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Tay ML, Bolam SM, Monk AP, McGlashan SR, Young SW, Matthews BG. Better post-operative outcomes at 1-year follow-up are associated with lower levels of pre-operative synovitis and higher levels of IL-6 and VEGFA in unicompartmental knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc 2023; 31:4109-4116. [PMID: 37449990 PMCID: PMC10471720 DOI: 10.1007/s00167-023-07503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Osteoarthritis (OA) is associated with inflammation, and residual inflammation may influence outcomes following knee arthroplasty. This may be more relevant for patients undergoing unicompartmental knee arthroplasty (UKA) due to larger remaining areas of native tissue. This study aimed to: (1) characterise inflammatory profiles for medial UKA patients and (2) investigate whether inflammation markers are associated with post-operative outcomes. METHODS This prospective, observational study has national ethics approval. Bloods, synovial fluid, tibial plateaus and synovium were collected from medial UKA patients in between 1 January 2021 and 31 December 2021. Cytokine and chemokine concentrations in serum and synovial fluid (SF) were measured with multiplexed assays. Disease severity of cartilage and synovium was assessed using validated histological scores. Post-operative outcomes were measured with Oxford Knee Score (OKS), Forgotten Joint Score (FJS-12) and pain scores. RESULTS The study included 35 patients. SF VEGFA was negatively correlated with pre-operative pain at rest (r - 0.5, p = 0.007), and FJS-12 at six-week (r 0.44, p = 0.02), six-month (r 0.61, p < 0.01) and one-year follow-up (r 0.63, p = 0.03). Serum and SF IL-6 were positively correlated with OKS at early follow-up (serum 6 weeks, r 0.39, p = 0.03; 6 months, r 0.48, p < 0.01; SF 6 weeks, r 0.35, p = 0.04). At six weeks, increased synovitis was negatively correlated with improvements in pain at rest (r - 0.41, p = 0.03) and with mobilisation (r - 0.37, p = 0.047). CONCLUSION Lower levels of synovitis and higher levels of IL-6 and VEGFA were associated with better post-operative outcomes after UKA, which could be helpful for identifying UKA patients in clinical practice. LEVEL OF EVIDENCE Level IV case series.
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Affiliation(s)
- Mei Lin Tay
- Department of Surgery, Faculty of Medical and Health Sciences (FMHS), University of Auckland, Private Bag 92-019, Auckland, 1023, New Zealand.
- Department of Orthopaedic Surgery, North Shore Hospital, Private Bag 93-503, Auckland, 0620, New Zealand.
| | - Scott M Bolam
- Department of Surgery, Faculty of Medical and Health Sciences (FMHS), University of Auckland, Private Bag 92-019, Auckland, 1023, New Zealand
- Department of Orthopaedic Surgery, Auckland City Hospital, Private Bag 92-024, Auckland, New Zealand
| | - A Paul Monk
- Department of Orthopaedic Surgery, Auckland City Hospital, Private Bag 92-024, Auckland, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92-019, Auckland, 0620, New Zealand
| | - Sue R McGlashan
- Department of Anatomy and Medical Imaging, University of Auckland, Private Bag 92-019, Auckland, 0620, New Zealand
| | - Simon W Young
- Department of Surgery, Faculty of Medical and Health Sciences (FMHS), University of Auckland, Private Bag 92-019, Auckland, 1023, New Zealand
- Department of Orthopaedic Surgery, North Shore Hospital, Private Bag 93-503, Auckland, 0620, New Zealand
| | - Brya G Matthews
- Department of Molecular Medicine and Pathology, University of Auckland, Private Bag 92-019, Auckland, 0620, New Zealand
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Hart DA. Osteoarthritis as an Umbrella Term for Different Subsets of Humans Undergoing Joint Degeneration: The Need to Address the Differences to Develop Effective Conservative Treatments and Prevention Strategies. Int J Mol Sci 2022; 23:ijms232315365. [PMID: 36499704 PMCID: PMC9736942 DOI: 10.3390/ijms232315365] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/30/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Abstract
Osteoarthritis (OA) of joints such as the knee and hip are very prevalent, and the number of individuals affected is expected to continue to rise. Currently, conservative treatments after OA diagnosis consist of a series of increasingly invasive interventions as the degeneration and pain increase, leading very often to joint replacement surgery. Most interventions are focused on alleviating pain, and there are no interventions currently available that stop and reverse OA-associated joint damage. For many decades OA was considered a disease of cartilage, but it is now considered a disease of the whole multi-tissue joint. As pain is the usual presenting symptom, for most patients, it is not known when the disease process was initiated and what the basis was for the initiation. The exception is post-traumatic OA which results from an overt injury to the joint that elevates the risk for OA development. This scenario leads to very long wait lists for joint replacement surgery in many jurisdictions. One aspect of why progress has been so slow in addressing the needs of patients is that OA has been used as an umbrella term that does not recognize that joint degeneration may arise from a variety of mechanistic causes that likely need separate analysis to identify interventions unique to each subtype (post-traumatic, metabolic, post-menopausal, growth and maturation associated). A second aspect of the slow pace of progress is that the bulk of research in the area is focused on post-traumatic OA (PTOA) in preclinical models that likely are not clearly relevant to human OA. That is, only ~12% of human OA is due to PTOA, but the bulk of studies investigate PTOA in rodents. Thus, much of the research community is failing the patient population affected by OA. A third aspect is that conservative treatment platforms are not specific to each OA subset, nor are they integrated into a coherent fashion for most patients. This review will discuss the literature relevant to the issues mentioned above and propose some of the directions that will be required going forward to enhance the impact of the research enterprise to affect patient outcomes.
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Affiliation(s)
- David A Hart
- Department of Surgery, Faculty of Kinesiology, McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, AB T2N 4N1, Canada
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Synovial fluid mesenchymal progenitor cells from patients with juvenile idiopathic arthritis demonstrate limited self-renewal and chondrogenesis. Sci Rep 2022; 12:16530. [PMID: 36192450 PMCID: PMC9530167 DOI: 10.1038/s41598-022-20880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/20/2022] [Indexed: 11/11/2022] Open
Abstract
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of inflammatory diseases affecting joints with a prevalence of one in a thousand children. There is a growing body of literature examining the use of mesenchymal stem/progenitor cells (MPCs) for the treatment of adult and childhood arthritis, however, we still lack a clear understanding of how these MPC populations are impacted by arthritic disease states and how this could influence treatment efficacy. In the current study we examined the immunophenotyping, self-renewal ability and chondrogenic capacity (in vitro and in vivo) of synovial derived MPCs from normal, JIA and RA joints. Synovial MPCs from JIA patients demonstrated reduced self-renewal ability and chondrogenic differentiation capacity. Furthermore, they did not induce cartilage regeneration when xenotransplanted in a mouse cartilage injury model. Synovial MPCs from JIA patients are functionally compromised compared to MPCs from normal and/or RA joints. The molecular mechanisms behind this loss of function remain elusive. Further study is required to see if these cells can be re-functionalized and used in cell therapy strategies for these JIA patients, or if allogenic approaches should be considered.
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Skrzypkowska M, Stasiak M, Sakowska J, Chmiel J, Maciejewska A, Buciński A, Słomiński B, Trzonkowski P, Łuczkiewicz P. Cytokines and chemokines multiplex analysis in patients with low disease activity rheumatoid arthritis. Rheumatol Int 2022; 42:609-619. [PMID: 35179632 PMCID: PMC8940835 DOI: 10.1007/s00296-022-05103-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/03/2022] [Indexed: 12/20/2022]
Abstract
Rheumatoid arthritis is a severe chronic autoimmune disorder that results from pathological activation of immune cells and altered cytokine/chemokine network. The aim of our study was to evaluate concentrations of chosen cytokines and chemokines in blood sera and synovial fluid samples isolated from low disease activity rheumatoid arthritis (RA) patients and osteoarthritis (OA) sufferers. Blood sera and synovial fluid samples have been obtained from 24 OA and 14 RA patients. Cytokines/chemokines levels have been determined using a Milliplex® Map 38-plex human cytokine/chemokine magnetic bead-based panel (Merck Millipore, Germany) and Luminex® MAGPIX® platform (Luminex USA). Low disease activity RA patients showed altered concentration of numerous cytokine/chemokine when compared to OA controls—they were characterized by, inter alia, increased: eotaxin/CCL11 (p = 0.037), GRO/CXCL1 (p = 0.037), IL-2 (p = 0.013), IL-4 (p = 0.017), IL-7 (p = 0.003), IL-8 (p = 0.0007) and GM-CSF (p = 0.037) serum levels, whilst MDC/CCL22 concentration was decreased in this group (p = 0.034). Eotaxin/CCL11 (p = 0.001), GRO/CXCL1 (p = 0.041), IL-10 (p = 0.003), GM-CSF (p = 0.01), IL-1RA (p = 0.0005) and VEGF (p = 0.01) concentrations in synovial fluid of RA females were also increased. Even with low disease activity score, RA patients exhibited increased concentrations of cytokines with pro- and anti-inflammatory activities, as well as numerous chemokines, growth factors and regulators of angiogenesis. Surprisingly, RA subjects also shown decreased concentration of CCL22 chemokine. The attempt to restore cytokine balance and tolerogenic environment is ineffective in RA sufferers even with good disease management. Distinguished factors could serve as possible indicators of disease progression even in low disease activity patients.
