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Zhang L, Kirkwood CL, Sohn J, Lau A, Bayers-Thering M, Bali SK, Rachala S, Marzo JM, Anders MJ, Beier F, Kirkwood KL. Expansion of myeloid-derived suppressor cells contributes to metabolic osteoarthritis through subchondral bone remodeling. Arthritis Res Ther 2021; 23:287. [PMID: 34784965 PMCID: PMC8594239 DOI: 10.1186/s13075-021-02663-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) subsequent to acute joint injury accounts for a significant proportion of all arthropathies. Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of myeloid progenitor cells classically known for potent immune-suppressive activity; however, MDSCs can also differentiate into osteoclasts. In addition, this population is known to be expanded during metabolic disease. The objective of this study was to determine the role of MDSCs in the context of OA pathophysiology. METHODS In this study, we examined the differentiation and functional capacity of MDSCs to become osteoclasts in vitro and in vivo using mouse models of OA and in MDSC quantitation in humans with OA pathology relative to obesity status. RESULTS We observed that MDSCs are expanded in mice and humans during obesity. MDSCs were expanded in peripheral blood of OA subjects relative to body mass index and in mice fed a high-fat diet (HFD) compared to mice fed a low-fat diet (LFD). In mice, monocytic MDSC (M-MDSC) was expanded in diet-induced obesity (DIO) with a further expansion after destabilization of the medial meniscus (DMM) surgery to induce post-traumatic OA (PTOA) (compared to sham-operated controls). M-MDSCs from DIO mice had a greater capacity to form osteoclasts in culture with increased subchondral bone osteoclast number. In humans, we observed an expansion of M-MDSCs in peripheral blood and synovial fluid of obese subjects compared to lean subjects with OA. CONCLUSION These data suggest that MDSCs are reprogrammed in metabolic disease, with the potential to contribute towards OA progression and severity.
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Affiliation(s)
- Lixia Zhang
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, 645 Biomedical Research Building, 3435 Main St, Buffalo, NY, 14214-8006, USA
| | - Cameron L Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, 645 Biomedical Research Building, 3435 Main St, Buffalo, NY, 14214-8006, USA
| | - Jiho Sohn
- Department of Medicine, University at Buffalo, Buffalo, NY, USA
| | - Ashley Lau
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, 645 Biomedical Research Building, 3435 Main St, Buffalo, NY, 14214-8006, USA
| | | | - Supinder Kour Bali
- Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario, Canada.,Western Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Sridhar Rachala
- Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA
| | - John M Marzo
- Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA
| | - Mark J Anders
- Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA
| | - Frank Beier
- Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario, Canada.,Western Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Keith L Kirkwood
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, 645 Biomedical Research Building, 3435 Main St, Buffalo, NY, 14214-8006, USA. .,Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
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The predictive significance of bone mineral density on postoperative pain relief in knee osteoarthritis patients after total knee arthroplasty: A prediction model. J Orthop Sci 2021; 26:622-628. [PMID: 32732146 DOI: 10.1016/j.jos.2020.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/01/2020] [Accepted: 05/15/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Bone mineral density (BMD) may be an important factor affecting the clinical outcomes after total knee arthroplasty (TKA). However, further information regarding BMD in postoperative pain relief is not present yet. This study aims to gain further insight into the predictive significance of BMD in postoperative pain relief in knee osteoarthritis (KOA) patients after TKA. METHODS 156 KOA patients treated by TKA were included in this study. Visual analogue scale (VAS) was used to measure the pain intensity in patients within one year after TKA. The patients were divided into good pain relief group (the improvement of VAS ≥ 3) and poor pain relief group (the improvement of VAS < 3). BMD and other clinical characteristics were also collected. Logistic regression analysis and receiver operating characteristic curve (ROC curve) were used to evaluate the predictive significance of BMD. Subgroup analysis was used to compare the difference of postoperative pain between High BMD group and Low BMD group extra. RESULTS 34 (21.8%) patients had poor pain relief after TKA. Logistic regression analysis indicated that age, BMD, preoperative hospital for special surgery (HSS) scores, preoperative VAS score and postoperative posterior slope angles (PSA) were the risk factors of poor pain relief (P < 0.05). Using BMD as a predictor, the optimum cut-off value of poor pain relief was T-level = -3.0 SD in the ROC curve, where sensitivity and specificity were 73.5% and 83.7%, respectively. Based on this cut-off value, obvious pain relief was observed in the High BMD group compared with Low BMD group from the 6th month after TKA in the subgroup analysis (P < 0.05). CONCLUSIONS BMD is an effective predictor for postoperative pain relief in KOA patients after TKA, and the poor pain relief should be fully considered especially when BMD T-level ≤ -3.0 SD.
