Hemodynamics and metabolism in arthrosis. Studies in the rabbit knee

Maintaining hypoxia environment of subchondral bone alleviates osteoarthritis progression

Abnormal subchondral bone remodeling featured by overactivated osteoclastogenesis leads to articular cartilage degeneration and osteoarthritis (OA) progression, but the mechanism is unclear. We used lymphocyte cytosolic protein 1 (Lcp1) knockout mice to suppress subchondral osteoclasts in a mice OA model with anterior cruciate ligament transection (ACLT), and Lcp1^-/- mice showed decreased bone remodeling in subchondral bone and retarded cartilage degeneration. For mechanisms, the activated osteoclasts in subchondral bone induced type-H vessels and elevated oxygen concentration, which ubiquitylated hypoxia-inducible factor 1 alpha subunit (HIF-1α) in chondrocytes and led to cartilage degeneration. Lcp1 knockout impeded angiogenesis, which maintained hypoxia environment in joints and delayed the OA progression. Stabilization of HIF-1α delayed cartilage degeneration, and knockdown of Hif1a abolished the protective effects of Lcp1 knockout. Last, we showed that Oroxylin A, an Lcp1-encoded protein l-plastin (LPL) inhibitor, could alleviate OA progression. In conclusion, maintaining hypoxic environment is an attractive strategy for OA treatment.

Novel hyaluronic acid-methotrexate conjugate suppresses joint inflammation in the rat knee: efficacy and safety evaluation in two rat arthritis models

Background

Methotrexate (MTX) is one of the most widely used medications to treat rheumatoid arthritis (RA), and recent studies have also suggested the potential benefit of the drug for the treatment of osteoarthritis (OA) of the knee. MTX is commonly administered in oral formulations, but is often associated with systemic adverse reactions. In an attempt to address this issue, we have shown previously that a conjugate of hyaluronic acid (HA) and MTX exhibits potential as a drug candidate for intra-articular treatment of inflammatory arthritis. In this study, we compare the efficacy and safety of an optimized HA-MTX conjugate, DK226, with that of MTX in inflammatory arthritis rat models.

Methods

In vitro activity of DK226 was assessed in human fibroblast-like synoviocytes (HFLS) and a synovial sarcoma cell line, SW982. Release of MTX from DK226 was investigated after incubation with rabbit synovial tissue homogenate or synovial fluid. In vivo efficacy of DK226 was evaluated in antigen-induced arthritis (AIA) and collagen-induced arthritis (CIA) in the rat knee. Pharmacokinetics and hematological toxicity after treatment with oral MTX or an intra-articular injection of DK226 were compared in AIA.

Results

Proliferation of HFLS and SW982 cells was inhibited by DK226, and the inhibitory activity was reversed by cotreatment with excess HA or anti-CD44 antibody. MTX was released from DK226 by incubation with rabbit synovial tissue homogenate or synovial fluid at pH 4.0, but not at pH 7.4. AIA was ameliorated by intra-articular DK226, but not by HA, as potently as oral MTX. Hematological toxicity was induced by oral MTX, but not by DK226. The maximum plasma concentration of MTX after oral MTX was 40 times higher than the concentration of MTX after an intra-articular injection of DK226. Knee swelling in AIA was inhibited by intra-articular injections of DK226, but not by free MTX or a mixture of HA and MTX. In CIA, an injection of DK226 into the right knee joint significantly reduced swelling and synovial inflammation of the treated knee joint, but had no effect on the untreated contralateral knee joint.

Conclusions

DK226 exerted anti-arthritic effects in two different models of arthritis. The conjugate had a wider therapeutic window than oral MTX, and could be a future drug for treatment of arthritic disorders, including inflammatory OA.

