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Sirotti S, Scanu A, Pascart T, Niessink T, Maroni P, Lombardi G, Filippou G. Calcium Pyrophosphate Crystal Formation and Deposition: Where Do we Stand and What Does the Future hold? Curr Rheumatol Rep 2024; 26:354-365. [PMID: 39088093 PMCID: PMC11377473 DOI: 10.1007/s11926-024-01161-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE OF THE REVIEW Although calcium pyrophosphate deposition (CPPD) has been known since the 1960s, our understanding of its pathogenesis remains rudimentary. This review aims to illustrate the known mechanisms underlying calcium pyrophosphate (CPP) crystal formation and deposition and explore future directions in research. By examining various perspectives, from basic research to clinical and imaging assessments, as well as new emerging methodologies, we can establish a starting point for a deeper understanding of CPPD pathogenesis. RECENT FINDINGS Recent years have seen significant advances in CPPD research, particularly in the clinical field with the development of the 2023 ACR/EULAR classification criteria for CPPD disease, and in imaging with the introduction of the OMERACT ultrasonographic definitions and scoring system. However, progress in basic research has been slower. New laboratory approaches, such as Raman spectroscopy and omics sciences, offer promising insights that may help piece together the puzzle of CPPD. CPPD is a common yet understudied condition. As the population ages and CPPD becomes more prevalent, there is an urgent need to better understand the disease and the mechanisms involved in crystal formation and deposition, in order to improve diagnosis and therapeutic approaches.
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Affiliation(s)
- Silvia Sirotti
- Rheumatology Department, IRCCS Galeazzi - Sant'Ambrogio Hospital, Milan, Italy
| | - Anna Scanu
- Department of Women's and Children's Health, University of Padova, Padua, Italy
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Tristan Pascart
- Department of Rheumatology, ETHICS Laboratory, Saint-Philibert Hospital, Lille Catholic University, Lille, France
| | - Tom Niessink
- Personalized Diagnostics and Therapeutics, Technical Medicine Centre, University of Twente, Enschede, the Netherlands
- Department of Rheumatology, VieCuri Medical Centre, Venlo, the Netherlands
| | - Paola Maroni
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Galeazzi - Sant'Ambrogio Hospital, Milan, Italy
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Galeazzi - Sant'Ambrogio Hospital, Milan, Italy
- Department of Athletics, Strength and Conditioning, Poznań University of Physical Education, Poznań, Poland
| | - Georgios Filippou
- Rheumatology Department, IRCCS Galeazzi - Sant'Ambrogio Hospital, Milan, Italy.
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
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Liew JW, Jarraya M, Guermazi A, Lynch J, Felson D, Nevitt M, Lewis CE, Torner J, Roemer FW, Crema MD, Wang N, Becce F, Rabasa G, Pascart T, Neogi T. Intra-Articular Mineralization on Computerized Tomography of the Knee and Risk of Cartilage Damage: The Multicenter Osteoarthritis Study. Arthritis Rheumatol 2024; 76:1054-1061. [PMID: 38369918 PMCID: PMC11213667 DOI: 10.1002/art.42832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE Intra-articular (IA) mineralization may contribute to osteoarthritis (OA) structural progression. We studied the association of IA mineralization on knee computed tomography (CT) with cartilage damage worsening on knee magnetic resonance imaging (MRI), with a focus on location- and tissue-specific effects. METHODS Participants from the Multicenter Osteoarthritis Study with knee CT and MRI scans were included. Presence of IA mineralization on CT was defined as a Boston University Calcium Knee Score >0 anywhere in the knee. Cartilage worsening on MRI was defined as any increase in the MRI OA Knee Score, including incident damage. We evaluated the association of whole-knee, compartment-specific (ie, medial or lateral), and subregion-specific (ie, location-matched) IA mineralization at baseline with cartilage worsening at two years' follow-up in the corresponding locations using binomial regression with generalized estimating equations, adjusting for age, sex, and body mass index (BMI). RESULTS We included 1,673 participants (mean age 60 years, 56% female, mean BMI 29). Nine percent had any IA mineralization in the knee, and 47.4% had any cartilage worsening on follow-up. Mineralization of any tissue in the knee, regardless of location, was not associated with MRI cartilage worsening. However, cartilage mineralization was associated with 1.39 (95% confidence interval 1.04-1.88) times higher risk of cartilage worsening in the same compartment, with similar results in subregion-specific analysis. CONCLUSION CT-detected IA mineralization in the cartilage was associated with higher risk of MRI cartilage worsening in the same compartment and subregion over two years. These findings suggest potential localized, tissue-specific effects of IA mineralization on cartilage pathology in knee OA.
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Affiliation(s)
| | - Mohammed Jarraya
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | | | | | - Frank W Roemer
- Universitätsklinikum Erlangen & Friedrich-Alexander Universität Erlangen Nürnberg, Erlangen, Germany, and Boston University, Boston, Massachusetts
| | - Michel D Crema
- Institut d'Imagerie du Sport, Institut National du Sport, de l'Expertise et de la Performance, Paris, France
| | - Na Wang
- Boston University, Boston, Massachusetts
| | - Fabio Becce
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Tristan Pascart
- Lille Catholic Hospitals and University of Lille, Lomme, France
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Stücker S, Koßlowski F, Buchholz A, Lohmann CH, Bertrand J. High frequency of BCP, but less CPP crystal-mediated calcification in cartilage and synovial membrane of osteoarthritis patients. Osteoarthritis Cartilage 2024:S1063-4584(24)01176-2. [PMID: 38735362 DOI: 10.1016/j.joca.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Ectopic articular calcification is a common phenomenon of osteoarthritic joints, and closely related to disease progression. Identification of the involved calcium crystal types represents an important topic in research and clinical practice. Difficulties in accurate detection and crystal type identification have led to inconsistent data on the prevalence and spatial distribution of Basic calcium phosphate (BCP) and calcium pyrophosphate (CPP) deposition. METHOD Combining multiple imaging methods including conventional radiography, histology and Raman spectroscopy, this study provides a comprehensive analysis of BCP and CPP-based calcification, its frequency and distribution in cartilage and synovial membrane samples of 92 osteoarthritis patients undergoing knee replacement surgery. RESULTS Conventional radiography showed calcifications in 35% of patients. Von Kossa staining detected calcified deposits in 88% and 57% of cartilage and synovial samples, respectively. BCP crystals presented as brittle deposits on top of the cartilage surface or embedded in synovial tissue. CPP deposits appeared as larger granular needle-shaped clusters or dense circular pockets below the cartilage surface or within synovial tissue. Spectroscopic analysis detected BCP crystals in 75% of cartilage and 43% of synovial samples. CPP deposition was only detected in 18% of cartilage and 15% of synovial samples, often coinciding with BCP deposits. CONCLUSION BCP is the predominant crystal type in calcified cartilage and synovium while CPP deposition is rare, often coinciding with BCP. Distinct and qualitative information on BCP and CPP deposits in joint tissues gives rise to the speculation that different disease entities are involved that might need different treatment strategies.
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Affiliation(s)
- Sina Stücker
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Franziska Koßlowski
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Adrian Buchholz
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany.
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Muñoz JD, Mosquera VH, Rengifo CF, Roldan E. Machine learning-based bioimpedance assessment of knee osteoarthritis severity. Biomed Phys Eng Express 2024; 10:045013. [PMID: 38670078 DOI: 10.1088/2057-1976/ad43ef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/26/2024] [Indexed: 04/28/2024]
Abstract
This study proposes a multiclass model to classify the severity of knee osteoarthritis (KOA) using bioimpedance measurements. The experimental setup considered three types of measurements using eight electrodes: global impedance with adjacent pattern, global impedance with opposite pattern, and direct impedance measurement, which were taken using an electronic device proposed by authors and based on the Analog Devices AD5933 impedance converter. The study comprised 37 participants, 25 with healthy knees and 13 with three different degrees of KOA. All participants performed 20 repetitions of each of the following five tasks: (i) sitting with the knee bent, (ii) sitting with the knee extended, (iii) sitting and performing successive extensions and flexions of the knee, (iv) standing, and (v) walking. Data from the 15 experimental setups (3 types of measurements×5 exercises) were used to train a multiclass random forest. The training and validation cycle was repeated 100 times using random undersampling. At each of the 100 cycles, 80% of the data were used for training and the rest for testing. The results showed that the proposed approach achieved average sensitivities and specificities of 100% for the four KOA severity grades in the extension, cyclic, and gait tasks. This suggests that the proposed method can serve as a screening tool to determine which individuals should undergo x-rays or magnetic resonance imaging for further evaluation of KOA.
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Affiliation(s)
- Juan D Muñoz
- Corporación Universitaria Comfacauca, Popayán, Colombia
| | - Víctor H Mosquera
- Department of Electronics, Instrumentation, and Control at the Universidad del Cauca, Popayán, Colombia
| | - Carlos F Rengifo
- Department of Electronics, Instrumentation, and Control at the Universidad del Cauca, Popayán, Colombia
| | - Elizabeth Roldan
- Department of Physiotherapy at the Fundación Universitaria Maria Cano, Popayán, Colombia
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Feng C, Lu BQ, Fan Y, Ni H, Zhao Y, Tan S, Zhou Z, Liu L, Hachtel JA, Kepaptsoglou D, Wu B, Gebauer D, He S, Chen F. Amorphous 1-D nanowires of calcium phosphate/pyrophosphate: A demonstration of oriented self-growth of amorphous minerals. J Colloid Interface Sci 2024; 657:960-970. [PMID: 38096779 DOI: 10.1016/j.jcis.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 01/02/2024]
Abstract
Amorphous inorganic solids are traditionally isotropic, thus, it is believed that they only grow in a non-preferential way without the assistance of regulators, leading to the morphologies of nanospheres or irregular aggregates of nanoparticles. However, in the presence of (ortho)phosphate (Pi) and pyrophosphate ions (PPi) which have synergistic roles in biomineralization, the highly elongated amorphous nanowires (denoted ACPPNs) form in a regulator-free aqueous solution (without templates, additives, organics, etc). Based on thorough characterization and tracking of the formation process (e.g., Cryo-TEM, spherical aberration correction high resolution TEM, solid state NMR, high energy resolution monochromated STEM-EELS), the microstructure and its preferential growth behavior are elucidated. In ACPPNs, amorphous calcium orthophosphate and amorphous calcium pyrophosphate are distributed at separated but close sites. The ACPPNs grow via either the preferential attachment of ∼2 nm nanoclusters in a 1-dimension way, or the transformation of bigger nanoparticles, indicating an inherent driving force-governed process. We propose that the anisotropy of ACPPNs microstructure, which is corroborated experimentally, causes their oriented growth. This study proves that, unlike the conventional view, amorphous minerals can form via oriented growth without external regulation, demonstrating a novel insight into the structures and growth behaviors of amorphous minerals.
