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Casado-Losada I, Acosta M, Schädl B, Priglinger E, Wolbank S, Nürnberger S. Unlocking Potential: Low Bovine Serum Albumin Enhances the Chondrogenicity of Human Adipose-Derived Stromal Cells in Pellet Cultures. Biomolecules 2024; 14:413. [PMID: 38672430 PMCID: PMC11048491 DOI: 10.3390/biom14040413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Bovine serum albumin (BSA) plays a crucial role in cell culture media, influencing cellular processes such as proliferation and differentiation. Although it is commonly included in chondrogenic differentiation media, its specific function remains unclear. This study explores the effect of different BSA concentrations on the chondrogenic differentiation of human adipose-derived stromal/stem cells (hASCs). hASC pellets from six donors were cultured under chondrogenic conditions with three BSA concentrations. Surprisingly, a lower BSA concentration led to enhanced chondrogenesis. The degree of this effect was donor-dependent, classifying them into two groups: (1) high responders, forming at least 35% larger, differentiated pellets with low BSA in comparison to high BSA; (2) low responders, which benefitted only slightly from low BSA doses with a decrease in pellet size and marginal differentiation, indicative of low intrinsic differentiation potential. In all cases, increased chondrogenesis was accompanied by hypertrophy under low BSA concentrations. To the best of our knowledge, this is the first study showing improved chondrogenicity and the tendency for hypertrophy with low BSA concentration compared to standard levels. Once the tendency for hypertrophy is understood, the determination of BSA concentration might be used to tune hASC chondrogenic or osteogenic differentiation.
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Affiliation(s)
- Isabel Casado-Losada
- Department of Orthopedics and Trauma-Surgery, Division of Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria; (I.C.-L.); (M.A.)
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria (E.P.); (S.W.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Melanie Acosta
- Department of Orthopedics and Trauma-Surgery, Division of Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria; (I.C.-L.); (M.A.)
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria (E.P.); (S.W.)
| | - Barbara Schädl
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria (E.P.); (S.W.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Eleni Priglinger
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria (E.P.); (S.W.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
- Department for Orthopedics and Traumatology, Kepler University Hospital GmbH, Johannes Kepler University Linz, 4020 Linz, Austria
| | - Susanne Wolbank
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria (E.P.); (S.W.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Sylvia Nürnberger
- Department of Orthopedics and Trauma-Surgery, Division of Trauma-Surgery, Medical University of Vienna, 1090 Vienna, Austria; (I.C.-L.); (M.A.)
- Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, 1200 Vienna, Austria (E.P.); (S.W.)
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
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Tang Y, Xu X, Zhang S, Kong W, Zhang W, Zhu T. Genetic liability for diet-derived circulating antioxidants, oxidative stress, and risk of osteoarthritis: a Mendelian randomization study. Front Nutr 2023; 10:1233086. [PMID: 38178976 PMCID: PMC10764631 DOI: 10.3389/fnut.2023.1233086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Background Although well-documented, the causal relationships between diet-derived circulating antioxidants, oxidative stress, and osteoarthritis (OA) are equivocal. The objective of this study is to employ two-sample Mendelian randomization (MR) to investigate possible causal relationships among dietary-derived circulating antioxidants, oxidative stress damage indicators, and OA risk. Methods Single-nucleotide polymorphisms for diet-derived circulating antioxidants (ascorbate, β-carotene, lycopene, retinol, and α-and γ-tocopherol), assessed as absolute levels and metabolites, as well as oxidative stress injury biomarkers (GSH, GPX, CAT, SOD, albumin, and total bilirubin), were retrieved from the published data and were used as genetic instrumental variables. Summary statistics for gene-OA associations were obtained from publicly available and two relatively large-scale GWAS meta-analyses to date. The inverse-variance weighting method was utilized as the primary MR analysis. Moreover, multivariable MR was used to determine if mediators (BMI and smoking) causally mediated any connection. Furthermore, for each exposure, MR analyses were conducted per outcome database and then meta-analyzed. Results Genetically predicted absolute retinol level was causally associated with hip OA risk [odds ratios (ORs) = 0.40, 95% confidence interval (CI) = 0.24-0.68, FDR-corrected p = 0.042]. Moreover, genetically predicted albumin level was causally associated with total OA risk (OR = 0.80, 95% CI = 0.75-0.86, FDR-corrected p = 2.20E-11), as well as the risk of hip OA (OR = 0.75, 95% CI = 0.68-0.84, FDR-corrected p = 1.38E-06) and knee OA (OR = 0.82, 95% CI = 0.76-0.89, FDR-corrected p = 4.49E-06). In addition, MVMR confirmed that the effect of albumin on hip OA is independent of smoking initiation, alcoholic drinks per week, and moderate-to-vigorous physical activity levels but may be influenced by BMI. Conclusion Evidence from our study supports a potentially protective effect of high levels of retinol and albumin on OA risk.
