1
|
Wang L, Wang Y, Jiang Y, Chen M, Li Z, Wang K, Luo C, Ning N, Zeng J, Zhou Z, Song Y, Yang F, Huang SS, Lin Y. Tetrahedral Framework Nuclear Acids Can Regulate Interleukin-17 Pathway to Alleviate Inflammation and Inhibit Heterotopic Ossification in Ankylosing Spondylitis. ACS NANO 2023; 17:24187-24199. [PMID: 37983164 DOI: 10.1021/acsnano.3c09480] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that leads to serious spinal deformity and ankylosis. Persistent inflammation and progressive ankylosis lead to loss of spinal flexibility in patients with AS. Tetrahedral framework nucleic acids (tFNAs) have emerged as a one kind of nanomaterial composed of four specially designed complementary DNA single strands with outstanding biological properties. Results from in vivo experiments demonstrated that tFNAs treatment could inhibit inflammatory responses and heterotopic ossification to halt disease progression. In vitro, tFNAs were proved to influence the biological behavior of AS primary chondrocytes and inhibit the secretion of pro-inflammatory cytokines through interleukin-17 pathway. The osteogenic process of chondrocytes was as well inhibited at the transcriptional level to regulate the expression of related proteins. Therefore, we believe tFNAs had a strong therapeutic effect and could serve as a nonsurgical remedy in the future to help patients suffering from AS.
Collapse
Affiliation(s)
- Lihang Wang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu 610041, China
- Department of Spine Surgery, Beijing Jishuitan Hospital Guizhou Hospital, No. 206 Sixian Road, Guiyang 550014, China
| | - Yun Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14. 3rd Sec, Ren Min Nan Road, Chengdu 610041, China
| | - Yang Jiang
- The Second Affiliated Hospital of Chengdu Medical College, 416 Nuclear Industry Hospital, No. 4, North Section 4, Second Ring Road, Chengdu 610057, China
| | - Ming Chen
- The Second Affiliated Hospital of Chengdu Medical College, 416 Nuclear Industry Hospital, No. 4, North Section 4, Second Ring Road, Chengdu 610057, China
| | - Zhuhai Li
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu 610041, China
- Department of Spine Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6 TaoYuan Road, Nanning 530016, China
| | - Kai Wang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu 610041, China
| | - Chunshan Luo
- Department of Spine Surgery, Beijing Jishuitan Hospital Guizhou Hospital, No. 206 Sixian Road, Guiyang 550014, China
| | - Ning Ning
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu 610041, China
| | - Jiancheng Zeng
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu 610041, China
| | - Zongke Zhou
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu 610041, China
| | - Yueming Song
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu 610041, China
| | - Fan Yang
- The Brain Cognition & Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences; Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518055, China
| | - Shi-Shu Huang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu 610041, China
| | - Yunfeng Lin
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14. 3rd Sec, Ren Min Nan Road, Chengdu 610041, China
- Sichuan Provincial Engineering Research Center of Oral Biomaterials, Chengdu, Sichuan 610041, China
| |
Collapse
|
2
|
Fang F, Sup M, Luzzi A, Ferrer X, Thomopoulos S. Hedgehog signaling underlying tendon and enthesis development and pathology. Matrix Biol 2022; 105:87-103. [PMID: 34954379 PMCID: PMC8821161 DOI: 10.1016/j.matbio.2021.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/18/2021] [Accepted: 12/19/2021] [Indexed: 02/08/2023]
Abstract
Hedgehog (Hh) signaling has been widely acknowledged to play essential roles in many developmental processes, including endochondral ossification and growth plate maintenance. Furthermore, a rising number of studies have shown that Hh signaling is necessary for tendon enthesis development. Specifically, the well-tuned regulation of Hh signaling during development drives the formation of a mineral gradient across the tendon enthesis fibrocartilage. However, aberrant Hh signaling can also lead to pathologic heterotopic ossification in tendon or osteophyte formation at the enthesis. Therefore, the therapeutic potential of Hh signaling modulation for treating tendon and enthesis diseases remains uncertain. For example, increased Hh signaling may enhance tendon-to-bone healing by promoting the formation of mineralized fibrocartilage at the healing interface, but pathologic heterotopic ossification may also be triggered in the adjacent tendon. Further work is needed to elucidate the distinct functions of Hh signaling in the tendon and enthesis to support the development of therapies that target the pathway.
Collapse
Affiliation(s)
- Fei Fang
- Department of Orthopedic Surgery, Columbia University, Black Building, Room 1408, 650W 168 ST, New York, NY 10032-3702, United States
| | - McKenzie Sup
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - Andrew Luzzi
- Department of Orthopedic Surgery, Columbia University, Black Building, Room 1408, 650W 168 ST, New York, NY 10032-3702, United States
| | - Xavier Ferrer
- Department of Orthopedic Surgery, Columbia University, Black Building, Room 1408, 650W 168 ST, New York, NY 10032-3702, United States
| | - Stavros Thomopoulos
- Department of Orthopedic Surgery, Columbia University, Black Building, Room 1408, 650W 168 ST, New York, NY 10032-3702, United States; Department of Biomedical Engineering, Columbia University, New York, NY, United States.
| |
Collapse
|
3
|
Gender-Related Differences in BMP Expression and Adult Hippocampal Neurogenesis within Joint-Hippocampal Axis in a Rat Model of Rheumatoid Arthritis. Int J Mol Sci 2021; 22:ijms222212163. [PMID: 34830044 PMCID: PMC8620092 DOI: 10.3390/ijms222212163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 11/16/2022] Open
Abstract
BMPs regulate synovial quiescence and adult neurogenesis in the hippocampus in non-stress conditions. However, changes in BMP expression that are induced by inflammation during rheumatoid arthritis (RA) have not yet been reported. Here, we show that signalling with synovial BMPs (BMP-4 and -7) mediates the effect of systemic inflammation on adult neurogenesis in the hippocampus during pristane-induced arthritis (PIA) in Dark Agouti (DA) rats, an animal model of RA. Moreover, we show gender differences in BMP expressions and their antagonists (Noggin and Gremlin) during PIA and their correlations with the clinical course and IL-17A and TNF-α levels in serum. Our results indicate gender differences in the clinical course, where male rats showed earlier onset and earlier recovery but a worse clinical course in the first two phases of the disease (onset and peak), which correlates with the initial increase of serum IL-17A level. The clinical course of the female rats worsened in remission. Their prolonged symptoms could be a reflection of an increased TNF-α level in serum during remission. Synovial inflammation was greater in females in PIA-remission with greater synovial BMP and antagonist expressions. More significant correlations between serum cytokines (IL-17A and TNF-α), and synovial BMPs and their antagonists were found in females than in males. On the other hand, males showed an increase in hippocampal BMP-4 expression during the acute phase, but both genders showed a decrease in antagonist expressions during PIA in general. Both genders showed a decrease in the number of Ki-67+ and SOX-2+ and DCX+ cells and in the ratio of DCX+ to Ki67+ cells in the dentate gyrus during PIA. However, in PIA remission, females showed a faster increase in the number of Ki67+, SOX-2+, and DCX+ cells and a faster increase in the DCX/Ki67 ratio than males. Both genders showed an increase of hippocampal BMP-7 expression during remission, although males constantly showed greater BMP-7 expression at all time points. Our data show that gender differences exist in the BMP expressions in the periphery-hippocampus axis and in the IL-17A and TNF-α levels in serum, which could imply differences in the mechanisms for the onset and progression of the disease, the clinical course severity, and adult neurogenesis with subsequent neurological complications between genders.