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Affiliation(s)
- Chaobo Feng
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Bing-Qiang Lu
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China.
| | - Yunshan Fan
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Haijian Ni
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Yunfei Zhao
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Shuo Tan
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Zhi Zhou
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China
| | - Lijia Liu
- Department of Chemistry, University of Western Ontario, London, ON N6A5B7, Canada
| | - Jordan A Hachtel
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37831, United States
| | - Demie Kepaptsoglou
- SuperSTEM Laboratory, SciTech Daresbury Campus, Daresbury WA4 4AD, UK; Department of Physics, University of York, York YO10 5DD, UK
| | - Baohu Wu
- Forschungszentrum Jülich GmbH, JCNS-4, JCNS at MLZ, Lichtenbergstr. 1, 85748 Garching, Germany
| | - Denis Gebauer
- Institute of Inorganic Chemistry, Leibniz University Hannover, Callinstr. 9, D-30167 Hanover, Germany
| | - Shisheng He
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China.
| | - Feng Chen
- Center for Orthopedic Science and Translational Medicine, Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, PR China; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Stomatological Hospital and School of Stomatology, Fudan University, Shanghai, 200001 PR China.
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Xiao P, Zhu Y, Xu H, Li J, Tao A, Wang H, Cheng D, Dou X, Guo L. CTGF regulates mineralization in human mature chondrocyte by controlling Pit-1 and modulating ANK via the BMP/Smad signalling. Cytokine 2024; 174:156460. [PMID: 38134555 DOI: 10.1016/j.cyto.2023.156460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/13/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE Connective tissue growth factor (CTGF) exhibits potent proliferative, differentiated, and mineralizing effects, and is believed to be contribute to cartilage mineralization in Osteoarthritis (OA). However, the underlying mechanism of chondrocyte mineralization induced by CTGF remains obscure. As a key regulator of mineral responses, type III phosphate transporter 1 (Pit-1) has been associated with the pathogenesis of articular mineralization. Therefore, the primary objective of this study was to investigate whether CTGF influences the development of mature chondrocyte mineralization and the underlying mechanisms governing such mineralization. METHODS The effect of Connective tissue growth factor (CTGF) on human C-28/I2 chondrocytes were investigated. The chondrocytes were treated with CTGF or related inhibitors, and transfected with Overexpression and siRNA transfection of Type III Phosphate Transporter 1(Pit-1). Subsequently, the cells were subjected to Alizarin red S staining, PiPer Phosphate Assay Kit, Alkaline Phosphatase Diethanolamine Activity Kit, ELISA, RT-PCR or Western blot analysis. RESULTS Stimulation with Connective tissue growth factor (CTGF) significantly upregulated the expression of the Type III Phosphate Transporter 1(Pit-1) and mineralization levels in chondrocytes through activation of α5β1 integrin and BMP/Samd1/5/8 signaling pathways. Furthermore, treatment with overexpressed Pit-1 markedly increased the expression of Multipass Transmembrane Ankylosis (ANK) transporter in the cells. The inhibitory effect of CTGF receptor blockade using α5β1 Integrin blocking antibody was demonstrated by significantly suppressed the expression of Pit-1 and ANK transporter, as well as chondrocyte mineralization. CONCLUSIONS Our data indicate that Connective tissue growth factor (CTGF) plays a critical role inchondrocyte mineralization, which is dependent on the expression of the Type III Phosphate Transporter 1(Pit-1) and Multipass Transmembrane Ankylosis (ANK) transporter. Consequently, inhibition of CTGF activity may represent a novel therapeutic approach for the management of Osteoarthritis (OA).
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Affiliation(s)
- Peng Xiao
- Jilin Hospital of Integrated Traditional Chinese and Western Medicine, No. 9, Changchun Road, Jilin, Jilin 132012, PR China.
| | - Yunong Zhu
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, PR China.
| | - Hongrui Xu
- Medical College, Dalian University, Dalian, Liaoning 116001, PR China.
| | - Junlei Li
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, PR China.
| | - Angui Tao
- Jilin Hospital of Integrated Traditional Chinese and Western Medicine, Jilin, Jilin 132012, PR China.
| | - Hongji Wang
- Jilin Hospital of Integrated Traditional Chinese and Western Medicine, Jilin, Jilin 132012, PR China.
| | - Dong Cheng
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, PR China.
| | - Xiaojie Dou
- Department of Orthopedics, The First People's Hospital of Huzhou, Huzhou, Zhejiang 313000, PR China.
| | - Lin Guo
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, PR China.
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Liew JW. Intra-articular Mineralization and Association with Osteoarthritis Development and Outcomes. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2023. [DOI: 10.1007/s40674-023-00203-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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Adinolfi A, Sirotti S, Sakellariou G, Cipolletta E, Filippucci E, Porta F, Zanetti A, Ughi N, Sarzi-Puttini P, Scirè CA, Keen H, Pineda C, Terslev L, D’Agostino MA, Filippou G. Which are the most frequently involved peripheral joints in calcium pyrophosphate crystal deposition at imaging? A systematic literature review and meta-analysis by the OMERACT ultrasound – CPPD subgroup. Front Med (Lausanne) 2023; 10:1131362. [PMID: 36968827 PMCID: PMC10034772 DOI: 10.3389/fmed.2023.1131362] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/09/2023] [Indexed: 03/11/2023] Open
Abstract
ObjectivesTo identify the prevalence of calcium pyrophosphate crystal deposition (CPPD) using ultrasound and conventional radiology at peripheral joints in patients with suspected or definite CPPD.MethodsA systematic literature search was performed in PubMed and Embase using pre-defined search strategies from inception to April 2021 to identify studies that evaluated conventional radiology and ultrasound in detecting CPPD at peripheral joints, including definite or suspected CPPD [Research question 1 (RQ1) and Research Question 2 (RQ2), respectively]. For the meta-analysis, the first, second, and third sub-analysis included studies with the knee, and knee or wrist as the index joint for CPPD (without restrictions on the reference standard) and synovial fluid analysis or histology as a reference standard (without restrictions on the index joint), respectively.ResultsOne-thousand eight hundred and twenty-seven manuscripts were identified, of which 94 articles were finally included. Twenty-two and seventy-two papers were included in RQ1 and RQ2, respectively. The knee had the highest prevalence for RQ1 and RQ2 by both conventional radiology and ultrasound, followed by the wrist with the highest prevalence for RQ1. The hand had the lowest CPPD prevalence. The third sub-analysis showed a higher CPPD prevalence on ultrasound than conventional radiology at the knee (only data available).ConclusionAmong all peripheral joints, the knees and wrists could be regarded as the target joints for CPPD detection by imaging. Furthermore, ultrasound seems to detect a higher number of calcium pyrophosphate deposits than conventional radiology, even when using a more restrictive reference standard.
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Affiliation(s)
- Antonella Adinolfi
- Rheumatology Division, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- *Correspondence: Antonella Adinolfi,
| | - Silvia Sirotti
- IRCCS Ospedale Galeazzi – Sant’Ambrogio, Rheumatology Department, Milan, Italy
| | - Garifallia Sakellariou
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Francesco Porta
- Interdisciplinary Pain Medicine Unit, Rheumatology Section, Santa Maria Maddalena Hospital, Rovigo, Italy
| | | | - Nicola Ughi
- Rheumatology Division, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- SIR Epidemiology, Research Unit, Milan, Italy
| | - Piercarlo Sarzi-Puttini
- IRCCS Ospedale Galeazzi – Sant’Ambrogio, Rheumatology Department, Milan, Italy
- Department of Biomedical and Clinical Sciences, Università degli studi di Milano, Milan, Italy
| | - Carlo Alberto Scirè
- SIR Epidemiology, Research Unit, Milan, Italy
- School of Medicine, University of Milano Bicocca, Milan, Italy
| | - Helen Keen
- Medicine and Pharmacology Department, The University of Western Australia, Murdoch, Perth, WA, Australia
| | - Carlos Pineda
- Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico, Mexico
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | | | - Georgios Filippou
- IRCCS Ospedale Galeazzi – Sant’Ambrogio, Rheumatology Department, Milan, Italy
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Bazin D. Nanomaterials in medicine: a concise review of nanomaterials intended to treat pathology, nanomaterials induced by pathology, and pathology provoked by nanomaterials. CR CHIM 2022. [DOI: 10.5802/crchim.194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Henry L, Bazin D, Policar C, Haymann JP, Daudon M, Frochot V, Mathonnet M. Characterization through scanning electron microscopy and μFourier transform infrared spectroscopy of microcalcifications present in fine needle aspiration smears. CR CHIM 2022. [DOI: 10.5802/crchim.187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bazin D, Daudon M, Frochot V, Haymann JP, Letavernier E. Foreword to microcrystalline pathologies: combining clinical activity and fundamental research at the nanoscale. CR CHIM 2022. [DOI: 10.5802/crchim.200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Gauffenic A, Bazin D, Combes C, Daudon M, Ea HK. Pathological calcifications in the human joint. CR CHIM 2022. [DOI: 10.5802/crchim.193] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Bazin D, Bouderlique E, Daudon M, Frochot V, Haymann JP, Letavernier E, Tielens F, Weil R. Scanning electron microscopy—a powerful imaging technique for the clinician. CR CHIM 2022. [DOI: 10.5802/crchim.101] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Carpal Tunnel Syndrome and Calcium Deposit in the Surgically Transacted Transverse Carpal Ligament. ScientificWorldJournal 2022; 2022:2864485. [PMID: 35431665 PMCID: PMC9010210 DOI: 10.1155/2022/2864485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/17/2022] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
A diagnosis of carpal tunnel syndrome (CTS) in a human often contains more than one test. Calcification of the traverse carpal ligament (TCL) is the common reason why patients seek CTS surgery. However, the determination of calcium (Ca) concentration in the TCL has not been studied. The results of environmental toxicity studies assessing the relationship between Ca and elemental deposition in the TCL are inconsistent. The purpose of this paper was to verify this hypothesis by conducting a chemical analysis of a portion of the released TCL to assess whether there is a relationship between CTS and Ca, measured as the total concentration of Ca, and to measure the precipitation of elements; the most closely related elements associated with Ca are cadmium and lead, which are also toxic. Surgical release of TCL was performed on forty patients. Total concentrations of Ca, Cd, and Pb in the extracted portion of TCL were digested and determined using inductively coupled plasma mass spectrometry (ICP-MS) and the possibility of using X-ray spectroscopy (XRF) for direct elemental analysis. Ca mineralisation was revealed in some TCLs. In assessing patients' environmental pollution, it was observed that the Cd and Pb concentrations were significant with a higher Ca concentration, and XRF was useful for direct detection of the elements in samples of the human body. These results indicate that TCL mineralisation by Ca does not characterise CTS, which has important concerns in improving patients' therapeutic strategies, and Cd and Pb concentrations varied due to different factors.