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Affiliation(s)
- Yidan Tang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaolin Xu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Shuangyi Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Weishuang Kong
- Department of Surgery, Xuanwei Hospital of Traditional Chinese Medicine, Xuanwei, China
| | - Weiyi Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Zhu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
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Albumin as a Biomaterial and Therapeutic Agent in Regenerative Medicine. Int J Mol Sci 2022; 23:ijms231810557. [PMID: 36142472 PMCID: PMC9502107 DOI: 10.3390/ijms231810557] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 02/07/2023] Open
Abstract
Albumin is a constitutional plasma protein, with well-known biological functions, e.g., a nutrient for stem cells in culture. However, albumin is underutilized as a biomaterial in regenerative medicine. This review summarizes the advanced therapeutic uses of albumin, focusing on novel compositions that take advantage of the excellent regenerative potential of this protein. Albumin coating can be used for enhancing the biocompatibility of various types of implants, such as bone grafts or sutures. Albumin is mainly known as an anti-attachment protein; however, using it on implantable surfaces is just the opposite: it enhances stem cell adhesion and proliferation. The anticoagulant, antimicrobial and anti-inflammatory properties of albumin allow fine-tuning of the biological reaction to implantable tissue-engineering constructs. Another potential use is combining albumin with natural or synthetic materials that results in novel composites suitable for cardiac, neural, hard and soft tissue engineering. Recent advances in materials have made it possible to electrospin the globular albumin protein, opening up new possibilities for albumin-based scaffolds for cell therapy. Several described technologies have already entered the clinical phase, making good use of the excellent biological, but also regulatory, manufacturing and clinical features of serum albumin.
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New Directions in the Development of Pharmacotherapy for Osteoarthrosis Based on Modern Concepts of the Disease Pathogenesis (A Review). Pharm Chem J 2022. [DOI: 10.1007/s11094-022-02572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Thomas G, Frederick E, Thompson L, Bar-Or R, Mulugeta Y, Hausburg M, Roshon M, Mains C, Bar-Or D. LMWF5A suppresses cytokine release by modulating select inflammatory transcription factor activity in stimulated PBMC. J Transl Med 2020; 18:452. [PMID: 33256749 PMCID: PMC7702209 DOI: 10.1186/s12967-020-02626-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/19/2020] [Indexed: 12/24/2022] Open
Abstract
Background Dysregulation of transcription and cytokine expression has been implicated in the pathogenesis of a variety inflammatory diseases. The resulting imbalance between inflammatory and resolving transcriptional programs can cause an overabundance of pro-inflammatory, classically activated macrophage type 1 (M1) and/or helper T cell type 1 (Th1) products, such as IFNγ, TNFα, IL1-β, and IL12, that prevent immune switching to resolution and healing. The low molecular weight fraction of human serum albumin (LMWF5A) is a novel biologic drug that is currently under clinical investigation for the treatment of osteoarthritis and the hyper-inflammatory response associated with COVID-19. This study aims to elucidate transcriptional mechanisms of action involved with the ability of LMWF5A to reduce pro-inflammatory cytokine release. Methods ELISA arrays were used to identify cytokines and chemokines influenced by