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Hügle T, Geurts J. What drives osteoarthritis?-synovial versus subchondral bone pathology. Rheumatology (Oxford) 2017; 56:1461-1471. [PMID: 28003493 DOI: 10.1093/rheumatology/kew389] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Indexed: 12/16/2022] Open
Abstract
Subchondral bone and the synovium play an important role in the initiation and progression of OA. MRI often permits an early detection of synovial hypertrophy and bone marrow lesions, both of which can precede cartilage damage. Newer imaging modalities including CT osteoabsorptiometry and hybrid SPECT-CT have underlined the importance of bone in OA pathogenesis. The subchondral bone in OA undergoes an uncoupled remodelling process, which is notably characterized by macrophage infiltration and osteoclast formation. Concomitant increased osteoblast activity leads to spatial remineralization and osteosclerosis in end-stage disease. A plethora of metabolic and mechanical factors can lead to synovitis in OA. Synovial tissue is highly vascularized and thus exposed to systemic influences such as hypercholesterolaemia or low grade inflammation. This review aims to describe the current understanding of synovitis and subchondral bone pathology and their connection in OA.
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Affiliation(s)
- Thomas Hügle
- Osteoarthritis Research Center Basel.,Department of Rheumatology
| | - Jeroen Geurts
- Osteoarthritis Research Center Basel.,Spine Surgery, University Hospital Basel, Basel, Switzerland
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4
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Hummel M, Whiteside GT. Measuring and realizing the translational significance of preclinical in vivo studies of painful osteoarthritis. Osteoarthritis Cartilage 2017; 25:376-384. [PMID: 27592040 DOI: 10.1016/j.joca.2016.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/15/2016] [Accepted: 08/17/2016] [Indexed: 02/02/2023]
Abstract
In this communication, we discuss some key issues surrounding the translation of preclinical efficacy studies in models of painful osteoarthritis (OA) to the clinical arena. We highlight potential pitfalls which could negatively impact successful translation. These include lack of alignment between a model + endpoint and the intended clinical population, employing testing strategies in animals that are not appropriate for the targeted human population such as pre-emptive treatment and lastly, underestimating the magnitude of the efficacy signal in animals that may be needed to see an effect in the clinical population. Through careful analysis, we highlight the importance of each pitfall by providing relevant examples that will hopefully improve future chances of optimizing translation in the area of OA pain research. We advocate advancing publications directed at comparing methods, outcomes and conclusions between preclinical and clinical studies, regardless of whether the findings are positive or negative, are important for improving the potential for a desired successful translation from the bench to bedside.
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Affiliation(s)
- M Hummel
- Discovery Research, Purdue Pharma L.P., 6 Cedar Brook Drive, Cranbury, NJ 08512, USA
| | - G T Whiteside
- Discovery Research, Purdue Pharma L.P., 6 Cedar Brook Drive, Cranbury, NJ 08512, USA.
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5
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Marker BA, Barber LG, Clifford CA, Correa SS, Thalhofer PL, LaDue TA, Mullin CM, Sauerbrey ML, Wood CC. Extravasation reactions associated with the administration of pamidronate: 11 cases (2008-2013). Vet Comp Oncol 2016; 15:470-480. [PMID: 27174040 DOI: 10.1111/vco.12191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 10/09/2015] [Accepted: 10/11/2015] [Indexed: 11/30/2022]
Abstract
Pamidronate is a bisphosphonate drug widely utilized in veterinary oncologic practice for the palliation of malignant osteolysis. Pamidronate has not been previously reported to cause tissue injury upon extravasation in dogs. The medical records of 11 client-owned dogs undergoing palliative treatment for primary bone tumors with known or suspected pamidronate extravasation reactions were reviewed. The majority of adverse events were low grade in nature, however in some cases, the reactions were severe and led to euthanasia in one instance. Time to complete resolution of lesions ranged from within several days to greater than one and a half months. Aside from the dog that was euthanized, no long-term sequelae of extravasation were identified. Treatments employed to address the reactions varied widely. Pamidronate extravasation reaction appears to be an uncommon, but potentially serious complication of intravenous administration.
