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Yang F, Zhang Y, Liu B, Cao M, Yang J, Tian F, Yang P, Qin K, Zhao D. Basic fibroblast growth factor and agarose gel promote the ability of immune privilege of allogeneic cartilage transplantation in rats. J Orthop Translat 2019; 22:73-80. [PMID: 32440502 PMCID: PMC7231919 DOI: 10.1016/j.jot.2019.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 01/16/2023] Open
Abstract
Objective Allogeneic cartilage transplantation is used to treat severe osteochondral defects or cartilaginous injury. However, acute immune rejection has been a key problem interfering with graft healing. Methods Full-thickness osteochondral defects were performed in Sprague Dawley rats. The allograft implants were set into the defect region. Blood and spleen samples from Postoperative Day 3 onward were collected for inflammatory cell analysis, including analysis of monocytes, natural killer cells, CD4+CD25+Foxp3+ regulatory T cells, CD4+ T cells, and CD8+ T cells. Gross observation and histologic staining (hematoxylin and eosin, toluidine blue) were carried out at the same time point to assess the repair effect of the cartilage graft and the degree of immune rejection. Results Treatment with basic fibroblast growth factor, agarose gel, and allogeneic cartilage was similar to that of the autologous group. The percentage of monocytes in allografts was at a higher level in the spleen and blood; the frequency of CD4+ T cells in the allogeneic group was higher than in the autologous group and the other agarose groups at 6 weeks after transplantation. The number of regulatory T cells in the autograft was increased from Postoperative Week 1; similar results were observed in groups containing basic fibroblast growth factor beginning at Postoperative Week 3. Conclusions Allogeneic cartilage transplantation induces acute immune rejection, which compromises the validity of the implant. The combination of basic fibroblast growth factor and agarose gel facilitates the goal of immune privilege and promotes the success of the allograft tissues. The translational potential of this article This study investigated the combination of basic fibroblast growth factor (bFGF) and agarose gel facilitates promotes the success of the allograft tissues transplantation. This work may help clinicians find a new way to repair articular cartilage damage. This will affect the treatment of articular cartilage movement injuries and arthritis.
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Affiliation(s)
- Fan Yang
- Department of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Linggong Road, Dalian, Liaoning, China.,Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, No 6 Jiefang Street, Dalian, Liaoning, China
| | - Yu Zhang
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, No 6 Jiefang Street, Dalian, Liaoning, China
| | - Baoyi Liu
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, No 6 Jiefang Street, Dalian, Liaoning, China.,Postdoctoral Workstation, Affiliated Zhongshan Hospital of Dalian University, No 6 Jiefang Street, Dalian, Liaoning, China
| | - Meng Cao
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, No 6 Jiefang Street, Dalian, Liaoning, China
| | - Jiahui Yang
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, No 6 Jiefang Street, Dalian, Liaoning, China
| | - Fengde Tian
- Department of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Linggong Road, Dalian, Liaoning, China.,Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, No 6 Jiefang Street, Dalian, Liaoning, China
| | - Pei Yang
- The First Department of Orthopaedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, 710000, China
| | - Kairong Qin
- Department of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Linggong Road, Dalian, Liaoning, China
| | - Dewei Zhao
- Department of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Linggong Road, Dalian, Liaoning, China.,Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, No 6 Jiefang Street, Dalian, Liaoning, China
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Vilela CA, Correia C, Oliveira JM, Sousa RA, Espregueira-Mendes J, Reis RL. Cartilage Repair Using Hydrogels: A Critical Review of in Vivo Experimental Designs. ACS Biomater Sci Eng 2015; 1:726-739. [DOI: 10.1021/acsbiomaterials.5b00245] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- C. A. Vilela
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life
and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- Orthopaedic
Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal
| | - C. Correia
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
| | - J. M. Oliveira
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - R. A. Sousa
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
| | - J. Espregueira-Mendes
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Life
and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- Clínica
do Dragão, Espregueira-Mendes Sports Centre, Porto, Portugal
| | - R. L. Reis
- 3B’s
Research Group, University of Minho, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Stemmatters, Biotecnologia e Medicina Regenerativa SA, Guimarães, Portugal
