1
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Lu KH, Lu PWA, Lin CW, Lu EWH, Yang SF. Different molecular weights of hyaluronan research in knee osteoarthritis: A state-of-the-art review. Matrix Biol 2023; 117:46-71. [PMID: 36849081 DOI: 10.1016/j.matbio.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/08/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
Osteoarthritis (OA), the most common form of arthritis, is characterized by progressive cartilage destruction, concomitant adaptive osteogenesis, and loss of joint function. The progression of OA with aging is associated with a decrease in native hyaluronan (HA, hyaluronate or hyaluronic acid) with a high molecular weight (HMW) in synovial fluid and a subsequent increase in lower MW HA and fragments. As HMW HA possesses numerous biochemical and biological properties, we review new molecular insights into the potential of HA to modify OA processes. Different MWs in the formulation of products appear to have varying effects on knee OA (KOA) pain relief, improved function, and postponing surgery. In addition to the safety profile, more evidence indicates that intraarticular (IA) HA administration may be an effective option to treat KOA, with a particular emphasis on the use of HA with fewer injections of higher MW, including potential applications of HA of very HMW. We also analyzed published systemic reviews and meta-analyses of IA HA in treating KOA in order to discuss their conclusions and consensus statements. According to its MW, HA may offer a simple way to refine therapeutic information in selective KOA.
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Affiliation(s)
- Ko-Hsiu Lu
- Department of Orthopedics, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | | | - Chiao-Wen Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Eric Wun-Hao Lu
- Department of Mechanical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
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2
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Pellicore MJ, Gangi LR, Murphy LA, Lee AJ, Jacobsen T, Kenawy HM, Shah RP, Chahine NO, Ateshian GA, Hung CT. Toward defining the role of the synovium in mitigating normal articular cartilage wear and tear. J Biomech 2023; 148:111472. [PMID: 36753853 PMCID: PMC10295808 DOI: 10.1016/j.jbiomech.2023.111472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023]
Abstract
Cartilage repair has been studied extensively in the context of injury and disease, but the joint's management of regular sub-injurious damage to cartilage, or 'wear and tear,' which occurs due to normal activity, is poorly understood. We hypothesize that this cartilage maintenance is mediated in part by cells derived from the synovium that migrate to the worn articular surface. Here, we demonstrate in vitro that the early steps required for such a process can occur. First, we show that under physiologic mechanical loads, chondrocyte death occurs in the cartilage superficial zone along with changes to the cartilage surface topography. Second, we show that synoviocytes are released from the synovial lining under physiologic loads and attach to worn cartilage. Third, we show that synoviocytes parachuted onto a simulated or native cartilage surface will modify their behavior. Specifically, we show that synoviocyte interactions with chondrocytes lead to changes in synoviocyte mechanosensitivity, and we demonstrate that cartilage-attached synoviocytes can express COL2A1, a hallmark of the chondrogenic phenotype. Our findings suggest that synoviocyte-mediated repair of cartilage 'wear and tear' as a component of joint homeostasis is feasible and is deserving of future study.
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Affiliation(s)
- Matthew J Pellicore
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Lianna R Gangi
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Lance A Murphy
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Andy J Lee
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Timothy Jacobsen
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Hagar M Kenawy
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Roshan P Shah
- Department of Orthopedic Surgery, Columbia University, New York, NY, USA
| | - Nadeen O Chahine
- Department of Biomedical Engineering, Columbia University, New York, NY, USA; Department of Orthopedic Surgery, Columbia University, New York, NY, USA
| | - Gerard A Ateshian
- Department of Orthopedic Surgery, Columbia University, New York, NY, USA; Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - Clark T Hung
- Department of Biomedical Engineering, Columbia University, New York, NY, USA; Department of Orthopedic Surgery, Columbia University, New York, NY, USA.
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3
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Wu YZ, Huang HT, Ho CJ, Shih CL, Chen CH, Cheng TL, Wang YC, Lin SY. Molecular Weight of Hyaluronic Acid Has Major Influence on Its Efficacy and Safety for Viscosupplementation in Hip Osteoarthritis: A Systematic Review and Meta-Analysis. Cartilage 2021; 13:169S-184S. [PMID: 34109828 PMCID: PMC8808882 DOI: 10.1177/19476035211021903] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This study aimed to compare the efficacy and safety of intra-articular hyaluronic acid (HA) injection with different molecular weights (MWs) for treating hip osteoarthritis (OA). METHODS A systematic literature search for relevant studies was conducted in 3 electronic databases, including PubMed, BMJ Journals, and Cochrane Library, from inception to April 2020. Extracted outcomes included visual analogue scale (VAS) (1, 3, and 6 months), Lequesne index (3 and 6 months), and adverse effects. HAs were classified into low-molecular-weight (LMW), moderate-molecular-weight (MMW), high-molecular-weight (HMW), and ultra-high-molecular-weight (UHMW) groups. Meta-analysis was performed using Review Manager 5.3. RESULTS A total of 15 studies with 614 patients were included. Our meta-analysis showed that the HMW HA group had the best improvement in VAS and Lequesne index compared with other HA groups for all the follow-up visits. Moreover, the HMW group demonstrated significantly better improvement than the other groups in VAS at 6-month follow-up and in Lequesne index at 3- and 6-month follow-ups. Analysis for adverse effects revealed low rates of systemic adverse effects (≤0.6%) in all groups and similar rate of local adverse effects (around 10%) among the groups except for UHMW HA group (37.5%). CONCLUSION Among different MWs of HA for treating hip OA, HMW HA injection demonstrated the best efficacy for up to 6 months after treatment without increased risk of adverse effects. Further studies with more comprehensive data and a higher level of evidence are required to prove our results.