Characterization of cutaneous primary afferent fibers excited by acetic acid in a model of nociception in frogs

Acetic acid applied to the hind limb of a frog evokes nocifensive behaviors, including a vigorous wiping of the exposed skin, referred to as the wiping response. The aim of this study was to examine the responses of cutaneous primary afferent fibers in frogs to acetic acid (pH 2.84-1.42) applied topically to the skin. Conventional electrophysiological methods were used to record neuronal activity from single identified primary afferent fibers with cutaneous receptive fields on the hind limb. Fibers were classified according to their conduction velocities and responses evoked by mechanical and thermal (heat and cold) stimuli. One hundred and twenty-two mechanosensitive afferent fibers were studied (44 Abeta, 60 Adelta, and 18 C fibers). Thirty-nine percent of all fibers were excited by acetic acid, but a greater percentage of Adelta (52%) and C fibers (44%) were excited than Abeta fibers (20%). Evoked responses of fibers increased with increasingly more acidic pH until the greatest responses were evoked by acetic acid at pH 2.59-2.41. Application of acetic acid at pHs <2.41 evoked less excitation, suggesting that fibers became desensitized. Similar percentages of nociceptors and low-threshold mechanoreceptors were excited by acetic acid. Thus primary afferent fibers were excited by acetic acid at pHs that have been shown to evoke the wiping response in our previous study. The results of the present study suggest that the model of acetic acid-induced nociception in frogs may be useful for studying the mechanisms by which tissue acidosis produces pain.

Animal models for osteoarthritis: processes, problems and prospects

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Intraosseous infusion using the osteoport implant in the caprine tibia

We evaluated the in vivo animal tolerance to intraosseous infusion via the Osteoport pediatric implant (model 2005PSO, Lifequest Medical, San Antonio, TX, U.S.A.) into the proximal tibia of immature goats and investigated the osseous effects of intermittent and sustained increases in intraosseous pressure (IOP). In group 1 (n = 3) autogenous whole blood was continuously infused (CI) for 5 days at flow rates producing an IOP of 30-45 mm Hg. Group 2 animals (n = 3) underwent a 5-s high-pressure infusion (HPI) of lactated Ringer solution (LRS) producing an IOP of 90-125 mm Hg twice daily for 10 days. In group 3, the Osteoports were left in place 5 (n = 2) or 10 days (n = 2) and evaluated for patency at 72-h intervals. An IOP > 35 mm Hg produced clinical evidence of bone pain. Bone mineral density was significantly increased (p < 0.05) in all implanted tibias (mean 1.04 g/cm2; range 0.87-1.21 g/cm2) compared with controls (mean 0.67 g/cm2; range 0.65-0.71 g/cm2). A nonsignificant increase (+9% to +31%) in periosteal new bone formation occurred in all implanted tibias. In the continuously infused group, there was a significant increase (p < 0.05) in cancellous new bone formation (+483%), percentage eroded bone surface (+143%), and osteoclast covered bone surface (+255%) compared with controls. HPI of LRS did not produce significant bone changes. Seemingly, the Osteoport provided a ready means of intraosseous infusion and may be associated with less complications than current methods of continual vascular access. Bone changes correlated more with the duration than the magnitude of increased intraosseous pressures.

Metabolic and haemodynamic changes in the pathologic hypermobile spine

The purpose of the study was to evaluate whether pathologic hypermobility of the lumbar spine could produce haemodynamic, metabolic, and histologic changes similar to those found in osteoarthritis. Five adult goats were surgically made hypermobile in the lumbar spine by an extensive laminectomy involving exarticulation of the facet joints of the L4 and L5 levels. Seven months following the operation oxygen partial pressure (pO2), was measured in situ in the nucleus pulposus and in the adjacent lumbar body of the hypermobile segment. A segment three levels more cranially served for control. Mass spectrometry was used for continuous registration of pO2. Intraosseous pressure (IOP) was measured in the lumbar bodies of the same levels. Hypermobility averaged a 60 per cent increase at the operated segment as measured on flexion-extension radiograms preoperatively and 7 months postoperatively. The hypermobile discs had decreased in height as measured by CT scanning and this was confirmed by histologic sections. Significant hypoxia was found in the nucleus pulposus of the hypermobile segment, while increased pO2 and IOP existed in the adjacent lumbar body.