LMWF5A treatment of LPS-stimulated peripheral blood mononuclear cells (PBMC). The resulting profiles were analyzed by gene enrichment to gain mechanistic insight into the biologic processes and transcription factors (TFs) underlying the identified differentially expressed cytokines. DNA-binding ELISAs, luciferase reporter assays, and TNFα or IL-1β relative potency were then employed to confirm the involvement of enriched pathways and TFs. Results LMWF5A was found to significantly inhibit a distinct set of pro-inflammatory cytokines (TNFα, IL-1β, IL-12, CXCL9, CXCL10, and CXCL11) associated with pro-inflammatory M1/Th1 immune profiles. Gene enrichment analysis also suggests these cytokines are, in part, regulated by NF-κB and STAT transcription factors. Data from DNA-binding and reporter assays support this with LMWF5A inhibition of STAT1α DNA-binding activity as well as a reduction in overall NF-κB-driven luciferase expression. Experiments using antagonists specific for the immunomodulatory and NF-κB/STAT-repressing transcription factors, peroxisome proliferator-activated receptor (PPAR)γ and aryl hydrocarbon receptor (AhR), indicate these pathways are involved in the LMWF5A mechanisms of action by reducing LMWF5A drug potency as measured by TNFα and IL-1β release. Conclusion In this report, we provide evidence that LMWF5A reduces pro-inflammatory cytokine release by activating the immunoregulatory transcription factors PPARγ and AhR. In addition, our data indicate that LMWF5A suppresses NF-κB and STAT1α pro-inflammatory pathways. This suggests that LMWF5A acts through these mechanisms to decrease pro-inflammatory transcription factor activity and subsequent inflammatory cytokine production.
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Affiliation(s)
- Gregory Thomas
- Ampio Pharmaceuticals Inc, 373 Inverness Parkway Suite 200, Englewood, CO, 80122, USA
| | - Elizabeth Frederick
- Ampio Pharmaceuticals Inc, 373 Inverness Parkway Suite 200, Englewood, CO, 80122, USA
| | - Lisa Thompson
- Ampio Pharmaceuticals Inc, 373 Inverness Parkway Suite 200, Englewood, CO, 80122, USA
| | - Raphael Bar-Or
- Ampio Pharmaceuticals Inc, 373 Inverness Parkway Suite 200, Englewood, CO, 80122, USA.,Trauma Research Department, Swedish Medical Center, 501 E. Hampden Ave. Rm 4-454, Englewood, CO, 80113, USA.,Trauma Research Department, St. Anthony Hospital, 11600 W 2nd Pl, Lakewood, CO, 80228, USA.,Trauma Research Department, Penrose Hospital, 2222 N Nevada Ave, Colorado Springs, CO, 80907, USA.,Centura Health Systems, 9100 E. Mineral Cir, Centennial, CO, 80112, USA
| | - Yetti Mulugeta
- Ampio Pharmaceuticals Inc, 373 Inverness Parkway Suite 200, Englewood, CO, 80122, USA
| | - Melissa Hausburg
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Ave. Rm 4-454, Englewood, CO, 80113, USA.,Trauma Research Department, St. Anthony Hospital, 11600 W 2nd Pl, Lakewood, CO, 80228, USA.,Trauma Research Department, Penrose Hospital, 2222 N Nevada Ave, Colorado Springs, CO, 80907, USA.,Centura Health Systems, 9100 E. Mineral Cir, Centennial, CO, 80112, USA
| | - Michael Roshon
- Trauma Research Department, Penrose Hospital, 2222 N Nevada Ave, Colorado Springs, CO, 80907, USA
| | - Charles Mains
- Centura Health Systems, 9100 E. Mineral Cir, Centennial, CO, 80112, USA
| | - David Bar-Or
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Ave. Rm 4-454, Englewood, CO, 80113, USA. .,Trauma Research Department, St. Anthony Hospital, 11600 W 2nd Pl, Lakewood, CO, 80228, USA. .,Trauma Research Department, Penrose Hospital, 2222 N Nevada Ave, Colorado Springs, CO, 80907, USA. .,Centura Health Systems, 9100 E. Mineral Cir, Centennial, CO, 80112, USA. .,Department of Molecular Biology, Rocky Vista University, 8401 S Chambers Rd, Parker, CO, 80134, USA.