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Affiliation(s)
- Yen-Zung Wu
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Hsuan-Ti Huang
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung
| | - Cheng-Jung Ho
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung,Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung
| | - Chia-Lung Shih
- Clinical Medicine Research Center,
Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City
| | - Chung-Hwan Chen
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung,Institute of Medical Science and
Technology, National Sun Yat-Sen University, Kaohsiung
| | - Tsung-Lin Cheng
- Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Department of Physiology, College of
Medicine, Kaohsiung Medical University, Kaohsiung
| | - Ying-Chun Wang
- Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Department of Orthopedics, Kaohsiung
Municipal Ta-Tung Hospital, Kaohsiung
| | - Sung-Yen Lin
- Department of Orthopedics, Kaohsiung
Medical University Hospital, Kaohsiung Medical University, Kaohsiung,Departments of Orthopedics, School of
Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung,Orthopaedic Research Center, Kaohsiung
Medical University, Kaohsiung,Regeneration Medicine and Cell Therapy
Research Center, Kaohsiung Medical University, Kaohsiung,Sung-Yen Lin, Department of Orthopedics,
Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100,
Tzyou 1st Road, Sanmin District, Kaohsiung City, Kaohsiung, 80756.
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4
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Synthesis of a Lubricant to Mimic the Biorheological Behavior of Osteoarthritic and Revision Synovial Fluid. LUBRICANTS 2021. [DOI: 10.3390/lubricants9090087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The rheological properties of synovial fluid (SF) are essential for the friction behavior and wear performance of total joint replacements. Standardized in vitro wear tests for endoprosthesis recommend diluted calf serum, which exhibits substantial different rheological properties compared to SF. Therefore, the in vitro test conditions do not mimic the in vivo conditions. SF samples from osteoarthritis knee patients and patients undergoing knee endoprosthesis revision surgery were compared biochemically and rheologically. The flow properties of SF samples were compared to synthetic fluid constituents, such as bovine serum albumin (BSA) and hyaluronic acid (HA). Interestingly, HA was identified as a significant contributor to shear-thinning. Using the acquired data and mathematical modelling, the flow behavior of human SF was modelled reliably by an adapted adjustment of biorelevant fluid components. Friction tests in a hard/soft bearing (ceramic/UHMWPE) demonstrated that, in contrast to serum, the synthetic model fluids generate a more realistic friction condition. The developed model for an SF mimicking lubricant is recommended for in vitro wear tests of endoprostheses. Furthermore, the results highlight that simulator tests should be performed with a modified lubricant considering an addition of HA for clinically relevant lubrication conditions.
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5
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Estell EG, Murphy LA, Gangi LR, Shah RP, Ateshian GA, Hung CT. Attachment of cartilage wear particles to the synovium negatively impacts friction properties. J Biomech 2021; 127:110668. [PMID: 34399243 DOI: 10.1016/j.jbiomech.2021.110668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/25/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022]
Abstract
Cartilage wear particles are released into the synovial fluid by mechanical and chemical degradation of the articular surfaces during osteoarthritis and attach to the synovial membrane. Accumulation of wear particles could alter key tissue-level mechanical properties of the synovium, hindering its characteristically low-friction interactions with underlying articular surfaces in the synovial joint. The present study employs a custom loading device to further the characterization of native synovium friction properties, while investigating the hypothesis that attachment of cartilage wear particles increases friction coefficient. Juvenile bovine synovium demonstrated characteristically low friction coefficients in sliding contact with glass, in agreement with historical measurements. Friction coefficient increased with higher normal load in saline, while lubrication with native synovial fluid maintained low friction coefficients at higher loads. Cartilage wear particles generated from juvenile bovine cartilage attached directly to synovium explants in static culture, with incorporation onto the tissue denoted by cell migration onto the particle surface. In dilute synovial fluid mimicking the decreased lubricating properties during osteoarthritis, wear particle attachment significantly increased friction coefficient against glass, and native cartilage and synovium. In addition to providing a novel characterization of synovial joint tribology this work highlights a potential mechanism for cartilage wear particles to perpetuate the degradative environment of osteoarthritis by modulating tissue-level properties of the synovium that could impact macroscopic wear as well as mechanical stimuli transmitted to resident cells.
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Affiliation(s)
- Eben G Estell
- Columbia University, Department of Biomedical Engineering, New York, NY, United States
| | - Lance A Murphy
- Columbia University, Department of Biomedical Engineering, New York, NY, United States
| | - Lianna R Gangi
- Columbia University, Department of Biomedical Engineering, New York, NY, United States
| | - Roshan P Shah
- Columbia University, Department of Orthopedic Surgery, New York, NY, United States
| | - Gerard A Ateshian
- Columbia University, Department of Biomedical Engineering, New York, NY, United States; Columbia University, Department of Mechanical Engineering, New York, NY, United States
| | - Clark T Hung
- Columbia University, Department of Biomedical Engineering, New York, NY, United States; Columbia University, Department of Orthopedic Surgery, New York, NY, United States.
