/2010] [Indexed: 01/24/2023] Open
Abstract
Background The purposes of the study were to determine the relevance and validity of in vivo non-invasive radiographic assessment of the CCLT (Cranial Cruciate Ligament Transection) rabbit model of osteoarthritis (OA) and to estimate the pertinence, reliability and reproducibility of a radiographic OA (ROA) grading scale and associated radiographic atlas. Methods In vivo non-invasive extended non weight-bearing radiography of the rabbit femorotibial joint was standardized. Two hundred and fifty radiographs from control and CCLT rabbits up to five months after surgery were reviewed by three readers. They subsequently constructed an original semi-quantitative grading scale as well as an illustrative atlas of individual ROA feature for the medial compartment. To measure agreements, five readers independently scored the same radiographic sample using this atlas and three of them performed a second reading. To evaluate the pertinence of the ROA grading scale, ROA results were compared with gross examination in forty operated and ten control rabbits. Results Radiographic osteophytes of medial femoral condyles and medial tibial condyles were scored on a four point scale and dichotomously for osteophytes of medial fabella. Medial joint space width was scored as normal, reduced or absent. Each ROA features was well correlated with gross examination (p < 0.001). ICCs of each ROA features demonstrated excellent agreement between readers and within reading. Global ROA score gave the highest ICCs value for between (ICC 0.93; CI 0.90-0.96) and within (ICC ranged from 0.94 to 0.96) observer agreements. Among all individual ROA features, medial joint space width scoring gave the highest overall reliability and reproducibility and was correlated with both meniscal and cartilage macroscopic lesions (rs = 0.68 and rs = 0.58, p < 0.001 respectively). Radiographic osteophytes of the medial femoral condyle gave the lowest agreements while being well correlated with the macroscopic osteophytes (rs = 0.64, p < 0.001). Conclusion Non-invasive in vivo radiography of the rabbit femorotibial joint is feasible, relevant and allows a reproducible grading of experimentally induced OA lesion. The radiographic grading scale and atlas presented could be used as a template for in vivo non invasive grading of ROA in preclinical studies and could allow future comparisons between studies.
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Affiliation(s)
- Caroline B Boulocher
- Université de Lyon, Université Claude Bernard Lyon 1, UPSP 2007,03,135 RTI2B, Lyon, France
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Ha TG, Kang JH, Lee IB, Ahn CS, Lee CH, Lee SC, Kang SW. Effect of Cis-9-Cetylmyristoleate Containing Fatty Acids Complex Extracted from Vegetable Oils on Knee Pain in Patients with Osteoarthritis. Korean J Fam Med 2010. [DOI: 10.4082/kjfm.2010.31.1.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Tae Guk Ha
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
- Institute of Complementary and Integrative Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Joo Hyoung Kang
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - In Bum Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Cheol Soo Ahn
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Chi Hoon Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang Chul Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
- Institute of Complementary and Integrative Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Seung Wan Kang
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
- Institute of Complementary and Integrative Medicine, Seoul National University Medical Research Center, Seoul, Korea
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Nganvongpanit K, Pothacharoen P, Suwankong N, Ong-Chai S, Kongtawelert P. The effect of doxycycline on canine hip osteoarthritis: design of a 6-months clinical trial. J Vet Sci 2009; 10:239-47. [PMID: 19687625 PMCID: PMC2801128 DOI: 10.4142/jvs.2009.10.3.239] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Twenty-five dogs were included in a randomized, double-blind trial to assess the efficacy of doxycycline (DOX) orally administered twice a day at 4 mg/kg/day (n = 12) for the treatment of osteoarthritis of the hip. Chondroitin sulfate (CS; 525 mg/day) was used as a positive control (n = 13). Dogs were re-examined monthly for 6 months after initiation of treatment. The assessment protocol included clinical score, radiographic findings and serum osteoarthritis biomarkers. Dogs treated with DOX showed statistically significant improvements (p < 0.05) in lameness, joint mobility, pain on palpation, weight-bearing and overall score at 2, 6, 4, 4 and 4 months, respectively, after treatment. Biomarker levels of CS-WF6 epitope and hyaluronan were significantly increased and decreased (p < 0.05) at 2 and 3 months after treatment compared to pretreatment. These results showed that DOX had a positive therapeutic effect in dogs with osteoarthritis.
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Affiliation(s)
- Korakot Nganvongpanit
- Bone and Joint Research Laboratory, Department of Veterinary Biosciences and Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand.