Collapse
|
4
|
Karimi Ghahfarrokhi E, Meimandi-Parizi A, Oryan A, Ahmadi N. Effects of Combination of BMP7, PFG, and Autograft on Healing of the Experimental Critical Radial Bone Defect by Induced Membrane (Masquelet) Technique in Rabbit. THE ARCHIVES OF BONE AND JOINT SURGERY 2021; 9:585-597. [PMID: 34692943 DOI: 10.22038/abjs.2020.50852.2532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/02/2020] [Indexed: 01/08/2023]
Abstract
Background Healing of large segmental bone defects can be challenging for orthopedic surgeons. This research was conducted to provide further insight into the effects of BMP7 in combination with autograft and platelet fibrin glue (PFG) on bone regeneration by Masquelet technique (MT). Methods Twenty five domestic male rabbits, more than 6 months old, weighing 2.00±0.25 kg were randomly divided into five equal groups as follows: MT-blank cavity (without any biological or synthetic materials) (1), blank cavity (2), MT-autograft (3), MT-autograft-BMP7 (4), and MT-BMP7-PFG (5). A 20 mm segmental defect was made in radial bone in both forelimbs. The Masquelet technique was done in all groups except group 2. The study was evaluated by radiology, biomechanics, histopathology and scanning electron microscopy. Results The results showed that Masquelet technique enhanced the healing process, as, the structural and functional criteria of the injured bone showed significantly improved bone healing (P<0.05). Treatment by PFG-BMP7, Autograft-BMP7, and autograft demonstrated beneficial effects on bone healing. However, Autograft-BMP7 was more effective than autograft in healing of the radial defect in rabbits. Conclusion Our findings introduce the osteogenic materials in combination with Masquelet technique as an alternative for reconstruction of the big diaphyseal defects in the long bones in animal models. Our findings may be useful for clinical application in future.
Collapse
Affiliation(s)
| | | | - Ahmad Oryan
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Nasrollah Ahmadi
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| |
Collapse
|
5
|
Song S, Shan N, Wang G, Yan X, Liu JS, Hou L. Openness Weighted Association Studies: Leveraging Personal Genome Information to Prioritize Noncoding Variants. Bioinformatics 2021; 37:4737-4743. [PMID: 34260700 PMCID: PMC8665759 DOI: 10.1093/bioinformatics/btab514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/16/2021] [Accepted: 07/07/2021] [Indexed: 11/15/2022] Open
Abstract
Motivation Identification and interpretation of non-coding variations that affect disease risk remain a paramount challenge in genome-wide association studies (GWAS) of complex diseases. Experimental efforts have provided comprehensive annotations of functional elements in the human genome. On the other hand, advances in computational biology, especially machine learning approaches, have facilitated accurate predictions of cell-type-specific functional annotations. Integrating functional annotations with GWAS signals has advanced the understanding of disease mechanisms. In previous studies, functional annotations were treated as static of a genomic region, ignoring potential functional differences imposed by different genotypes across individuals. Results We develop a computational approach, Openness Weighted Association Studies (OWAS), to leverage and aggregate predictions of chromosome accessibility in personal genomes for prioritizing GWAS signals. The approach relies on an analytical expression we derived for identifying disease associated genomic segments whose effects in the etiology of complex diseases are evaluated. In extensive simulations and real data analysis, OWAS identifies genes/segments that explain more heritability than existing methods, and has a better replication rate in independent cohorts than GWAS. Moreover, the identified genes/segments show tissue-specific patterns and are enriched in disease relevant pathways. We use rheumatic arthritis and asthma as examples to demonstrate how OWAS can be exploited to provide novel insights on complex diseases. Availability and implementation The R package OWAS that implements our method is available at https://github.com/shuangsong0110/OWAS. Supplementary information Supplementary data are available at Bioinformatics online.
Collapse
Affiliation(s)
- Shuang Song
- Center for Statistical Science, Tsinghua University, Beijing, China.,Department of Industrial Engineering, Tsinghua University, Beijing, China
| | - Nayang Shan
- Center for Statistical Science, Tsinghua University, Beijing, China.,Department of Industrial Engineering, Tsinghua University, Beijing, China
| | - Geng Wang
- University of Queensland Diamantina Institute, University of Queensland, Brisbane, Australia
| | - Xiting Yan
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Jun S Liu
- Department of Statistics, Harvard University, Cambridge, MA, 02138, USA
| | - Lin Hou
- Center for Statistical Science, Tsinghua University, Beijing, China.,Department of Industrial Engineering, Tsinghua University, Beijing, China.,MOE Key Laboratory of Bioinformatics, School of Life Sciences, Tsinghua University, Beijing, China
| |
Collapse
|
6
|
Yang J, Xu S, Chen M, Yuan Y, Zhang X, Ma Y, Wu M, Han R, Hu X, Liu R, Deng J, Guan S, Gao X, Pan M, Xu S, Shuai Z, Jiang S, Guan S, Chen L, Pan F. Serum Sclerostin and Bone Morphogenetic Protein-2 Levels in Patients with Ankylosing Spondylitis: A Meta-Analysis. Calcif Tissue Int 2019; 105:37-50. [PMID: 30911810 DOI: 10.1007/s00223-019-00542-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/16/2019] [Indexed: 12/17/2022]
Abstract
Various studies have investigated the serum sclerostin and bone morphogenetic protein-2 (BMP-2) levels in patients with ankylosing spondylitis (AS), but the results were inconsistent. The aim of this meta-analysis was to synthetically assess the associations of serum levels of sclerostin and BMP-2 with AS. Multiple electronic databases were searched to locate relevant articles published before November 2018. Pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated by the random-effect model. Totally, 21 studies were included. Meta-analysis results showed no significant difference between AS group and control group in serum sclerostin levels (SMD = 0.098, 95% CI - 0.395 to 0.591, p = 0.697). Nevertheless, serum BMP-2 levels in AS patients were higher than that in controls (SMD = 1.184, 95% CI 0.209 to 2.159, p = 0.017). Subgroup analysis demonstrated that European and South American AS patients had lower serum levels of sclerostin than controls. AS patients with age ≥ 40 years, erythrocyte sedimentation rate (ESR) ≤ 20 mm/h and Bath Ankylosing Spondylitis Functional Index (BASFI) < 4 had statistically significant lower serum sclerostin concentrations compared to controls. Chinese and Korean AS patients as well as patients with lower CRP had higher serum BMP-2 levels than controls, and country may be a source of heterogeneity across the studies. No publication bias existed and sensitivity analysis confirmed the stability of results. Serum BMP-2, but not sclerostin levels may be closely related to the development of AS.
Collapse
Affiliation(s)
- Jiajia Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Shanshan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Mengya Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Yaping Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Xu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Meng Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Renfang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Xingxing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Rui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Jixiang Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Shiyang Guan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Xing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Meijuan Pan
- Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People's Republic of China
| | - Shengqian Xu
- Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People's Republic of China
| | - Zongwen Shuai
- Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, People's Republic of China
| | - Shanqun Jiang
- School of Life Sciences, Anhui University, 111 Jiulong Road, Hefei, 230601, People's Republic of China
| | - Shihe Guan
- Department of Clinical Laboratory, The Second Hospital of Anhui Medical University, NO. 678#, Furong Road, Hefei, 230601, Anhui, People's Republic of China
| | - Liwen Chen
- Department of Clinical Laboratory, The Second Hospital of Anhui Medical University, NO. 678#, Furong Road, Hefei, 230601, Anhui, People's Republic of China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
| |
Collapse
|
7
|
Bray TJP, Lopes A, Fisher C, Ciurtin C, Sen D, Hall-Craggs MA. Sacroiliac Joint Ankylosis in Young Spondyloarthritis Patients Receiving Biologic Therapy: Observation of Serial Magnetic Resonance Imaging Scans. Arthritis Rheumatol 2019; 71:594-598. [PMID: 30295426 PMCID: PMC6915840 DOI: 10.1002/art.40750] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 10/02/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess the temporal relationship between initiating biologic therapy and magnetic resonance imaging (MRI) scores of inflammation and structural damage in young patients with spondyloarthritis. METHODS A local adolescent/young adult patient rheumatology database was searched for patients ages 12-24 years who had evidence of sacroiliitis on MRI and a clinical diagnosis of enthesitis-related arthritis (ERA) with axial involvement or nonradiographic axial spondyloarthritis. Patients treated with tumor necrosis factor inhibitor (TNFi) therapy who had undergone a minimum of 1 MRI scan before and 2 MRI scans after starting TNFi therapy (over ≥2 years) were included. Images of the sacroiliac joints were scored for inflammation and structural abnormalities (including erosions, fat metaplasia, and fusion). The effects of TNFi therapy and of time since initiation of TNFi therapy on inflammation and structural abnormalities were assessed using a mixed-effects regression analysis. RESULTS Twenty-nine patients (ages 12-23 years) with ERA or nonradiographic axial spondyloarthritis who underwent TNFi therapy were included. Inflammation scores were significantly lower in patients receiving TNFi treatment (P = 0.013), but there was no significant effect of time from TNFi initiation on inflammation (P = 0.125). Conversely, there was no significant effect of active TNFi treatment on fusion scores (P = 0.308), but fusion scores significantly increased with time from TNFi initiation (P < 0.001); a similar positive relationship between time since biologic start and fat metaplasia scores was observed. CONCLUSION TNFi therapy failed to prevent the eventual development of joint ankylosis in this cohort of young patients with spondyloarthritis, despite a substantial reduction in inflammation with TNFi therapy.