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Orth P, Cucchiarini M, Zurakowski D, Menger MD, Kohn DM, Madry H. Parathyroid hormone [1-34] improves articular cartilage surface architecture and integration and subchondral bone reconstitution in osteochondral defects in vivo. Osteoarthritis Cartilage 2013; 21:614-24. [PMID: 23353669 DOI: 10.1016/j.joca.2013.01.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 01/07/2013] [Accepted: 01/12/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The 1-34 amino acid segment of the parathyroid hormone (PTH [1-34]) mediates anabolic effects in chondrocytes and osteocytes. The aim of this study was to investigate whether systemic application of PTH [1-34] improves the repair of non-osteoarthritic, focal osteochondral defects in vivo. DESIGN Standardized cylindrical osteochondral defects were bilaterally created in the femoral trochlea of rabbits (n = 8). Daily subcutaneous injections of 10 μg PTH [1-34]/kg were given to the treatment group (n = 4) for 6 weeks, controls (n = 4) received saline. Articular cartilage repair was evaluated by macroscopic, biochemical, histological and immunohistochemical analyses. Reconstitution of the subchondral bone was assessed by micro-computed tomography. Effects of PTH [1-34] on synovial membrane, apoptosis, and expression of the PTH receptor (PTH1R) were determined. RESULTS Systemic PTH [1-34] increased PTH1R expression on both, chondrocytes and osteocytes within the repair tissue. PTH [1-34] ameliorated the macro- and microscopic aspect of the cartilaginous repair tissue. It also enhanced the thickness of the subchondral bone plate and the microarchitecture of the subarticular spongiosa within the defects. No significant correlations were established between these coexistent processes. Apoptotic levels, synovial membrane, biochemical composition of the repair tissue, and type-I/II collagen immunoreactivity remained unaffected. CONCLUSIONS PTH [1-34] emerges as a promising agent in the treatment of focal osteochondral defects as its systemic administration simultaneously stimulates articular cartilage and subchondral bone repair. Importantly, both time-dependent mechanisms of repair did not correlate significantly at this early time point and need to be followed over prolonged observation periods.
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Affiliation(s)
- P Orth
- Center of Experimental Orthopaedics, Saarland University, Homburg/Saar, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg/Saar, Germany.
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Vaquero J, Forriol F. Knee chondral injuries: clinical treatment strategies and experimental models. Injury 2012; 43:694-705. [PMID: 21733516 DOI: 10.1016/j.injury.2011.06.033] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 05/30/2011] [Accepted: 06/15/2011] [Indexed: 02/02/2023]
Abstract
Articular cartilage has a very limited capacity to repair and as such premature joint degeneration is often the end point of articular injuries. Patients with chondral injury have asymptomatic periods followed by others in which discomfort or pain is bearable. The repair of focal cartilage injuries requires a precise diagnosis, a completed knee evaluation to give the correct indication for surgery proportional to the damage and adapted to each patient. Many of the surgical techniques currently performed involve biotechnology. The future of cartilage repair should be based on an accurate diagnosis using new MRI techniques. Clinical studies would allow us to establish the correct indications and surgical techniques implanting biocompatible and biodegradable matrices with or without stem cells and growth factors. Arthroscopic techniques with the design of new instruments can facilitate repair of patella and tibial plateau lesions.
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Affiliation(s)
- Javier Vaquero
- Hospital Gregorio Marañon, Orthopaedic Surgery Department, Madrid, Spain
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Farkas B, Kvell K, Czömpöly T, Illés T, Bárdos T. Increased chondrocyte death after steroid and local anesthetic combination. Clin Orthop Relat Res 2010; 468:3112-20. [PMID: 20700677 PMCID: PMC2947661 DOI: 10.1007/s11999-010-1443-0] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Accepted: 06/08/2010] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hyaline articular cartilage has limited repair and regeneration capacity. Intraarticular administration of glucocorticoid and local anesthetic injections play an important role in the therapy of osteoarthritis. Glucocorticoids and anesthetics reportedly enhance apoptosis in chondrocytes, but effects of the combined use of glucocorticoids and local anesthetics are unknown. QUESTIONS/PURPOSES We asked whether glucocorticoid and local anesthetic agents combined had any synergistic effects on chondrocyte apoptosis. METHODS Cell viability and apoptosis/necrosis assessment of human articular chondrocytes were performed in vitro (chondrocyte cell cultures) and ex vivo (osteochondral specimens) using flow cytometry and TUNEL analysis, respectively. RESULTS Glucocorticoids and local anesthetics induce apoptosis in chondrocytes at various rates. When used in combination, the percentage of dead chondrocytes was increased in in vitro chondrocyte cell cultures and osteochondral ex vivo specimens. CONCLUSIONS We observed a time-dependent decrease in chondrocyte viability after concurrent steroid and local anesthetic exposure. CLINICAL RELEVANCE The combination of glucocorticoids and local anesthetics has an adverse effect on articular chondrocytes, and it raises a question regarding whether concomitant administration should be used in treating osteoarthritis.