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6
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Matheson AR, Sheehy EJ, Jay GD, Scott WM, O'Brien FJ, Schmidt TA. The role of synovial fluid constituents in the lubrication of collagen-glycosaminoglycan scaffolds for cartilage repair. J Mech Behav Biomed Mater 2021; 118:104445. [PMID: 33740688 DOI: 10.1016/j.jmbbm.2021.104445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/15/2021] [Accepted: 03/02/2021] [Indexed: 11/18/2022]
Abstract
Extracellular matrix (ECM)-derived scaffolds have shown promise as tissue-engineered grafts for promoting cartilage repair. However, there has been a lack of focus on fine-tuning the frictional properties of scaffolds for cartilage tissue engineering as well as understanding their interactions with synovial fluid constituents. Proteoglycan-4 (PRG4) and hyaluronan (HA) are macromolecules within synovial fluid that play key roles as boundary mode lubricants during cartilage surface interactions. The overall objective of this study was to characterize the role PRG4 and HA play in the lubricating function of collagen-glycosaminoglycan (GAG) scaffolds for cartilage repair. As a first step towards this goal, we aimed to develop a suitable in vitro friction test to establish the boundary mode lubrication parameters for collagen-GAG scaffolds articulated against glass in a phosphate buffered saline (PBS) bath. Subsequently, we sought to leverage this system to determine the effect of physiological synovial fluid lubricants, PRG4 and HA, on the frictional properties of collagen-GAG scaffolds, with scaffolds hydrated in PBS and bovine synovial fluid (bSF) serving as negative and positive controls, respectively. At all compressive strains examined (ε = 0.1-0.5), fluid depressurization within hydrated collagen-GAG scaffolds was >99% complete at ½ minute. The coefficient of friction was stable at all compressive strains (ranging from a low 0.103 ± 0.010 at ε = 0.3 up to 0.121 ± 0.015 at ε = 0.4) and indicative of boundary-mode conditions. Immunohistochemistry demonstrated that PRG4 from recombinant human (rh) and bovine sources adsorbed to collagen-GAG scaffolds and the coefficient of friction for scaffolds immersed in rhPRG4 (0.067 ± 0.027) and normal bSF (0.056 ± 0.020) solution decreased compared to PBS (0.118 ± 0.21, both p < 0.05, at ε = 0.2). The ability of the adsorbed rhPRG4 to reduce friction on the scaffolds indicates that its incorporation within collagen-GAG biomaterials may enhance their lubricating ability as potential tissue-engineered cartilage replacements. To conclude, this study reports the development of an in vitro friction test capable of characterizing the coefficient of friction of ECM-derived scaffolds tested in a range of synovial fluid lubricants and demonstrates frictional properties as a potential design parameter for implants and materials for soft tissue replacement.
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Affiliation(s)
- Austyn R Matheson
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, AB, Canada
| | - Eamon J Sheehy
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, Ireland
| | - Gregory D Jay
- Department of Emergency Medicine, Warren Alpert Medical School & School of Engineering, Brown University, Providence, RI, USA
| | - W Michael Scott
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, AB, Canada; Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Fergal J O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland; Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, Ireland
| | - Tannin A Schmidt
- Biomedical Engineering Department, University of Connecticut Health Center, Farmington, CT, USA.
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7
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Feeney E, Galesso D, Secchieri C, Oliviero F, Ramonda R, Bonassar LJ. Inflammatory and Noninflammatory Synovial Fluids Exhibit New and Distinct Tribological Endotypes. J Biomech Eng 2020; 142:111001. [PMID: 32577715 DOI: 10.1115/1.4047628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Indexed: 07/25/2024]
Abstract
Inferior synovial lubrication is a hallmark of osteoarthritis (OA), and synovial fluid (SF) lubrication and composition are variable among OA patients. Hyaluronic acid (HA) viscosupplementation is a widely used therapy for improving SF viscoelasticity and lubrication, but it is unclear how the effectiveness of HA viscosupplements varies with arthritic endotype. The objective of this study was to investigate the effects of the HA viscosupplement, Hymovis®, on the lubricating properties of diseased SF from patients with noninflammatory OA and inflammatory arthritis (IA). The composition (cytokine, HA, and lubricin concentrations) of the SF was measured as well as the mechanical properties (rheology, tribology) of the SF alone and in a 1:1 mixture with the HA viscosupplement. Using rotational rheometry, no difference in SF viscosity was detected between disease types, and the addition of HA significantly increased all fluids' viscosities. In noninflammatory OA SF, friction coefficients followed a typical Stribeck pattern, and their magnitude was decreased by the addition of HA. While some of the IA SF also showed typical Stribeck behavior, a subset showed more erratic behavior with highly variable and larger friction coefficients. Interestingly, this aberrant behavior was not eliminated by the addition of HA, and it was associated with low concentrations of lubricin. Aberrant SF exhibited significantly lower effective viscosities compared to noninflammatory OA and IA SF with typical tribological behavior. Collectively, these results suggest that different endotypes of arthritis exist with respect to lubrication, which may impact the effectiveness of HA viscosupplements in reducing friction.