Collapse
|
8
|
Lories RJ. Advances in understanding the pathophysiology of spondyloarthritis. Best Pract Res Clin Rheumatol 2019; 32:331-341. [PMID: 31171306 DOI: 10.1016/j.berh.2018.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 11/10/2018] [Indexed: 01/02/2023]
Abstract
Progressive understanding of the underlying pathophysiology of axial spondyloarthritis has successfully translated into innovative therapeutic strategies and successful management of patients in the clinic. This review summarizes the key roles of the pro-inflammatory cytokines tumor necrosis factor and interleukin-17 in the onset and progression of disease and how these cytokines are instrumental in shaping the concept that enthesitis is a key feature of axial spondyloarthritis. Advances in immunological technologies have led to the important insight that different cell populations, part of both the innate and adaptive immune system, play a key role in axial spondyloarthritis. In addition to inflammation, structural damage to the axial skeleton, in particular progressive ankylosis of the sacroiliac joints and the spine, is key to the outcome of patients. Novel data integrate the role of pro-inflammatory cytokines and enthesitis in this context.
Collapse
Affiliation(s)
- Rik J Lories
- KU Leuven, Skeletal Biology and Engineering Research Center, Laboratory of Tissue Homeostasis and Disease, Leuven, Belgium; University Hospitals Leuven, Division of Rheumatology, Leuven, Belgium.
| |
Collapse
|
9
|
Crotti C, Becciolini A, Biggioggero M, Favalli EG. Vitamin D and Spondyloarthritis: Review of the Literature. Open Rheumatol J 2018. [DOI: 10.2174/1874312901812010214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background:
Spondyloarthritides (SpAs) encompass heterogeneous diseases sharing similar genetic background, pathogenic mechanisms, and phenotypic features. Vitamin D is essential for calcium metabolism and skeletal homeostasis. Some recent evidences reported supplemental functions of vitamin D, such as modulation of inflammatory reactions.
Objective:
To analyze published data about a possible association between vitamin D and SpAs.
Results:
Vitamin D could play a role in immune reactions, influencing both immune and adaptive response. Vitamin D deficiency is more frequent in SpAs than in general population: an active and more severe disease infers patients’ mobility and reduces sunlight exposure. Quiescent inflammatory bowel disease, frequently associated with SpAs, could worsen vitamin D deficiency. All the parameters related to UVB exposure are the most important determinants for vitamin D status and need to be considered evaluating the vitamin D levels in SpAs.
Apart from musculoskeletal problems, patients affected by SpAs frequently suffer from other comorbidities, especially cardiovascular diseases and osteoporosis, and vitamin D status could have a relevance in this field. Bone is involved in SpAs with a dualistic role, coexisting trabecular bone resorption and new bone formation.
It seems rational to monitor vitamin D levels in SpA subjects and to target it to global health threshold.
Conclusion:
Literature data were not completely in agreement about a possible relation between poor vitamin D status and onset or worse disease course of SpAs. In fact, these results come from cross-sectional studies, which affect our ability to infer causality. Therefore, large, randomized controlled trials are needed.
Collapse
|
10
|
|
11
|
Wang C, Zang H, Zhou D. Bone morphogenetic protein-2 exhibits therapeutic benefits for osteonecrosis of the femoral head through induction of cartilage and bone cells. Exp Ther Med 2018; 15:4298-4308. [PMID: 29849774 PMCID: PMC5962870 DOI: 10.3892/etm.2018.5941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/20/2017] [Indexed: 12/29/2022] Open
Abstract
Osteonecrosis of the femoral head is an orthopedic disease caused by femoral head damage or insufficient blood supply, which leads to the death of bone cells and bone marrow. Osteonecrosis of the femoral head leads to changes in the structure of the femoral head, femoral head collapse and joint dysfunction. Bone morphogenetic protein-2 (BMP-2) exhibits beneficial effects on bone formation, repair and angiogenesis at the femoral head. In the present study, the therapeutic effects of recombinant human BMP-2 containing an Fc fragment (rBMP-2/Fc) were investigated on a steroid induced mouse model of osteonecrosis of the femoral head. Bone cell viability was used to determine the in vitro effects of rBMP-2/Fc. The therapeutic efficacies of rBMP-2/Fc on mice with osteonecrosis of the femoral head were evaluated using clinical arthritis scores. The expression levels of inflammatory factors in the mice were analyzed by reverse transcription-quantitative polymerase chain reaction. Histological analysis was used to evaluate the effects of rBMP-2/Fc on the femoral head. The results revealed that rBMP-2/Fc treatment significantly increased the IL-6, IL-10, vascular endothelial growth factor and macrophage colony-stimulating factor expression levels in synovial cells compared with the control group (P<0.01). Furthermore, it was observed that rBMP-2/Fc significantly improved the viability and growth of synovial cells (P<0.01) through the nuclear factor (NF)-κB signaling pathway. Treatment with rBMP-2/Fc significantly decreased receptor activator of NF-κB ligand expression levels. Furthermore, in vivo experiments demonstrated that rBMP-2/Fc treatment markedly relieved the arthralgia and damage caused by osteonecrosis of the femoral head. In conclusion, rBMP-2/Fc treatment may be beneficial for articular cartilage repair by the upregulation of angiogenesis factors through the down regulation of the NF-κB signaling pathway in mice with osteonecrosis of the femoral head. This preclinical data suggests that rBMP-2/Fc may be a promising novel agent for treatment of osteonecrosis of the femoral head.
Collapse
Affiliation(s)
- Chunhui Wang
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Huimei Zang
- Department of Cardiovascular Medicine, Shandong University Qilu Hospital Research Center for Cell Therapy, Key Laboratory of Cardiovascular Remodeling and Function, Jinan, Shandong 250012, P.R. China
| | - Dongsheng Zhou
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| |
Collapse
|
12
|
Zhen R, Yang J, Wang Y, Li Y, Chen B, Song Y, Ma G, Yang B. Hepatocyte growth factor improves bone regeneration via the bone morphogenetic protein‑2‑mediated NF‑κB signaling pathway. Mol Med Rep 2018; 17:6045-6053. [PMID: 29436622 DOI: 10.3892/mmr.2018.8559] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/03/2017] [Indexed: 11/05/2022] Open
Abstract
Bone regeneration is an important process associated with the treatment of osteonecrosis, which is caused by various factors. Hepatocyte growth factor (HGF) is an active biological factor that has multifunctional roles in cell biology, life sciences and clinical medicine. It has previously been suggested that bone morphogenetic protein (BMP)‑2 exerts beneficial roles in bone formation, repair and angiogenesis in the femoral head. The present study aimed to investigate the benefits and molecular mechanisms of HGF in bone regeneration. The viability of osteoblasts and osteoclasts were studied in vitro. In addition, the expression levels of tumor necrosis factor (TNF)‑α, monocyte chemotactic protein (MCP)‑1, interleukin (IL)‑1 and IL‑6 were detected in a mouse fracture model following treatment with HGF. The expression and activity of nuclear factor (NF)‑κB were also analyzed in osteocytes post‑treatment with HGF. Histological analysis was used to determine the therapeutic effects of HGF on mice with fractures. The migration and differentiation of osteoblasts and osteoclasts were investigated in HGF‑incubated cells. Furthermore, angiogenesis and BMP‑2 expression were analyzed in the mouse fracture model post‑treatment with HGF. The results indicated that HGF regulates the cell viability of osteoblasts and osteoclasts, and also balanced the ratio between osteoblasts and osteoclasts. In addition, HGF decreased the serum expression levels of TNF‑α, MCP‑1, IL‑1 and IL‑6 in experimental mice. The results of a mechanistic analysis demonstrated that HGF upregulated p65, IκB kinase‑β and IκBα expression in osteoblasts from experimental mice. In addition, the expression levels of vascular endothelial growth factor, BMP‑2 receptor, receptor activator of NF‑κB ligand and macrophage colony‑stimulating factor were upregulated by HGF, which may effectively promote blood vessel regeneration, and contribute to the formation and revascularization of tissue‑engineered bone. Furthermore, HGF promoted BMP‑2 expression and enhanced angiogenesis at the fracture location. These results suggested that HGF treatment may significantly promote bone regeneration in a mouse fracture model. In conclusion, these results indicated that HGF is involved in bone regeneration, angiogenesis and the balance between osteoblasts and osteoclasts, thus suggesting that HGF may be considered a potential agent for the treatment of fractures via the promotion of bone regeneration through regulation of the BMP‑2‑mediated NF‑κB signaling pathway.