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Relationship between Investigative Biomarkers and Radiographic Grading in Patients with Knee Osteoarthritis. Int J Rheumatol 2009; 2009:747432. [PMID: 20130801 PMCID: PMC2814097 DOI: 10.1155/2009/747432] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 02/26/2009] [Accepted: 03/11/2009] [Indexed: 11/17/2022] Open
Abstract
Objective. To examine new investigative biomarkers and their relevance for radiographic severity in knee osteoarthritis. Methods. The group comprised 63 patients with 73 knees examined. Patients were divided according to radiographic severity to allow for comparison of biomarker levels. Hyaluronic acid (HA), matrix metalloproteases (MMP-1, MMP-3 and MMP-13), tissue inhibitors of metalloproteases (TIMP-1 and TIMP-2), platelet-derived growth factor (PDGF-AB), transformed growth factor (TGF-beta), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF) and insulin-like growth factor (IGF-I) were measured on synovial fluid and in plasma releasate at a single time point. Principal component analysis (PCA) followed by analysis of covariance were applied to evaluate data. Results. Four different groups of biomarker were identified in plasma releasates. The first (platelet number, PDGF-AB and TGF-beta) and second groups (HA and IGF-I) were related to radiographic severity, P = .005 and P = .022, respectively. The third (MMP-1 and TIMP-2) and fourth groups (MMP-3 and TIMP-1) represented the catabolic balance, but were not associated to radiographic grading. Three different clusters of biomarkers were found in synovial fluid but did not show any significant association to radiographic grading. Conclusions. New imaging approaches to assess structural deterioration and correlation with biomarker levels are warranted to advance in OA research.
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Hayashi T, Sumida T. [Therapy for osteoarthritis]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2008; 97:2430-2436. [PMID: 19149041 DOI: 10.2169/naika.97.2430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Aigner T, Söder S, Gebhard PM, McAlinden A, Haag J. Mechanisms of disease: role of chondrocytes in the pathogenesis of osteoarthritis--structure, chaos and senescence. ACTA ACUST UNITED AC 2007; 3:391-9. [PMID: 17599073 DOI: 10.1038/ncprheum0534] [Citation(s) in RCA: 188] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2006] [Accepted: 05/01/2007] [Indexed: 01/16/2023]
Abstract
The extracellular matrix of articular cartilage is the primary target of osteoarthritic cartilage degradation. However, cartilage cells have a pivotal role during osteoarthritis, as they are mainly responsible for the anabolic-catabolic balance required for matrix maintenance and tissue function. In addition to the severe changes in the extracellular matrix, the cells also display abnormalities during osteoarthritic cartilage degeneration, such as inappropriate activation of anabolic and catabolic activities, and alterations in cell number through processes like proliferation and (apoptotic) cell death. The cells are exposed to additional stimuli such as nonphysiologic loading conditions and byproducts of matrix destruction, as well as abnormal levels of cytokines and growth factors. This exposure can lead to a structured cellular response pattern that may be either beneficial or detrimental to the cartilage tissue. Potentially even more problematic for preserving tissue homeostasis, neighboring osteoarthritic chondrocytes display strong heterogeneity in their phenotype, gene expression patterns, and cellular responses. As the disease progresses, osteoarthritic chondrocytes can no longer maintain tissue integrity. Evidence suggests that cell aging is important in the pathogenesis of osteoarthritis. Thus, anti-aging strategies might complement existing therapeutic targets related to anabolism, catabolism, inflammation, and apoptosis-processes that are integral to the pathogenesis of osteoarthritis.
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Affiliation(s)
- Thomas Aigner
- Institute of Pathology, University of Leipzig, Germany.
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Abstract
PURPOSE OF REVIEW This review describes advances in our knowledge on the clinical burden of hand osteoarthritis, its relation to radiographic signs of osteoarthritis and potential targets for therapy. Treatments and trial methodology for hand osteoarthritis are critically reviewed. RECENT FINDINGS Recent studies have shown that there is an association between radiographic hand osteoarthritis and hand pain, and that symptomatic hand osteoarthritis leads to substantial disability. Some risk factors for hand osteoarthritis have been described but the development of hand osteoarthritis is still unclear. Unfortunately, pharmacological therapies for hand osteoarthritis are lacking and have been investigated little. Only a few studies on other treatment modalities are available. Surgical treatments are not covered in this review. SUMMARY Advances have been made in our understanding of symptomatic hand osteoarthritis. Potential targets for therapy are recognized. The challenge for the coming years is to conduct clinical trials of high quality in hand osteoarthritis.