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Thomas G, Frederick E, Hausburg M, Goldberg L, Hoke M, Roshon M, Mains C, Bar-Or D. The novel immunomodulatory biologic LMWF5A for pharmacological attenuation of the "cytokine storm" in COVID-19 patients: a hypothesis. Patient Saf Surg 2020; 14:21. [PMID: 32431755 PMCID: PMC7220573 DOI: 10.1186/s13037-020-00248-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/06/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A common complication of viral pulmonary infections, such as in the ongoing COVID-19 pandemic, is a phenomenon described as a "cytokine storm". While poorly defined, this hyperinflammatory response results in diffuse alveolar damage. The low molecular weight fraction of commercial human serum albumin (LMWF5A), a novel biologic in development for osteoarthritis, demonstrates beneficial in vitro immunomodulatory effects complimentary to addressing inflammation, thus, we hypothesize that LMWF5A could improve the clinical outcomes of COVID-19 by attenuating hyperinflammation and the potential development of a cytokine storm. PRESENTATION OF THE HYPOTHESIS A variety of human in vitro immune models indicate that LMWF5A reduces the production of pro-inflammatory cytokines implicated in cytokine storm associated with COVID-19. Furthermore, evidence suggests LMWF5A also promotes the production of mediators required for resolving inflammation and enhances the barrier function of endothelial cultures. TESTING THE HYPOTHESIS A randomized controlled trial, to evaluate the safety and efficacy of nebulized LMWF5A in adults with Acute Respiratory Distress Syndrome (ARDS) secondary to COVID-19 infection, was developed and is currently under review by the Food and Drug Administration. IMPLICATIONS OF HYPOTHESIS If successful, this therapy may attenuate the cytokine storm observed in these patients and potentially reduce mortality, increase ventilation free days, improve oxygenation parameters and consequently lessen the burden on patients and the intensive care unit. CONCLUSIONS In conclusion, in vitro findings suggest that the immunomodulatory effects of LMWF5A make it a viable candidate for treating cytokine storm and restoring homeostasis to the immune response in COVID-19.
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Affiliation(s)
- Gregory Thomas
- Ampio Pharmaceuticals, Inc, 373 Inverness Pkwy #200, Englewood, CO 80112 USA
| | - Elizabeth Frederick
- Ampio Pharmaceuticals, Inc, 373 Inverness Pkwy #200, Englewood, CO 80112 USA
| | - Melissa Hausburg
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden, Englewood, CO 80113 USA
- Trauma Research Department, St. Anthony Hospital, 11600 W 2nd Pl, Lakewood, CO 80228 USA
- Trauma Research Department, Medical City Plano, 3901 W 15th St, Plano, TX 75075 USA
- Trauma Research Department, Penrose Hospital, 2222 N Nevada Ave, Colorado Springs, CO 80907 USA
- Trauma Research Department, Research Medical Center, 2316 E Meyer Blvd, Kansas City, MO 64132 USA
- Trauma Research Department, Wesley Medical Center, 550 N Hillside St, Wichita, KS 67214 USA
| | - Laura Goldberg
- Ampio Pharmaceuticals, Inc, 373 Inverness Pkwy #200, Englewood, CO 80112 USA
| | - Marshall Hoke
- Ampio Pharmaceuticals, Inc, 373 Inverness Pkwy #200, Englewood, CO 80112 USA
| | - Michael Roshon
- Emergency Department, Penrose Hospital, Colorado Springs, Colorado USA
| | | | - David Bar-Or
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden, Englewood, CO 80113 USA
- Trauma Research Department, St. Anthony Hospital, 11600 W 2nd Pl, Lakewood, CO 80228 USA
- Trauma Research Department, Medical City Plano, 3901 W 15th St, Plano, TX 75075 USA
- Trauma Research Department, Penrose Hospital, 2222 N Nevada Ave, Colorado Springs, CO 80907 USA
- Trauma Research Department, Research Medical Center, 2316 E Meyer Blvd, Kansas City, MO 64132 USA
- Trauma Research Department, Wesley Medical Center, 550 N Hillside St, Wichita, KS 67214 USA
- Department of Molecular Biology, Rocky Vista University, 8401 S Chambers Rd, Parker, CO 80134 USA
- Swedish Medical Center, 501 E. Hampden Ave. Rm 4-454, Englewood, CO 80013 USA
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7
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Bar-Or D, Thomas G, Rael LT, Frederick E, Hausburg M, Bar-Or R, Brody E. On the Mechanisms of Action of the Low Molecular Weight Fraction of Commercial Human Serum Albumin in Osteoarthritis. Curr Rheumatol Rev 2020; 15:189-200. [PMID: 30451114 PMCID: PMC6791032 DOI: 10.2174/1573397114666181119121519] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 01/05/2023]
