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Wu J, Wu J, Liu Z, Gong Y, Feng D, Xiang W, Fang S, Chen R, Wu Y, Huang S, Zhou Y, Liu N, Xu H, Zhou S, Liu B, Ni Z. Mesenchymal stem cell-derived extracellular vesicles in joint diseases: Therapeutic effects and underlying mechanisms. J Orthop Translat 2024; 48:53-69. [PMID: 39170747 PMCID: PMC11338158 DOI: 10.1016/j.jot.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/09/2024] [Accepted: 07/08/2024] [Indexed: 08/23/2024] Open
Abstract
Joint diseases greatly impact the daily lives and occupational functioning of patients globally. However, conventional treatments for joint diseases have several limitations, such as unsatisfatory efficacy and side effects, necessitating the exploration of more efficacious therapeutic strategies. Mesenchymal stem cell (MSC)-derived EVs (MSC-EVs) have demonstrated high therapeutic efficacyin tissue repair and regeneration, with low immunogenicity and tumorigenicity. Recent studies have reported that EVs-based therapy has considerable therapeutic effects against joint diseases, including osteoarthritis, tendon and ligament injuries, femoral head osteonecrosis, and rheumatoid arthritis. Herein, we review the therapeutic potential of various types of MSC-EVs in the aforementioned joint diseases, summarise the mechanisms underlying specific biological effects of MSC-EVs, and discuss future prospects for basic research on MSC-EV-based therapeutic modalities and their clinical translation. In general, this review provides an in-depth understanding of the therapeutic effects of MSC-EVs in joint diseases, as well as the underlying mechanisms, which may be beneficial to the clinical translation of MSC-EV-based treatment. The translational potential of this article: MSC-EV-based cell-free therapy can effectively promote regeneration and tissue repair. When used to treat joint diseases, MSC-EVs have demonstrated desirable therapeutic effects in preclinical research. This review may supplement further research on MSC-EV-based treatment of joint diseases and its clinical translation.
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Affiliation(s)
- Jinhui Wu
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Jiangyi Wu
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Zheng Liu
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Yunquan Gong
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
| | - Daibo Feng
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
| | - Wei Xiang
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
| | - Shunzheng Fang
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
| | - Ran Chen
- War Trauma Medical Center, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical Center, Daping Hospital, Army Medical University, Chongqing, 40038, China
| | - Yaran Wu
- Department of Clinical Biochemistry, Faculty of Pharmacy and Laboratory Medicine, Army Medical University, Gantaoyan Street, Shapinba District, Chongqing, 400038, China
| | - Shu Huang
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Yizhao Zhou
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Ningning Liu
- Department of Laboratory Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, 450003, China
| | - Hao Xu
- Department of Laboratory Medicine, the Third Affiliated Hospital of Zhengzhou University Zhengzhou, 450003, China
| | - Siru Zhou
- War Trauma Medical Center, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical Center, Daping Hospital, Army Medical University, Chongqing, 40038, China
| | - Baorong Liu
- Department of Joint Surgery and Sport Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410000, China
| | - Zhenhong Ni
- Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing, 400022, China
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Chen W, Zhou Q. Opposite Effect of Cyclic Loading on the Material Properties of Medial Collateral Ligament at Different Temperatures: An Animal Study. Front Bioeng Biotechnol 2022; 10:925033. [PMID: 35774057 PMCID: PMC9237215 DOI: 10.3389/fbioe.2022.925033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
In traffic accidents, the medial collateral ligament (MCL) injury of the knee joint of pedestrians is common. Biofidelic material is important to realize MCL’s native biomechanics in simulations to clarify the injury mechanisms of pedestrians. Pedestrians’ MCLs usually experience cyclic loading at the intra-articular temperature of the knee joint before accidents. Temperature influences the material behaviors of ligaments. However, the mechanical properties of ligaments under cyclic loading have been widely evaluated only at room temperature rather than physiological temperature. Therefore, this study aimed to determine whether the difference between room and intra-articular temperatures influences the effect of cyclic loading on the mechanical properties of MCL. We measured the tensile properties of 34 porcine MCLs at room temperature (21–23°C) and intra-articular temperature (35–37°C), with either 10 cycles or 240 cycles of cyclic loading, a total of four different conditions. The structural responses and geometric data were recorded. After 240 cycles of cyclic loading, stiffness increased by 29.0% (p < 0.01) at room temperature and decreased by 11.5% (p = 0.106) at intra-articular temperature. Material properties were further compared because the geometric differences between samples were inevitable. At room temperature, after 240 cycles of cyclic loading, elastic modulus increased by 29.6% (p < 0.001), and failure strain decreased by 20.4% (p < 0.05). By contrast, at intra-articular temperature, after 240 cycles of cyclic loading, modulus decreased by 27.4% (p < 0.001), and failure strain increased by 17.5% (p = 0.193), insignificant though. In addition, there were no significant differences between the four groups in other structural or material properties. The results showed that temperature reversed the effect of cyclic loading on the mechanical properties of MCL, which may be caused by the high strength and thermally stable crosslinks of MCL. Therefore, for improving the fidelity of knee joint simulations and elucidating the injury mechanism of pedestrians, it is better to measure the mechanical properties of MCL at intra-articular temperature rather than room temperature.