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Affiliation(s)
- Elizabeth Feeney
- Nancy and Peter Meinig School of Biomedical Engineering, Cornell University, Weill Hall 152 526 Campus Road, Ithaca, NY 14853
| | - Devis Galesso
- Fidia Farmaceutici S.p.A, Via Ponte della Fabbrica 3/A, Abano Terme, Padua 35031, Italy
| | - Cynthia Secchieri
- Fidia Farmaceutici S.p.A, Via Ponte della Fabbrica 3/A, Abano Terme, Padua 35031, Italy
| | - Francesca Oliviero
- Rheumatology Unit, Department of Medicine-DIMED, University of Padua, Via Giustiniani, 2, Padua 35128, Italy
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED, University of Padua, Via Giustiniani, 2, Padua 35128, Italy
| | - Lawrence J Bonassar
- Nancy and Peter Meinig School of Biomedical Engineering, Cornell University, Weill Hall 152, 526 Campus Road, Ithaca, NY 14853; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Weill Hall 149, 526 Campus Road, Ithaca, NY 14853
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8
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9
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Hayes AJ, Melrose J. Glycosaminoglycan and Proteoglycan Biotherapeutics in Articular Cartilage Protection and Repair Strategies: Novel Approaches to Visco‐supplementation in Orthobiologics. ADVANCED THERAPEUTICS 2019. [DOI: 10.1002/adtp.201900034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Anthony J. Hayes
- Bioimaging Research HubCardiff School of BiosciencesCardiff University Cardiff CF10 3AX Wales UK
| | - James Melrose
- Graduate School of Biomedical EngineeringUNSW Sydney Sydney NSW 2052 Australia
- Raymond Purves Bone and Joint Research LaboratoriesKolling Institute of Medical ResearchRoyal North Shore Hospital and The Faculty of Medicine and HealthUniversity of Sydney St. Leonards NSW 2065 Australia
- Sydney Medical SchoolNorthernRoyal North Shore HospitalSydney University St. Leonards NSW 2065 Australia
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10
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Cai Z, Zhang H, Wei Y, Wu M, Fu A. Shear-thinning hyaluronan-based fluid hydrogels to modulate viscoelastic properties of osteoarthritis synovial fluids. Biomater Sci 2019; 7:3143-3157. [DOI: 10.1039/c9bm00298g] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Hyaluronan-based injectable fluid hydrogel was prepared and used as an artificial synovial fluid for the treatment of osteoarthritis.
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Affiliation(s)
- Zhixiang Cai
- Advanced Rheology Institute
- Department of Polymer Science and Engineering
- School of Chemistry and Chemical Engineering
- Shanghai Jiao Tong University
- Shanghai 200240
| | - Hongbin Zhang
- Advanced Rheology Institute
- Department of Polymer Science and Engineering
- School of Chemistry and Chemical Engineering
- Shanghai Jiao Tong University
- Shanghai 200240
| | - Yue Wei
- Advanced Rheology Institute
- Department of Polymer Science and Engineering
- School of Chemistry and Chemical Engineering
- Shanghai Jiao Tong University
- Shanghai 200240
| | - Min Wu
- Advanced Rheology Institute
- Department of Polymer Science and Engineering
- School of Chemistry and Chemical Engineering
- Shanghai Jiao Tong University
- Shanghai 200240
| | - Ailing Fu
- Shanghai Jingfeng Pharmaceutical Co. Ltd
- Shanghai 200120
- China
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11
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Kim H, Jeong H, Han S, Beack S, Hwang BW, Shin M, Oh SS, Hahn SK. Hyaluronate and its derivatives for customized biomedical applications. Biomaterials 2017; 123:155-171. [DOI: 10.1016/j.biomaterials.2017.01.029] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/23/2016] [Accepted: 01/27/2017] [Indexed: 01/02/2023]
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12
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Larson KM, Zhang L, Elsaid KA, Schmidt TA, Fleming BC, Badger GJ, Jay GD. Reduction of friction by recombinant human proteoglycan 4 in IL-1α stimulated bovine cartilage explants. J Orthop Res 2017; 35:580-589. [PMID: 27411036 PMCID: PMC5957283 DOI: 10.1002/jor.23367] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 07/02/2016] [Indexed: 02/04/2023]
Abstract
A boundary lubricant attaches and protects sliding bearing surfaces by preventing interlocking asperity-asperity contact. Proteoglycan-4 (PRG4) is a boundary lubricant found in the synovial fluid that provides chondroprotection to articular surfaces. Inflammation of the diarthrodial joint modulates local PRG4 concentration. Thus, we measured the effects of inflammation, with Interleukin-1α (IL-1α) incubation, upon boundary lubrication and PRG4 expression in bovine cartilage explants. We further aimed to determine whether the addition of exogenous human recombinant PRG4 (rhPRG4) could mitigate the effects of inflammation on boundary lubrication and PRG4 expression in vitro. Cartilage explants, following a 7 day incubation with IL-1α, were tested in a disc-on-disc configuration using either rhPRG4 or saline (PBS control) as a lubricant. Following mechanical testing, explants were studied immunohistochemically or underwent RNA extraction for real-time polymerase chain reaction (RT-PCR). We found that static coefficient of friction (COF) significantly decreased to 0.14 ± 0.065 from 0.21 ± 0.059 (p = 0.014) in IL-1α stimulated explants lubricated with rhPRG4, as compared to PBS. PRG4 expression was significantly up regulated from 30.8 ± 19 copies in control explants lubricated with PBS to 3330 ± 1760 copies in control explants lubricated with rhPRG4 (p < 0.001). Explants stimulated with IL-1α displayed no increase in PRG4 expression upon lubrication with rhPRG4, but with PBS as the lubricant, IL-1α stimulation significantly increased PRG4 expression compared to the control condition from 30.8 ± 19 copies to 401 ± 340 copies (p = 0.015). Overall, these data suggest that exogenous rhPRG4 may provide a therapeutic option for reducing friction in transient inflammatory conditions and increasing PRG4 expression. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:580-589, 2017.