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Affiliation(s)
- B A Marker
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, 01536, USA
| | - L G Barber
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, 01536, USA
| | - C A Clifford
- Red Bank Veterinary Hospital, Tinton Falls, NJ, 07724, USA
| | - S S Correa
- Animal Cancer Care Clinic, Ft. Lauderdale, FL, 33304, USA
| | - P L Thalhofer
- Metropolitan Veterinary Hospital, Akron, OH, 44321, USA
| | - T A LaDue
- Southeast Veterinary Oncology, Orange Park, FL, 32073, USA
| | - C M Mullin
- Red Bank Veterinary Hospital, Tinton Falls, NJ, 07724, USA
| | - M L Sauerbrey
- Oakland Veterinary Referral Services, Bloomfield Hills, MI, 48302, USA
| | - C C Wood
- Veterinary Referral and Emergency Center of Westbury, Westbury, NY, USA
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Siebelt M, Waarsing JH, Groen HC, Müller C, Koelewijn SJ, de Blois E, Verhaar JAN, de Jong M, Weinans H. Inhibited osteoclastic bone resorption through alendronate treatment in rats reduces severe osteoarthritis progression. Bone 2014; 66:163-70. [PMID: 24933343 DOI: 10.1016/j.bone.2014.06.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 06/05/2014] [Accepted: 06/06/2014] [Indexed: 11/30/2022]
Abstract
Osteoarthritis (OA) is a non-rheumatoid joint disease characterized by progressive degeneration of extra-cellular cartilage matrix (ECM), enhanced subchondral bone remodeling, osteophyte formation and synovial thickening. Alendronate (ALN) is a potent inhibitor of osteoclastic bone resorption and results in reduced bone remodeling. This study investigated the effects of pre-emptive use of ALN on OA related osteoclastic subchondral bone resorption in an in vivo rat model for severe OA. Using multi-modality imaging we measured effects of ALN treatment within cartilage and synovium. Severe osteoarthritis was induced in left rat knees using papain injections in combination with a moderate running protocol. Twenty rats were treated with subcutaneous ALN injections and compared to twenty untreated controls. Animals were longitudinally monitored for 12weeks with in vivo μCT to measure subchondral bone changes and SPECT/CT to determine synovial macrophage activation using a folate-based radiotracer. Articular cartilage was analyzed at 6 and 12weeks with ex vivo contrast enhanced μCT and histology to measure sulfated-glycosaminoglycan (sGAG) content and cartilage thickness. ALN treatment successfully inhibited subchondral bone remodeling. As a result we found less subchondral plate porosity and reduced osteophytosis. ALN treatment did not reduce subchondral sclerosis. However, after the OA induction phase, ALN treatment protected cartilage ECM from degradation and reduced synovial macrophage activation. Surprisingly, ALN treatment also improved sGAG content of tibia cartilage in healthy joints. Our data was consistent with the hypothesis that osteoclastic bone resorption might play an important role in OA and may be a driving force for progression of the disease. However, our study suggest that this effect might not solely be effects on osteoclastic activity, since ALN treatment also influenced macrophage functioning. Additionally, ALN treatment and physical activity exercised a positive effect in healthy control joints, which increased cartilage sGAG content. More research on this topic might lead to novel insights as to improve cartilage quality.
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Affiliation(s)
- M Siebelt
- Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - J H Waarsing
- Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - H C Groen
- Department of Nuclear Medicine, Erasmus University Medical Center, The Netherlands
| | - C Müller
- Center for Radiopharmaceutical Sciences ETH-PSI-USZ, Paul Scherrer Institute, Villigen-PSI, Switzerland
| | - S J Koelewijn
- Department of Nuclear Medicine, Erasmus University Medical Center, The Netherlands
| | - E de Blois
- Department of Nuclear Medicine, Erasmus University Medical Center, The Netherlands
| | - J A N Verhaar
- Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M de Jong
- Department of Nuclear Medicine, Erasmus University Medical Center, The Netherlands; Department of Radiology, Erasmus University Medical Center, The Netherlands
| | - H Weinans
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands; Dept. Orthopaedics & Dept. Rheumatology, UMC Utrecht, The Netherlands
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7
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Dearmin MG, Trumble TN, García A, Chambers JN, Budsberg SC. Chondroprotective effects of zoledronic acid on articular cartilage in dogs with experimentally induced osteoarthritis. Am J Vet Res 2014; 75:329-37. [DOI: 10.2460/ajvr.75.4.329] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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Duesterdieck-Zellmer KF, Driscoll N, Ott JF. Concentration-dependent effects of tiludronate on equine articular cartilage explants incubated with and without interleukin-1β. Am J Vet Res 2013; 73:1530-9. [PMID: 23013178 DOI: 10.2460/ajvr.73.10.1530] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine concentration-dependent effects of tiludronate on cartilage explants incubated with or without recombinant equine interleukin-1β (rEq IL-1). SAMPLE Articular cartilage explants from the femorotibial joints of 3 young adult horses. PROCEDURES Cartilage explants were incubated with 1 of 6 concentrations (0, 0.19, 1.9, 19, 190, or 1,900 mg/L) of tiludronate and with or without rEq IL-1 (0.01 ng/mL) for 96 hours. Prostaglandin E(2) (PGE(2)) concentrations in culture medium and explant digests were analyzed via PGE(2) enzyme immunoassay. Sulfated glycosaminoglycan (sGAG) concentrations in culture medium were quantified via 1,9-dimethylmethylene blue assay. Chondrocyte apoptosis in paraffin embedded explant sections was measured via terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay. Relative gene expression of matrix metalloproteinases (MMPs), interleukin (IL)-6, and IL-8 was determined via the comparative cycle threshold method. RESULTS rEq IL-1 increased PGE(2) concentration, sGAG release from explants, chondrocyte apoptosis, and MMP gene expression. Lower tiludronate concentrations reduced rEq IL-1-induced sGAG release and chondrocyte apoptosis, whereas the higher tiludronate concentrations increased sGAG release and chondrocyte apoptosis. At the highest tiludronate concentration evaluated, IL-8 gene expression was increased independent of whether rEq IL-1 was present. CONCLUSIONS AND CLINICAL RELEVANCE Tiludronate had biphasic concentration-dependent effects on cartilage explants that were independent of PGE(2) secretion or MMP gene expression. Low tiludronate concentrations had some chondroprotective effects, whereas high tiludronate concentrations were detrimental to equine articular cartilage. Administration of tiludronate intra-articularly to horses may be detrimental, dependent on the dose used. In vivo studies are needed before intra-articular tiludronate administration to horses can be recommended.
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Affiliation(s)
- Katja F Duesterdieck-Zellmer
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA.