Collapse
Affiliation(s)
- Ruixin Zhen
- Department of Spinal Surgery, Chengde Medical College Affiliated Hospital, Chengde, Hebei 067000, P.R. China
| | - Jianing Yang
- Department of Spinal Surgery, Chengde Medical College Affiliated Hospital, Chengde, Hebei 067000, P.R. China
| | - Yu Wang
- Department of Spinal Surgery, Chengde Medical College Affiliated Hospital, Chengde, Hebei 067000, P.R. China
| | - Yubo Li
- Department of Spinal Surgery, Chengde Medical College Affiliated Hospital, Chengde, Hebei 067000, P.R. China
| | - Bin Chen
- Department of Spinal Surgery, Chengde Medical College Affiliated Hospital, Chengde, Hebei 067000, P.R. China
| | - Youxin Song
- Department of Spinal Surgery, Chengde Medical College Affiliated Hospital, Chengde, Hebei 067000, P.R. China
| | - Guiyun Ma
- Department of Spinal Surgery, Chengde Medical College Affiliated Hospital, Chengde, Hebei 067000, P.R. China
| | - Bo Yang
- Department of Spinal Surgery, Chengde Medical College Affiliated Hospital, Chengde, Hebei 067000, P.R. China
| |
Collapse
|
13
|
Stamatis-Liossis N, Daoussis D, Drosos A, Sakkas L. Is there a link between IL-23/IL-17 and developmental pathways such as the Wnt and Hedgehog pathway? Mediterr J Rheumatol 2017; 28:59-61. [PMID: 32185257 PMCID: PMC7045931 DOI: 10.31138/mjr.28.1.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/30/2016] [Accepted: 12/15/2016] [Indexed: 12/17/2022] Open
Abstract
Recent experimental evidence suggests that IL-23 may induce spondyloarthropathy by acting on entheseal resident "innate-like" T cells. These cells express IL-23R and respond to IL-23 by secreting inflammatory cytokines such as IL-6 and IL-17 as well as IL-22 which acts on osteoblasts and regulates bone remodeling. Moreover, a large amount of evidence indicates that new bone formation in the form of osteophytes is mainly driven by reactivation of developmental pathways such as the Wnt and the Hedgehog pathway. We hypothesize that IL-23/IL-17 may mediate bone remodeling by affecting the expression of developmental pathways.
Collapse
Affiliation(s)
- Nicholas Stamatis-Liossis
- University Department of Internal Medicine, Rheumatology Department, Rheumatology Research Laboratory, Medical University of Patras, Greece
| | - Dimitrios Daoussis
- University Department of Internal Medicine, Rheumatology Department, Rheumatology Research Laboratory, Medical University of Patras, Greece
| | | | | | - Lazaros Sakkas
- Rheumatology Department, University Medical School of Larissa
| |
Collapse
|
14
|
Liao HT, Lin YF, Tsai CY, Chou TC. Bone morphogenetic proteins and Dickkopf-1 in ankylosing spondylitis. Scand J Rheumatol 2017; 47:56-61. [PMID: 28303752 DOI: 10.1080/03009742.2017.1287305] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To determine bone morphogenetic proteins (BMPs) and Dickkopf homologue-1 (Dkk-1) levels in ankylosing spondylitis (AS). METHOD Serum BMPs and Dkk-1 were measured in 72 AS patients and 30 healthy controls. For AS patients, we recorded the demographic data, disease activity, functional index, and global assessment with questionnaires, and image changes with roentgenography. We also measured human leucocyte antigen-B27 and systemic inflammatory reactants. RESULTS BMPs were higher but Dkk-1 was significantly lower in AS patients than in controls. Dkk-1 was higher in AS patients who received non-steroidal anti-inflammatory drugs (NSAIDs) regularly in the past year (p = 0.001). Serum BMP-7 level and the BMP-7/Dkk-1 ratio correlated significantly with sacroiliitis severity, Bath Ankylosing Spondylitis Radiology Index (BASRI)-total, modified Stoke Ankylosing Spondylitis Spinal Score, and disease duration. There were also significant positive correlations among serum levels of BMP-2, -4, and -6, BASRI-total, and disease duration (p < 0.05). However, BMP-2/Dkk-1 was only significantly correlated with disease duration. The calculated area under the standard receiver operating characteristics curve suggested that BMP-2/Dkk-1 and serum BMP-2 are good indicators to predict disease activity, functional index, and patient global assessment in AS patients. CONCLUSION BMPs and BMPs/Dkk-1 were significantly correlated with disease activity, and radiological and functional indices in AS patients. Dkk-1 was lower in AS patients than in controls. Among AS patients, Dkk-1 was higher in those taking NSAIDs regularly. BMP or Dkk-1 may be taken as a biomarker for disease severity or a treatment outcome predictor in AS, but this needs further study.
Collapse
Affiliation(s)
- H-T Liao
- a Graduate Institute of Clinical Medicine, College of Medicine , Taipei Medical University , Taipei , Taiwan.,b Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine , Taipei Veterans General Hospital , Taipei , Taiwan.,c Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.,d School of Medicine, College of Medicine , National Yang-Ming University , Taipei , Taiwan
| | - Y-F Lin
- a Graduate Institute of Clinical Medicine, College of Medicine , Taipei Medical University , Taipei , Taiwan.,e Division of Nephrology, Department of Internal Medicine , Shuang Ho Hospital, Taipei Medical University , New Taipei , Taiwan
| | - C-Y Tsai
- b Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine , Taipei Veterans General Hospital , Taipei , Taiwan.,d School of Medicine, College of Medicine , National Yang-Ming University , Taipei , Taiwan
| | - T-C Chou
- b Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine , Taipei Veterans General Hospital , Taipei , Taiwan.,d School of Medicine, College of Medicine , National Yang-Ming University , Taipei , Taiwan
| |
Collapse
|
15
|
Klavdianou K, Liossis SN, Papachristou DJ, Theocharis G, Sirinian C, Kottorou A, Filippopoulou A, Andonopoulos AP, Daoussis D. Decreased Serotonin Levels and Serotonin-Mediated Osteoblastic Inhibitory Signaling in Patients With Ankylosing Spondylitis. J Bone Miner Res 2016; 31:630-9. [PMID: 26420546 DOI: 10.1002/jbmr.2724] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 09/23/2015] [Accepted: 09/28/2015] [Indexed: 12/17/2022]
Abstract
Evidence suggests that serotonin is an inhibitor of bone formation. We aimed to assess: 1) serum serotonin levels in patients with ankylosing spondylitis (AS), a prototype bone-forming disease, compared with patients with rheumatoid arthritis (RA) and healthy subjects; 2) the effect(s) of TNFα blockers on serum serotonin levels in patients with AS and RA; and 3) the effect(s) of serum of AS patients on serotonin signaling. Serum serotonin levels were measured in 47 patients with AS, 28 patients with RA, and 40 healthy subjects by radioimmunoassay; t test was used to assess differences between groups. The effect of serum on serotonin signaling was assessed using the human osteoblastic cell line Saos2, evaluating levels of phospho-CREB by Western immunoblots. Serotonin serum levels were significantly lower in patients with AS compared with healthy subjects (mean ± SEM ng/mL 122.9 ± 11.6 versus 177.4 ± 24.58, p = 0.038) and patients with RA (mean ± SEM ng/mL 244.8 ± 37.5, p = 0.0004). Patients with AS receiving TNFα blockers had significantly lower serotonin levels compared with patients with AS not on such treatment (mean ± SEM ng/mL 95.8 ± 14.9 versus 149.2 ± 16.0, p = 0.019). Serotonin serum levels were inversely correlated with pCREB induction in osteoblast-like Saos-2 cells. Serotonin levels are low in patients with AS and decrease even further during anti-TNFα treatment. Differences in serotonin levels are shown to have a functional impact on osteoblast-like Saos-2 cells. Therefore, serotonin may be involved in new bone formation in AS.