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Affiliation(s)
- Katherine M. Larson
- Center for Biomedical Engineering and School of Engineering, Brown University, Providence, RI, USA
| | - Ling Zhang
- Emergency Medicine Research Laboratory, Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA
| | - Khaled A. Elsaid
- Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, CA, USA
| | - Tannin A. Schmidt
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada,Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Braden C. Fleming
- Center for Biomedical Engineering and School of Engineering, Brown University, Providence, RI, USA,Bioengineering Laboratory, Department of Orthopaedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI, USA
| | - Gary J. Badger
- Department of Medical Biostatistics, University of Vermont, Burlington, VT, USA
| | - Gregory D. Jay
- Center for Biomedical Engineering and School of Engineering, Brown University, Providence, RI, USA,Emergency Medicine Research Laboratory, Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA,Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
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13
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Teeple E, Karamchedu NP, Larson KM, Zhang L, Badger GJ, Fleming BC, Jay GD. Arthroscopic irrigation of the bovine stifle joint increases cartilage surface friction and decreases superficial zone lubricin. J Biomech 2016; 49:3106-3110. [PMID: 27511596 PMCID: PMC5056145 DOI: 10.1016/j.jbiomech.2016.07.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 07/21/2016] [Accepted: 07/22/2016] [Indexed: 11/21/2022]
Abstract
The purpose of this study was to determine the effects of arthroscopic irrigation on cartilage superficial zone lubricin and surface friction. Arthroscopic partial meniscectomy is one of the most commonly performed orthopedic surgeries in the United States, but rates of osteoarthritis progression following this procedure are high. The effect of arthroscopic irrigation on articular surface lubrication has not been previously considered as a contributing factor in outcomes after arthroscopy. Fourteen bovine stifle joints were randomized to receive arthroscopic irrigation (n=7) or no treatment (n=7). Full-thickness osteochondral explants from these joints underwent friction testing to measure static and dynamic coefficients of friction. Following mechanical testing, samples were fixed and stained for lubricin. Percent integrated density, a measure of the amount of lubricin in the superficial zone (0-100µm depth), was determined. Static and dynamic coefficients of friction were found to be significantly greater in arthroscopy specimens compared to controls (p=0.02 and p<0.001, respectively). Percent integrated density of lubricin in the superficial zone was significantly lower in arthroscopy specimens compared to controls (p<0.001).
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Affiliation(s)
- Erin Teeple
- Department of Occupational and Environmental Medicine, Harvard School of Public Health, Boston, MA, USA; Department of Orthopedic Surgery, Brigham and Women׳s Hospital, Boston, MA, USA
| | - Naga Padmini Karamchedu
- Bioengineering Laboratory, Department of Orthopaedics, Warren Alpert Medical School, Brown University/Rhode Island Hospital, Providence, RI, USA
| | | | - Ling Zhang
- Department of Emergency Medicine, Brown University/Rhode Island Hospital, Providence, RI, USA
| | - Gary J Badger
- Department of Medical Biostatistics, University of Vermont, Burlington, VT, USA
| | - Braden C Fleming
- School of Engineering, Brown University, Providence, RI, USA; Bioengineering Laboratory, Department of Orthopaedics, Warren Alpert Medical School, Brown University/Rhode Island Hospital, Providence, RI, USA
| | - Gregory D Jay
- School of Engineering, Brown University, Providence, RI, USA; Department of Emergency Medicine, Brown University/Rhode Island Hospital, Providence, RI, USA.