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Affiliation(s)
- Boglárka Farkas
- Department of Orthopaedics, University of Pécs, Ifjúság u. 13, 7624 Pécs, Hungary ,Department of Anatomy, University of Pécs, Pécs, Hungary
| | - Krisztián Kvell
- Department of Immunology and Biotechnology, University of Pécs, Pécs, Hungary
| | - Tamás Czömpöly
- Department of Immunology and Biotechnology, University of Pécs, Pécs, Hungary
| | - Tamás Illés
- Department of Orthopaedics, University of Pécs, Ifjúság u. 13, 7624 Pécs, Hungary
| | - Tamás Bárdos
- Department of Orthopaedics, University of Pécs, Ifjúság u. 13, 7624 Pécs, Hungary
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Abstract
Articular cartilage lesions in the athletic population are observed with increasing frequency and, due to limited intrinsic healing capacity, can lead to progressive pain and functional limitation over time. If left untreated, isolated cartilage lesions can lead to progressive chondropenia or global cartilage loss over time. A chondropenia curve is described to help predict the outcome of cartilage injury based on different lesion and patient characteristics. Nutriceuticals and chondroprotective agents are being investigated as tools to slow the development of chondropenia. Several operative techniques have been described for articular cartilage repair or replacement and, more recently, cartilage regeneration. Rehabilitation guidelines are being developed to meet the needs of these new techniques. Next-generation techniques are currently evaluated to optimize articular cartilage repair biology and to provide a repair cartilage tissue that can withstand the high mechanical loads experienced by the athlete with consistent long-term durability.
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Affiliation(s)
| | - Kai Mithoefer
- Harvard Vanguard Orthopedics and Sports Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
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van Osch GJVM, Brittberg M, Dennis JE, Bastiaansen-Jenniskens YM, Erben RG, Konttinen YT, Luyten FP. Cartilage repair: past and future--lessons for regenerative medicine. J Cell Mol Med 2009; 13:792-810. [PMID: 19453519 PMCID: PMC3823400 DOI: 10.1111/j.1582-4934.2009.00789.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Since the first cell therapeutic study to repair articular cartilage defects in the knee in 1994, several clinical studies have been reported. An overview of the results of clinical studies did not conclusively show improvement over conventional methods, mainly because few studies reach level I of evidence for effects on middle or long term. However, these explorative trials have provided valuable information about study design, mechanisms of repair and clinical outcome and have revealed that much is still unknown and further improvements are required. Furthermore, cellular and molecular studies using new technologies such as cell tracking, gene arrays and proteomics have provided more insight in the cell biology and mechanisms of joint surface regeneration. Besides articular cartilage, cartilage of other anatomical locations as well as progenitor cells are now considered as alternative cell sources. Growth Factor research has revealed some information on optimal conditions to support cartilage repair. Thus, there is hope for improvement. In order to obtain more robust and reproducible results, more detailed information is needed on many aspects including the fate of the cells, choice of cell type and culture parameters. As for the clinical aspects, it becomes clear that careful selection of patient groups is an important input parameter that should be optimized for each application. In addition, the study outcome parameters should be improved. Although reduced pain and improved function are, from the patient's perspective, the most important outcomes, there is a need for more structure/tissue-related outcome measures. Ideally, criteria and/or markers to identify patients at risk and responders to treatment are the ultimate goal for these more sophisticated regenerative approaches in joint surface repair in particular, and regenerative medicine in general.
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Affiliation(s)
- Gerjo J V M van Osch
- Department of Orthopaedics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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