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9
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Abstract
The subchondral bone is involved in the pathophysiology of osteoarthritis (OA), both by biochemical and mechanical pathways. Overloaded OA subchondral bone osteoblasts express a pro-angiogenic and pro-inflammatory phenotype which contributes to explain the structural changes (sclerosis and bone marrow lesion) visible in OA subchondral bone. Further, microfractures and conjonctivo-vascular structures constitute exchange routes between bone and the overlying cartilage for mediators produced by osteoblasts. This narrative review describes these physiopathological mechanisms and identifies possible therapeutic targets for pharmacological modalities.
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Affiliation(s)
- Y Henrotin
- Bone and Cartilage Research Unit, University of Liège, 4000, Liège, Belgium.
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10
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Abstract
Osteoarthritis (OA) is a major cause of pain and disability in the aging population, but its pathogenesis remains incompletely understood. Alterations beneath the articular cartilage at the osteochondral junction are attracting interest as possible mediators of pain and structural progression in OA. Osteochondral changes occur early during the development of OA and may aggravate pathology elsewhere in the joint. Loss of osteochondral integrity removes the barrier between intra-articular and subchondral compartments, exposing subchondral bone and its nerves to abnormal chemical and biomechanical influence. Osteochondral plasticity results in a merging of tissue compartments across the junction. Loss of the clearly differentiated demarcation between bone and articular cartilage is associated with invasion of articular cartilage by blood vessels and sensory nerves, and advancing endochondral ossification. Increased subchondral bone turnover is intimately associated with these alterations at the osteochondral junction. Cells signal across the osteochondral junction, and this cross-talk may be both a consequence of, and contribute to these pathological changes. Bone turnover, angiogenesis and nerve growth are also features of other diseases such as osteoporosis and cancers, for which therapeutic interventions are already advanced in their development. Here we review pathological changes at the osteochondral junction and explore their potential therapeutic implications for OA. This article is part of a Special Issue entitled "Osteoarthritis".
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Affiliation(s)
- Sunita Suri
- Arthritis Research UK Pain Centre, Academic Rheumatology, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham, NG5 1PB, UK
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Kaijima M, Foutz TL, McClendon RW, Budsberg SC. Diagnosis of lameness in dogs by use of artificial neural networks and ground reaction forces obtained during gait analysis. Am J Vet Res 2012; 73:973-8. [DOI: 10.2460/ajvr.73.7.973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Hayami T, Zhuo Y, Wesolowski GA, Pickarski M, Duong LT. Inhibition of cathepsin K reduces cartilage degeneration in the anterior cruciate ligament transection rabbit and murine models of osteoarthritis. Bone 2012; 50:1250-9. [PMID: 22484689 DOI: 10.1016/j.bone.2012.03.025] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 03/19/2012] [Accepted: 03/22/2012] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the disease modifying effects of cathepsin K (CatK) inhibitor L-006235 compared to alendronate (ALN) in two preclinical models of osteoarthritis (OA). METHODS Skeletally mature rabbits underwent sham or anterior cruciate ligament transection (ACLT)-surgery and were treated with L-006235 (L-235, 10 mg/kg or 50 mg/kg, p.o., daily) or ALN (0.6 mg/kg, s.c., weekly) for 8-weeks. ACLT joint instability was also induced in CatK(-/-) versus wild type (wt) mice and treated for 16-weeks. Changes in cartilage degeneration, subchondral bone volume and osteophyte area were determined by histology and μ-CT. Collagen type I helical peptide (HP-I), a bone resorption marker and collagen type II C-telopeptide (CTX-II), a cartilage degradation marker were measured. RESULTS L-235 (50 mg/kg) and ALN treatment resulted in significant chondroprotective effects, reducing CTX-II by 60% and the histological Mankin score for cartilage damage by 46% in the ACLT-rabbits. Both doses of L-235 were more potent than ALN in protecting against focal subchondral bone loss, and reducing HP-I by 70% compared to vehicle. L-235 (50 mg/kg) and ALN significantly reduced osteophyte formation in histomorphometric analysis by 55%. The Mankin score in ACLT-CatK(-/-) mice was ~2.5-fold lower than the ACLT-wt mice and was not different from sham-CatK(-/-). Osteophyte development was not different among the groups. CONCLUSION Inhibition of CatK provides significant benefits in ACLT-model of OA, including: 1) protection of subchondral bone integrity, 2) protection against cartilage degradation and 3) reduced osteophytosis. Preclinical evidence supports the role of CatK as a potential therapeutic target for the treatment of OA.