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Migliore A, Bizzi E, De Lucia O, Delle Sedie A, Bentivegna M, Mahmoud A, Foti C. Differences among Branded Hyaluronic Acids in Italy, Part 1: Data from In Vitro and Animal Studies and Instructions for Use. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2016; 9:89-101. [PMID: 27257398 PMCID: PMC4881871 DOI: 10.4137/cmamd.s38857] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/31/2016] [Accepted: 03/31/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND The use of hyaluronic acid (HA) for intra-articular (IA) injection is widespread around the world for patients affected by osteoarthritis. AIM The aim of this study is to identify scientific evidence from in vitro and in vivo studies supporting the use of IA HAs marketed in Italy. We also evaluated the accuracy of indications and contraindications reported in the leaflets of such HAs compared with the available scientific evidence. MATERIALS AND METHODS An extensive literature search was performed to identify all in vitro and in vivo model studies reporting on the effects of various HAs marketed in Italy for IA use. Data reported in the leaflets of different HA-based products for IA use were extracted and analyzed alongside evidence from in vitro and in vivo model studies. RESULTS Nine in vitro studies and 11 studies on animal models were examined. Comparing results with what is reported in the leaflets of HAs marketed in Italy, it was observed that many branded formulations are introduced in the market without any reporting of basic scientific evidence. Only 12.82% and 17.95% of branded products had been shown to be effective with scientific evidence from in vitro and in vivo studies, respectively. The rationale of use of these products is based on their nature, as if a class effect existed such that all HAs would yield similar effects. CONCLUSIONS Data on HAs deriving from in vitro and in vivo studies are scarce and relate to only a small percentage of products marketed in Italy. Many indications and contraindications are arbitrarily reported in Italian HA leaflets without the support of scientific evidence. Larger and brand-specific studies are necessary and should be reported in the leaflets to guide clinicians in making an appropriate choice regarding HA-based IA therapy.
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Affiliation(s)
- A Migliore
- Operative Unit of Rheumatology, S. Pietro Fatebenefratelli Hospital, Rome, Italy
| | - E Bizzi
- Operative Unit of Rheumatology, S. Pietro Fatebenefratelli Hospital, Rome, Italy
| | - O De Lucia
- Division and Chair of Rheumatology, Gaetano Pini Institute, Milan, Italy
| | | | - M Bentivegna
- Rheumatology Provincial Network Coordinator, ASP 7, Scicli Hospital, Ragusa, Italy
| | - Asmaa Mahmoud
- Physical Medicine, Rheumatology and Rehabilitation Department, Ain Shams University, Cairo, Egypt.; Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy
| | - C Foti
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, Rome, Italy
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15
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Karamchedu NP, Tofte JN, Waller KA, Zhang LX, Patel TK, Jay GD. Superficial zone cellularity is deficient in mice lacking lubricin: a stereoscopic analysis. Arthritis Res Ther 2016; 18:64. [PMID: 26975998 PMCID: PMC5477516 DOI: 10.1186/s13075-016-0967-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 03/04/2016] [Indexed: 01/09/2023] Open
Abstract
Background Lubricin, a mucinous glycoprotein secreted by synoviocytes and chondrocytes plays an important role in reducing the coefficient of friction in mammalian joints. Elevated cartilage surface friction is thought to cause chondrocyte loss; however, its quantification and methodological approaches have not been reported. We adapted a stereological method and incorporated vital cell staining to assess cellular loss in superficial and upper intermediate zones in lubricin deficient mouse cartilage. Methods The femoral condyle cartilage of the intact knees from lubricin wild type (Prg4+/+), heterozygote (Prg4+/-), and knockout (Prg4-/-) mice was imaged using fluorescein diacetate (FDA), propidium iodide (PI), and Hoechst staining, and confocal microscopy. Three dimensional reconstructions of confocal images to a depth of 14 μm were analyzed using Matlab to determine the volume fraction occupied by chondrocytes in cartilage of both medial and lateral femoral condyles. Living chondrocyte volume fraction was defined as FDA stained chondrocyte volume/total volume of superficial + upper intermediate zone. Living and dead (total) chondrocyte volume fraction was defined as FDA + PI stained chondrocyte volume/total volume of superficial + upper intermediate zone. MicroCT provided an orthogonal measure of cartilage thickness. Immunohistology for activated caspase-3 and TUNEL staining were performed to evaluate the presence of apoptotic chondrocytes in Prg4 mutant mice. Results Living chondrocyte volume fraction of the medial femoral condyle was significantly lower in Prg4-/- mice compared to Prg4+/+ (p = 0.002) and Prg4+/- (p = 0.002) littermates. There was no significant difference in medial condyle chondrocyte volume fraction between Prg4+/+ and Prg4+/- mice (p = 0.82). No significant differences were observed for the chondrocyte volume fraction for the lateral condyle (p > 0.26). Cartilage thickness increased in the medial condyle for Prg4-/- mice compared to Prg4+/+ (p = 0.02) and Prg4+/- (p = 0.03) littermates, and the lateral condyle for Prg4-/- mice compared to Prg4+/+ (p < 0.0001) and Prg4+/- (p < 0.0001) littermates, indicating that a multi-dimensional increase in cartilage volume did not artifactually lower the chondrocyte volume fraction in the medial condyle. Significantly higher number of caspase-3 positive cells were observed in the superficial and upper intermediate zone cartilage of the medial femoral condyle of Prg4-/- mice compared to Prg4+/+ (p = 0.01) and Prg4+/- (p = 0.04) littermates, and the lateral femoral condyle of Prg4-/- mice compared to Prg4+/+ (p = 0.02) and Prg4+/- (p = 0.02) littermates. There were no significant differences in TUNEL staining among different Prg4 genotypes in both condyles (p > 0.05 for all comparisons). Conclusions Increased Caspase-3 activation is observed in Prg4 deficient mice compared to Prg4 sufficient littermates. Absence of Prg4 induces loss of chondrocytes in the superficial and upper intermediate zone of mouse cartilage that is quantifiable by a novel image processing technique. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-0967-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Naga Padmini Karamchedu
- Department of Orthopedics, Rhode Island Hospital; Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Josef N Tofte
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Kimberly A Waller
- Department of Orthopedics, Rhode Island Hospital; Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ling X Zhang
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, 02903, USA
| | - Tarpit K Patel
- Department of Orthopedics, Rhode Island Hospital; Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Gregory D Jay
- Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, 02903, USA. .,Department of Engineering, Brown University, Providence, RI, USA.