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Chotard E, Blanchard A, Ostertag A, Latourte A, Gailly G, Frochot V, Lioté F, Bousson V, Richette P, Bardin T, Vargas-Poussou R, Ea HK. Calcium Pyrophosphate Crystal Deposition in a Cohort of 57 Patients with Gitelman Syndrome. Rheumatology (Oxford) 2021; 61:2494-2503. [PMID: 34508565 DOI: 10.1093/rheumatology/keab578] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/06/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Gitelman syndrome (GS) is the most frequent salt-wasting genetic tubulopathy and a source of hypokalaemia and hypomagnesemia. Chondrocalcinosis (CC) is a frequent feature of GS. The aim of our study was to determine the prevalence, distribution patterns, clinical phenotypes and risk factors of CC in GS. METHODS This prospective study of a cohort of 57 patients with GS included a systematic screening for CC by peripheral joint radiography, cervical spine computerized tomography (CT) and joint ultrasonography. The prevalence of cervical C1-C2 CC by CT was compared between 33 GS patients and sex- and age-matched controls. Clinical and biochemical features were analysed to identify factors associated with CC. RESULTS Mean age of patients was 46.5 ± 12.4 years, 66.7% were women, and 93.0% carried SLC12A3 mutations. Mean serum magnesium level was 0.60 ± 0.30 mmol/l. CC was observed in 79% of patients, with the highest prevalence at the cervical spine (81.8%) followed by the knee (52.6%), wrist (50.9%), ankle (38.6%), temporomandibular joint (36.4%), shoulder (33.3%), hip (22.8%), elbow (14.0%) and sclero-choroid (12.1%). Prevalence of CC at the C1-C2 level was higher in the GS cohort than control group (72.7% vs 9.1%) (adjusted odds ratio 21.0, 95% CI 2.8-156.1, p= 0.003). Independent factors associated with CC were low serum magnesium level and age. CONCLUSION GS was associated with widespread CC, favoured by aging and hypomagnesemia. The C1-C2 level was the most affected site. Follow-up of this unique cohort will help understanding the clinical consequences of CC, especially the precise characterization of pyrophosphate arthropathy.
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Affiliation(s)
- Emile Chotard
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Anne Blanchard
- AP-HP, Hôpital européen Georges Pompidou, service de néphrologie, Paris, France
| | - Agnès Ostertag
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Augustin Latourte
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Gilles Gailly
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Vincent Frochot
- Hôpital Tenon, Service des explorations fonctionnelles multidisciplinaires, Sorbonne université, UMR_S1155, Paris, France
| | - Frédéric Lioté
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Valérie Bousson
- Université de Paris, hôpital Lariboisière, Service de radiologie, Paris, France
| | - Pascal Richette
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Thomas Bardin
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
| | - Rosa Vargas-Poussou
- AP-HP, Hôpital européen Georges Pompidou, service de génétique, Paris, France
| | - Hang Korng Ea
- Université de Paris, INSERM UMR 1132, BIOSCAR, Hôpital Lariboisière, Service de rhumatologie, centre Viggo Petersen, DMU locomotion, APHP, Paris, France
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Casal-Beiroa P, Balboa-Barreiro V, Oreiro N, Pértega-Díaz S, Blanco FJ, Magalhães J. Optical Biomarkers for the Diagnosis of Osteoarthritis through Raman Spectroscopy: Radiological and Biochemical Validation Using Ex Vivo Human Cartilage Samples. Diagnostics (Basel) 2021; 11:diagnostics11030546. [PMID: 33803917 PMCID: PMC8003208 DOI: 10.3390/diagnostics11030546] [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: 02/07/2021] [Revised: 03/08/2021] [Accepted: 03/17/2021] [Indexed: 12/30/2022] Open
Abstract
Osteoarthritis (OA) is the most common rheumatic disease, characterized by progressive articular cartilage degradation. Raman spectroscopy (RS) has been recently proposed as a label-free tool to detect molecular changes in musculoskeletal tissues. We used cartilage samples derived from human femoral heads to perform an ex vivo study of different Raman signals and ratios, related to major and minor molecular components of articular cartilage, hereby proposed as candidate optical biomarkers for OA. Validation was performed against the radiological Kellgren-Lawrence (K-L) grading system, as a gold standard, and cross-validated against sulfated glycosaminoglycans (sGAGs) and total collagens (Hyp) biochemical contents. Our results showed a significant decrease in sGAGs (SGAGs, A1063 cm-1/A1004 cm-1) and proteoglycans (PGs, A1375 cm-1/A1004 cm-1) and a significant increase in collagen disorganization (ColD/F, A1245 cm-1/A1270 cm-1), with OA severity. These were correlated with sGAGs or Hyp contents, respectively. Moreover, the SGAGs/HA ratio (A1063 cm-1/A960 cm-1), representing a functional matrix, rich in proteoglycans, to a mineralized matrix-hydroxyapatite (HA), was significantly lower in OA cartilage (K-L I vs. III-IV, p < 0.05), whilst the mineralized to collagenous matrix ratio (HA/Col, A960 cm-1/A920 cm-1) increased, being correlated with K-L. OA samples showed signs of tissue mineralization, supported by the presence of calcium crystals-related signals, such as phosphate, carbonate, and calcium pyrophosphate dihydrate (MGP, A960 cm-1/A1004 cm-1, MGC, A1070 cm-1/A1004 cm-1 and A1050 cm-1/A1004 cm-1). Finally, we observed an increase in lipids ratio (IL, A1450 cm-1/A1670 cm-1) with OA severity. As a conclusion, we have described the molecular fingerprint of hip cartilage, validating a panel of optical biomarkers and the potential of RS as a complementary diagnostic tool for OA.
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Affiliation(s)
- Paula Casal-Beiroa
- Unidad de Medicina Regenerativa, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (P.C.-B.); (N.O.)
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña (UDC), As Carballeiras S/N, Campus de Elviña, 15071 A Coruña, Spain
| | - Vanesa Balboa-Barreiro
- Unidad de Epidemiología Clínica e Investigación Bioestadística, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (V.B.-B.); (S.P.-D.)
| | - Natividad Oreiro
- Unidad de Medicina Regenerativa, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (P.C.-B.); (N.O.)
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña (UDC), As Carballeiras S/N, Campus de Elviña, 15071 A Coruña, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Avenida Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Sonia Pértega-Díaz
- Unidad de Epidemiología Clínica e Investigación Bioestadística, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (V.B.-B.); (S.P.-D.)
| | - Francisco J. Blanco
- Unidad de Medicina Regenerativa, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (P.C.-B.); (N.O.)
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña (UDC), As Carballeiras S/N, Campus de Elviña, 15071 A Coruña, Spain
- Grupo de Investigación de Reumatología y Salud (GIR-S), Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Facultad de Fisioterapia, Universidade da Coruña (UDC), Campus de Oza, 15008 A Coruña, Spain
- Correspondence: (F.J.B.); (J.M.)
| | - Joana Magalhães
- Unidad de Medicina Regenerativa, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), C/As Xubias de Arriba 84, 15006 A Coruña, Spain; (P.C.-B.); (N.O.)
- Centro de Investigaciones Científicas Avanzadas (CICA), Universidade da Coruña (UDC), As Carballeiras S/N, Campus de Elviña, 15071 A Coruña, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Avenida Monforte de Lemos, 3-5, Pabellón 11, 28029 Madrid, Spain
- Correspondence: (F.J.B.); (J.M.)
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Budzik JF, Marzin C, Legrand J, Norberciak L, Becce F, Pascart T. Can Dual-Energy Computed Tomography Be Used to Identify Early Calcium Crystal Deposition in the Knees of Patients With Calcium Pyrophosphate Deposition? Arthritis Rheumatol 2020; 73:687-692. [PMID: 33131218 DOI: 10.1002/art.41569] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/27/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess the ability of dual-energy computed tomography (DECT) in identifying early calcium crystal deposition in menisci and articular cartilage of the knee, depending on the presence/absence of chondrocalcinosis seen on conventional CT. METHODS One hundred thirty-two knee DECT scans from patients with suspected crystal-associated arthropathy were reviewed and assigned to a calcium pyrophosphate deposition (CPPD) group (n = 50) or a control group (n = 82). Five DECT attenuation parameters were measured in preset regions of interest (ROIs) in menisci and articular cartilage and compared between groups using linear mixed models with adjustment for confounders. Subgroup analysis, excluding ROIs with chondrocalcinosis seen on conventional CT, was performed. RESULTS In both menisci and articular cartilage, and for all 5 DECT attenuation parameters, calcified ROIs in CPPD patients showed significantly higher values than ROIs in controls (P ≤ 0.036). Conversely, noncalcified ROIs in CPPD patients were comparable with those in controls (P ≥ 0.09). While specific DECT parameters yielded good accuracy (area under the curve [AUC] 0.87-0.88) in differentiating calcified ROIs in CPPD patients from ROIs in controls, DECT failed to distinguish between noncalcified ROIs in CPPD patients and controls (AUC 0.58-0.59). CONCLUSION While DECT has the potential to characterize knee intraarticular mineralization, this technique cannot yet accurately identify early calcium crystal deposition that is not visible as chondrocalcinosis on conventional CT.