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Affiliation(s)
- Tadashi Hayami
- Bone Biology Group, Merck Research Laboratories, West Point, PA 19486, USA
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13
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Abstract
During osteoarthritis (OA), angiogenesis is increased in the synovium, osteophytes and menisci and leads to ossification in osteophytes and the deep layers of articular cartilage. Angiogenic and antiangiogenic factors might both be upregulated in the osteoarthritic joint; however, vascular growth predominates, and the articular cartilage loses its resistance to vascularization. In addition, blood vessel growth is increased at--and disrupts--the osteochondral junction. Angiogenesis in this location is dependent on the creation of channels from subchondral bone spaces into noncalcified articular cartilage. Inflammation drives synovial angiogenesis through macrophage activation. Blood vessel and nerve growth are linked by common pathways that involve the release of proangiogenic factors, such as vascular endothelial growth factor, β-nerve growth factor and neuropeptides. Proangiogenic factors might also stimulate nerve growth, and molecules produced by vascular cells could both stimulate and guide nerve growth. As sensory nerves grow along new blood vessels in osteoarthritic joints, they eventually penetrate noncalcified articular cartilage, osteophytes and the inner regions of menisci. Angiogenesis could, therefore, contribute to structural damage and pain in OA and provide potential targets for new treatments.
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Abstract
Bisphosphonate use has increased in veterinary medicine over the last decade. During this time, bisphosphonate related osteonecrosis of the jaws (BRONJ) in human patients has been identified. Only recently was a dog model for BRONJ developed for human oral surgery and medicine. Veterinary patients treated with bisphosphonates may be at an increased risk for BRONJ There has been little, to no, investigation of potential long term side-effects of bisphosphonate use in veterinary patients; potential sequelae are unknown. The history of bisphosphonates, their use, and BRONJ in veterinary patients are discussed.
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Affiliation(s)
- Kevin Stepaniuk
- College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA.
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15
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Tiludronate treatment improves structural changes and symptoms of osteoarthritis in the canine anterior cruciate ligament model. Arthritis Res Ther 2011; 13:R98. [PMID: 21693018 PMCID: PMC3218913 DOI: 10.1186/ar3373] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Accepted: 06/21/2011] [Indexed: 12/15/2022] Open
Abstract
Introduction The aim of this prospective, randomized, controlled, double-blind study was to evaluate the effects of tiludronate (TLN), a bisphosphonate, on structural, biochemical and molecular changes and function in an experimental dog model of osteoarthritis (OA). Methods Baseline values were established the week preceding surgical transection of the right cranial/anterior cruciate ligament, with eight dogs serving as OA placebo controls and eight others receiving four TLN injections (2 mg/kg subcutaneously) at two-week intervals starting the day of surgery for eight weeks. At baseline, Week 4 and Week 8, the functional outcome was evaluated using kinetic gait analysis, telemetered locomotor actimetry and video-automated behaviour capture. Pain impairment was assessed using a composite numerical rating scale (NRS), a visual analog scale, and electrodermal activity (EDA). At necropsy (Week 8), macroscopic and histomorphological analyses of synovium, cartilage and subchondral bone of the femoral condyles and tibial plateaus were assessed. Immunohistochemistry of cartilage (matrix metalloproteinase (MMP)-1, MMP-13, and a disintegrin and metalloproteinase domain with thrombospondin motifs (ADAMTS5)) and subchondral bone (cathepsin K) was performed. Synovial fluid was analyzed for inflammatory (PGE2 and nitrite/nitrate levels) biomarkers. Statistical analyses (mixed and generalized linear models) were performed with an α-threshold of 0.05. Results A better functional outcome was observed in TLN dogs than OA placebo controls. Hence, TLN dogs had lower gait disability (P = 0.04 at Week 8) and NRS score (P = 0.03, group effect), and demonstrated behaviours of painless condition with the video-capture (P < 0.04). Dogs treated with TLN demonstrated a trend toward improved actimetry and less pain according to EDA. Macroscopically, both groups had similar level of morphometric lesions, TLN-treated dogs having less joint effusion (P = 0.01), reduced synovial fluid levels of PGE2 (P = 0.02), nitrites/nitrates (P = 0.01), lower synovitis score (P < 0.01) and a greater subchondral bone surface (P < 0.01). Immunohistochemical staining revealed lower levels in TLN-treated dogs of MMP-13 (P = 0.02), ADAMTS5 (P = 0.02) in cartilage and cathepsin K (P = 0.02) in subchondral bone. Conclusion Tiludronate treatment demonstrated a positive effect on gait disability and joint symptoms. This is likely related to the positive influence of the treatment at improving some OA structural changes and reducing the synthesis of catabolic and inflammatory mediators.