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Affiliation(s)
- Maria Skrzypkowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 1, 80-210 Gdańsk, Poland
| | - Mariusz Stasiak
- Second Clinic of Orthopaedics and Kinetic Organ Traumatology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Justyna Sakowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 1, 80-210 Gdańsk, Poland
| | - Joanna Chmiel
- Second Clinic of Orthopaedics and Kinetic Organ Traumatology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Agata Maciejewska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 1, 80-210 Gdańsk, Poland
| | - Adam Buciński
- Department of Biopharmacy, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Bartosz Słomiński
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 1, 80-210 Gdańsk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 1, 80-210 Gdańsk, Poland
| | - Piotr Łuczkiewicz
- Second Clinic of Orthopaedics and Kinetic Organ Traumatology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Ratneswaran A, Rockel JS, Antflek D, Matelski JJ, Shestopaloff K, Kapoor M, Baltzer H. Investigating Molecular Signatures Underlying Trapeziometacarpal Osteoarthritis Through the Evaluation of Systemic Cytokine Expression. Front Immunol 2022; 12:794792. [PMID: 35126358 PMCID: PMC8814933 DOI: 10.3389/fimmu.2021.794792] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
PurposeNon-operative management of trapeziometacarpal osteoarthritis (TMOA) demonstrates only short-term symptomatic alleviation, and no approved disease modifying drugs exist to treat this condition. A key issue in these patients is that radiographic disease severity can be discordant with patient reported pain, illustrating the need to identify molecular mediators of disease. This study characterizes the biochemical profile of TMOA patients to elucidate molecular mechanisms driving TMOA progression.MethodsPlasma from patients with symptomatic TMOA undergoing surgical (n=39) or non-surgical management (n=44) with 1-year post-surgical follow-up were compared using a targeted panel of 27 cytokines. Radiographic (Eaton-Littler), anthropometric, longitudinal pain (VAS, TASD, quick DASH) and functional (key pinch, grip strength) data were used to evaluate relationships between structure, pain, and systemic cytokine expression. Principal Component Analysis was used to identify clusters of patients.ResultsPatients undergoing surgery had greater BMI as well as higher baseline quick DASH, TASD scores. Systemically, these patients could only be distinguished by differing levels of Interleukin-7 (IL-7), with an adjusted odds ratio of 0.22 for surgery for those with increased levels of this cytokine. Interestingly, PCA analysis of all patients (regardless of surgical status) identified a subset of patients with an “inflammatory” phenotype, as defined by a unique molecular signature consisting of thirteen cytokines.ConclusionOverall, this study demonstrated that circulating cytokines are capable of distinguishing TMOA disease severity, and identified IL-7 as a target capable of differentiating disease severity with higher levels associated with a decreased likelihood of TMOA needing surgical intervention. It also identified a cluster of patients who segregate based on a molecular signature of select cytokines.
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Affiliation(s)
- Anusha Ratneswaran
- Hand Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Division of Orthopedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Jason S. Rockel
- Division of Orthopedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Daniel Antflek
- Hand Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - John J. Matelski
- Biostatistics Research Unit, University Health Network, Toronto, ON, Canada
| | - Konstantin Shestopaloff
- Division of Orthopedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Mohit Kapoor
- Division of Orthopedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Department of Surgery and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Heather Baltzer
- Hand Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON, Canada
- *Correspondence: Heather Baltzer,
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Chan MWY, Gomez-Aristizábal A, Mahomed N, Gandhi R, Viswanathan S. A tool for evaluating novel osteoarthritis therapies using multivariate analyses of human cartilage-synovium explant co-culture. Osteoarthritis Cartilage 2022; 30:147-159. [PMID: 34547432 DOI: 10.1016/j.joca.2021.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/07/2021] [Accepted: 09/14/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is a need to incorporate multiple tissues into in vitro OA models to evaluate novel therapeutics. This approach is limited by inherent donor variability. We present an optimized research tool: a human OA cartilage-synovium explant co-culture model (OA-EXM) that employs donor-matched lower and upper limit response controls combined with statistical approaches to address variability. Multiple rapid read-outs allow for evaluation of therapeutics while cataloguing cartilage-synovium interactions. DESIGN 48-h human explant cultures were sourced from OA knee arthroplasties. An OA-like cartilage-synovium co-culture baseline was established relative to donor-matched upper limit supraphysiological pro-inflammatory cytokine and lower limit OA cartilage or synovium alone controls. 100 nM dexamethasone treatment validated possible "rescue effects" within the OA-EXM dual tissue environment. Gene expression, proteoglycan loss, MMP activity, and soluble protein concentrations were analyzed using blocking and clustering methods. RESULTS The OA-EXM demonstrates the value of the co-culture approach as the addition of OA synovium increases OA cartilage proteoglycan loss and expression of MMP1, MMP3, MMP13, CXCL8, CCL2, IL6, and PTGS2, but not to the extent of supraphysiological stimulation. Conversely, OA cartilage does not affect gene expression or MMP activity of OA synovium. Dexamethasone shows dual treatment effects on synovium (pro-resolving macrophage upregulation, protease downregulation) and cartilage (pro-inflammatory, catabolic, and anabolic downregulation), and decreases soluble CCL2 levels in co-culture, thereby validating OA-EXM utility. CONCLUSIONS The OA-EXM is representative of late-stage OA pathology, captures dual interactions between cartilage and synovium, and combined with statistical strategies provides a rapid, sensitive research tool for evaluating OA therapeutics.
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Affiliation(s)
- M W Y Chan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada.
| | - A Gomez-Aristizábal
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada.
| | - N Mahomed
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada.
| | - R Gandhi
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada.
| | - S Viswanathan
- Osteoarthritis Research Program, Division of Orthopedic Surgery, Schroeder Arthritis Institute, University Health Network, Canada; Krembil Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada; Division of Hematology, Department of Medicine, University of Toronto, Canada.
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7
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Pauk J, Trinkunas J, Puronaite R, Ihnatouski M, Wasilewska A. A computational method to differentiate rheumatoid arthritis patients using thermography data. Technol Health Care 2021; 30:209-216. [PMID: 34806634 DOI: 10.3233/thc-219004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The traditional rheumatoid arthritis (RA) diagnosis is very complicated because it uses many clinical and image data. Therefore, there is a need to develop a new method for diagnosing RA using a consolidated set of blood analysis and thermography data. OBJECTIVE The following issues related to RA are discussed: 1) Which clinical data are significant in the primary diagnosis of RA? 2) What parameters from thermograms should be used to differentiate patients with RA from the healthy? 3) Can artificial neural networks (ANN) differentiate patients with RA from the healthy? METHODS The dataset was composed of clinical and thermal data from 65 randomly selected patients with RA and 104 healthy subjects. Firstly, the univariate logistic regression model was proposed in order to find significant predictors. Next, the feedforward neural network model was used. The dataset was divided into the training set (75% of data) and the test set (25% of data). The Broyden-Fletcher-Goldfarb-Shanno (BFGS) and non-linear logistic function to transformation nodes in the output layer were used for training. Finally, the 10 fold Cross-Validation was used to assess the predictive performance of the ANN model and to judge how it performs. RESULT The training set consisted of the temperature of all fingers, patient age, BMI, erythrocyte sedimentation rate, C-reactive protein and White Blood Cells (10 parameters in total). High level of sensitivity and specificity was obtained at 81.25% and 100%, respectively. The accuracy was 92.86%. CONCLUSIONS This methodology suggests that the thermography data can be considered in addition to the currently available tools for screening, diagnosis, monitoring of disease progression.