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Affiliation(s)
- Jean-François Budzik
- Lille Catholic University Hospital Group, MABLab ULR 4490, University of Lille, Lille, France
| | - Claire Marzin
- Lille Catholic University Hospital Group, University of Lille, Lille, France
| | - Julie Legrand
- Lille Catholic University Hospital Group, University of Lille, Lille, France
| | - Laurène Norberciak
- Lille Catholic University Hospital Group, University of Lille, Lille, France
| | - Fabio Becce
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Tristan Pascart
- Lille Catholic University Hospital Group, MABLab ULR 4490, University of Lille, Lille, France
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18
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Hubert J, Beil FT, Rolvien T, Butscheidt S, Hischke S, Püschel K, Frosch S, Mussawy H, Ries C, Hawellek T. Cartilage calcification is associated with histological degeneration of the knee joint: a highly prevalent, age-independent systemic process. Osteoarthritis Cartilage 2020; 28:1351-1361. [PMID: 32683044 DOI: 10.1016/j.joca.2020.04.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/10/2020] [Accepted: 04/29/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate if cartilage calcification (CC) is a systemic process, the purpose of this study was to determine the prevalence and the amount of meniscal/hyaline CC of the knee joint in the general population by high-resolution imaging (DCR) and to evaluate the association between CC with cartilage degeneration and age. METHODS Cross-sectional DCR-study of 180 knee joints of 90 donors (42 female/48 male, mean age 62.3y). Histological hyaline (OARSI) and meniscal (Krenn) cartilage degeneration was determined of all knees. RESULTS CC was observed in 100% of the donors (bilaterally in 98%), hyaline cartilage calcification (HCC) in 92% and meniscal calcification (MC) in 100%. CC was detected in more than three out of six distinct cartilage areas in 84.4% of all knees. The mean amount of CC correlated between both sides of donors, the different analyzed areas of the knee joint and between the various types of cartilage structures. There was more calcification in meniscal than in hyaline cartilage (factor 5.3) and in the medial than the lateral compartment (factor 1.2). HCC/MC were already detectable with only mild cartilage lesions and the amount correlated with histological cartilage degeneration, but not with age. CONCLUSIONS The present study provides evidence that meniscal and hyaline CC occurs in a pattern that is compatible with CC being a systemically driven process and that meniscal fibrocartilage is more prone to calcification than hyaline cartilage. Furthermore, the age-independent association between the amount of CC and the grade of degeneration in both hyaline and meniscal cartilage, suggests that CC is an obligatory early event in initiating cartilage degeneration.
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Affiliation(s)
- J Hubert
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Germany.
| | - F T Beil
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - T Rolvien
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - S Butscheidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - S Hischke
- Department of Medical Biometry and Epidemiology and Institute for Health Services Research in Dermatology and Nursing | IVDP, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - K Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - S Frosch
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Germany.
| | - H Mussawy
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - C Ries
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - T Hawellek
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Germany.
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Pascart T, Falgayrac G, Norberciak L, Lalanne C, Legrand J, Houvenagel E, Ea HK, Becce F, Budzik JF. Dual-energy computed-tomography-based discrimination between basic calcium phosphate and calcium pyrophosphate crystal deposition in vivo. Ther Adv Musculoskelet Dis 2020; 12:1759720X20936060. [PMID: 32636945 PMCID: PMC7315653 DOI: 10.1177/1759720x20936060] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 05/30/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Dual-energy computed tomography (DECT) is being considered as a non-invasive diagnostic and characterization tool in calcium crystal-associated arthropathies. Our objective was to assess the potential of DECT in distinguishing between basic calcium phosphate (BCP) and calcium pyrophosphate (CPP) crystal deposition in and around joints in vivo. Methods: A total of 13 patients with calcific periarthritis and 11 patients with crystal-proven CPPD were recruited prospectively to undergo DECT scans. Samples harvested from BCP and CPP calcification types were analyzed using Raman spectroscopy and validated against synthetic crystals. Regions of interest were placed in BCP and CPP calcifications, and the following DECT attenuation parameters were obtained: CT numbers (HU) at 80 and 140 kV, dual-energy index (DEI), electron density (Rho), and effective atomic number (Zeff). These DECT attenuation parameters were compared and validated against crystal calibration phantoms at two known equal concentrations. Receiver operating characteristic (ROC) curves were plotted to determine the highest accuracy thresholds for DEI and Zeff. Results: Raman spectroscopy enabled chemical fingerprinting of BCP and CPP crystals both in vitro and in vivo. DECT was able to distinguish between HA and CPP in crystal calibration phantoms at two known equal concentrations, most notably by DEI (200 mg/cm3: 0.037 ± 0 versus 0.034 ± 0, p = 0.008) and Zeff (200 mg /cm3: 9.4 ± 0 versus 9.3 ± 0, p = 0.01) analysis. Likewise, BCP calcifications had significantly higher DEI (0.041 ± 0.005 versus 0.034 ± 0.005, p = 0.008) and Zeff (9.5 ± 0.2 versus 9.3 ± 0.2, p = 0.03) than CPP crystal deposits with comparable CT numbers in patients. With an area under the ROC curve of 0.83 [best threshold value = 0.0 39, sensitivity = 90. 9% (81.8, 97. 7%), specificity = 64.6% (50.0, 64. 6%)], DEI was the best parameter in distinguishing between BCP and CPP crystal depositions. Conclusion: DECT can help distinguish between crystal-proven BCP and CPP calcification types in vivo and, thus, aid in the diagnosis of challenging clinical cases, and in the characterization of CPP and BCP crystal deposition occurring in osteoarthritis.
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Affiliation(s)
- Tristan Pascart
- Department of Rheumatology, Lille Catholic Hospitals, Saint-Philibert Hospital, University of Lille, Rue du Grand But, Lomme, F-59160, France
| | - Guillaume Falgayrac
- EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, Lille, France
| | - Laurène Norberciak
- Department of Medical Research, Biostatistics, Lille Catholic Hospitals, University of Lille, Lomme, France
| | - Clément Lalanne
- Department of Orthopaedic Surgery, Lille Catholic Hospitals, University of Lille, Lomme, France
| | - Julie Legrand
- Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals, University of Lille, Lomme, France
| | - Eric Houvenagel
- Department of Rheumatology, Lille Catholic Hospitals, University of Lille, Lomme, France
| | - Hang-Korng Ea
- Department of Rheumatology, Hôpital Lariboisière, AP-HP, Paris, France
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-François Budzik
- EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, Lille, France
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Yan JF, Qin WP, Xiao BC, Wan QQ, Tay FR, Niu LN, Jiao K. Pathological calcification in osteoarthritis: an outcome or a disease initiator? Biol Rev Camb Philos Soc 2020; 95:960-985. [PMID: 32207559 DOI: 10.1111/brv.12595] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 12/12/2022]
Abstract
In the progression of osteoarthritis, pathological calcification in the affected joint is an important feature. The role of these crystallites in the pathogenesis and progression of osteoarthritis is controversial; it remains unclear whether they act as a disease initiator or are present as a result of joint damage. Recent studies reported that the molecular mechanisms regulating physiological calcification of skeletal tissues are similar to those regulating pathological or ectopic calcification of soft tissues. Pathological calcification takes place when the equilibrium is disrupted. Calcium phosphate crystallites are identified in most affected joints and the presence of these crystallites is closely correlated with the extent of joint destruction. These observations suggest that pathological calcification is most likely to be a disease initiator instead of an outcome of osteoarthritis progression. Inhibiting pathological crystallite deposition within joint tissues therefore represents a potential therapeutic target in the management of osteoarthritis.
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Affiliation(s)
- Jian-Fei Yan
- Department of Oral Mucosal Diseases, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 145 changle xi road, Xi'an, Shaanxi, 710032, China
| | - Wen-Pin Qin
- Department of Oral Mucosal Diseases, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 145 changle xi road, Xi'an, Shaanxi, 710032, China
| | - Bo-Cheng Xiao
- Department of Oral Mucosal Diseases, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 145 changle xi road, Xi'an, Shaanxi, 710032, China
| | - Qian-Qian Wan
- Department of Oral Mucosal Diseases, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 145 changle xi road, Xi'an, Shaanxi, 710032, China
| | - Franklin R Tay
- Department of Oral Mucosal Diseases, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 145 changle xi road, Xi'an, Shaanxi, 710032, China.,Department of Endodontics, College of Graduate Studies, Augusta University, 1430, John Wesley Gilbert Drive, Augusta, GA, 30912, U.S.A
| | - Li-Na Niu
- Department of Oral Mucosal Diseases, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 145 changle xi road, Xi'an, Shaanxi, 710032, China
| | - Kai Jiao
- Department of Oral Mucosal Diseases, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, 145 changle xi road, Xi'an, Shaanxi, 710032, China
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21
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Bian F, Ruan G, Xu J, Wang K, Wu J, Ren J, Chang B, Ding C. Associations of serum citrate levels with knee structural changes and cartilage enzymes in patients with knee osteoarthritis. Int J Rheum Dis 2020; 23:435-442. [PMID: 31957331 DOI: 10.1111/1756-185x.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/14/2019] [Accepted: 08/20/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to investigate cross-sectional associations between serum levels of citrate and knee structural changes and cartilage enzymes in patients with knee osteoarthritis (OA). METHOD A total of 137 subjects with symptomatic knee OA (mean age 55.0 years, range 34-74, 84% female) were included. Knee radiography was used to assess knee osteophytes, joint space narrowing (JSN) and radiographic OA assessed by Kellgren-Lawrence (K-L) grading system. T2-weighted fat-suppressed fast spin echo magnetic resonance imaging (MRI) was used to determine knee cartilage defects, bone marrow lesions (BMLs) and infrapatellar fat pad (IPFP) signal intensity alternations. Colorimetric fluorescence was used to measure the serum levels of citrate. Enzyme-linked immunosorbent assay was used to measure the serum cartilage enzymes including matrix metalloproteinase (MMP)-3 and MMP-13. RESULTS After adjustment for potential confounders (age, sex, body mass index), serum citrate was negatively associated with knee osteophytes at the femoral site, cartilage defects at medial femoral site, total cartilage defects, and total BMLs (odds ratio [OR] 0.17-0.30, all P < .05). Meanwhile, serum citrate was negatively associated with IPFP signal intensity alteration (OR 0.30, P = .05) in multivariable analyses. Serum citrate was significantly and negatively associated with MMP-13 (β -3106.37, P < .05) after adjustment for potential confounders. However, citrate was not significantly associated with MMP-3 in patients with knee OA. CONCLUSION Serum citrate was negatively associated with knee structural changes including femoral osteophytes, cartilage defects, and BMLs and also serum MMP-13 in patients with knee OA, suggesting that low serum citrate may be a potential indicator for advanced knee OA.