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PELLETIER JEANPIERRE, TRONCY ÉRIC, BERTAIM THIERRY, THIBAUD DOMINIQUE, GOULET ANNECHRISTINE, ABRAM FRANÇOIS, CARON JUDITH, BOILEAU CHRISTELLE, d’ANJOU MARCANDRÉ, MOREAU MAXIM, LUSSIER BERTRAND, MARTEL-PELLETIER JOHANNE. Treatment with Tiludronic Acid Helps Reduce the Development of Experimental Osteoarthritis Lesions in Dogs with Anterior Cruciate Ligament Transection Followed by Reconstructive Surgery: A 1-Year Study with Quantitative Magnetic Resonance Imaging. J Rheumatol 2010; 38:118-28. [DOI: 10.3899/jrheum.100642] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective.To investigate over a 1-year period in dogs that underwent extracapsular stabilization surgery (ECS) following anterior cruciate ligament (ACL) transection: whether reconstructive surgery could prevent osteoarthritis (OA) progression and whether treatment with the bisphosphonate tiludronic acid (TA) could improve the chronic evolution of OA structural changes.Methods.ACL transection was performed on dogs on Day 0 and ECS on Day 28. Dogs were randomly divided into 2 groups: 15 received placebo and 16 were treated with TA (2 mg/kg subcutaneous injection) on Days 14, 28, 56, and 84. Magnetic resonance images were acquired on Days −10, 26, 91, 210, and 357, and cartilage volume was quantified. At sacrifice (Day 364), cartilage from femoral condyles and tibial plateaus was macroscopically and histologically evaluated. Expression levels of MMP-1, -3, -13, ADAMTS-4, -5, BMP-2, FGF-2, IGF-1, TGF-ß1, collagen type II, and aggrecan were determined using real-time RT-PCR.Results.The loss of cartilage volume observed after ACL transection stabilized following ECS. Thereafter, a gradual gain occurred, with the cartilage volume loss on the tibial plateaus reduced at Day 91 (p < 0.02) and Day 210 (p < 0.001) in the TA-treated dogs. At sacrifice, TA-treated dogs presented a reduction in the severity of macroscopic (p = 0.03 for plateaus) and histologic (p = 0.07 for plateaus) cartilage lesions, had a better preserved collagen network, and showed decreased MMP-13 (p = 0.04), MMP-1 and MMP-3 levels.Conclusion.Our findings indicate that in dogs with ACL transection, ECS greatly prevents development of cartilage volume loss. Treatment with TA provided an additional benefit of reducing the development of OA lesions.
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Strassle BW, Mark L, Leventhal L, Piesla MJ, Jian Li X, Kennedy JD, Glasson SS, Whiteside GT. Inhibition of osteoclasts prevents cartilage loss and pain in a rat model of degenerative joint disease. Osteoarthritis Cartilage 2010; 18:1319-28. [PMID: 20633675 DOI: 10.1016/j.joca.2010.06.007] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 06/22/2010] [Accepted: 06/28/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the relationship between efficacy of a bisphosphonate, pain and extent of joint damage in the monosodium iodoacetate (MIA) model of painful degenerative joint disease. METHODS Zoledronate treatment was initiated prior to and at various times following model induction, including late time points representing advanced disease. Radiographic and histological structural parameters were correlated with pain as measured by weight bearing. RESULTS Intraarticular (IA) MIA resulted in a progressive loss of bone mineral density (BMD) and chondrocytes, thinning of cartilage, loss of proteoglycan, resorption of calcified cartilage and subchondral bone, as well as pain. This was completely prevented by pre-emptive chronic zoledronate treatment with joint sections being histologically indistinguishable from saline-injected controls. When initiation of treatment was delayed efficacy was reduced. In animals with advanced joint degeneration, treatment partially restored BMD and had a significant, but limited, effect on pain. We confirmed these radiographic and behavioral findings in the medial meniscal tear model. To understand the mechanism-of-action of zoledronate we investigated an early time point 4 days post-model induction when chondrocytes were histologically viable, with minor loss of proteoglycan and generalized synovitis. Osteoclast-mediated resorption of the calcified cartilage was observed and was prevented by two doses of zoledronate. CONCLUSION Subchondral bone remodeling plays an important role in nociception and the pathobiology of the MIA model with osteoclasts being implicated in both bone and cartilage resorption. Inhibition of osteoclastic activity when initiated early leads to improved efficacy.
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Affiliation(s)
- B W Strassle
- Neuroscience, Discovery Research, Pfizer Global Research and Development, Princeton, NJ 08543, USA
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Intema F, Hazewinkel HAW, Gouwens D, Bijlsma JWJ, Weinans H, Lafeber FPJG, Mastbergen SC. In early OA, thinning of the subchondral plate is directly related to cartilage damage: results from a canine ACLT-meniscectomy model. Osteoarthritis Cartilage 2010; 18:691-8. [PMID: 20175978 DOI: 10.1016/j.joca.2010.01.004] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 01/16/2010] [Accepted: 01/22/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The pathogenesis of osteoarthritis (OA) includes cartilage degeneration, synovial inflammation, and bone changes. Slowly, the sequence and inter-relationship of these features is becoming clearer. Early models of OA suggest thinning of the subchondral plate in addition to trabecular bone changes. In the present study subchondral bone changes were studied in the canine anterior cruciate ligament transection (ACLT)-meniscectomy model. This model is characterized by intra-joint variability with respect to cartilage damage (predominantly medial) and loading (lateral unloading due to a shifted axis). METHODS In 13 Labrador dogs, OA was induced by transection of the anterior cruciate ligament and removal of the medial meniscus. Twelve weeks later, cartilage integrity was evaluated histologically using the modified Mankin score (0-11), and proteoglycan content was determined by Alcian Blue assay. Bone architecture of the tibia was quantified by micro-CT. RESULTS Cartilage damage was severe in the medial compartment (Mankin score +3.5, glycosaminoglycan (GAG) content -28%) and mild in the lateral compartment (Mankin score +1.6, GAG content -15%). Thinning and porosity of the subchondral plate were only present on the medial side (-21%, +87%, respectively). Interestingly, changes in trabecular bone structure did almost not occur in the medial compartment (volume fraction -7%) but were clear in the lateral compartment (-20%). CONCLUSION Thinning of the subchondral plate is a localized phenomenon related to cartilage degeneration while trabecular bone changes are related to mechanical (un)loading. The different mechanisms responsible for bone changes in OA should be taken in account when designing and interpreting studies interfering with bone turnover in the treatment of OA.