Abstract
The low molecular weight fraction of commercial human serum albumin (LMWF5A) has been shown to successfully relieve pain and inflammation in severe osteoarthritis of the knee (OAK). LMWF5A contains at least three active components that could account for these antiinflammatory and analgesic effects. We summarize in vitro experiments in bone marrow-derived mesenchymal stem cells, monocytic cell lines, chondrocytes, peripheral blood mononuclear cells, fibroblast-like synoviocytes, and endothelial cells on the biochemistry of anti-inflammatory changes induced by LMWF5A. We then look at four of the major pathways that cut across cell-type considerations to examine which biochemical reactions are affected by mTOR, COX-2, CD36, and AhR pathways. All three components show anti-inflammatory activities in at least some of the cell types. The in vitro experiments show that the effects of LMWF5A in chondrocytes and bone marrow- derived stem cells in particular, coupled with recent data from previous clinical trials of single and multiple injections of LMWF5A into OAK patients demonstrated improvements in pain, function, and Patient Global Assessment (PGA), as well as high responder rates that could be attributed to the multiple mechanism of action (MOA) pathways are summarized here. In vitro and in vivo data are highly suggestive of LMWF5A being a disease-modifying drug for OAK.
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Affiliation(s)
- David Bar-Or
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80113, United States.,Trauma Research Department, St. Anthony Hospital, 1600 W. 2nd Place, Lakewood, CO 80228, United States.,Trauma Research Department, Medical City Plano, 3901 W. 15th Street, Plano, TX 75075, United States.,Trauma Research Department, Penrose Hospital, 2222 N. Nevada Avenue, Colorado Springs, CO 80907, United States.,Trauma Research Department, Research Medical Center, 2315 E. Meyer Boulevard, Kansas City, MO 64132, United States.,Trauma Research Department, Wesley Medical Center, 550 N. Hillside Street, Witchita, KS 67214, United States.,Ampio Pharmaceuticals, Inc., 373 Inverness Parkway, #200, Englewood, CO 80112, United States
| | - Gregory Thomas
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80113, United States.,Trauma Research Department, St. Anthony Hospital, 1600 W. 2nd Place, Lakewood, CO 80228, United States.,Trauma Research Department, Medical City Plano, 3901 W. 15th Street, Plano, TX 75075, United States.,Trauma Research Department, Penrose Hospital, 2222 N. Nevada Avenue, Colorado Springs, CO 80907, United States.,Trauma Research Department, Research Medical Center, 2315 E. Meyer Boulevard, Kansas City, MO 64132, United States.,Trauma Research Department, Wesley Medical Center, 550 N. Hillside Street, Witchita, KS 67214, United States.,Ampio Pharmaceuticals, Inc., 373 Inverness Parkway, #200, Englewood, CO 80112, United States
| | - Leonard T Rael
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80113, United States.,Trauma Research Department, St. Anthony Hospital, 1600 W. 2nd Place, Lakewood, CO 80228, United States.,Trauma Research Department, Medical City Plano, 3901 W. 15th Street, Plano, TX 75075, United States.,Trauma Research Department, Penrose Hospital, 2222 N. Nevada Avenue, Colorado Springs, CO 80907, United States.,Trauma Research Department, Research Medical Center, 2315 E. Meyer Boulevard, Kansas City, MO 64132, United States.,Trauma Research Department, Wesley Medical Center, 550 N. Hillside Street, Witchita, KS 67214, United States
| | - Elizabeth Frederick
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80113, United States.,Trauma Research Department, St. Anthony Hospital, 1600 W. 2nd Place, Lakewood, CO 80228, United States.,Trauma Research Department, Medical City Plano, 3901 W. 15th Street, Plano, TX 75075, United States.,Trauma Research Department, Penrose Hospital, 2222 N. Nevada Avenue, Colorado Springs, CO 80907, United States.,Trauma Research Department, Research Medical Center, 2315 E. Meyer Boulevard, Kansas City, MO 64132, United States.,Trauma Research Department, Wesley Medical Center, 550 N. Hillside Street, Witchita, KS 67214, United States.,Ampio Pharmaceuticals, Inc., 373 Inverness Parkway, #200, Englewood, CO 80112, United States
| | - Melissa Hausburg