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Affiliation(s)
- Jolanta Pauk
- Faculty of Mechanical Engineering, Bialystok University of Technology, Bialystok, Poland
| | | | - Roma Puronaite
- Institute of Data Science and Digital Technologies, Vilnius University, Vilnius, Lithuania
| | - Mikhail Ihnatouski
- Scientific and Research Department, Yanka Kupala State University of Grodno, Grodno, Belarus
| | - Agnieszka Wasilewska
- Faculty of Mechanical Engineering, Bialystok University of Technology, Bialystok, Poland
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Korochina KV, Chernysheva TV, Korochina IE. Clinical Manifestations, Histopathological Changes And Quality Of Life In Patients With Advanced Knee Osteoarthritis Caused By Age, Trauma, Obesity And Their Combination. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective — to reveal and analyze clinical characteristics, knee joint histopathology, and quality of life in patients at late stages of knee osteoarthritis (OA) triggered by age, trauma, metabolic syndrome, or their combination. Material and methods — We studied 120 subjects with knee OA (sensu Altman R.D., 1991) of Kellgren-Lawrence Grades 3-4. They were distributed among 4 groups (30 participants in each) based on the presence of age-related, post-traumatic, metabolic, or combined phenotypes. Clinical examination of patients with pain and their functional status evaluation (via Visual Analogue Scale, WOMAC, Lequesne index), quality of life assessment (MOS SF-36 questionnaire), along with histopathological study of medial tibial plateau cartilage and synovial membrane, were caried out, followed by statistical data processing. Results — Age-related OA phenotype was characterized by the latest clinical onset [59.5 (54-68) years of age] with the largest average patient age [72.5 (63-77) years], moderate to severe pain and knee dysfunction [total WOMAC score of 160 (127-190) points and Lequesne index of 20 (8-21) points], severe degenerative cartilage lesions [8.5 (6-10) points sensu Mankin] with high-grade synovitis [5 (3-8) points sensu Krenn]. Post-traumatic OA phenotype was distinguished by the lowest pain, stiffness and knee functional limitations [total WOMAC score of 129 (100-166), Lequesne index of 15 (14-19)], the highest quality of life in patients [physical component summary of 34.1 (30.5-36.1) points, mental component summary of 40.4 (32.9-43.8) points] against the background of local severe cartilage lesions [8 (6-8) sensu Mankin] with reparative pattern and synovial fibrosis. For metabolic OA phenotype, the typical traits included female-biased sex ratio (87%), high prevalence of clinical synovitis (77%), severe pain and functional knee disorders [total WOMAC score of 188 (162-207) points, Lequesne index of 20 (19-23) points], the worst quality of life [physical component summary of 28.0 (24.3-31.9) points, mental component summary of 30.9 (26.9-35.9) points], vascular invasion of cartilage, and high-grade synovitis [4 (3-5) points sensu Krenn]. Combined OA phenotype was characterized by variable clinical and histopathological features. Conclusion — Comprehensive comparative clinical and morphological analysis of late-stage knee OA of various origin was completed, and age-related, post-traumatic, metabolic and combined OA phenotypes were studied. The methodological basis for differential approach to treating different categories of OA patients was developed.
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Fortuna R, Hart DA, Sharkey KA, Schachar RA, Johnston K, Reimer RA. Effect of a prebiotic supplement on knee joint function, gut microbiota, and inflammation in adults with co-morbid obesity and knee osteoarthritis: study protocol for a randomized controlled trial. Trials 2021; 22:255. [PMID: 33827639 PMCID: PMC8025512 DOI: 10.1186/s13063-021-05212-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic and painful condition where the articular cartilage surfaces progressively degenerate, resulting in loss of function and progressive disability. Obesity is a primary risk factor for the development and progression of knee OA, defined as the "metabolic OA" phenotype. Metabolic OA is associated with increased fat deposits that release inflammatory cytokines/adipokines, thereby resulting in systemic inflammation which can contribute to cartilage degeneration. There is currently no cure for OA. Prebiotics are a type of dietary fiber that can positively influence gut microbiota thereby reducing systemic inflammation and offering protection of joint integrity in rodents. However, no human clinical trials have tested the effects of prebiotics in adults with obesity suffering from knee OA. Therefore, the purpose of this double-blind, placebo-controlled, randomized trial is to determine if prebiotic supplementation can, through positive changes in the gut microbiota, improve knee function and physical performance in adults with obesity and knee OA. METHODS Adults (n = 60) with co-morbid obesity (BMI > 30 kg/m2) and knee OA (Kellgren-Lawrence grade II-III) will be recruited from the Alberta Hip and Knee Clinic and the Rocky Mountain Health Clinic and surrounding community of Calgary, Canada, and randomized (stratified by sex, BMI, and age) to prebiotic (oligofructose-enriched inulin; 16 g/day) or a calorie-matched placebo (maltodextrin) for 6 months. Anthropometrics, performance-based tests, knee pain, serum inflammatory markers and metabolomics, quality of life, and gut microbiota will be assessed at baseline, 3 months, 6 months (end of prebiotic supplementation), and 3 months following the end of the prebiotic supplementation. CLINICAL SIGNIFICANCE There is growing pressure on health care systems for aggressive OA treatment such as total joint replacement. Less aggressive, yet effective, conservative treatment options have the potential to address the growing prevalence of co-morbid obesity and knee OA by delaying the need for joint replacement or ideally preventing its need altogether. The results of this clinical trial will provide the first evidence regarding the efficacy of prebiotic supplementation on knee joint function and pain in adults with obesity and knee OA. If successful, the results may provide a simple, safe, and easy to adhere to intervention to reduce knee joint pain and improve the quality of life of adults with co-morbid knee OA and obesity. TRIAL REGISTRATION Clinical Trials.gov NCT04172688 . Registered on 21 November 2019.
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Affiliation(s)
- Rafael Fortuna
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta Canada
| | - David A. Hart
- McCaig Institute for Bone and Joint Health, Department of Surgery, and Faculty of Kinesiology, University of Calgary, Calgary, Alberta Canada
| | - Keith A. Sharkey
- Hotchkiss Brain Institute and Snyder Institute for Chronic Diseases, Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | | | - Kelly Johnston
- Division of Hip and Knee Reconstruction, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
| | - Raylene A. Reimer
- Faculty of Kinesiology and Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, 2500 University Dr. NW, Calgary, Alberta Canada
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Ren G, Al-Jezani N, Railton P, Powell JN, Krawetz RJ. CCL22 induces pro-inflammatory changes in fibroblast-like synoviocytes. iScience 2021; 24:101943. [PMID: 33490888 PMCID: PMC7809191 DOI: 10.1016/j.isci.2020.101943] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/18/2020] [Accepted: 12/10/2020] [Indexed: 01/23/2023] Open
Abstract
Synovitis is common in patients with osteoarthritis (OA) and is associated with pain and disease progression. We have previously demonstrated that the chemokine C-C motif chemokine 22 (CCL22) induces chondrocyte apoptosis in vitro; however, the effects of CCL22 on the synovium remain unknown. Therefore, our goal was to investigate the effect of CCL22 on fibroblast-like synoviocytes (FLS). CCL22 treatment suppressed expression of IL-4 and IL-10 and promoted expression of S100A12 in FLS. The response of FLS to CCL22 was not dependent on the disease state of the joint (e.g., normal versus OA), but was instead correlated with the individuals' synovial fluid level of CCL22. CCL22 induction of S100A12 in FLS was attenuated after knockdown of CCR3, yet ligands of CCR3 (CCL7, CCL11) did not induce S100A12 expression. In the presence of CCL22, CCR3-positive FLS upregulate CCL22 and S100A12 driving a potential feedforward pro-inflammatory mechanism distinct from canonical CCL22 and CCR3 pathways.