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Affiliation(s)
- F Intema
- Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
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Allen MJ, Leone KA, Lamonte K, Townsend KL, Mann KA. Cemented total knee replacement in 24 dogs: surgical technique, clinical results, and complications. Vet Surg 2009; 38:555-67. [PMID: 19573056 DOI: 10.1111/j.1532-950x.2009.00528.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To characterize the performance of cemented total knee replacement (TKR) in dogs. STUDY DESIGN Preclinical research study. ANIMALS Skeletally mature, male Hounds (25-30 kg; n=24) with no preexisting joint pathology. METHODS Dogs had unilateral cemented TKR and were evaluated at 6, 12, 26, or 52 weeks (6 dogs/time point) by radiography, bone density analysis, visual gait assessment, and direct measurement of thigh circumference and stifle joint range of motion as indicators of functional recovery. At study end, the stability of the cemented tibial component was determined by destructive mechanical testing. RESULTS Joint stability was excellent in 16 dogs (67%) and good in 8 dogs. None of the tibial components had evidence of migration or periprosthetic osteolysis whereas 1 femoral component was loose at 52 weeks. There was an early and significant decrease in tibial bone density, likely because of disuse of the operated limb. Dogs returned to full activity by 12 weeks. The tibial cement-bone interface maintained its strength over 52 weeks. CONCLUSIONS Cement provides stable fixation of the tibial component in canine TKR. CLINICAL RELEVANCE Cemented TKR yields adequate clinical function and stifle joint excursion in the dog. Clinical studies are needed to determine the long-term fate of cemented TKR implants, to assess the influence of implant design on implant fixation and wear, and to obtain objective functional data.
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Affiliation(s)
- Matthew J Allen
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.
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New perspective in osteoarthritis: the OPG and RANKL system as a potential therapeutic target? Keio J Med 2009; 58:29-40. [PMID: 19398882 DOI: 10.2302/kjm.58.29] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bone remodelling is tightly regulated by a molecular triad composed of OPG/RANK/RANKL. The receptor activator of NF-kappaB ligand (RANKL) (localized on osteoblasts) enhances osteoclastogenesis via interaction with its receptor RANK (localized on osteoclasts), whereas osteoprotegerin (OPG) (produced by osteoblasts) inhibits this osteoclastogenesis by binding to RANKL. The equilibrium between OPG and RANKL plays a crucial role in the pathophysiology of bone. Although some studies have shown the efficacy of OPG as a therapeutic agent against bone resorption, its bioavailability and mechanism of action after binding to RANKL have only recently been studied. A mechanistic investigation based on what becomes of OPG after binding to cells expressing membranous RANKL demonstrated an internalization process of OPG through the clathrin pathway prior to proteasomal and/or lysosomal degradation. Interestingly, the OPG internalization process reduced the half-life of RANKL. Recent evidence has shown that subchondral bone alterations in osteoarthritis (OA) are intimately involved in cartilage degradation, and that OPG/RANKL may be implicated. Data show that human OA subchondral bone osteoblasts have abnormal OPG and RANKL levels and consequently an altered OPG and RANKL ratio. Further data also reveal the involvement of some osteotropic factors in these altered levels and that some of these factors generally target RANKL with a differential modulation of the RANKL isoforms. Altogether, data suggest that this system could be targeted as a new strategy for the treatment of OA.
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Bouchgua M, Alexander K, Carmel EN, d'Anjou MA, Beauchamp G, Richard H, Laverty S. Use of routine clinical multimodality imaging in a rabbit model of osteoarthritis--part II: bone mineral density assessment. Osteoarthritis Cartilage 2009; 17:197-204. [PMID: 18757215 DOI: 10.1016/j.joca.2008.06.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 06/25/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess bone mineral density (BMD) at different depths from the articular surface in vivo and temporally in a rabbit model of osteoarthritis (OA) using clinical computed tomography (CT) equipment. METHODS The knee joints of rabbits (N=10 with Anterior cruciate ligament transection (ACLT) and contralateral sham joints, and N=6 unoperated controls) were scanned in a transverse image plane with a single-slice helical CT scanner. BMD was calculated at defined depths from the articular surface to the growth plate in the lateral femoral condyle (LFC), medial femoral condyle (MFC), lateral tibial plateau (LTP) and medial tibial plateau (MTP). Baseline BMD was measured at 2 weeks before surgery, and then repeated at weeks 2, 4 and 8 post-surgery in all 10 operated rabbits, and again at week 12 in five of the operated rabbits and at weeks -2 and 8 in the six control rabbits. RESULTS In the control joints, BMD decreased with increasing distance into the epiphysis and remained stable over time within each depth. A significant reduction in BMD was observed at week 2 post-operatively in three compartments (LFC, MFC and MTP) in the ACLT joints and persisted to week 12. A modest reduction in BMD occurred in the LTP and MTP of the sham joints at week 12 alone. CONCLUSION Clinical CT equipment permitted rapid, repeated, in vivo, non-invasive BMD assessment in a rabbit model of OA. A marked BMD reduction was measured with progression of OA until the end point at 12 weeks.