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16
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Hill A, Waller KA, Cui Y, Allen JM, Smits P, Zhang LX, Ayturk UM, Hann S, Lessard SG, Zurakowski D, Warman ML, Jay GD. Lubricin restoration in a mouse model of congenital deficiency. Arthritis Rheumatol 2016. [PMID: 26216721 DOI: 10.1002/art.39276] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Congenital deficiency of the principal boundary lubricant in cartilage (i.e., lubricin, encoded by the gene PRG4) increases joint friction and causes progressive joint failure. This study was undertaken to determine whether restoring lubricin expression in a mouse model would prevent, delay, or reverse the disease process caused by congenital deficiency. METHODS Using genetically engineered lubricin-deficient mice, we restored gene function before conception or at ages 3 weeks, 2 months, or 6 months after birth. The effect of restoring gene function (i.e., expression of lubricin) on the tibiofemoral patellar joints of mice was evaluated histologically and by ex vivo biomechanical testing. RESULTS Restoring gene function in mice prior to conception prevented joint disease. In 3-week-old mice, restoring gene function improved, but did not normalize, histologic features of the articular cartilage and whole-joint friction. In addition, cyclic loading of the joints produced fewer activated caspase 3-containing chondrocytes when lubricin expression was restored, as compared to that in littermate mice whose gene function was not restored (nonrestored controls). Restoration of lubricin expression in 2-month-old or 6-month-old mice had no beneficial effect on histopathologic cartilage damage, extent of whole-joint friction, or activation of caspase 3 when compared to nonrestored controls. CONCLUSION When boundary lubrication is congenitally deficient and cartilage becomes damaged, the window of opportunity for restoring lubrication and slowing disease progression is limited.
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Affiliation(s)
- Adele Hill
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kimberly A Waller
- Alpert Medical School of Brown University and Rhode Island Hospital, Providence
| | - Yajun Cui
- Boston Children's Hospital, Boston, Massachusetts
| | - Justin M Allen
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Ling X Zhang
- Alpert Medical School of Brown University and Rhode Island Hospital, Providence
| | - Ugur M Ayturk
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Steven Hann
- Boston Children's Hospital, Boston, Massachusetts
| | | | | | - Matthew L Warman
- Howard Hughes Medical Institute, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Gregory D Jay
- Rhode Island Hospital, Alpert Medical School of Brown University, and Brown University School of Engineering, Providence, Rhode Island
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Ludwig TE, Hunter MM, Schmidt TA. Cartilage boundary lubrication synergism is mediated by hyaluronan concentration and PRG4 concentration and structure. BMC Musculoskelet Disord 2015; 16:386. [PMID: 26666513 PMCID: PMC4678696 DOI: 10.1186/s12891-015-0842-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 12/02/2015] [Indexed: 11/26/2022] Open
Abstract
Background Proteoglycan 4 (PRG4) and hyaluronan (HA) are key synovial fluid constituents that contribute synergistically to cartilage boundary lubrication; however, the effects of their concentrations as well as their structure, both of which can be altered in osteoarthritis, on this functional synergism are unknown. The objectives of this study were to evaluate cartilage boundary lubricating ability of 1) PRG4 + HA in solution at constant HA concentration in a range of PRG4 concentrations, 2) constant PRG4 concentration in a range of HA concentrations, 3) HA + reduced/alkylated (R/A) PRG4, and 4) hylan G-F 20 + PRG4. Methods Static and kinetic friction coefficients (μstatic,Neq, <μkinetic,Neq>) were measured using a previously characterized cartilage-cartilage boundary mode friction test for the following concentrations of purified PRG4 and HA: Test 1: HA (1.5 MDa, 3.3 mg/mL) + PRG4 from 4.5 – 1500 μg/mL; Test 2: PRG4 (450, 150, 45 μg/mL) + HA (1.5 MDa) from 0.3 – 3.3 mg/mL. Test 3: hylan G-F 20 (3. 3 mg/mL) + PRG4 (450 μg/mL). Test 4: HA (3.3 mg/mL) + R/A PRG4 (450 μg/mL). ANOVA was used to compare lubricants within (comparing 6 lubricants of interest) and between (comparing 3 lubricants of interest) test sequences, with Tukey and Fishers post-hoc testing respectively. Results This study demonstrates that both PRG4 and HA concentration, as well as PRG4 disulfide-bonded structure, can alter the cartilage boundary lubricating ability of PRG4 + HA solutions. The boundary lubricating ability of high MW HA + PRG4 solutions was limited by very low concentrations of PRG4. Decreased concentrations of high MW HA also limited the cartilage boundary lubricating ability of HA + PRG4 solutions, with the effect exacerbated by low PRG4 concentrations. The reduction of friction by addition of PRG4 to a cross-linked HA viscosupplement product, but not with addition of R/A PRG4 to HA, is consistent with a non-covalent mechanism of interaction where tertiary and quaternary PRG4 structure are important. Conclusions Collectively, these results demonstrate that deficiency of either or both PRG4 and HA, or alterations in PRG4 structure, may be detrimental to SF cartilage boundary lubricating function. This study provides further insight into the nature of cartilage boundary lubrication and advancement towards potential formulation of new intra-articular biotherapeutic treatments for osteoarthritis using PRG4 ± HA.