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Affiliation(s)
- Guomin Ren
- McCaig Institute for Bone & Joint Health, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- University of Calgary, Biomedical Engineering Graduate Program, Calgary, AB T2N 4N1, Canada
| | - Nedaa Al-Jezani
- McCaig Institute for Bone & Joint Health, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
| | - Pamela Railton
- Charles Sturt University, School of Biomedical Science, Wagga Wagga, NSW 2650, Australia
| | - James N. Powell
- McCaig Institute for Bone & Joint Health, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- University of Calgary, Department of Surgery, Calgary, AB T2N 4N1, Canada
| | - Roman J. Krawetz
- McCaig Institute for Bone & Joint Health, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- University of Calgary, Biomedical Engineering Graduate Program, Calgary, AB T2N 4N1, Canada
- University of Calgary, Department of Surgery, Calgary, AB T2N 4N1, Canada
- University of Calgary, Department of Anatomy and Cell Biology, Calgary, AB T2N 4N1, Canada
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11
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Insulin Resistance in Osteoarthritis: Similar Mechanisms to Type 2 Diabetes Mellitus. J Nutr Metab 2020; 2020:4143802. [PMID: 32566279 PMCID: PMC7261331 DOI: 10.1155/2020/4143802] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/01/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis (OA) and type 2 diabetes mellitus (T2D) are two of the most widespread chronic diseases. OA and T2D have common epidemiologic traits, are considered heterogenic multifactorial pathologies that develop through the interaction of genetic and environmental factors, and have common risk factors. In addition, both of these diseases often manifest in a single patient. Despite differences in clinical manifestations, both diseases are characterized by disturbances in cellular metabolism and by an insulin-resistant state primarily associated with the production and utilization of energy. However, currently, the primary cause of OA development and progression is not clear. In addition, although OA is manifested as a joint disease, evidence has accumulated that it affects the whole body. As pathological insulin resistance is viewed as a driving force of T2D development, now, we present evidence that the molecular and cellular metabolic disturbances associated with OA are linked to an insulin-resistant state similar to T2D. Moreover, the alterations in cellular energy requirements associated with insulin resistance could affect many metabolic changes in the body that eventually result in pathology and could serve as a unified mechanism that also functions in many metabolic diseases. However, these issues have not been comprehensively described. Therefore, here, we discuss the basic molecular mechanisms underlying the pathological processes associated with the development of insulin resistance; the major inducers, regulators, and metabolic consequences of insulin resistance; and instruments for controlling insulin resistance as a new approach to therapy.
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12
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Yu MX, Ma XQ, Song X, Huang YM, Jiang HT, Wang J, Yang WH. Validation of the Key Active Ingredients and Anti-Inflammatory and Analgesic Effects of Shenjin Huoxue Mixture Against Osteoarthritis by Integrating Network Pharmacology Approach and Thin-Layer Chromatography Analysis. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:1145-1156. [PMID: 32214800 PMCID: PMC7083645 DOI: 10.2147/dddt.s243951] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 02/25/2020] [Indexed: 12/11/2022]
Abstract
Background Shenjin Huoxue Mixture (SHM), a classic traditional herb mixture has shown significant clinical efficacy against osteoarthritis (OA). Our previous experimental study has confirmed its anti–inflammatory and analgesic effect on acute soft tissue injury in rats, with the compound of glycyrrhizinate in SHM identified and the content of paeoniflorin in SHM determined by high-performance liquid chromatography (HPLC). However, the components and its pharmacological mechanisms of SHM against OA have not been systematically elucidated yet. Thus this study aimed to predict the key active ingredients and potential pharmacological mechanisms of SHM in the treatment of OA by network pharmacology approach and thin-layer chromatography (TLC) validation. Methods The active ingredients of SHM and their targets, as well as OA-related targets, were identified from databases. The key active ingredients were defined and ranked by the number of articles retrieved in PubMed using the keyword “(the active ingredients [Title/Abstract]) AND Osteoarthritis[Title/Abstract] ”, and validated partially by TLC. The pharmacological mechanisms of SHM against OA were displayed by GO term and Reactome pathway enrichment analysis with Discovery Studio 3.0 software docking to testing the reliability. Results Finally, 16 key active ingredients were identified and ranked, including quercetin validated through TLC. Inflammatory response, IL-6 signaling pathway and toll-like receptor (TLR) cascades pathway were predicted as the main pharmacological mechanisms of SHM against OA. Especially, 12 out of 16 key active ingredients, including validated quercetin, were well docked to IL-6 proteins. Conclusion Our results confirmed the anti–inflammatory and analgesic effect of SHM against OA through multiple components, multiple targets and multiple pathways, which revealed the theoretical basis of SHM against OA and may provide a new drug option for treating OA.
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Affiliation(s)
- Mei-Xiang Yu
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China
| | - Xiao-Qin Ma
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China
| | - Xin Song
- South Campus, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201100, People's Republic of China
| | - Yong-Mei Huang
- Jinshan Hospital, Shanghai Fudan University School of Medicine, Shanghai 201508, People's Republic of China
| | - Hui-Ting Jiang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China
| | - Jing Wang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China
| | - Wan-Hua Yang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.,Department of Pharmacy, Ruijin Hospital North Affiliated to the Shanghai Jiao Tong University Medical School, Shanghai 201801, People's Republic of China
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13
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Perruccio AV, Badley EM, Power JD, Canizares M, Kapoor M, Rockel J, Chandran V, Gandhi R, Mahomed NM, Davey JR, Syed K, Veillette C, Rampersaud YR. Sex differences in the relationship between individual systemic markers of inflammation and pain in knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2019; 1:100004. [DOI: 10.1016/j.ocarto.2019.100004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 09/16/2019] [Indexed: 02/08/2023] Open
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14
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Grieshaber-Bouyer R, Kämmerer T, Rosshirt N, Nees TA, Koniezke P, Tripel E, Schiltenwolf M, Kirsch J, Hagmann S, Moradi B. Divergent Mononuclear Cell Participation and Cytokine Release Profiles Define Hip and Knee Osteoarthritis. J Clin Med 2019; 8:jcm8101631. [PMID: 31590365 PMCID: PMC6832735 DOI: 10.3390/jcm8101631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 01/15/2023] Open
Abstract
Osteoarthritis (OA) is a progressive joint disease driven by a blend of inflammatory and biomechanical processes. Studies using human samples to understand inflammatory mechanisms in OA frequently recruit OA patients with different affected joints, even though recent evidence indicates that OA is a heterogeneous disease which only culminates in a common end point. Differences in age of onset and the dynamics of disease progression suggest that different joints may represent different disease entities, thereby diluting the discovery potential in a combined analysis. We hypothesized that different OA joints may also differ in immunopathology within the synovium. To investigate this hypothesis, we profiled the immune cell contribution (flow cytometry) and cytokine release profiles (ELISA) in purified synovial membrane mononuclear cells from 50 patients undergoing either hip (n = 34) or knee (n = 16) replacement surgery. Unsupervised computational approaches were used for disease deconstruction. We found that hip and knee osteoarthritis are not identical in respect to the inflammatory processes that take place in the synovial membrane. Instead, we report that principally CD14+ macrophages are expanded fourfold in the synovial membrane of patients with knee OA compared to hip OA, with a trend to higher expression in CD8+ T cells, while CD4+ T cells, B cells, and NK cells were found at comparable quantities. Upon isolation and culture of cells from synovial membrane, isolates from hip OA released higher concentrations of Eotaxin (CCL11), G-CSF, GM-CSF, INF-γ, IP-10 (CXCL10), TNF-α, MIP-1α (CCL3), MIP-1β (CCL4), IL-4, IL-10, IL-17, and lower concentrations of stem cell factor (SCF), thereby highlighting the difference in the nature of hip and knee osteoarthritis. Taken together, this study establishes hip and knee OA as immunologically distinct types of OA, and creates a resource of the cytokine expression landscape and mononuclear cell infiltration pattern of patients with hip and knee osteoarthritis.
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Affiliation(s)
- Ricardo Grieshaber-Bouyer
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | - Till Kämmerer
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
| | - Nils Rosshirt
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
| | - Timo A Nees
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
| | - Philipp Koniezke
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
| | - Elena Tripel
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
| | - Marcus Schiltenwolf
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
| | - Johannes Kirsch
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
| | - Sébastien Hagmann
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
| | - Babak Moradi
- University Clinic of Heidelberg, Clinic for Orthopaedic and Trauma Surgery, Schlierbacher, Landstr, 200a 69118 Heidelberg, Germany.
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15
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Synovial Cytokines Significantly Correlate with Osteoarthritis-Related Knee Pain and Disability: Inflammatory Mediators of Potential Clinical Relevance. J Clin Med 2019; 8:jcm8091343. [PMID: 31470613 PMCID: PMC6780543 DOI: 10.3390/jcm8091343] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/24/2019] [Accepted: 08/26/2019] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to identify inflammatory mediators of potential clinical relevance in synovial fluid (SF) samples of patients with knee osteoarthritis (OA). Therefore, radiographic OA severity, knee pain and function of 34 OA patients undergoing unicompartmental (UC) and bicompartmental (BC) knee arthroplasty were assessed prior to surgery and SF samples were analyzed for a broad variety of inflammatory mediators, including interleukins (ILs), interferons (IFNs), C-X-C motif ligand chemokines (CXCLs), and growth factors (nerve growth factor; NGF, vascular endothelial growth factor; VEGF, and stem cell growth factor β; SCGF-β) using multiplex assay. Significant differences were observed between the SF levels of different inflammatory markers. When compared to UC OA, significantly higher concentrations of IL-7, IL-8, IL-10, IL-12, IL-13, IFN-γ, VEGF and CXCL1 were detected in BC OA. Correlation analyses revealed significant associations between OA severity and IL-6, IL-8, IFN-γ, SCGF-β, VEGF, CXCL1. Interestingly, increases in both anti- (IL-10, IL-13) and pro-inflammatory (IL-7, IL-12, IFN-γ) cytokines, as well as growth factors (SCGF-β, VEGF), correlated significantly with the level of knee pain. Poorer knee function was associated with higher IL-6, IL-10, IL-12, IL-13, IL-18, βNGF, SCGF-β, VEGF and CXCL9 levels. In conclusion, this study provides an extensive profile of synovial inflammatory mediators in knee OA and identifies cytokines of potential clinical relevance. In fact, five of the mediators examined (IL-10, IL-12, IL-13, SCGF-β, VEGF) significantly correlate with both knee pain and function.