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Affiliation(s)
- Fuqin Bian
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guangfeng Ruan
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jianhua Xu
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Kang Wang
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Juan Wu
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiale Ren
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Bingru Chang
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Changhai Ding
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Pascart T, Norberciak L, Legrand J, Becce F, Budzik JF. Dual-energy computed tomography in calcium pyrophosphate deposition: initial clinical experience. Osteoarthritis Cartilage 2019; 27:1309-1314. [PMID: 31146015 DOI: 10.1016/j.joca.2019.05.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 04/08/2019] [Accepted: 05/01/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the dual-energy computed tomography (DECT) attenuation properties of meniscal calcifications in calcium pyrophosphate deposition (CPPD) in vivo, and assess whether DECT was able to discriminate meniscal CPP deposits from calcium hydroxyapatite (HA) in subchondral and trabecular bone. METHOD Patients with clinical suspicion of crystal-related arthropathy (gout and/or CPPD) and knee DECT scans were retrospectively assigned to CPPD (n = 19) or control (n = 21) groups depending on the presence/absence of chondrocalcinosis on DECT. Two observers drew standardized regions of interest (ROI) in meniscal calcifications, non-calcified menisci, as well as subchondral and trabecular bone. Five DECT parameters were obtained: CT numbers (HU) at 80 and 140 kV, dual-energy index (DEI), electron density (ρe), and effective atomic number (Zeff). The four different knee structures were compared within/between patients and controls using linear mixed models, adjusting for confounders. RESULTS Meniscal calcifications (n = 89) in CPPD patients had mean ± SD CT numbers at 80 and 140 kV of 257 ± 64 and 201 ± 48 HU, respectively; with a DEI of 0.023 ± 0.007, and ρe and Zeff of 140 ± 35 and 8.8 ± 0.3, respectively. Meniscal CPP deposits were readily distinguished from calcium HA in subchondral and trabecular bone (p ≤ 0.001), except at 80 kV separately (p = 0.74). Zeff and ρe both significantly differed between CPP deposits and calcium HA in subchondral and trabecular bone (p < 0.0001). CONCLUSION This proof-of-concept study shows that DECT has the potential to discriminate meniscal CPP deposits from calcium HA in subchondral and trabecular bone in vivo, paving the way for the non-invasive biochemical signature assessment of intra- and juxta-articular calcium crystal deposits.
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Affiliation(s)
- T Pascart
- Department of Rheumatology, Lille Catholic Hospitals, University of Lille, F-59160 Lomme, France; EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, Lille, France.
| | - L Norberciak
- Department of Medical Research, Biostatistics, Lille Catholic Hospitals, University of Lille, Lomme, France.
| | - J Legrand
- Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals, University of Lille, Lomme, France.
| | - F Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - J-F Budzik
- EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, Lille, France; Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals, University of Lille, Lomme, France.
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Castelblanco M, Nasi S, Pasch A, So A, Busso N. The role of the gasotransmitter hydrogen sulfide in pathological calcification. Br J Pharmacol 2019; 177:778-792. [PMID: 31231793 DOI: 10.1111/bph.14772] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/29/2019] [Accepted: 06/05/2019] [Indexed: 12/11/2022] Open
Abstract
Calcification is the deposition of minerals, mainly hydroxyapatite, inside the cell or in the extracellular matrix. Physiological calcification is central for many aspects of development including skeletal and tooth growth; conversely, pathological mineralization occurs in soft tissues and is significantly associated with malfunction and impairment of the tissue where it is located. Various mechanisms have been proposed to explain calcification. However, this research area lacks a more integrative, systemic, and global perspective that could explain both physiological and pathological processes. In this review, we propose such an integrated explanation. Hydrogen sulfide (H2 S) is a newly recognized multifunctional gasotransmitters and tis actions have been studied in different physiological and pathological contexts, but little is known about its potential role on calcification. Interestingly, we found that H2 S promotes calcification under physiological conditions and has an inhibitory effect on pathological processes. This makes H2 S a potential therapy for diseases related to pathological calcification. LINKED ARTICLES: This article is part of a themed section on Hydrogen Sulfide in Biology & Medicine. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.4/issuetoc.
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Affiliation(s)
- Mariela Castelblanco
- Service of Rheumatology, DAL, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Sonia Nasi
- Service of Rheumatology, DAL, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | | | - Alexander So
- Service of Rheumatology, DAL, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Nathalie Busso
- Service of Rheumatology, DAL, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
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Rong J, Pool B, Zhu M, Munro J, Cornish J, McCarthy GM, Dalbeth N, Poulsen R. Basic Calcium Phosphate Crystals Induce Osteoarthritis-Associated Changes in Phenotype Markers in Primary Human Chondrocytes by a Calcium/Calmodulin Kinase 2-Dependent Mechanism. Calcif Tissue Int 2019; 104:331-343. [PMID: 30456555 DOI: 10.1007/s00223-018-0494-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/12/2018] [Indexed: 01/09/2023]
Abstract
Chondrocytes in osteoarthritis undergo a phenotype shift leading to increased production of cartilage-degrading enzymes. There are similarities between the phenotype of osteoarthritic chondrocytes and those of growth plate chondrocytes. Hydroxyapatite can promote chondrocyte differentiation in the growth plate. Basic calcium phosphate (BCP) crystals (which consist of hydroxyapatite, octacalcium apatite and tricalcium phosphate) are frequently found in osteoarthritic joints. The objective of this study was to determine whether BCP crystals induce disease-associated changes in phenotypic marker expression in chondrocytes. Primary human chondrocytes isolated from macroscopically normal cartilage were treated with BCP for up to 48 h. Expression of indian hedgehog (IHH), matrix metalloproteinase 13 (MMP13), interleukin-6 (IL-6) and type X collagen (COLX) were higher, and expression of sry-box 9 (SOX9) lower, in BCP-treated chondrocytes (50 µg/mL) compared to untreated controls. COLX protein was also present in BCP-treated chondrocytes. Intracellular calcium and levels of phosphorylated and total calcium/calmodulin kinase 2 (CaMK2) were elevated following BCP treatment due to BCP-induced release of calcium from intracellular stores. CaMK2 inhibition or knockdown ameliorated the BCP-induced changes in SOX9, IHH, COLX, IL-6 and MMP13 expression. BCP crystals induce osteoarthritis-associated changes in phenotypic marker expression in chondrocytes by calcium-mediated activation of CaMK2. The presence of BCP crystals in osteoarthritic joints may contribute to disease progression.
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Affiliation(s)
- Jing Rong
- Department of Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Bregina Pool
- Department of Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Mark Zhu
- Department of Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
- Department of Surgery, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Jacob Munro
- Department of Surgery, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Jillian Cornish
- Department of Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | | | - Nicola Dalbeth
- Department of Medicine, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Raewyn Poulsen
- Department of Medicine, School of Medicine, University of Auckland, Auckland, New Zealand.
- Faculty of Medical & Health Sciences, University of Auckland, 85 Park Rd Grafton, 1023, Auckland, New Zealand.
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25
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Hawellek T, Hubert J, Hischke S, Krause M, Bertrand J, Schmidt BC, Kronz A, Püschel K, Rüther W, Niemeier A. Calcification of the acetabular labrum of the hip: prevalence in the general population and relation to hip articular cartilage and fibrocartilage degeneration. Arthritis Res Ther 2018; 20:104. [PMID: 29848355 PMCID: PMC5977492 DOI: 10.1186/s13075-018-1595-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 04/17/2018] [Indexed: 12/25/2022] Open
Abstract
Background Meniscal calcification is considered to play a relevant role in the pathogenesis of osteoarthritis of the knee. Little is known about the biology of acetabular labral disease and its importance in hip pathology. Here, we analyze for the first time the calcification of the acetabular labrum of the hip (ALH) and its relation to hip cartilage degeneration. Methods In this cross-sectional post-mortem study of an unselected sample of the general population, 170 ALH specimens and 170 femoral heads from 85 donors (38 female, 47 male; mean age 62.1 years) were analyzed by high-resolution digital contact radiography (DCR) and histological degeneration grade. The medial menisci (MM) from the same 85 donors served as an intra-individual reference for cartilage calcification (CC). Scanning electron microscopy (SEM), energy dispersive analysis (ED) and Raman spectroscopy were performed for characterization of ALH CC. Results The prevalence of CC in the ALH was 100% and that in the articular cartilage of the hip (ACH) was 96.5%. Quantitative analysis revealed that the amount of ALH CC was higher than that in the ACH (factor 3.0, p < 0.001) and in the MM (factor 1.3, p < 0.001). There was significant correlation between the amount of CC in the fibrocartilage of the left and right ALH (r = 0.70, p < 0.001). Independent of age, the amount of ALH CC correlated with histological degeneration of the ALH (Krenn score) (r = 0.55; p < 0.001) and the ACH (Osteoarthritis Research Society International (OARSI), r = 0.69; p < 0.001). Calcification of the ALH was characterized as calcium pyrophosphate dihydrate deposition. Conclusion The finding that ALH fibrocartilage is a strongly calcifying tissue is unexpected and novel. The fact that ALH calcification correlates with cartilage degeneration independent of age is suggestive of an important role of ALH calcification in osteoarthritis of the hip and renders it a potential target for the prevention and treatment of hip joint degeneration.