Collapse
Affiliation(s)
- Kalliopi Klavdianou
- Division of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece
| | - Stamatis-Nick Liossis
- Division of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece
| | - Dionysios J Papachristou
- Department of Anatomy-Histology-Embryology, Laboratory of Bone and Soft Tissue Studies, University of Patras Medical School, Patras, Greece
| | - Georgios Theocharis
- Department of Gastroenterology, University of Patras Medical School, Patras University Hospital, Patras, Greece
| | - Chaido Sirinian
- Clinical and Molecular Oncology Laboratory, University of Patras Medical School, Patras University Hospital, Patras, Greece
| | - Anastasia Kottorou
- Clinical and Molecular Oncology Laboratory, University of Patras Medical School, Patras University Hospital, Patras, Greece
| | - Alexandra Filippopoulou
- Division of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece
| | - Andrew P Andonopoulos
- Division of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece
| | - Dimitrios Daoussis
- Division of Rheumatology, University of Patras Medical School, Patras University Hospital, Patras, Greece
| |
Collapse
|
16
|
Varas A, Valencia J, Lavocat F, Martínez VG, Thiam NN, Hidalgo L, Fernández-Sevilla LM, Sacedón R, Vicente A, Miossec P. Blockade of bone morphogenetic protein signaling potentiates the pro-inflammatory phenotype induced by interleukin-17 and tumor necrosis factor-α combination in rheumatoid synoviocytes. Arthritis Res Ther 2015. [PMID: 26215036 PMCID: PMC4517404 DOI: 10.1186/s13075-015-0710-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction Bone morphogenetic proteins (BMPs) are multifunctional secreted growth factors regulating a broad spectrum of functions in numerous systems. An increased expression and production of specific BMPs have been described in the rheumatoid arthritis (RA) synovium. The aim of this study was to analyze the involvement of the BMP signaling pathway in RA synoviocytes in response to interleukin-17 (IL-17) and tumor necrosis factor-alpha (TNF-α). Methods The expression of components of the BMP signaling pathway (BMP receptors, BMP ligands, BMP signal transducers, and BMP antagonists) was analyzed by quantitative polymerase chain reaction before and after treatment of RA synoviocytes with TNF-α or IL-17 or both. Regulation was studied in the presence of the specific BMP inhibitor DMH1 (dorsomorphin homologue 1) or an exogenous BMP ligand, BMP6. Expression and production of pro-inflammatory cytokines (IL-6 and granulocyte-macrophage colony-stimulating factor), chemokines (IL-8, CCL2, CCL5, and CXCL10), and matrix metalloproteinases (MMP-1, −2, −3, −9, and −13) were analyzed. Results RA synoviocytes express BMP receptors (mainly BMPRIA, ACTRIA, and BMPRII), signal transducers of the Smad family (Smad1 and 5 and co-Smad4), and different BMP antagonists. The modulation of the expression of the BMP target genes—Id (inhibitor of DNA-binding/differentiation) proteins and Runx (Runt-related transcription factor) transcription factors—after the addition of exogenous BMP shows that the BMP signaling pathway is active. RA synoviocytes also express BMP ligands (BMP2, BMP6, and BMP7) which are highly upregulated after activation with TNF-α and IL-17. Autocrine BMP signaling pathway can be blocked by treatment with the inhibitor DMH1, leading to an increase in the upregulated expression of pro-inflammatory cytokines, chemokines, and MMPs induced by the activation of RA synoviocytes with TNF-α and IL-17. Conversely, the additional stimulation of the BMP pathway with the exogenous addition of the BMP6 ligand decreases the expression of those pro-inflammatory and pro-destructive factors. Conclusion The results indicate that the canonical BMP pathway is functionally active in human RA synoviocytes and that the inhibition of autocrine BMP signaling exacerbates the pro-inflammatory phenotype induced in RA synoviocytes by the stimulation with IL-17 and TNF-α.
Collapse
Affiliation(s)
- Alberto Varas
- Department of Cell Biology, Faculty of Medicine, Complutense University, Plaza Ramón y Cajal s/n, Madrid, 28040, Spain.
| | - Jaris Valencia
- Department of Cell Biology, Faculty of Medicine, Complutense University, Plaza Ramón y Cajal s/n, Madrid, 28040, Spain.
| | - Fabien Lavocat
- Immunogenomics and Inflammation Research Unit and Department of Clinical Immunology and Rheumatology, Hospices Civils de Lyon, EA 4130 University of Lyon 1, Hôpital Edouard Herriot, Lyon, 69437, France.
| | - Víctor G Martínez
- Department of Cell Biology, Faculty of Medicine, Complutense University, Plaza Ramón y Cajal s/n, Madrid, 28040, Spain.
| | - Ndiémé Ndongo Thiam
- Immunogenomics and Inflammation Research Unit and Department of Clinical Immunology and Rheumatology, Hospices Civils de Lyon, EA 4130 University of Lyon 1, Hôpital Edouard Herriot, Lyon, 69437, France.
| | - Laura Hidalgo
- Department of Cell Biology, Faculty of Medicine, Complutense University, Plaza Ramón y Cajal s/n, Madrid, 28040, Spain.
| | - Lidia M Fernández-Sevilla
- Department of Cell Biology, Faculty of Medicine, Complutense University, Plaza Ramón y Cajal s/n, Madrid, 28040, Spain.
| | - Rosa Sacedón
- Department of Cell Biology, Faculty of Medicine, Complutense University, Plaza Ramón y Cajal s/n, Madrid, 28040, Spain.
| | - Angeles Vicente
- Department of Cell Biology, Faculty of Medicine, Complutense University, Plaza Ramón y Cajal s/n, Madrid, 28040, Spain.
| | - Pierre Miossec
- Immunogenomics and Inflammation Research Unit and Department of Clinical Immunology and Rheumatology, Hospices Civils de Lyon, EA 4130 University of Lyon 1, Hôpital Edouard Herriot, Lyon, 69437, France.
| |
Collapse
|
17
|
Chen MH, Chen HA, Chen WS, Chen MH, Tsai CY, Chou CT. Upregulation of BMP-2 expression in peripheral blood mononuclear cells by proinflammatory cytokines and radiographic progression in ankylosing spondylitis. Mod Rheumatol 2015; 25:913-8. [PMID: 25835314 DOI: 10.3109/14397595.2015.1029221] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To investigate the effect of inflammation on expressions of bone morphogenetic proteins (BMPs) in peripheral blood mononuclear cells (PBMCs) and its association with individual radiographic changes in patients with ankylosing spondylitis (AS). METHODS The changes in BMP-2, -4, and -7 gene expressions in PBMCs were measured after stimulation by tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). The correlation of increase in gene expression with clinical and radiographic findings in patients with AS were analyzed. RESULTS Both TNF-α and IL-1β could enhance BMP-2 expression in PBMCs from AS patients. Increases in BMP-2, -4, and -7 expressions in PBMCs positively correlated with total modified Stoke Ankylosing Spondylitis Spinal Score (all p < 0.05). Moreover, increases in BMP-2, -4, and -7 gene expressions after TNF-α and IL-1β stimulation were greater among AS patients with versus without severe sacroiliitis (all p < 0.05). Increases in BMP-2 and -7 expressions were greater in PBMCs from 4 patients with total (cervical, thoracic, and lumbar) spinal ankylosis than in the 8 patients who did not have total spinal ankylosis (all p < 0.05). CONCLUSIONS In AS, inflammation upregulates the expression of BMPs in PBMCs which may lead to the radiographic progression with new bone formation.