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Affiliation(s)
- Taryn E Ludwig
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Canada.
| | - Miles M Hunter
- Faculty of Kinesiology, University of Calgary, Calgary, Canada.
| | - Tannin A Schmidt
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Canada. .,Faculty of Kinesiology, University of Calgary, Calgary, Canada.
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18
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Altman RD, Manjoo A, Fierlinger A, Niazi F, Nicholls M. The mechanism of action for hyaluronic acid treatment in the osteoarthritic knee: a systematic review. BMC Musculoskelet Disord 2015; 16:321. [PMID: 26503103 PMCID: PMC4621876 DOI: 10.1186/s12891-015-0775-z] [Citation(s) in RCA: 239] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/15/2015] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is one of the leading causes of disability within the adult population. Current treatment options for OA of the knee include intra-articular (IA) hyaluronic acid (HA), a molecule found intrinsically within the knee joint that provides viscoelastic properties to the synovial fluid. A variety of mechanisms in which HA is thought to combat knee OA are reported in the current basic literature. METHODS We conducted a comprehensive literature search to identify currently available primary non-clinical basic science articles focussing on the mechanism of action of IA-HA treatment. Included articles were assessed and categorized based on the mechanism of action described within them. The key findings and conclusions from each included article were obtained and analyzed in aggregate with studies of the same categorical assignment. RESULTS Chondroprotection was the most frequent mechanism reported within the included articles, followed by proteoglycan and glycosaminoglycan synthesis, anti-inflammatory, mechanical, subchondral, and analgesic actions. HA-cluster of differentiation 44 (CD44) receptor binding was the most frequently reported biological cause of the mechanisms presented. High molecular weight HA was seen to be superior to lower molecular weight HA products. HA derived through a biological fermentation process is also described as having favorable safety outcomes over avian-derived HA products. CONCLUSIONS The non-clinical basic science literature provides evidence for numerous mechanisms in which HA acts on joint structures and function. These actions provide support for the purported clinical benefit of IA-HA in OA of the knee. Future research should not only focus on the pain relief provided by IA-HA treatment, but the disease modification properties that this treatment modality possesses as well.
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Affiliation(s)
- R D Altman
- Division of Rheumatology and Immunology, David Geffen School of Medicine, University of California at Los Angeles, 1000 Veterans Ave, 90024, Los Angeles, CA, USA.
| | - A Manjoo
- Division of Orthopaedics, McMaster University, Hamilton, ON, Canada.
| | - A Fierlinger
- Ferring Pharmaceuticals Inc., Parsippany, NJ, USA.
| | - F Niazi
- Ferring Pharmaceuticals Inc., Parsippany, NJ, USA.
| | - M Nicholls
- Kentucky Orthopaedic and Hand Surgeons, A division of Ortho Kentucky, Lexington, KY, USA.
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20
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Role of lubricin and boundary lubrication in the prevention of chondrocyte apoptosis. Proc Natl Acad Sci U S A 2013; 110:5852-7. [PMID: 23530215 DOI: 10.1073/pnas.1219289110] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Osteoarthritis is a complex disease involving the mechanical breakdown of articular cartilage in the presence of altered joint mechanics and chondrocyte death, but the connection between these factors is not well established. Lubricin, a mucinous glycoprotein encoded by the PRG4 gene, provides boundary lubrication in articular joints. Joint friction is elevated and accompanied by accelerated cartilage damage in humans and mice that have genetic deficiency of lubricin. Here, we investigated the relationship between coefficient of friction and chondrocyte death using ex vivo and in vitro measurements of friction and apoptosis. We observed increases in whole-joint friction and cellular apoptosis in lubricin knockout mice compared with wild-type mice. When we used an in vitro bovine explant cartilage-on-cartilage bearing system, we observed a direct correlation between coefficient of friction and chondrocyte apoptosis in the superficial layers of cartilage. In the bovine explant system, the addition of lubricin as a test lubricant significantly lowered the static coefficient of friction and number of apoptotic chondrocytes. These results demonstrate a direct connection between lubricin, boundary lubrication, and cell survival and suggest that supplementation of synovial fluid with lubricin may be an effective treatment to prevent cartilage deterioration in patients with genetic or acquired deficiency of lubricin.
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