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Affiliation(s)
- Thelonius Hawellek
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Jan Hubert
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Sandra Hischke
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Krause
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guerricke-University Magdeburg, Magdeburg, Germany
| | - Burkhard C Schmidt
- Centrum of Geoscience, Georg-August-University Göttingen, Göttingen, Germany
| | - Andreas Kronz
- Centrum of Geoscience, Georg-August-University Göttingen, Göttingen, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Rüther
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Andreas Niemeier
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
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26
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Hubert J, Weiser L, Hischke S, Uhlig A, Rolvien T, Schmidt T, Butscheidt SK, Püschel K, Lehmann W, Beil FT, Hawellek T. Cartilage calcification of the ankle joint is associated with osteoarthritis in the general population. BMC Musculoskelet Disord 2018; 19:169. [PMID: 29793463 PMCID: PMC5968601 DOI: 10.1186/s12891-018-2094-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/16/2018] [Indexed: 12/17/2022] Open
Abstract
Background Cartilage calcification (CC) is associated with osteoarthritis (OA) in weight-bearing joints, such as the hip and the knee. However, little is known about the impact of CC and degeneration on other weight-bearing joints, especially as it relates to the occurrence of OA in the ankles. The goal of this study is to analyse the prevalence of ankle joint cartilage calcification (AJ CC) and to determine its correlation with factors such as histological OA grade, age and BMI in the general population. Methods CC of the distal tibia and talus in 160 ankle joints obtained from 80 donors (mean age 62.4 years, 34 females, 46 males) was qualitatively and quantitatively analysed using high-resolution digital contact radiography (DCR). Correlations with factors, such as the joint’s histological OA grade (OARSI score), donor’s age and BMI, were investigated. Results The prevalence of AJ CC was 51.3% (95% CI [0.40, 0.63]), independent of gender (p = 0.18) and/or the joint’s side (p = 0.82). CC of the distal tibia was detected in 35.0% (28/80) (95% CI [0.25, 0.47]) and talar CC in 47.5% (38/80) (95% CI [0.36, 0.59]) of all cases. Significant correlations were noted between the mean amount of tibial and talar CC (r = 0.59, p = 0.002), as well as between the mean amount of CC observed in one ankle joint with that of the contralateral side (r = 0.52, p = 0.02). Furthermore, although the amount of AJ CC observed in the distal tibia and talus correlated with the histological OA-grade of the joint (r = 0.70, p < 0.001 and r = 0.72, p < 0.001, respectively), no such correlation was seen in the general population with relation to age (p = 0.32 and p = 0.49) or BMI (p = 0.51 and p = 0.87). Conclusion The prevalence of AJ CC in the general population is much higher than expected. The relationship between the amount of AJ CC and OA, independent of the donors’ age and BMI, indicates that CC may play a causative role in the development of OA in ankles.
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Affiliation(s)
- Jan Hubert
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - Lukas Weiser
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Sandra Hischke
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annemarie Uhlig
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
| | - Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Schmidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Karl Butscheidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Lehmann
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Frank Timo Beil
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Thelonius Hawellek
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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27
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Hubert J, Hawellek T, Moe M, Hischke S, Krause M, Rolvien T, Schmidt T, Rüther W, Niemeier A. Labral calcification in end-stage osteoarthritis of the hip correlates with pain and clinical function. J Orthop Res 2018; 36:1248-1255. [PMID: 28906050 DOI: 10.1002/jor.23736] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/31/2017] [Indexed: 02/04/2023]
Abstract
UNLABELLED The acetabular labrum of the hip (ALH) is recognized as a clinically important structure, but knowledge about the pathophysiology of this fibrocartilage is scarce. In this prospective study we determined the prevalence of ALH calcification in patients with end-stage osteoarthritis (OA) and analyzed the relationship of cartilage calcification (CC) with hip pain and clinical function. Cohort of 80 patients (70.2 ± 7.6years) with primary OA scheduled for total hip replacement. Harris Hip Score (HHS) was recorded preoperatively. Total ALH and femoral head (FH) were sampled intraoperatively. CC of the ALH and FH was analyzed by high-resolution digital contact radiography. Histological degeneration of the ALH (Krenn-Score) and FH (OARSI-Score) was determined. Multivariate linear regression model and partial correlation analyses were performed. The prevalence of cartilage calcification both in the ALH and FH was 100%, while the amount of CC in the ALH was 1.55 times higher than in the FH (p < 0.001). There was a significant inverse regression between the amount of calcification of both the ALH and the FH and preoperative HHS (βALH = -2.1, p = 0.04), (βFH = -2.9, p = 0.005), but pain was influenced only by ALH calcification (βALH = -2.7, p = 0.008). Age-adjusted, there was a significant correlation between cartilage calcification and histological degeneration (ALH:rs = 0.53, p < 0.001/FH: rs = 0.30, p = 0.007). Fibrocartilage and articular cartilage calcification are inseparable pathological findings in end-stage osteoarthritis of the hip. Fibrocartilage calcification is associated with poor and painful hip function. CLINICAL SIGNIFICANCE ALH fibrocartilage appears to be particularly prone to calcification, which may explain higher pain levels in individuals with a high degree of ALH calcification independent of age and histological degeneration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1248-1255, 2018.
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Affiliation(s)
- Jan Hubert
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Thelonius Hawellek
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Martin Moe
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Sandra Hischke
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Matthias Krause
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 52, Hamburg, 22529, Germany
| | - Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 52, Hamburg, 22529, Germany
| | - Tobias Schmidt
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Wolfgang Rüther
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Andreas Niemeier
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
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28
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Ripmeester EGJ, Timur UT, Caron MMJ, Welting TJM. Recent Insights into the Contribution of the Changing Hypertrophic Chondrocyte Phenotype in the Development and Progression of Osteoarthritis. Front Bioeng Biotechnol 2018; 6:18. [PMID: 29616218 PMCID: PMC5867295 DOI: 10.3389/fbioe.2018.00018] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 02/08/2018] [Indexed: 12/31/2022] Open
Abstract
Osteoarthritis (OA) is an extremely prevalent age-related condition. The economic and societal burden due to the cost of symptomatic treatment, inability to work, joint replacement, and rehabilitation is huge and increasing. Currently, there are no effective medical therapies that delay or reverse the pathological manifestations of OA. Current treatment options are, without exception, focused on slowing down progression of the disease to postpone total joint replacement surgery for as long as possible and keeping the associated pain and joint immobility manageable. Alterations in the articular cartilage chondrocyte phenotype might be fundamental in the pathological mechanisms of OA development. In many ways, the changing chondrocyte phenotype in osteoarthritic cartilage resembles the process of endochondral ossification as seen, for instance, in developing growth plates. However, the relative contribution of endochondral ossification to the changing chondrocyte phenotype in the development and progression of OA remains poorly described. In this review, we will discuss the current knowledge regarding the cartilage endochondral phenotypic changes occurring during OA development and progression, as well as the molecular and environmental effectors driving these changes. Understanding how these molecular mechanisms determine the chondrocyte cell fate in OA will be essential in enabling cartilage regenerative approaches in future treatments of OA.
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Affiliation(s)
- Ellen G J Ripmeester
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Ufuk Tan Timur
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Marjolein M J Caron
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Tim J M Welting
- Laboratory for Experimental Orthopedics, Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, Netherlands
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29
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Hawellek T, Hubert J, Hischke S, Rolvien T, Krause M, Püschel K, Rüther W, Niemeier A. Microcalcification of lumbar spine intervertebral discs and facet joints is associated with cartilage degeneration, but differs in prevalence and its relation to age. J Orthop Res 2017; 35:2692-2699. [PMID: 28467655 DOI: 10.1002/jor.23591] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 04/24/2017] [Indexed: 02/04/2023]
Abstract
Cartilage calcification (CC) is associated with degeneration in non-vertebral joints, but little is known about CC and lumbar vertebral joints. The goal of this study was to analyze the prevalence of CC in lumbar facet joints (FJ) and intervertebral discs (IVD) and its relation to cartilage degeneration and age in a non-selected cohort of the general population. The segment L4/5 of 85 consecutive donors (mean age 61.9 years) was analyzed by high-resolution imaging digital-contact radiography (DCR). Quantification was achieved by measuring CC in % of total cartilage area. Histological degeneration of FJs and IVDs was determined by OARSI and Boos scores. Prevalence of CC was 36.5% for FJ (95%CI (0.26, 0.48)) and 100% for IVD (95%CI (0.96, 1.00)). The amount of IVD CC (3.36% SD ± 7.14) was 16.3 times higher (p < 0.001) than that of the FJ (0.23% SD ± 0.53) and independent of each other (p = 0.07). The amount of FJ CC correlated significantly with FJ and IVD degeneration (FJ r = 0.44, p = 0.01, IVD r = 0.49, p = 0.006) while the amount of IVD CC correlated only with IVD degeneration (r = 0.54, p < 0.001). Age correlated with IVD CC (rs = 0.35, p < 0.001), but not FJ CC (rs = 0.04, p = 0.85). We conclude that IVD fibrocartilage is particularly prone to calcification. A causal relationship between lumbar CC and degeneration is possible, but the clear differences in IVD fibrocartilage CC and FJ synovial joint CC in regard to prevalence and in relation to age point to a differential role of CC in single compartments of the respective motion segment in lumbar spine degeneration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2692-2699, 2017.