Collapse
Affiliation(s)
- Ming-Han Chen
- a Department of Medicine , National Yang-Ming University , Taipei , Taiwan.,b Division of Allergy, Immunology and Rheumatology, Department of Medicine , Taipei Veterans General Hospital , Taipei , Taiwan
| | - Hung-An Chen
- c Division of Allergy-Immunology-Rheumatology, Department of Medicine , Chi Mei Medical Center , Tainan , Taiwan
| | - Wei-Sheng Chen
- a Department of Medicine , National Yang-Ming University , Taipei , Taiwan.,b Division of Allergy, Immunology and Rheumatology, Department of Medicine , Taipei Veterans General Hospital , Taipei , Taiwan
| | - Ming-Huang Chen
- a Department of Medicine , National Yang-Ming University , Taipei , Taiwan
| | - Chang-Youh Tsai
- a Department of Medicine , National Yang-Ming University , Taipei , Taiwan.,b Division of Allergy, Immunology and Rheumatology, Department of Medicine , Taipei Veterans General Hospital , Taipei , Taiwan
| | - Chung-Tei Chou
- a Department of Medicine , National Yang-Ming University , Taipei , Taiwan.,b Division of Allergy, Immunology and Rheumatology, Department of Medicine , Taipei Veterans General Hospital , Taipei , Taiwan
| |
Collapse
|
18
|
Abstract
In cross-sectional studies, vitamin D deficiency is frequent in spondyloarthritic patients and associated with increased spondyloarthritis (SpA) activity and structural damage. Experimental studies also show that vitamin D interferes with molecular pathways critically involved in SpA, especially regarding entheseal inflammation and ossification (involving cytokines such as IL-23 and sclerostin). Vitamin D deficiency might also affect the course of the disease through periodontal and gut inflammation, leading to increased functional impairment. Therefore, Vitamin D receptor selective agonists could represent a promising therapeutic pathway in this pathology. Randomised-controlled intervention studies are required in order to further elucidate complex relationships between vitamin D deficiency and SpA.
Collapse
Affiliation(s)
- Xavier Guillot
- Department of rheumatology, Besançon University Hospital, Boulevard Fleming, 25030, Besançon, France
| | | | | |
Collapse
|
19
|
Schelbergen RFP, de Munter W, van den Bosch MHJ, Lafeber FPJG, Sloetjes A, Vogl T, Roth J, van den Berg WB, van der Kraan PM, Blom AB, van Lent PLEM. Alarmins S100A8/S100A9 aggravate osteophyte formation in experimental osteoarthritis and predict osteophyte progression in early human symptomatic osteoarthritis. Ann Rheum Dis 2014; 75:218-25. [PMID: 25180294 DOI: 10.1136/annrheumdis-2014-205480] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 08/10/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Alarmins S100A8 and S100A9 are major products of activated macrophages regulating cartilage damage and synovial activation during murine and human osteoarthritis (OA). In the current study, we investigated whether S100A8 and S100A9 are involved in osteophyte formation during experimental OA and whether S100A8/A9 predicts osteophyte progression in early human OA. METHODS OA was elicited in S100A9-/- mice in two experimental models that differ in degree of synovial activation. Osteophyte size, S100A8, S100A9 and VDIPEN neoepitope was measured histologically. Chondrogenesis was induced in murine mesenchymal stem cells in the presence of S100A8. Levels of S100A8/A9 were determined in plasma of early symptomatic OA participants of the Cohort Hip and Cohort Knee (CHECK) cohort study and osteophytes measured after 2 and 5 years. RESULTS Osteophyte size was drastically reduced in S100A9-/- mice in ligaments and at medial femur and tibia on days 21 and 42 of collagenase-induced OA, in which synovial activation is high. In contrast, osteophyte size was not reduced in S100A9-/- mice during destabilised medial meniscus OA, in which synovial activation is scant. S100A8 increased expression and activation of matrix metalloproteinases during micromass chondrogenesis, thereby possibly increasing cartilage matrix remodelling allowing for larger osteophytes. Interestingly, early symptomatic OA participants of the CHECK study with osteophyte progression after 2 and 5 years had elevated S100A8/A9 plasma levels at baseline, while C-reactive protein, erythrocyte sedimentation rate and cartilage oligomeric matrix protein were not elevated at baseline. CONCLUSIONS S100A8/A9 aggravate osteophyte formation in experimental OA with high synovial activation and may be used to predict osteophyte progression in early symptomatic human OA.
Collapse
Affiliation(s)
- R F P Schelbergen
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - W de Munter
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M H J van den Bosch
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - F P J G Lafeber
- Departments of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A Sloetjes
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T Vogl
- Institute of Immunology, University of Muenster, Muenster, Germany
| | - J Roth
- Institute of Immunology, University of Muenster, Muenster, Germany
| | - W B van den Berg
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P M van der Kraan
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A B Blom
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P L E M van Lent
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
20
|
Melas IN, Chairakaki AD, Chatzopoulou EI, Messinis DE, Katopodi T, Pliaka V, Samara S, Mitsos A, Dailiana Z, Kollia P, Alexopoulos LG. Modeling of signaling pathways in chondrocytes based on phosphoproteomic and cytokine release data. Osteoarthritis Cartilage 2014; 22:509-18. [PMID: 24457104 DOI: 10.1016/j.joca.2014.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 01/02/2014] [Accepted: 01/07/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Chondrocyte signaling is widely identified as a key component in cartilage homeostasis. Dysregulations of the signaling processes in chondrocytes often result in degenerative diseases of the tissue. Traditionally, the literature has focused on the study of major players in chondrocyte signaling, but without considering the cross-talks between them. In this paper, we systematically interrogate the signal transduction pathways in chondrocytes, on both the phosphoproteomic and cytokine release levels. METHODS The signaling pathways downstream 78 receptors of interest are interrogated. On the phosphoproteomic level, 17 key phosphoproteins are measured upon stimulation with single treatments of 78 ligands. On the cytokine release level, 55 cytokines are measured in the supernatant upon stimulation with the same treatments. Using an Integer Linear Programming (ILP) formulation, the proteomic data is combined with a priori knowledge of proteins' connectivity to construct a mechanistic model, predictive of signal transduction in chondrocytes. RESULTS We were able to validate previous findings regarding major players of cartilage homeostasis and inflammation (e.g., IL1B, TNF, EGF, TGFA, INS, IGF1 and IL6). Moreover, we studied pro-inflammatory mediators (IL1B and TNF) together with pro-growth signals for investigating their role in chondrocytes hypertrophy and highlighted the role of underreported players such as Inhibin beta A (INHBA), Defensin beta 1 (DEFB1), CXCL1 and Flagellin, and uncovered the way they cross-react in the phosphoproteomic level. CONCLUSIONS The analysis presented herein, leveraged high throughput proteomic data via an ILP formulation to gain new insight into chondrocytes signaling and the pathophysiology of degenerative diseases in articular cartilage.
Collapse
Affiliation(s)
- I N Melas
- Mechanical Engineering Department, National Technical University of Athens, Athens, Greece; Protatonce Ltd., Athens, Greece
| | - A D Chairakaki
- Mechanical Engineering Department, National Technical University of Athens, Athens, Greece
| | - E I Chatzopoulou
- Mechanical Engineering Department, National Technical University of Athens, Athens, Greece
| | - D E Messinis
- Mechanical Engineering Department, National Technical University of Athens, Athens, Greece; Protatonce Ltd., Athens, Greece
| | - T Katopodi
- Mechanical Engineering Department, National Technical University of Athens, Athens, Greece
| | | | - S Samara
- Department of Genetics & Biotechnology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - A Mitsos
- AVT Process Systems Engineering (SVT), RWTH Aachen University, Aachen, Germany
| | - Z Dailiana
- Department of Orthopaedic Surgery, University of Thessalia, Larissa, Greece
| | - P Kollia
- Department of Genetics & Biotechnology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - L G Alexopoulos
- Mechanical Engineering Department, National Technical University of Athens, Athens, Greece.