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16
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Amlani A, Choi MY, Tarnopolsky M, Brady L, Clarke AE, Garcia-De La Torre I, Mahler M, Schmeling H, Barber CE, Jung M, Fritzler MJ. Anti-NT5c1A Autoantibodies as Biomarkers in Inclusion Body Myositis. Front Immunol 2019; 10:745. [PMID: 31024569 PMCID: PMC6465553 DOI: 10.3389/fimmu.2019.00745] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 03/19/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: Sporadic Inclusion Body Myositis (sIBM) is an inflammatory myopathy (IIM) without a specific diagnostic biomarker until autoantibodies to the cytosolic 5′-nucleotidase 1A (NT5c1A/Mup44) were reported. The objectives of our study were to determine the sensitivity and specificity of anti-NT5c1A for sIBM, demonstrate demographic, clinical and serological predictors for anti-NT5c1A positivity and determine if anti-nuclear antibody (ANA) indirect immunofluorescence (IIF) staining on HEp-2 cells is a reliable screening method for anti-NT5c1A. Methods: Sera from sIBM patients and controls were stored at −80°C until required for analysis. IgG antibodies to NT5c1A were detected by an addressable laser bead immunoassay (ALBIA) using a full-length human recombinant protein. Autoantibodies to other autoimmune myopathy antigens (Jo-1, OJ, TIF1y, PL-12, SAE, EJ, MDA5, PL7, SRP, NXP2, MI-2) were detected by line immunoassay (LIA), chemiluminescence immunoassay (CIA) or enzyme linked immunosorbent assay (ELISA) and ANA detected by IIF on HEp-2 substrate. Demographic, clinical and serological data were obtained by chart review. Results: Forty-three patients with sIBM, 537 disease control patients with other autoimmune, degenerative and neuromuscular diseases, and 78 healthy controls were included. 48.8% (21/43) of sIBM patients were positive for anti-NT5c1A. The overall sensitivity, specificity, positive predictive value, and negative predictive value of anti-NT5c1A for sIBM were 0.49, 0.92, 0.29, and 0.96, respectively. Compared to sIBM, the frequency of anti-NT5c1A was lower in both the disease control group (8.8%, OR 0.10 [95%CI: 0.05–0.20], p < 0.0001) and in the apparently healthy control group (5.1%, OR 0.06 [95%CI: 0.02–0.18], p < 0.0001). In the univariable analysis, sIBM patients with more severe muscle weakness were more likely to be anti-NT5c1A positive (OR 4.10 [95% CI: 1.17, 14.33], p = 0.027), although this was not statistically significant (adjusted OR 4.30 [95% CI: 0.89, 20.76], p = 0.069) in the multivariable analysis. The ANA of sIBM sera did not demonstrate a consistent IIF pattern associated with anti-NT5c1A. Conclusions: Anti-NT5c1A has moderate sensitivity and high specificity for sIBM using ALBIA. The presence of anti-NT5c1A antibodies may be associated with muscle weakness. Anti-NT5c1A antibodies were not associated with a specific IIF staining pattern, hence screening using HEp-2 substrate is unlikely to be a useful predictor for presence of these autoantibodies.
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Affiliation(s)
- Adam Amlani
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - May Y Choi
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mark Tarnopolsky
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON, Canada
| | - Lauren Brady
- Department of Pediatrics, McMaster University Medical Center, Hamilton, ON, Canada
| | - Ann E Clarke
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ignacio Garcia-De La Torre
- Hospital General de Occidente and University of Guadalajara, Guadalajara, Mexico.,PANLAR Myositis Study Group, Guadalajara, Mexico
| | | | | | - Claire E Barber
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michelle Jung
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Marvin J Fritzler
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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17
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Kisand K, Tamm AE, Lintrop M, Tamm AO. New insights into the natural course of knee osteoarthritis: early regulation of cytokines and growth factors, with emphasis on sex-dependent angiogenesis and tissue remodeling. A pilot study. Osteoarthritis Cartilage 2018; 26:1045-1054. [PMID: 29782915 DOI: 10.1016/j.joca.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study was conducted to identify cytokine profiles associated with radiographic phenotypes of knee osteoarthritis (rKOA) with a focus on early stage of the disease. METHODS The pilot population study involved 60 middle-aged patients (mean age 50 ± 7.3y.). Standardized weight-bearing anteroposterior and axial radiographs were used to assess rKOA severity in tibiofemoral (TFJ) of patellofemoral joint (PFJ) by grading system (grades 0-3). Luminex (xMAP®) technology was used to simultaneously assess 60 biomarkers (BMs). RESULTS Several pathways of angiogenic (CXCL10/IP-10, FGF1/2, PDGF-AA/BB, ANG1, RANTES), tissue remodeling/fibrosis (MMP1/3, TIMP2/3/4, TGFβ), and fat tissue (leptin) BMs associated with rKOA severity already in very early phase (grade 1). We identified several sets of cytokines as key markers of early knee osteoarthritis (KOA) predicting radiographic features in logistic-regression models (AUC = 0.80-0.97). Marked sex-specificity of rKOA course was detected: upregulation of angiogenesis dominated in females, whereas the activation of tissue remodeling was dominant in males. Several of these shifts, e.g., decrease of CXCL10/IP-10, took place only in grade 1 KOA and disappeared or reversed in later stages. OA of different knee-joint compartments has distinct profiles of cytokines. A broad list of BMs (TIMP2/3/4, MMP1/3, TGFβ1/2, vWF-A2, sE-selectin and leptin) associated with OA in the PFJ. CONCLUSION Our results demonstrate that substantial and time-limited shifts in the angiogenic and TIMP/MMP systems occur in the early stage of KOA. Our study findings highlight the sex-, grade- and compartment-dependent shifts in above processes. The data may contribute to the individualized prevention of KOA in the future.
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Affiliation(s)
- K Kisand
- Department of Immunology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia; Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
| | - A E Tamm
- Department of Sports Medicine and Rehabilitation, University of Tartu, Tartu, Estonia.
| | - M Lintrop
- Department of Radiology, University of Tartu, Tartu, Estonia.
| | - A O Tamm
- Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
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18
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Collins KH, Herzog W, MacDonald GZ, Reimer RA, Rios JL, Smith IC, Zernicke RF, Hart DA. Obesity, Metabolic Syndrome, and Musculoskeletal Disease: Common Inflammatory Pathways Suggest a Central Role for Loss of Muscle Integrity. Front Physiol 2018; 9:112. [PMID: 29527173 PMCID: PMC5829464 DOI: 10.3389/fphys.2018.00112] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 02/05/2018] [Indexed: 01/14/2023] Open
Abstract
Inflammation can arise in response to a variety of stimuli, including infectious agents, tissue injury, autoimmune diseases, and obesity. Some of these responses are acute and resolve, while others become chronic and exert a sustained impact on the host, systemically, or locally. Obesity is now recognized as a chronic low-grade, systemic inflammatory state that predisposes to other chronic conditions including metabolic syndrome (MetS). Although obesity has received considerable attention regarding its pathophysiological link to chronic cardiovascular conditions and type 2 diabetes, the musculoskeletal (MSK) complications (i.e., muscle, bone, tendon, and joints) that result from obesity-associated metabolic disturbances are less frequently interrogated. As musculoskeletal diseases can lead to the worsening of MetS, this underscores the imminent need to understand the cause and effect relations between the two, and the convergence between inflammatory pathways that contribute to MSK damage. Muscle mass is a key predictor of longevity in older adults, and obesity-induced sarcopenia is a significant risk factor for adverse health outcomes. Muscle is highly plastic, undergoes regular remodeling, and is responsible for the majority of total body glucose utilization, which when impaired leads to insulin resistance. Furthermore, impaired muscle integrity, defined as persistent muscle loss, intramuscular lipid accumulation, or connective tissue deposition, is a hallmark of metabolic dysfunction. In fact, many common inflammatory pathways have been implicated in the pathogenesis of the interrelated tissues of the musculoskeletal system (e.g., tendinopathy, osteoporosis, and osteoarthritis). Despite these similarities, these diseases are rarely evaluated in a comprehensive manner. The aim of this review is to summarize the common pathways that lead to musculoskeletal damage and disease that result from and contribute to MetS. We propose the overarching hypothesis that there is a central role for muscle damage with chronic exposure to an obesity-inducing diet. The inflammatory consequence of diet and muscle dysregulation can result in dysregulated tissue repair and an imbalance toward negative adaptation, resulting in regulatory failure and other musculoskeletal tissue damage. The commonalities support the conclusion that musculoskeletal pathology with MetS should be evaluated in a comprehensive and integrated manner to understand risk for other MSK-related conditions. Implications for conservative management strategies to regulate MetS are discussed, as are future research opportunities.