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Affiliation(s)
- Thelonius Hawellek
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Hubert
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra Hischke
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Krause
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Rüther
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Niemeier
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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30
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Zeng C, Wei J, Terkeltaub R, Yang T, Choi HK, Wang YL, Xie DX, Hunter DJ, Zhang Y, Li H, Cui Y, Li LJ, Lei GH. Dose-response relationship between lower serum magnesium level and higher prevalence of knee chondrocalcinosis. Arthritis Res Ther 2017; 19:236. [PMID: 29065924 PMCID: PMC5655810 DOI: 10.1186/s13075-017-1450-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 10/09/2017] [Indexed: 12/13/2022] Open
Abstract
Background The aim was to assess serum magnesium levels in relation to prevalence of knee chondrocalcinosis in two population-based Chinese studies. Methods Data included in this analysis consisted of two population-based cross-sectional studies, i.e., the Xiangya Hospital Health Management Center Study and the Xiangya Osteoarthritis (XO) Study I. A bilateral knee anteroposterior radiograph was obtained from each subject. Radiographic knee chondrocalcinosis was present if there was definite linear cartilage calcification. Serum magnesium concentration was measured using the chemiluminescence method. We examined the relation of serum magnesium levels to prevalence of knee chondrocalcinosis using generalized estimating equations. Results The prevalence of knee chondrocalcinosis was 1.4% in the Xiangya Hospital Health Management Center Study (n = 12,631). Compared with the lowest tertile, the age, sex and body mass index (BMI)-adjusted odds ratios (ORs) of chondrocalcinosis were 0.59 (95% CI 0.40–0.87) and 0.49 (95% CI 0.33–0.72) in the second and the third tertiles of serum magnesium, respectively (P for trend <0.001). The prevalence of knee chondrocalcinosis in the XO Study I (n = 1316) was 4.1%. The age, sex and BMI-adjusted ORs of chondrocalcinosis were 0.67 (95% CI 0.34–1.30) in the second and 0.45 (95% CI 0.21–0.94) in the third tertile of serum magnesium when compared with the lowest tertile (P for trend = 0.030). Similar results were observed in men and women in both studies. Adjusting for additional potential confounders did not change the results materially. Conclusions Subjects with lower levels of serum magnesium, even within the normal range, had higher prevalence of knee chondrocalcinosis in a dose-response relationship manner, suggesting that magnesium may have a preventive or therapeutic potential for knee chondrocalcinosis. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1450-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan Province, 410008, China
| | - Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China.,Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China
| | - Robert Terkeltaub
- VA San Diego Medical Center, San Diego, CA, 92161, USA.,Department of Medicine, UCSD, San Diego, CA, 92161, USA
| | - Tuo Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan Province, 410008, China
| | - Hyon K Choi
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Yi-Lun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan Province, 410008, China
| | - Dong-Xing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan Province, 410008, China
| | - David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, 2065, Australia
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan Province, 410008, China
| | - Yang Cui
- International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Liang-Jun Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan Province, 410008, China.,Department of Orthopaedics, Changsha Central Hospital, Changsha, Hunan, 410000, China
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, Hunan Province, 410008, China.
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Detection of Calcium Crystals in Knee Osteoarthritis Synovial Fluid: A Comparison Between Polarized Light and Scanning Electron Microscopy. J Clin Rheumatol 2017; 22:369-71. [PMID: 27660935 DOI: 10.1097/rhu.0000000000000416] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The identification of calcium crystals in synovial fluid (SF) of patients with osteoarthritis (OA) represents an important step in understanding the role of these crystals in synovial inflammation and disease progression. OBJECTIVES This study aimed to investigate the presence of calcium pyrophosphate (CPP) and basic calcium phosphate (BCP) crystals in SF collected from patients with symptomatic knee OA by scanning electron microscopy (SEM) coupled to x-ray energy dispersive spectroscopy, compensated polarized light microscopy (CPLM), and alizarin red staining. METHODS Seventy-four patients with knee OA were included in the study. Synovial fluid samples were collected after arthrocentesis and examined under CPLM for the assessment of CPP crystals. Basic calcium phosphate crystals were evaluated by alizarin red staining. All the samples were examined by SEM. The concordance between the 2 techniques was evaluated by Cohen κ agreement coefficient. RESULTS Calcium pyrophosphate and BCP crystals were found, respectively, in 23 (31.1%) and 13 (17.5%) of 74 OA SFs by SEM analysis. Calcium pyrophosphate crystals were identified in 23 (31.1%) of 74 samples by CPLM, whereas BCP crystals were suspected in 27 (36.4%) of 74 samples. According to κ coefficient, the concordance between CPLM and SEM was 0.83 for CPP, and that between alizarin red and SEM was 0.68 for BCP. CONCLUSIONS The results of our study showed a high level of concordance between the 2 microscope techniques as regards CPP crystal identification and a lower agreement for BCP crystals. Although this finding highlights the difficulty in identifying BCP crystals by alizarin red staining, the use of SEM remains unsuitable to apply in the clinical setting. Because of the in vitro inflammatory effect of BCP crystals, further work on their analysis in SF could provide important information about the OA process.
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Carlson AK, McCutchen CN, June RK. Mechanobiological implications of articular cartilage crystals. Curr Opin Rheumatol 2017; 29:157-162. [DOI: 10.1097/bor.0000000000000368] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Hawellek T, Hubert J, Hischke S, Krause M, Bertrand J, Pap T, Püschel K, Rüther W, Niemeier A. Articular cartilage calcification of the hip and knee is highly prevalent, independent of age but associated with histological osteoarthritis: evidence for a systemic disorder. Osteoarthritis Cartilage 2016; 24:2092-2099. [PMID: 27390030 DOI: 10.1016/j.joca.2016.06.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 06/12/2016] [Accepted: 06/27/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Based on the concept of a systemic predisposition for articular cartilage calcification (CC), the aim of this study was to determine the prevalence and amount of bilateral CC of hip and knee joints in an unselected sample cohort by high-resolution digital contact radiography (DCR) and to analyze the association of CC with histological OA. METHODS Both hip and knee joints of 87 donors (48 m and 39 f; mean age 62) were analyzed by DCR in this post-mortem study of an unselected cohort of donors. Histological OA (OARSI) of the main load bearing area of femoral heads and medial femoral condyles was determined. RESULTS The prevalence of CC of the femoral head was 96.6%, of the knee 94.3%. Bilateral calcification was detected in 79.3% of hips and 86.2% of knees. Concomitant CC of all four joints was detected in 69.0% of donors. There was no difference between the amount of CC of hips and knees (P = 0.47). The amount of CC of any given hip or knee correlated with that of the contralateral hip (rs = 0.54, P < 0.001) or knee (rs = 0.50, P < 0.001). There was a correlation between the amount of CC and histological OA (hips rs = 0.48, P < 0.001, knees rs = 0.30, P = 0.004), but not between CC and age (hips rs = -0.09, P = 0.42; knees rs = 0.10, P = 0.34). CONCLUSIONS These data support the concept that articular CC occurs as the result of a systemic disorder. CC appears to be an early element of hip and knee OA pathogenesis independent of age.
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Affiliation(s)
- T Hawellek
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - J Hubert
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - S Hischke
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - M Krause
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - J Bertrand
- Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany.
| | - T Pap
- Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany.
| | - K Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - W Rüther
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - A Niemeier
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Hubert J, Hawellek T, Hischke S, Bertrand J, Krause M, Püschel K, Rüther W, Niemeier A. Hyaline cartilage calcification of the first metatarsophalangeal joint is associated with osteoarthritis but independent of age and BMI. BMC Musculoskelet Disord 2016; 17:474. [PMID: 27842586 PMCID: PMC5109667 DOI: 10.1186/s12891-016-1324-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 11/01/2016] [Indexed: 01/09/2023] Open
Abstract
Background Hyaline cartilage calcification (CC) is associated with osteoarthritis (OA) in hip and knee joints. The first metatarsophalangeal joint (1stMTPJ) is frequently affected by OA, but it is unclear if CC occurs in the 1stMTPJ. The aim of the present study was to analyze the prevalence of CC of the 1stMTPJ in the general population by high-resolution digital contact radiography (DCR) and to determine its association with histological OA severity, age and body mass index (BMI). Methods 168 metatarsal heads of 84 donors (n = 47 male, n = 37 female; mean age 62.73 years, SD ±18.8, range 20–93) were analyzed by DCR for the presence of CC. Histological OA grade (hOA) by OARSI was analyzed in the central load-bearing zone of the first metatarsal head (1st MH). Structural equation modeling (SEM) was performed to analyze the interrelationship between CC, hOA, age and BMI. Results The prevalence of CC of 1stMH was 48.8 % (41/84) (95 %-CI [37.7 %, 60.0 %]), independent of the affected side (p = 0.42), gender (p = 0.41) and BMI (p = 0.51). The mean amount of CC of one MH correlated significantly with that of the contralateral side (rs = 0.4, 95 %-CI [0.26, 0.52], p < 0.001). The mean amount of CC (in % of total cartilage area) of the MH correlated significantly with the severity of hOA (rs = 0.51, 95 %-CI [0.32, 0.65], p < 0.001). SEM revealed significant associations between CC and hOA (r = 0.74, p < 0.001) and between hOA and age (β = 0.62, p = 0.001), but not between CC and age (p = 0.15). There was no significant influence of BMI on either CC (p = 0.37) or hOA (p = 0.16). Conclusion The observation that CC of the 1stMH is significantly associated with the severity of OA but independent of age and BMI, suggests an intimate relationship between CC and the pathogenesis of OA, the exact nature of which will have to be explored by future studies. Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-1324-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Hubert
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany.
| | - Thelonius Hawellek
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany.