| |
Collapse
|
21
|
Korkosz M, Gąsowski J, Leszczyński P, Pawlak-Buś K, Jeka S, Siedlar M, Grodzicki T. Effect of tumour necrosis factor-α inhibitor on serum level of dickkopf-1 protein and bone morphogenetic protein-7 in ankylosing spondylitis patients with high disease activity. Scand J Rheumatol 2013; 43:43-8. [DOI: 10.3109/03009742.2013.805241] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
22
|
|
23
|
Korkosz M, Gąsowski J, Leszczyński P, Pawlak-Buś K, Jeka S, Kucharska E, Grodzicki T. High disease activity in ankylosing spondylitis is associated with increased serum sclerostin level and decreased wingless protein-3a signaling but is not linked with greater structural damage. BMC Musculoskelet Disord 2013; 14:99. [PMID: 23509994 PMCID: PMC3639156 DOI: 10.1186/1471-2474-14-99] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Accepted: 03/05/2013] [Indexed: 12/17/2022] Open
Abstract
Background Clinical activity of ankylosing spondylitis (AS) predicts the natural course of the disease and the response to treatment. Several molecules are involved in new bone formation resulting in structural damage in patients with AS. However, the link between the clinical and molecular phenomena has not yet been fully established. The aim of the study was to investigate the relation between markers of bone remodeling and inflammation with clinical activity and structural damage in AS. Methods We assessed the serum levels of sclerostin, Dickkopf-1 protein, Wingless protein-3a, bone morphogenic protein-7, matrix metalloproteinase-3, osteoprotegerin, bone alkaline phosphatase and inflammatory markers in 50 AS patients with high disease activity (BASDAI ≥ 4), 28 with low disease activity (BASDAI <4), and 23 healthy controls. Cervical and lumbar spine x-rays were performed in 46 patients to measure structural damage (mSASSS). Results Sclerostin level was significantly greater in high disease activity patients than in controls. Wingless protein-3a and Dikkopf-1 protein levels were significantly lower in high activity group compared to low activity group and controls. Negative correlation was found between sclerostin and Dikkopf-1 protein in high activity group (R = −0.28, P = 0.048). The median mSASSS values were not different between patient groups. Conclusions Higher disease activity in AS may not be per se associated with greater new bone formation.
Collapse
Affiliation(s)
- Mariusz Korkosz
- Division of Rheumatology, Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Polish Spondyloarthritis Initiative, Kraków, Poland.
| | | | | | | | | | | | | |
Collapse
|
24
|
Coates LC, Marzo-Ortega H, Bennett AN, Emery P. Anti-TNF Therapy in Ankylosing Spondylitis: Insights for the Clinician. Ther Adv Musculoskelet Dis 2012; 2:37-43. [PMID: 22870436 DOI: 10.1177/1759720x09359728] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The introduction of tumour necrosis factor (TNF)-blocking therapy has revolutionized the management of ankylosing spondylitis (AS) over the last decade. This review highlights the current evidence relating to the use of TNF-blocking therapy in AS. International guidelines for the use of TNF blockers in AS are summarized. An outline of the evidence for efficacy and safety of these drugs is included, highlighting recent data from registries and real-life observational studies. Such cohort data is also reviewed highlighting the evidence for 'switching' TNF blockers in AS in the case of non-response or adverse events. The potential new application of TNF blockers in preradiographic axial spondyloarthropathy (SpA) or 'early AS' is discussed with reviews of two recent studies in this area. Finally research into the possible additional impacts of TNF therapies is reviewed. The question of whether TNF blockers are truly disease modifying in AS remains unanswered with conflicting reports. The additional burden of AS in terms of cardiovascular disease is now becoming understood. Recent data from basic science studies highlights the potential impact of TNF blockers on this excess cardiovascular morbidity and mortality. Future studies and registry data will be able to assess whether TNF blockers have an additional role in controlling systemic inflammation and its associated cardiovascular risk.
Collapse
Affiliation(s)
- Laura C Coates
- Section of Musculoskeletal Disease, University of Leeds, Leeds, UK
| | | | | | | |
Collapse
|
25
|
Elshishtawy H, Assaf N, Farouk N. Dickkopf-1 in ankylosing spondylitis: Relation to spinal dysmobility and radiographic findings. EGYPTIAN RHEUMATOLOGIST 2012. [DOI: 10.1016/j.ejr.2012.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
26
|
|
27
|
Abstract
The concept of osteoimmunology is based on growing insight into the links between the immune system and bone at the anatomical, vascular, cellular, and molecular levels. In both rheumatoid arthritis (RA) and ankylosing spondylitis (AS), bone is a target of inflammation. Activated immune cells at sites of inflammation produce a wide spectrum of cytokines in favor of increased bone resorption in RA and AS, resulting in bone erosions, osteitis, and peri-inflammatory and systemic bone loss. Peri-inflammatory bone formation is impaired in RA, resulting in non-healing of erosions, and this allows a local vicious circle of inflammation between synovitis, osteitis, and local bone loss. In contrast, peri-inflammatory bone formation is increased in AS, resulting in healing of erosions, ossifying enthesitis, and potential ankylosis of sacroiliac joints and intervertebral connections, and this changes the biomechanical competence of the spine. These changes in bone remodeling and structure contribute to the increased risk of vertebral fractures (in RA and AS) and non-vertebral fractures (in RA), and this risk is related to severity of disease and is independent of and superimposed on background fracture risk. Identifying patients who have RA and AS and are at high fracture risk and considering fracture prevention are, therefore, advocated in guidelines. Local peri-inflammatory bone loss and osteitis occur early and precede and predict erosive bone destruction in RA and AS and syndesmophytes in AS, which can occur despite clinically detectable inflammation (the so-called 'disconnection'). With the availability of new techniques to evaluate peri-inflammatory bone loss, osteitis, and erosions, peri-inflammatory bone changes are an exciting field for further research in the context of osteoimmunology.
Collapse
Affiliation(s)
- Piet Geusens
- Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, P, Debyelaan 25 Postbus 5800, 6202 AZ Maastricht, The Netherlands.
| | | |
Collapse
|
28
|
Abstract
PURPOSE OF REVIEW To present an updated summary of the relationship between inflammation and localized and generalized bone loss in the rheumatic diseases. RECENT FINDINGS In addition to the well established role of inflammatory cytokines in promoting enhanced osteoclast function and bone loss, recent work has discovered the cytokine milieu may also inhibit osteoblast function and bone repair. The WNT and bone morphogenetic protein pathways provide molecular links between inflammation and altered bone homeostasis in chronic inflammatory states. These pathways and others have been the targets of emerging therapies for the management of inflammatory bone loss. SUMMARY Inflammation and bone loss are linked through a number of molecular pathways. Both of these processes need to be addressed when designing an effective treatment strategy for the rheumatic diseases.
Collapse
|
29
|
Lories RJU, de Vlam K, Luyten FP. Are current available therapies disease-modifying in spondyloarthritis? Best Pract Res Clin Rheumatol 2011; 24:625-35. [PMID: 21035084 DOI: 10.1016/j.berh.2010.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Disease modification in spondyloarthritis should target the improvement of symptoms and preservation of function. Therefore, inhibition of structural damage caused by the disease processes appears essential. In spondyloarthritis, structural damage results mainly in progressive ankylosis of the spine and peripheral joint destruction. Currently available therapies for the treatment of spondyloarthritis appear effective at inhibiting tissue destruction but, with the exception of celecoxib, do not appear to affect new tissue formation leading to ankylosis. In this article, we discuss clinical and pathophysiological concepts of disease modification in spondyloarthritis, challenges in its evaluation, recent clinical data and new concepts that may help explain structural damage as well as the onset and progression of disease.