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Affiliation(s)
- M Bouchgua
- Département de Pathologie, Faculté de Médecine Vétérinaire, Université de Montréal, Québec, Canada
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Bouchgua M, Alexander K, d'Anjou MA, Girard CA, Carmel EN, Beauchamp G, Richard H, Laverty S. Use of routine clinical multimodality imaging in a rabbit model of osteoarthritis--part I. Osteoarthritis Cartilage 2009; 17:188-96. [PMID: 18760939 DOI: 10.1016/j.joca.2008.06.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 06/25/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate in vivo the evolution of osteoarthritis (OA) lesions temporally in a rabbit model of OA with clinically available imaging modalities: computed radiography (CR), helical single-slice computed tomography (CT), and 1.5 tesla (T) magnetic resonance imaging (MRI). METHODS Imaging was performed on knees of anesthetized rabbits [10 anterior cruciate ligament transection (ACLT) and contralateral sham joints and six control rabbits] at baseline and at intervals up to 12 weeks post-surgery. Osteophytosis, subchondral bone sclerosis, bone marrow lesions (BMLs), femoropatellar effusion and articular cartilage were assessed. RESULTS CT had the highest sensitivity (90%) and specificity (91%) to detect osteophytes. A significant increase in total joint osteophyte score occurred at all time-points post-operatively in the ACLT group alone. BMLs were identified and occurred most commonly in the lateral femoral condyle of the ACLT joints and were not identified in the tibia. A significant increase in joint effusion was present in the ACLT joints until 8 weeks after surgery. Bone sclerosis or cartilage defects were not reliably assessed with the selected imaging modalities. CONCLUSION Combined, clinically available CT and 1.5 T MRI allowed the assessment of most of the characteristic lesions of OA and at early time-points in the development of the disease. However, the selected 1.5 T MRI sequences and acquisition times did not permit the detection of cartilage lesions in this rabbit OA model.
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Affiliation(s)
- M Bouchgua
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Québec, Canada
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Lucas P, Fan T, Garrett L, Griffon D, Wypij J. A Comparison of Five Different Bone Resorption Markers in Osteosarcoma-Bearing Dogs, Normal Dogs, and Dogs with Orthopedic Diseases. J Vet Intern Med 2008; 22:1008-13. [DOI: 10.1111/j.1939-1676.2008.0134.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Martín-Jiménez T, De Lorimier LP, Fan TM, Freise KJ. Pharmacokinetics and pharmacodynamics of a single dose of zoledronate in healthy dogs. J Vet Pharmacol Ther 2007; 30:492-5. [PMID: 17803746 DOI: 10.1111/j.1365-2885.2007.00883.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- T Martín-Jiménez
- College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA.
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Budsberg SC, Bergh MS, Reynolds LR, Streppa HK. Evaluation of Pentosan Polysulfate Sodium in the Postoperative Recovery from Cranial Cruciate Injury in Dogs: A Randomized, Placebo-Controlled Clinical Trial. Vet Surg 2007; 36:234-44. [PMID: 17461948 DOI: 10.1111/j.1532-950x.2007.00256.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the efficacy of pentosan polysulfate (PPS) for improving the recovery period and mitigate the progression of osteoarthritis (OA) of the canine stifle after extracapsular stabilization of cranial cruciate ligament (CCL) injuries. STUDY DESIGN Randomized, blinded, placebo-controlled clinical trial. ANIMALS Dogs (n=40) with unilateral CCL instability. METHODS Each dog had an extracapsular stabilization of the stifle with or without partial meniscectomy. Dogs were divided into 4 groups based on preoperative radiographic assessment and whether a partial meniscectomy was performed. Dogs were randomly assigned to either (3 mg/kg) PPS or placebo treatment in each group, and then injected subcutaneously weekly for 4 weeks. Lameness, radiographic changes, biological marker concentration in blood and urine, and ground reaction forces (GRFs) were collected preoperatively, and at 6, 12, 24, and 48 weeks. Data were analyzed within and between groups using repeated measures ANOVA; P<.05 was considered significant. RESULTS No adverse reactions to PPS were reported. Thirty-nine dogs completed a minimum of 24-weeks follow-up and 33 dogs completed 48 weeks. All dogs clinically improved after surgery without differences in lameness score, vertical GRFs, or radiographic progression. Grouped and evaluated only by initial radiographic score, PPS-treated dogs improved significantly faster in braking GRFs than placebo-treated dogs. In dogs with partial meniscectomies, urine deoxypyridinoline, and serum carboxy-propeptide of type II collagen were significantly increased at 6 weeks in placebo-treated dogs compared with PPS-treated dogs. CONCLUSIONS PPS administered after stabilization of the cruciate deficient stifle may prove to be a useful adjunctive treatment option, although further studies are necessary to substantiate this claim.
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Affiliation(s)
- Steven C Budsberg
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, GA 30602, USA.
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