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Ristaniemi A, Torniainen J, Stenroth L, Finnilä M, Paakkonen T, Töyräs J, Korhonen R. Comparison of water, hydroxyproline, uronic acid and elastin contents of bovine knee ligaments and patellar tendon and their relationships with biomechanical properties. J Mech Behav Biomed Mater 2020; 104:103639. [DOI: 10.1016/j.jmbbm.2020.103639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 12/13/2022]
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Ristaniemi A, Stenroth L, Mikkonen S, Korhonen R. Comparison of elastic, viscoelastic and failure tensile material properties of knee ligaments and patellar tendon. J Biomech 2018; 79:31-38. [DOI: 10.1016/j.jbiomech.2018.07.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/07/2018] [Accepted: 07/21/2018] [Indexed: 01/04/2023]
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Abstract
The hierarchical structure of tendon allows for attenuation of mechanical strain down decreasing length scales. While reorganization of collagen fibers accounts for microscale strain attenuation, cross-linking between collagen molecules contributes to deformation mechanisms at the fibrillar and molecular scales. Divalent and trivalent enzymatic cross-links form during the development of collagen fibrils through the enzymatic activity of lysyl oxidase (LOX). By establishing connections between telopeptidyl and triple-helical domains of adjacent molecules within collagen fibrils, these cross-links stiffen the fibrils by resisting intermolecular sliding. Ultimately, greater enzymatic cross-linking leads to less compliant and stronger tendon as a result of stiffer fibrils. In contrast, nonenzymatic cross-links such as glucosepane and pentosidine are not produced during development but slowly accumulate through glycation of collagen. Therefore, these cross-links are only expected to be present in significant quantities in advanced age, where there has been sufficient time for glycation to occur, and in diabetes, where the presence of more free sugar in the extracellular matrix increases the rate of glycation. Unlike enzymatic cross-links, current evidence suggests that nonenzymatic cross-links are at least partially isolated to the surface of collagen fibers. As a result, glycation has been proposed to primarily impact tendon mechanics by altering molecular interactions at the fiber interface, thereby diminishing sliding between fibers. Thus, increased nonenzymatic cross-linking decreases microscale strain attenuation and the viscous response of tendon. In conclusion, enzymatic and nonenzymatic collagen cross-links have demonstrable and distinct effects on the mechanical properties of tendon across different length scales.
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Affiliation(s)
- Jeremy D Eekhoff
- a Department of Biomedical Engineering , Washington University in St. Louis , St. Louis , USA
| | - Fei Fang
- b Department of Orthopedic Surgery , Columbia University , New York , USA
| | - Spencer P Lake
- a Department of Biomedical Engineering , Washington University in St. Louis , St. Louis , USA.,c Department of Mechanical Engineering and Materials Science , Washington University in St. Louis , St. Louis , USA.,d Department of Orthopaedic Surgery , Washington University in St. Louis , St. Louis , USA
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Bechshøft CL, Schjerling P, Bornø A, Holm L. Existence of life-time stable proteins in mature rats-Dating of proteins' age by repeated short-term exposure to labeled amino acids throughout age. PLoS One 2017; 12:e0185605. [PMID: 28957442 PMCID: PMC5619800 DOI: 10.1371/journal.pone.0185605] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 09/15/2017] [Indexed: 01/08/2023] Open
Abstract
In vivo turnover rates of proteins covering the processes of protein synthesis and breakdown rates have been measured in many tissues and protein pools using various techniques. Connective tissue and collagen protein turnover is of specific interest since existing results are rather diverging. The aim of this study is to investigate whether we can verify the presence of protein pools within the same tissue with very distinct turnover rates over the life-span of rats with special focus on connective tissue. Male and female Lewis rats (n = 35) were injected with five different isotopically labeled amino acids tracers. The tracers were injected during fetal development (Day -10 to -2), after birth (Day 5-9), at weaning (Day 25-32) at puberty (Day 54-58) and at adulthood (Day 447-445). Subgroups of rats were euthanized three days after every injection period, at different time point between injection periods and lastly at day 472. Tissue (liver, muscle, eye lens and patellar tendon) and blood samples were collected after euthanization. The enrichment of the labeled amino acids in the tissue or blood samples was measured using GC-MS-MS. In muscle and liver we demonstrated a rapid decrease of tracer enrichments throughout the rat's life, indicating that myofibrillar and cytoskeleton proteins have a high turnover. In contrast, the connective tissue protein in the eye lens and patellar tendon of the mature rat showed detainment of tracer enrichment injected during fetal development and first living days, indicating very slow turnover. The data support the hypothesis that some proteins synthesized during the early development and growth still exist much later in life of animals and hence has a very slow turnover rate.