Collapse
Affiliation(s)
- Rik J U Lories
- Laboratory for Skeletal Development and Joint Disorders, Division of Rheumatology, Department of Musculoskeletal Sciences, Katholieke Universiteit Leuven, Belgium.
| | | | | |
Collapse
|
30
|
CHEN HUNGAN, CHEN CHUNHSIUNG, LIN YEONGJANG, CHEN PEICHIH, CHEN WEISHENG, LU CHINLI, CHOU CHUNGTEI. Association of Bone Morphogenetic Proteins with Spinal Fusion in Ankylosing Spondylitis. J Rheumatol 2010; 37:2126-32. [DOI: 10.3899/jrheum.100200] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective.To measure serum concentrations of bone morphogenetic proteins (BMP) in patients with ankylosing spondylitis (AS), and to investigate the relationship between BMP and clinical manifestations and radiographic changes.Methods.We studied 60 consecutive AS patients with and 60 patients without spinal fusion. Spinal radiographs were assessed using the Bath Ankylosing Spondylitis Radiology Index (BASRI) and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Spinal fusion was defined as the presence of total bony bridging between 2 adjacent vertebral bodies in either the lumbar or cervical spine. Serum levels of BMP were determined by enzyme-linked immunosorbent assay.Results.Patients with spinal fusion had higher serum levels of BMP-2 and BMP-4 than either the healthy controls or patients without spinal fusion (p < 0.001), but there was no difference between the latter 2 groups. Serum BMP-7, erythrocyte sedimentation rate, and C-reactive protein (CRP) levels were elevated in patients with spinal fusion compared with those without (p < 0.05). Serum BMP-4 and BMP-7 levels were higher in patients with hip involvement than in those without (p < 0.05). BMP-2 and BMP-4 levels had a significant correlation with spinal radiograph scores, especially for BASRI of the lumbar spine (r = 0.356 and 0.348, respectively, p < 0.001). CRP showed a significant correlation with spine BASRI and mSASSS scores (r = 0.261 and 0.260, respectively, p < 0.05).Conclusion.Rising levels of BMP in AS patients with spinal fusion and the positive correlation between BMP and spinal radiograph scores indicate that BMP may play a role in the process of spinal ankylosis. Serum levels of BMP may reflect radiographic progression of the spine and hip joints.
Collapse
|
31
|
Daoussis D, Liossis SNC, Solomou EE, Tsanaktsi A, Bounia K, Karampetsou M, Yiannopoulos G, Andonopoulos AP. Evidence that Dkk-1 is dysfunctional in ankylosing spondylitis. ACTA ACUST UNITED AC 2010; 62:150-8. [PMID: 20039407 DOI: 10.1002/art.27231] [Citation(s) in RCA: 169] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Dkk-1 is an inhibitory molecule that regulates the Wnt pathway, which controls osteoblastogenesis. This study was undertaken to explore the potential role of Dkk-1 in ankylosing spondylitis (AS), a prototypical bone-forming disease. METHODS Serum Dkk-1 levels were measured in 45 patients with AS, 45 patients with rheumatoid arthritis (RA), 15 patients with psoriatic arthritis (PsA), and 50 healthy subjects by sandwich enzyme-linked immunosorbent assay (ELISA). A functional ELISA was used to assess the binding of Dkk-1 to its receptor (low-density lipoprotein receptor-related protein 6). Furthermore, we studied the effect of sera from patients with AS and healthy subjects on the activity of the Wnt pathway in the Jurkat T cell model, with and without a neutralizing anti-Dkk-1 monoclonal antibody, by Western immunoblotting. RESULTS Serum Dkk-1 levels were significantly increased in patients with AS (mean +/- SEM 2,730 +/- 135.1 pg/ml) as compared with normal subjects (P = 0.040), patients with RA (P = 0.020), and patients with PsA (P = 0.049). Patients with AS receiving anti-tumor necrosis factor alpha (anti-TNFalpha) treatment had significantly higher serum Dkk-1 levels than patients with AS not receiving such treatment (P = 0.007). Patients with AS studied serially prior to and following anti-TNFalpha administration exhibited a significant increase in serum Dkk-1 levels (P = 0.020), in contrast to patients with RA, who exhibited a dramatic decrease (P < 0.001). Jurkat cells treated with serum from AS patients exhibited increased Wnt signaling compared with cells treated with control serum. In that system, Dkk-1 blockade significantly enhanced Wnt signaling in control serum-treated, but not AS serum-treated, Jurkat T cells. CONCLUSION Our findings indicate that in patients with AS, circulating bone formation-promoting factors functionally prevail. This can be at least partially attributed to decreased Dkk-1-mediated inhibition.
Collapse
MESH Headings
- Adult
- Antibodies, Blocking/pharmacology
- Antibodies, Monoclonal/pharmacology
- Arthritis, Psoriatic/blood
- Arthritis, Psoriatic/physiopathology
- Arthritis, Rheumatoid/blood
- Arthritis, Rheumatoid/physiopathology
- Etanercept
- Female
- Health Status
- Humans
- Immunoglobulin G/therapeutic use
- Intercellular Signaling Peptides and Proteins/blood
- Intercellular Signaling Peptides and Proteins/physiology
- Jurkat Cells
- Male
- Middle Aged
- Receptors, Tumor Necrosis Factor/therapeutic use
- Severity of Illness Index
- Signal Transduction/drug effects
- Spondylitis, Ankylosing/blood
- Spondylitis, Ankylosing/drug therapy
- Spondylitis, Ankylosing/physiopathology
- Tumor Necrosis Factor-alpha/immunology
- Wnt Proteins/metabolism
Collapse
Affiliation(s)
- Dimitrios Daoussis
- Department of Internal Medicine, Division of Rheumatology, Patras University Hospital, University of Patras, Patras, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Scarpa R, Altomare G, Marchesoni A, Balato N, Matucci Cerinic M, Lotti T, Olivieri I, Vena GA, Salvarani C, Valesini G, Giannetti A. Psoriatic disease: concepts and implications. J Eur Acad Dermatol Venereol 2010; 24:627-30. [DOI: 10.1111/j.1468-3083.2010.03574.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
33
|
|
34
|
|
35
|
Maksymowych WP, Chiowchanwisawakit P, Clare T, Pedersen SJ, Østergaard M, Lambert RGW. Inflammatory lesions of the spine on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis: Evidence of a relationship between inflammation and new bone formation. ACTA ACUST UNITED AC 2009; 60:93-102. [DOI: 10.1002/art.24132] [Citation(s) in RCA: 273] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
36
|
Occipitocervical fusion using recombinant human bone morphogenetic protein-2: adverse effects due to tissue swelling and seroma. Spine (Phila Pa 1976) 2008; 33:2361-6. [PMID: 18827703 DOI: 10.1097/brs.0b013e318183971d] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Case presentation and literature review. OBJECTIVE To review the safety of using INFUSE bone graft (recombinant human bone morphogenetic protein-2 applied to an absorbable collagen sponge) in occipitocervical (OC) fusion. SUMMARY OF BACKGROUND DATA Although INFUSE bone graft is currently approved for use in certain tibial fractures, oral maxillary procedures, and anterior lumbar interbody fusion, it has been extensively used "off-label" in posterolateral lumbar and anterior cervical fusions. INFUSE is highly effective in promoting cervical spine fusion via an anterior approach, but its potential role in promoting bony fusion in posterior cervical or OC fixation has not been studied. METHODS A 53-year-old woman with basilar invagination underwent OC fixation using INFUSE bone graft. Three days after surgery she experienced neurologic decline associated with significant tissue swelling and a large postoperative seroma under significant pressure. She made excellent recovery after reoperation and drainage. An extensive review of the literature was performed to propose a modified approach to the use of INFUSE in OC fixation. RESULTS Proper dosing and delivery of INFUSE for posterior cervical/OC fixation is not currently known. Previously published experience with anterior cervical fusion suggests that INFUSE can have potent inflammatory effects on paraspinal soft tissue. CONCLUSION INFUSE should only be used for OC fixation in patients at elevated risk of nonunion. To prevent complications due to soft tissue swelling, consideration should be given to preventing direct exposure of INFUSE to paraspinal musculature, prolonged soft tissue drainage, and prophylactic treatment with perioperative steroid therapy.
Collapse
|
37
|
Abstract
Osteoarthritis is the major cause of joint failure. The outcome of the disease process is determined by complex interactions between cells and molecules steering homeostasis, destruction, restoration, and remodeling. The articular cartilage has a limited restoration and repair capacity. Genetic studies in humans and the development of mouse models have identified the role of signaling pathways that are important for skeletal development in the postnatal biology and pathology of articular cartilage. These include bone morphogenetic protein, transforming growth factor beta, fibroblast growth factor, wingless-type signaling, and their respective antagonists such as noggin and frizzled related protein. The synovium is prone to inflammation and emerging evidence suggests that innate and adaptive immune responses are important. Bone and cartilage form a biomechanical unit; stiffer bones might impair cartilage homeostasis. The biology of frizzled related protein provides a basis for the hypothesized inverse relationship between osteoarthritis and osteoporosis.
Collapse
|