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Affiliation(s)
- Kelsey H. Collins
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - Walter Herzog
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
| | - Graham Z. MacDonald
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Raylene A. Reimer
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, AB, Canada
| | - Jaqueline L. Rios
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
- CAPES Foundation, Brasilia, Brazil
| | - Ian C. Smith
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Ronald F. Zernicke
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Departments of Orthopaedic Surgery and Biomedical Engineering, School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Surgery, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - David A. Hart
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada
- Department of Family Practice, The Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada
- Alberta Health Services Bone and Joint Health Strategic Clinical Network, Calgary, AB, Canada
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Knee osteoarthritis phenotypes and their relevance for outcomes: a systematic review. Osteoarthritis Cartilage 2017; 25:1926-1941. [PMID: 28847624 DOI: 10.1016/j.joca.2017.08.009] [Citation(s) in RCA: 191] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/22/2017] [Accepted: 08/18/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To systematically review the literature for studies investigating knee osteoarthritis (OA) phenotypes to examine what OA characteristics are relevant for phenotyping. METHODS A comprehensive search was performed in Medline, EMBASE, Web of Sciences, CINAHL, and Scopus databases from inception to September 2016. Inclusion was limited to observational studies of individuals with symptomatic knee OA that identified phenotypes based on any OA characteristics and assessed their association with clinically important outcomes. A descriptive synthesis of the data was performed. RESULTS Of the 2777 citations retrieved, 34 studies were included. Clinical phenotypes were investigated most frequently, followed by laboratory, imaging and aetiologic phenotypes. Eight studies defined subgroups based on outcome trajectories (pain, function and radiographic progression trajectories). Most studies used a single patient or disease characteristic to identify patients subgroups while five included characteristics from multiple domains. We found evidence from multiple studies suggesting that pain sensitization, psychological distress, radiographic severity, body mass index (BMI), muscle strength, inflammation and comorbidities are associated with clinically distinct phenotypes. Gender, obesity and other metabolic abnormalities, the pattern of cartilage damage, and inflammation may be implicated in delineating distinct structural phenotypes. Only a few studies investigated the external validity of the phenotypes or their prospective validity using longitudinal outcomes. CONCLUSIONS There is marked heterogeneity in the data selected by the studies investigating knee OA phenotypes. We identified the phenotypic characteristics that can be considered for a comprehensive phenotype classification in future studies. A framework for the investigation of phenotypes could be useful for future studies. PROTOCOL REGISTRATION PROSPERO CRD42016036220.
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Qi C, Shan Y, Wang J, Ding F, Zhao D, Yang T, Jiang Y. Circulating T helper 9 cells and increased serum interleukin-9 levels in patients with knee osteoarthritis. Clin Exp Pharmacol Physiol 2016; 43:528-34. [PMID: 26926842 DOI: 10.1111/1440-1681.12567] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/21/2016] [Accepted: 02/24/2016] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to examine the roles of T helper 9 (Th9) cells and the serum interleukin (IL)-9 level in the pathogenesis of osteoarthritis (OA). The numbers of IL-9(+) CD4(+) CD8(-) T cells, interferon (IFN)-γ+ CD4(+) CD8(-) T cells, IL-4(+) CD4(+) CD8(-) T cells, and IL-17A(+) CD4(+) CD8(-) T cells in 25 OA patients and 13 healthy controls (HC) were examined by flow cytometry. The serum concentrations of IL-9, IL-4, IL-17A, and IFN-γ were also determined. The numbers of CD4(+) CD45RO(+) T cells, Th9 cells, Th1 cells, and Th17 cells in OA patients were significantly higher than those in HCs. Furthermore, serum IL-9, IL-17A, and IFN-γ levels in OA patients were higher than those in HCs. The number of Th9 cells was positively correlated with the number of Th17 cells in OA patients. Furthermore, greater numbers of Th9 cells were positively associated with elevated C-reactive protein, and both Th9 cells and IL-9 levels were positively correlated with the Western Ontario and McMaster Universities Osteoarthritis index in OA patients. Th9 cell numbers and IL-9 levels are correlated with OA patient symptoms and joint functionality and may be a marker of disease activity.
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Affiliation(s)
- Changlin Qi
- Genetic Diagnosis Centre, Ministry of Education, the First Hospital, Jilin University, Changchun, China
| | - Yuxing Shan
- Genetic Diagnosis Centre, Ministry of Education, the First Hospital, Jilin University, Changchun, China
| | - Jing Wang
- Genetic Diagnosis Centre, Ministry of Education, the First Hospital, Jilin University, Changchun, China
| | - Fupeng Ding
- Genetic Diagnosis Centre, Ministry of Education, the First Hospital, Jilin University, Changchun, China
| | - Ding Zhao
- Genetic Diagnosis Centre, Ministry of Education, the First Hospital, Jilin University, Changchun, China
| | - Teng Yang
- Genetic Diagnosis Centre, Ministry of Education, the First Hospital, Jilin University, Changchun, China
| | - Yanfang Jiang
- Genetic Diagnosis Centre, Ministry of Education, the First Hospital, Jilin University, Changchun, China.,Key Laboratory of Zoonosis Research, Ministry of Education, the First Hospital, Jilin University, Changchun, China.,Jiangsu Co-innovation Centre for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, China
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Séjourné A, Boudot C, Objois T, Fardellone P, Brazier M, Six I, Kamel S, Mentaverri R, Goëb V. Expression of the calcium-sensing receptor in monocytes from synovial fluid is increased in osteoarthritis. Joint Bone Spine 2016; 84:175-181. [PMID: 27346252 DOI: 10.1016/j.jbspin.2016.03.012] [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: 10/26/2015] [Accepted: 03/20/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We assessed calcium-sensing receptor (CaSR) expression in monocytes isolated from synovial fluid of patients with different types of rheumatisms and explored whether CaSR expression was related to the inflammatory nature of synovial fluid. METHODS Forty-one patients were included: osteoarthritis (n=10), microcristallin rheumatisms (n=10), rheumatoid arthritis (n=12) and other inflammatory rheumatisms (n=9). Surface and total CaSR expressions in monocytes isolated from synovial fluid and blood were assessed by flow cytometry analysis. U937 cells were cultured during 24hours in presence of cell-free synovial fluids. RESULTS Every monocyte population tested express the CaSR intra- and extracellularly. Whereas similar pattern of CaSR expression exist in monocyte isolated from blood or synovial fluids, our results indicate that higher CaSR expression levels can be observed in monocytes from synovial fluids than in circulating monocytes. In both populations of monocytes, surface and total CaSR expressions were found to be significantly increased in patients with osteoarthritis compared to rheumatoid arthritis. Similar data were obtained when U937 cells were incubated with cell-free synovial fluids from osteoarthritis patients. Still present, this effect was significantly lowered when "inflammatory" synovial fluids were introduced in culture. CONCLUSIONS Our results indicate that CaSR expression in synovial derived monocytes is higher in osteoarthritis than in inflammatory rheumatisms and that CaSR expression is modulated by the nature of the synovial fluid. Given the role played by monocytes in the pathogenesis of chronic rheumatisms, monocytes could be interesting therapeutic targets via the CaSR.