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Affiliation(s)
- Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands.
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Herrero-Beaumont G, Rovati LC, Castañeda S, Alvarez-Soria MA, Largo R. The reverse glucosamine sulfate pathway: application in knee osteoarthritis. Expert Opin Pharmacother 2007; 8:215-25. [PMID: 17257091 DOI: 10.1517/14656566.8.2.215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Glucosamine is a natural amino sugar and a normal constituent of glycosaminoglycans in the cartilage matrix and synovial fluid of joints. Crystalline glucosamine sulfate salt has been approved as a medicinal product for the treatment of osteoarthritis in several European countries. Nevertheless, although it has been prescribed for more than 10 years, it is only due to the research in the last 5 years that the scientific basis underlying its beneficial effects are starting to be clarified. In randomised, double-blind, placebo-controlled trials, this compound clinically controls pain and produces beneficial effects in patients with knee osteoarthritis, possibly delaying the appearance of long-term structural changes in the joint (i.e., it has a structure-modifying effect). Furthermore, it has an excellent toxicity profile. Despite the different lines of investigation that have been followed, the mechanism of action of glucosamine sulfate still remains to be clearly defined. However, the activity of glucosamine sulfate has recently been related to its capacity to downregulate the catabolic effects of pro-inflammatory molecules, such as IL-1, which are present in osteoarthritic cartilage.
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Affiliation(s)
- Gabriel Herrero-Beaumont
- Rheumatology Department, Joint and Bone Research Laboratory, Fundación Jiménez Díaz--Capio, Autonomous University of Madrid, Avenida Reyes Católicos 2, 28040 Madrid, Spain.
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Yudoh K, Shishido K, Murayama H, Yano M, Matsubayashi K, Takada H, Nakamura H, Masuko K, Kato T, Nishioka K. Water-soluble C60 fullerene prevents degeneration of articular cartilage in osteoarthritis via down-regulation of chondrocyte catabolic activity and inhibition of cartilage degeneration during disease development. ACTA ACUST UNITED AC 2007; 56:3307-18. [PMID: 17907184 DOI: 10.1002/art.22917] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Studies have shown the roles of oxidative stress in the pathogenesis of osteoarthritis (OA) and induction of chondrocyte senescence during OA progression. The aim of this study was to examine the potential of a strong free-radical scavenger, water-soluble fullerene (C60), as a protective agent against catabolic stress-induced degeneration of articular cartilage in OA, both in vitro and in vivo. METHODS In the presence or absence of C60 (100 microM), human chondrocytes were incubated with interleukin-1beta (10 ng/ml) or H2O2 (100 microM), and chondrocyte activity was analyzed. An animal model of OA was produced in rabbits by resection of the medial meniscus and medial collateral ligament. Rabbits were divided into 5 subgroups: sham operation or treatment with C60 at 0.1 microM, 1 microM, 10 microM, or 40 microM. The left knee joint was injected intraarticularly with water-soluble C60 (2 ml), while, as a control, the right knee joint received 50% polyethylene glycol (2 ml), once weekly for 4 weeks or 8 weeks. Knee bone and cartilage tissue were prepared for histologic analysis. In addition, in the OA rabbit model, the effect of C60 (10 microM) on degeneration of articular cartilage was compared with that of sodium hyaluronate (HA) (5 mg/ml). RESULTS C60 (100 microM) inhibited the catabolic stress-induced production of matrix-degrading enzymes (matrix metalloproteinases 1, 3, and 13), down-regulation of matrix production, and apoptosis and premature senescence in human chondrocytes in vitro. In rabbits with OA, treatment with water-soluble C60 significantly reduced articular cartilage degeneration, whereas control knee joints showed progression of cartilage degeneration with time. This inhibitory effect was dose dependent, and was superior to that of HA. Combined treatment with C60 and HA yielded a significant reduction in cartilage degeneration compared with either treatment alone. CONCLUSION The results indicate that C60 fullerene is a potential therapeutic agent for the protection of articular cartilage against progression of OA.
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Affiliation(s)
- Kazuo Yudoh
- St. Marianna University School of Medicine, Kawasaki, Japan.
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