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Affiliation(s)
- Cecilie Leidesdorff Bechshøft
- Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center of Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Peter Schjerling
- Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center of Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Bornø
- Clinical Metabolomics Core Facility, Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Lars Holm
- Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center of Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Clinical Metabolomics Core Facility, Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- Institute of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Connizzo BK, Adams SM, Adams TH, Jawad AF, Birk DE, Soslowsky LJ. Multiscale regression modeling in mouse supraspinatus tendons reveals that dynamic processes act as mediators in structure-function relationships. J Biomech 2016; 49:1649-1657. [PMID: 27067362 DOI: 10.1016/j.jbiomech.2016.03.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/11/2016] [Accepted: 03/28/2016] [Indexed: 12/26/2022]
Abstract
Recent advances in technology have allowed for the measurement of dynamic processes (re-alignment, crimp, deformation, sliding), but only a limited number of studies have investigated their relationship with mechanical properties. The overall objective of this study was to investigate the role of composition, structure, and the dynamic response to load in predicting tendon mechanical properties in a multi-level fashion mimicking native hierarchical collagen structure. Multiple linear regression models were investigated to determine the relationships between composition/structure, dynamic processes, and mechanical properties. Mediation was then used to determine if dynamic processes mediated structure-function relationships. Dynamic processes were strong predictors of mechanical properties. These predictions were location-dependent, with the insertion site utilizing all four dynamic responses and the midsubstance responding primarily with fibril deformation and sliding. In addition, dynamic processes were moderately predicted by composition and structure in a regionally-dependent manner. Finally, dynamic processes were partial mediators of the relationship between composition/structure and mechanical function, and results suggested that mediation is likely shared between multiple dynamic processes. In conclusion, the mechanical properties at the midsubstance of the tendon are controlled primarily by fibril structure and this region responds to load via fibril deformation and sliding. Conversely, the mechanical function at the insertion site is controlled by many other important parameters and the region responds to load via all four dynamic mechanisms. Overall, this study presents a strong foundation on which to design future experimental and modeling efforts in order to fully understand the complex structure-function relationships present in tendon.
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Affiliation(s)
- Brianne K Connizzo
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, 424 Stemmler Hall, 36th and Hamilton Walk, Philadelphia, PA 19104-6081, United States
| | - Sheila M Adams
- Department of Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, United States
| | - Thomas H Adams
- Department of Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, United States
| | - Abbas F Jawad
- Division of Biostatistics, Department of Pediatrics, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - David E Birk
- Department of Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, United States
| | - Louis J Soslowsky
- McKay Orthopaedic Research Laboratory, University of Pennsylvania, 424 Stemmler Hall, 36th and Hamilton Walk, Philadelphia, PA 19104-6081, United States.
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Slane LC, Thelen DG. Achilles tendon displacement patterns during passive stretch and eccentric loading are altered in middle-aged adults. Med Eng Phys 2015; 37:712-6. [PMID: 25962378 DOI: 10.1016/j.medengphy.2015.04.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 02/14/2015] [Accepted: 04/16/2015] [Indexed: 01/09/2023]
Abstract
The purpose of this study was to investigate middle-age effects on Achilles displacement patterns under passive stretch and eccentric loading. Healthy young (24.1 ± 1.4 years, n = 9) and middle-aged (49.0 ± 3.1 years, n = 9) adults were positioned prone and the ankle was cyclically dorsiflexed (0.5 Hz, 25° range) during passive stretch and active lengthening. Achilles displacements were tracked in cine ultrasound using 2D speckle tracking. Displacements were found to be non-uniform, with mid and deep portions of the tendon displacing more than superficial portions. However, the degree of non-uniformity was significantly reduced in middle-aged adults, suggesting a potential age-related reduction in inter-fascicle sliding or a shift in loading sharing between plantarflexors. Eccentric loading reduced displacement magnitudes, likely reflecting distal tendon stretch induced via active muscle contractions. Changes in tendon displacement with active loading were greater in middle-aged adults, which could reflect greater tendon compliance. The observed age-related changes in Achilles tendon behavior may have implications for both plantarflexor performance and injury risk.
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Affiliation(s)
- Laura Chernak Slane
- Department of Biomedical Engineering, 1550 Engineering Drive, Madison, WI 53706, United States.
| | - Darryl G Thelen
- Department of Biomedical Engineering, 1550 Engineering Drive, Madison, WI 53706, United States; Department of Mechanical Engineering, 1513 University Ave, Madison, WI 53706, United States; Department of Orthopedics and Rehabilitation, 1300 University Ave, Madison, WI 53706, United States.
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