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Affiliation(s)
- Alice Séjourné
- Department of Rheumatology, University Hospital Amiens, 1, place Victor-Pauchet, 80000 Amiens, France; Inserm U1088, University of Picardie Jules-Verne, CURS site CHU Sud, 80054 Amiens cedex 1, France.
| | - Cédric Boudot
- Inserm U1088, University of Picardie Jules-Verne, CURS site CHU Sud, 80054 Amiens cedex 1, France
| | - Thibaut Objois
- Inserm U1088, University of Picardie Jules-Verne, CURS site CHU Sud, 80054 Amiens cedex 1, France
| | - Patrice Fardellone
- Department of Rheumatology, University Hospital Amiens, 1, place Victor-Pauchet, 80000 Amiens, France; Inserm U1088, University of Picardie Jules-Verne, CURS site CHU Sud, 80054 Amiens cedex 1, France
| | - Michel Brazier
- Inserm U1088, University of Picardie Jules-Verne, CURS site CHU Sud, 80054 Amiens cedex 1, France; Department of Endocrine and Bone Biology, University Hospital Amiens, CHU Sud, 80054 Amiens cedex 1, France
| | - Isabelle Six
- Inserm U1088, University of Picardie Jules-Verne, CURS site CHU Sud, 80054 Amiens cedex 1, France
| | - Saïd Kamel
- Inserm U1088, University of Picardie Jules-Verne, CURS site CHU Sud, 80054 Amiens cedex 1, France; Department of Biochemistry, University Hospital Amiens, CHU Sud, 80054 Amiens cedex 1, France
| | - Romuald Mentaverri
- Inserm U1088, University of Picardie Jules-Verne, CURS site CHU Sud, 80054 Amiens cedex 1, France; Department of Endocrine and Bone Biology, University Hospital Amiens, CHU Sud, 80054 Amiens cedex 1, France
| | - Vincent Goëb
- Department of Rheumatology, University Hospital Amiens, 1, place Victor-Pauchet, 80000 Amiens, France
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22
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Ren G, Krawetz R. Applying computation biology and "big data" to develop multiplex diagnostics for complex chronic diseases such as osteoarthritis. Biomarkers 2016; 20:533-9. [PMID: 26809774 PMCID: PMC4819822 DOI: 10.3109/1354750x.2015.1105499] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The data explosion in the last decade is revolutionizing diagnostics research and the healthcare industry, offering both opportunities and challenges. These high-throughput “omics” techniques have generated more scientific data in the last few years than in the entire history of mankind. Here we present a brief summary of how “big data” have influenced early diagnosis of complex diseases. We will also review some of the most commonly used “omics” techniques and their applications in diagnostics. Finally, we will discuss the issues brought by these new techniques when translating laboratory discoveries to clinical practice.
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Affiliation(s)
- Guomin Ren
- a McCaig Institute for Bone & Joint Health, University of Calgary , Calgary , AB , Canada
| | - Roman Krawetz
- a McCaig Institute for Bone & Joint Health, University of Calgary , Calgary , AB , Canada .,b Department of Surgery , University of Calgary , Calgary , AB , Canada , and.,c Department of Anatomy and Cell Biology , University of Calgary , Calgary , AB , Canada
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23
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Mickiewicz B, Kelly JJ, Ludwig TE, Weljie AM, Wiley JP, Schmidt TA, Vogel HJ. Metabolic analysis of knee synovial fluid as a potential diagnostic approach for osteoarthritis. J Orthop Res 2015; 33:1631-8. [PMID: 26010167 DOI: 10.1002/jor.22949] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 05/13/2015] [Indexed: 02/04/2023]
Abstract
Osteoarthritis (OA) is a leading cause of chronic joint pain in the older human population. Diagnosis of OA at an earlier stage may enable the development of new treatments to one day effectively modify the progression and prognosis of the disease. In this work, we explore whether an integrated metabolomics approach could be utilized for the diagnosis of OA. Synovial fluid (SF) samples were collected from symptomatic chronic knee OA patients and normal human cadaveric knee joints. The samples were analyzed using (1)H nuclear magnetic resonance (NMR) spectroscopy and gas chromatography-mass spectrometry (GC-MS) followed by multivariate statistical analysis. Based on the metabolic profiles, we were able to distinguish OA patients from the controls and validate the statistical models. Moreover, we have integrated the (1)H NMR and GC-MS results and we found that 11 metabolites were statistically important for the separation between OA and normal SF. Additionally, statistical analysis showed an excellent predictive ability of the constructed metabolomics model (area under the receiver operating characteristic curve = 1.0). Our findings indicate that metabolomics might serve as a promising approach for the diagnosis and prognosis of degenerative changes in the knee joint and should be further validated in clinical settings.
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Affiliation(s)
- Beata Mickiewicz
- Department of Biological Sciences, Bio-NMR-Centre, University of Calgary, Calgary, Alberta, Canada
| | - Jordan J Kelly
- Department of Biological Sciences, Bio-NMR-Centre, University of Calgary, Calgary, Alberta, Canada
| | - Taryn E Ludwig
- McCaig Institute for Bone and Joint Health, Health Science Centre, University of Calgary, Calgary, Alberta, Canada.,Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Aalim M Weljie
- Department of Biological Sciences, Bio-NMR-Centre, University of Calgary, Calgary, Alberta, Canada.,Department of Pharmacology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - J Preston Wiley
- McCaig Institute for Bone and Joint Health, Health Science Centre, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Tannin A Schmidt
- McCaig Institute for Bone and Joint Health, Health Science Centre, University of Calgary, Calgary, Alberta, Canada.,Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Hans J Vogel
- Department of Biological Sciences, Bio-NMR-Centre, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, Health Science Centre, University of Calgary, Calgary, Alberta, Canada
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Moradi B, Rosshirt N, Tripel E, Kirsch J, Barié A, Zeifang F, Gotterbarm T, Hagmann S. Unicompartmental and bicompartmental knee osteoarthritis show different patterns of mononuclear cell infiltration and cytokine release in the affected joints. Clin Exp Immunol 2015; 180:143-54. [PMID: 25393692 DOI: 10.1111/cei.12486] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2014] [Indexed: 01/18/2023] Open
Abstract
It is still controversial which cell types are responsible for synovial inflammation in osteoarthritic (OA) joints. The aim of this study was to quantify the mononuclear cell populations and their cytokines in patients with different knee OA subtypes. Synovial membrane (SM), synovial fluid (SF) and peripheral blood (PB) were harvested from patients with unicompartmental (UC) and bicompartmental (BC) knee OA. Frequencies of mononuclear cells were assessed by flow cytometry in PB and SM. Naive SF samples were analysed for a broad variety of cytokines by multiplex analysis. SM of both groups displayed a distinct mononuclear cell infiltration, with CD14(+) macrophages being the major cell population, followed by CD4(+) T cells and only small numbers of CD8(+) T, CD19(+) B and CD16(+) CD56(+) natural killer (NK) cells. Between the two groups, SM of BC OA showed significantly higher amounts of mononuclear cells (135·7 ± 180 versus 805 ± 675 cells/mg, P = 0·0009) and higher CD4(+) T cell presence (3·4 ± 4·6 versus 9·1 ± 7·5%, P = 0·0267). SF of BC OA displayed significantly higher concentrations for a number of proinflammatory cytokines [CXCL1, eotaxin, interferon (IFN)-γ, interleukin (IL)-7, IL-8, IL-9, IL-12]. UC and BC OA show significant differences in their synovial inflammatory pattern. Whereas in UC OA CD14(+) macrophages are the predominant cell population, BC OA has a higher inflammatory profile and seems to be driven by CD14(+) macrophages and CD4(+) T cells. Inclusion of clinical information into the analysis of cellular and molecular results is pivotal in understanding the pathophysiology of OA.
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Affiliation(s)
- B Moradi
- Clinic for Orthopedics and Traumatology, University of Heidelberg, Heidelberg, Germany
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25
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Heard BJ, Rosvold JM, Fritzler MJ, El-Gabalawy H, Wiley JP, Krawetz RJ. A computational method to differentiate normal individuals, osteoarthritis and rheumatoid arthritis patients using serum biomarkers. J R Soc Interface 2015; 11:20140428. [PMID: 24920114 DOI: 10.1098/rsif.2014.0428] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The objective of this study was to develop a method for categorizing normal individuals (normal, n = 100) as well as patients with osteoarthritis (OA, n = 100), and rheumatoid arthritis (RA, n = 100) based on a panel of inflammatory cytokines expressed in serum samples. Two panels of inflammatory proteins were used as training sets in the construction of two separate artificial neural networks (ANNs). The first training set consisted of all proteins (38 in total) and the second consisted of only the significantly different proteins expressed (12 in total) between at least two patient groups. Both ANNs obtained high levels of sensitivity and specificity, with the first and second ANN each diagnosing 100% of test set patients correctly. These results were then verified by re-investigating the entire dataset using a decision tree algorithm. We show that ANNs can be used for the accurate differentiation between serum samples of patients with OA, a diagnosed RA patient comparator cohort and normal/control cohort. Using neural network and systems biology approaches to manage large datasets derived from high-throughput proteomics should be further explored and considered for diagnosing diseases with complex pathologies.