| | - Sandra Hischke
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Jessica Bertrand
- Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Domagkstrasse 3, Münster, 48149, Germany.,Department of Orthopaedic Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Magdeburg, 39120, Germany
| | - Matthias Krause
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestraße 59, Hamburg, 22529, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Wolfgang Rüther
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Andreas Niemeier
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
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Wu Y, Chen K, Terkeltaub R. Systematic review and quality analysis of emerging diagnostic measures for calcium pyrophosphate crystal deposition disease. RMD Open 2016; 2:e000339. [PMID: 27933211 PMCID: PMC5133413 DOI: 10.1136/rmdopen-2016-000339] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/16/2016] [Accepted: 10/10/2016] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Calcium pyrophosphate crystal deposition disease (CPPD) is common, yet prevalence and overall clinical impact remain unclear. Sensitivity and specificity of CPPD reference standards (conventional crystal analysis (CCA) and radiography (CR)) were meta-analysed by EULAR (published 2011). Since then, new diagnostic modalities are emerging. Hence, we updated 2009-2016 literature findings by systematic review and evidence grading, and assessed unmet needs. METHODS We performed systematic search of full papers (PubMed, Scopus/EMBASE, Cochrane 2009-2016 databases). Search terms included CPPD, chondrocalcinosis, pseudogout, ultrasound, MRI, dual energy CT (DECT). Paper selection, data abstraction, EULAR evidence level, and Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 bias and applicability grading were performed independently by 3 authors. RESULTS We included 26 of 111 eligible papers, which showed emergence in CPPD diagnosis of ultrasound (U/S), and to lesser degree, DECT and Raman spectroscopy. U/S detected CPPD crystals in peripheral joints with sensitivity >80%, superior to CR. However, most study designs, though analytical, yielded low EULAR evidence level. DECT was marginally explored for CPPD, compared with 35 published DECT studies in gout. QUADAS-2 grading indicated strong applicability of U/S, DECT and Raman spectroscopy, but high study bias risk (in ∼30% of papers) due to non-controlled designs, and non-randomised subject selection. CONCLUSIONS Though CCA and CR remain reference standards for CPPD diagnosis, U/S, DECT and Raman spectroscopy are emerging U/S sensitivity appears to be superior to CR. We identified major unmet needs, including for randomised, blinded, controlled studies of CPPD diagnostic performance and rigorous analyses of 4 T MRI and other emerging modalities.
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Affiliation(s)
- Y Wu
- Department of Rheumatology , VAMC/UCSD , San Diego, California , USA
| | - K Chen
- Department of Radiology , VAMC/UCSD , San Diego, California , USA
| | - R Terkeltaub
- Department of Rheumatology , VAMC/UCSD , San Diego, California , USA
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Combining field effect scanning electron microscopy, deep UV fluorescence, Raman, classical and synchrotron radiation Fourier transform Infra-Red Spectroscopy in the study of crystal-containing kidney biopsies. CR CHIM 2016. [DOI: 10.1016/j.crci.2015.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Hawellek T, Hubert J, Hischke S, Vettorazzi E, Wegscheider K, Bertrand J, Pap T, Krause M, Püschel K, Rüther W, Niemeier A. Articular cartilage calcification of the humeral head is highly prevalent and associated with osteoarthritis in the general population. J Orthop Res 2016; 34:1984-1990. [PMID: 26970411 DOI: 10.1002/jor.23227] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 03/06/2016] [Indexed: 02/04/2023]
Abstract
Articular cartilage calcification is considered a pathological albeit incompletely understood process which is known to be associated with osteoarthritis of the knee and hip. The goal of this study was to determine the prevalence of articular cartilage calcification of the shoulder as a non-weight-bearing joint and to analyze the interrelationship of calcification with age and histological severity of shoulder osteoarthritis in the general population. In a cross-sectional study of 180 humeral heads from 90 donors (n = 49 male, n = 41 female; mean age 62.7 years [20-93]), cartilage calcification of the humeral head was quantified by digital contact radiography (DCR). Histological OA grade (OARSI) was determined and structural equation modeling (SEM) was used to analyze the interrelationship of cartilage calcification, OARSI and age. The prevalence of articular cartilage calcification was 98.9% (95%CI: [93.96%, 99.97%]) and was independent of gender (p = 0.55). Cartilage calcification of one shoulder correlated significantly with that of the contralateral side (r = 0.61, 95%CI: [0.46, 0.73], p < 0.001). SEM demonstrated significant associations between histological OA grade and cartilage calcification (r = 0.55, p = 0.039), between histological OA grade and age (β = 0.59, p < 0.001) but not between age and cartilage calcification (β = 0.24, p = 0.116). In conclusion, the prevalence of shoulder cartilage calcification in the general population is higher than anticipated. The high prevalence, its concomitant bilateral manifestation and the association between the amount of cartilage calcification and OA severity, but not age, suggest that cartilage calcification is a systemically driven process with early onset in life and may be a causative factor in the pathogenesis of OA. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1984-1990, 2016.
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Affiliation(s)
- Thelonius Hawellek
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Hubert
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sandra Hischke
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eik Vettorazzi
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jessica Bertrand
- Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany
| | - Thomas Pap
- Institute of Experimental Musculoskeletal Medicine, University Hospital Münster, Münster, Germany
| | - Matthias Krause
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Rüther
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Niemeier
- Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Cros J, Bazin D, Kellum A, Rebours V, Daudon M. Investigation at the micrometer scale of pancreatic calcifications in chronic pancreatitis by μFTIR spectroscopy and field emission scanning electron microscopy. CR CHIM 2016. [DOI: 10.1016/j.crci.2015.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Reguer S, Mocuta C, Thiaudière D, Daudon M, Bazin D. Combination of X-ray synchrotron radiation techniques to gather information for clinicians. CR CHIM 2016. [DOI: 10.1016/j.crci.2015.03.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Sun Y, Haines N, Roberts A, Ruffolo M, Mauerhan DR, Mihalko KL, Ingram J, Cox M, Hanley EN. Disease-modifying effects of phosphocitrate and phosphocitrate-β-ethyl ester on partial meniscectomy-induced osteoarthritis. BMC Musculoskelet Disord 2015; 16:270. [PMID: 26424660 PMCID: PMC4588234 DOI: 10.1186/s12891-015-0724-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 09/18/2015] [Indexed: 12/27/2022] Open
Abstract
Background It is believed that phosphocitrate (PC) exerts its disease-modifying effects on osteoarthritis (OA) by inhibiting the formation of crystals. However, recent findings suggest that PC exerts its disease-modifying effect, at least in part, through a crystal-independent action. This study sought to examine the disease-modifying effects of PC and its analogue PC-β-ethyl ester (PC-E) on partial meniscectomy-induced OA and the structure-activity relationship. Methods Calcification- and proliferation-inhibitory activities were examined in OA fibroblast-like synoviocytes (FLSs) culture. Disease-modifying effects were examined using Hartley guinea pigs undergoing partial meniscectomy. Cartilage degeneration was examined with Indian ink, safranin-O, and picrosirius red. Levels of matrix metalloproteinase-13 (MMP-13), ADAM metallopeptidase with thrombospondin type 1 motif 5 (ADAMTS5), chemokine (C-C motif) ligand 5 (CCL5), and cyclooxygenase-2 (Cox-2) were examined with immunostaining. The effects of PC-E and PC on gene expressions in OA FLSs were examined with microarray. Results are expressed as mean ± standard deviation and analyzed using Student’s t test or Wilcoxon rank sum test. Results PC-E was slightly less powerful than PC as a calcification inhibitor but as powerful as PC in the inhibition of OA FLSs proliferation. PC significantly inhibited cartilage degeneration in the partial meniscectomied right knee. PC-E was less powerful than PC as a disease-modifying drug, especially in the inhibition of cartilage degeneration in the non-operated left knee. PC significantly reduced the levels of ADAMTS5, MMP-13 and CCL5, whereas PC-E reduced the levels of ADAMTS5 and CCL5. Microarray analyses revealed that PC-E failed to downregulate the expression of many PC-downregulated genes classified in angiogenesis and inflammatory response. Conclusions PC is a disease-modifying drug for posttraumatic OA therapy. PC exerts its disease-modifying effect through two independent actions: inhibiting pathological calcification and modulating the expression of many genes implicated in OA. The β-carboxyl group of PC plays an important role in the inhibition of cartilage degeneration, little role in the inhibition of FLSs proliferation, and a moderate role in the inhibition of FLSs-mediated calcification.
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Affiliation(s)
- Yubo Sun
- Department of Orthopedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
| | - Nikkole Haines
- Department of Orthopedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
| | - Andrea Roberts
- Department of Orthopedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
| | - Michael Ruffolo
- Department of Orthopedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
| | - David R Mauerhan
- Department of Orthopedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
| | - Kim L Mihalko
- Department of Comparative Medicine, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
| | - Jane Ingram
- Department of Orthopedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
| | - Michael Cox
- Department of Orthopedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
| | - Edward N Hanley
- Department of Orthopedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, NC, 28232, USA.
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Ottaviani S, Juge PA, Aubrun A, Palazzo E, Dieudé P. Sensitivity and Reproducibility of Ultrasonography in Calcium Pyrophosphate Crystal Deposition in Knee Cartilage: A Cross-sectional Study. J Rheumatol 2015; 42:1511-3. [DOI: 10.3899/jrheum.141067] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2015] [Indexed: 12/15/2022]
Abstract
Objective.To compare the ability to detect calcium pyrophosphate (CPP) crystals deposition (CPPD) in knee cartilage by ultrasonography (US) and radiography.Methods.Patients with knee effusion were consecutively included and underwent radiography and US evaluation of knees. Diagnosis of CPPD was made by the identification of CPP crystals. Two blinded rheumatologists performed US assessment.Results.We included 51 patients (25 with CPPD). US revealed hyperechoic spots in all 25 patients with CPPD (sensitivity 100%, specificity 92.3%), whereas radiography revealed CPPD in 16 (sensitivity 64%, specificity 100%; p < 0.0001).Conclusion.US of knees is more sensitive than radiography for CPPD diagnosis.
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Samarasinghe RM, Kanwar RK, Kanwar JR. The effect of oral administration of iron saturated-bovine lactoferrin encapsulated chitosan-nanocarriers on osteoarthritis. Biomaterials 2014; 35:7522-34. [DOI: 10.1016/j.biomaterials.2014.04.109] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 04/27/2014] [Indexed: 02/09/2023]
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Diagnosis and Clinical Manifestations of Calcium Pyrophosphate and Basic Calcium Phosphate Crystal Deposition Diseases. Rheum Dis Clin North Am 2014; 40:207-29. [DOI: 10.1016/j.rdc.2014.01.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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