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Affiliation(s)
- Bryan J Heard
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Joshua M Rosvold
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada Department of Civil Engineering, Faculty of Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Marvin J Fritzler
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Hani El-Gabalawy
- Arthritis Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - J Preston Wiley
- Sports Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Roman J Krawetz
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada Department of Anatomy and Cell Biology, University of Calgary, Calgary, Alberta, Canada
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26
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Xiong F, Janko M, Walker M, Makropoulos D, Weinstock D, Kam M, Hrebien L. Analysis of cytokine release assay data using machine learning approaches. Int Immunopharmacol 2014; 22:465-79. [DOI: 10.1016/j.intimp.2014.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/01/2014] [Accepted: 07/21/2014] [Indexed: 12/18/2022]
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27
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Tsuchida AI, Beekhuizen M, 't Hart MC, Radstake TRDJ, Dhert WJA, Saris DBF, van Osch GJVM, Creemers LB. Cytokine profiles in the joint depend on pathology, but are different between synovial fluid, cartilage tissue and cultured chondrocytes. Arthritis Res Ther 2014; 16:441. [PMID: 25256035 PMCID: PMC4201683 DOI: 10.1186/s13075-014-0441-0] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 08/28/2014] [Indexed: 12/20/2022] Open
Abstract
Introduction This study aimed to evaluate whether profiles of several soluble mediators in synovial fluid and cartilage tissue are pathology-dependent and how their production is related to in vitro tissue formation by chondrocytes from diseased and healthy tissue. Methods Samples were obtained from donors without joint pathology (n = 39), with focal defects (n = 65) and osteoarthritis (n = 61). A multiplex bead assay (Luminex) was performed measuring up to 21 cytokines: Interleukin (IL)-1α, IL-1β, IL-1RA, IL-4, IL-6, IL-6Rα, IL-7, IL-8, IL-10, IL-13, tumor necrosis factor (TNF)α, Interferon (IFN)γ, oncostatin M (OSM), leukemia inhibitory factor (LIF), adiponectin, leptin, monocyte chemotactic factor (MCP)1, RANTES, basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF), vascular growth factor (VEGF). Results In synovial fluid of patients with cartilage pathology, IL-6, IL-13, IFNγ and OSM levels were higher than in donors without joint pathology (P ≤0.001). IL-13, IFNγ and OSM were also different between donors with cartilage defects and OA (P <0.05). In cartilage tissue from debrided defects, VEGF was higher than in non-pathological or osteoarthritic joints (P ≤0.001). IL-1α, IL-6, TNFα and OSM concentrations (in ng/ml) were markedly higher in cartilage tissue than in synovial fluid (P <0.01). Culture of chondrocytes generally led to a massive induction of most cytokines (P <0.001). Although the release of inflammatory cytokines was also here dependent on the pathological condition (P <0.001) the actual profiles were different from tissue or synovial fluid and between non-expanded and expanded chondrocytes. Cartilage formation was lower by healthy unexpanded chondrocytes than by osteoarthritic or defect chondrocytes. Conclusions Several pro-inflammatory, pro-angiogenic and pro-repair cytokines were elevated in joints with symptomatic cartilage defects and/or osteoarthritis, although different cytokines were elevated in synovial fluid compared to tissue or cells. Hence a clear molecular profile was evident dependent on disease status of the joint, which however changed in composition depending on the biological sample analysed. These alterations did not affect in vitro tissue formation with these chondrocytes, as this was at least as effective or even better compared to healthy chondrocytes.
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28
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Finn A, Angeby Möller K, Gustafsson C, Abdelmoaty S, Nordahl G, Ferm M, Svensson C. Influence of model and matrix on cytokine profile in rat and human. Rheumatology (Oxford) 2014; 53:2297-305. [PMID: 25065008 DOI: 10.1093/rheumatology/keu281] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Emerging evidence indicates that low-grade inflammation is part of the clinical picture of OA and that there is a need to identify soluble biomarkers of ongoing inflammation in the joint from a translational aspect. The aim of this study was to compare levels of pro-inflammatory biomarkers in SF, serum and/or EDTA plasma. METHODS SF and blood from rats subjected to Freund's complete adjuvant (FCA; n = 48) or monoiodoacetate (MIA; n = 88) monoarthritis and from control rats were collected over time. SF, EDTA plasma and serum were obtained from six individuals with OA of the knee and healthy controls. Levels of IL-6, KC/GRO, IL-8, monocyte chemoattractant protein 1 (MCP-1), macrophage inflammatory protein 3α (MIP-3α), IL-1β, TNF and l(+)-lactate were assessed either by immune assay or by a colorimetric method. RESULTS Elevated levels of biomarkers were shown in monoarthritic animals in SF compared with the control groups, although with considerably lower magnitude in the MIA groups, which also indicated a biphasic pattern. Levels of KC/GRO and MIP-3α in serum from the FCA model and IL-6 in the MIA model followed the pattern of SF. In serum samples from OA individuals, MIP-3α correlated significantly with levels in SF. CONCLUSION While we found increased levels of markers in joint fluid and blood, no single systemic biochemical biomarkers that were a common denominator between the animal models and the patient material could be identified. Our data indicate that it is critical to delineate the temporal profile of multiple local and systemic factors in order to pinpoint soluble biomarkers for OA.
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Affiliation(s)
- Anja Finn
- Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Kristina Angeby Möller
- Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Gustafsson
- Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Sally Abdelmoaty
- Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Nordahl
- Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Mats Ferm
- Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Camilla Svensson
- Translational Sciences, Neuroscience, Discovery Sciences, AstraZeneca R&D, Södertälje and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Waldstein W, Perino G, Jawetz ST, Gilbert SL, Boettner F. Does intraarticular inflammation predict biomechanical cartilage properties? Clin Orthop Relat Res 2014; 472:2177-84. [PMID: 24664199 PMCID: PMC4048417 DOI: 10.1007/s11999-014-3583-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/13/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Intact cartilage in the lateral compartment is an important requirement for medial unicompartmental knee arthroplasty (UKA). Progression of cartilage degeneration in the lateral compartment is a common failure mode of medial UKA. Little is known about factors that influence the mechanical properties of lateral compartment cartilage. QUESTIONS/PURPOSES The purposes of this study were to answer the following questions: (1) Does the synovial fluid white blood cell count predict the biomechanical properties of macroscopically intact cartilage of the distal lateral femur? (2) Is there a correlation between MRI grading of synovitis and the biomechanical properties of macroscopically intact cartilage? (3) Is there a correlation between the histopathologic assessment of the synovium and the biomechanical properties of macroscopically intact cartilage? METHODS The study included 84 patients (100 knees) undergoing primary TKA for varus osteoarthritis between May 2010 and January 2012. All patients underwent preoperative MRI to assess the degree of synovitis. During surgery, the cartilage of the distal lateral femur was assessed macroscopically using the Outerbridge grading scale. In knees with an Outerbridge grade of 0 or 1, osteochondral plugs were harvested from the distal lateral femur for biomechanical and histologic assessment. The synovial fluid was collected to determine the white blood cell count. Synovial tissue was taken for histologic evaluation of the degree of synovitis. RESULTS The mean aggregate modulus and the mean dynamic modulus were significantly greater in knees with 150 or less white blood cells/mL synovial fluid compared with knees with greater than 150 white blood cells/mL synovial fluid. There was no correlation among MRI synovitis grades, histopathologic synovitis grades, and biomechanical cartilage properties. CONCLUSIONS The study suggests that lateral compartment cartilage in patients with elevated synovial fluid white blood cell counts has a reduced ability to withstand compressive loads. LEVEL OF EVIDENCE Level III, diagnostic study. See the Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Wenzel Waldstein
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
| | - Giorgio Perino
- Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, New York, NY USA
| | - Shari T. Jawetz
- Division of Magnetic Resonance Imaging, Hospital for Special Surgery, New York, NY USA
| | | | - Friedrich Boettner
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
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Rich T, Patterson-Kane JC. Science-in-brief: What is needed to prevent tendon injury in equine athletes? A conversation between researchers and industry stakeholders. Equine Vet J 2014; 46:393-8. [DOI: 10.1111/evj.12269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- T. Rich
- Institute of Infection, Immunity and Inflammation; University of Glasgow; Glasgow UK
| | - J. C. Patterson-Kane
- Institute of Infection, Immunity and Inflammation; University of Glasgow; Glasgow UK
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31
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Hart DA. Perspectives on endogenous and exogenous tissue engineering following injury to tissues of the knee. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/jbise.2014.72009] [Citation(s) in RCA: 3] [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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