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80113, United States.,Trauma Research Department, St. Anthony Hospital, 1600 W. 2nd Place, Lakewood, CO 80228, United States.,Trauma Research Department, Medical City Plano, 3901 W. 15th Street, Plano, TX 75075, United States.,Trauma Research Department, Penrose Hospital, 2222 N. Nevada Avenue, Colorado Springs, CO 80907, United States.,Trauma Research Department, Research Medical Center, 2315 E. Meyer Boulevard, Kansas City, MO 64132, United States.,Trauma Research Department, Wesley Medical Center, 550 N. Hillside Street, Witchita, KS 67214, United States
| | - Raphael Bar-Or
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80113, United States.,Trauma Research Department, St. Anthony Hospital, 1600 W. 2nd Place, Lakewood, CO 80228, United States.,Trauma Research Department, Medical City Plano, 3901 W. 15th Street, Plano, TX 75075, United States.,Trauma Research Department, Penrose Hospital, 2222 N. Nevada Avenue, Colorado Springs, CO 80907, United States.,Trauma Research Department, Research Medical Center, 2315 E. Meyer Boulevard, Kansas City, MO 64132, United States.,Trauma Research Department, Wesley Medical Center, 550 N. Hillside Street, Witchita, KS 67214, United States.,Ampio Pharmaceuticals, Inc., 373 Inverness Parkway, #200, Englewood, CO 80112, United States
| | - Edward Brody
- SomaLogic, Inc., 2945 Wilderness Place, Boulder, CO 80301, United States
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Jones IA, Togashi R, Wilson ML, Heckmann N, Vangsness CT. Intra-articular treatment options for knee osteoarthritis. Nat Rev Rheumatol 2019; 15:77-90. [PMID: 30498258 PMCID: PMC6390843 DOI: 10.1038/s41584-018-0123-4] [Citation(s) in RCA: 262] [Impact Index Per Article: 52.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Intra-articular drug delivery has a number of advantages over systemic administration; however, for the past 20 years, intra-articular treatment options for the management of knee osteoarthritis (OA) have been limited to analgesics, glucocorticoids, hyaluronic acid (HA) and a small number of unproven alternative therapies. Although HA and glucocorticoids can provide clinically meaningful benefits to an appreciable number of patients, emerging evidence indicates that the apparent effectiveness of these treatments is largely a result of other factors, including the placebo effect. Biologic drugs that target inflammatory processes are used to manage rheumatoid arthritis, but have not translated well into use in OA. A lack of high-level evidence and methodological limitations hinder our understanding of so-called 'stem' cell therapies and, although the off-label administration of intra-articular cell therapies (such as platelet-rich plasma and bone marrow aspirate concentrate) is common, high-quality clinical data are needed before these treatments can be recommended. A number of promising intra-articular treatments are currently in clinical development in the United States, including small-molecule and biologic therapies, devices and gene therapies. Although the prospect of new, non-surgical treatments for OA is exciting, the benefits of new treatments must be carefully weighed against their costs and potential risks.
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Affiliation(s)
- Ian A Jones
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Ryan Togashi
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Melissa L Wilson
- Department of Preventive Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Nathanael Heckmann
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - C Thomas Vangsness
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
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9
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Zhang W, Robertson WB, Zhao J, Chen W, Xu J. Emerging Trend in the Pharmacotherapy of Osteoarthritis. Front Endocrinol (Lausanne) 2019; 10:431. [PMID: 31312184 PMCID: PMC6614338 DOI: 10.3389/fendo.2019.00431] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 06/14/2019] [Indexed: 12/25/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disorder and one of the most prevalent diseases among the elderly population. Due to the limited spontaneous healing capacity of articular cartilage, it still remains challenging to find satisfactory treatment for OA. This review covers the emerging trends of pharmacologic therapies for OA such as traditional OA drugs (acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, serotonin-norepinephrine reuptake inhibitors (SNRIs), intra-articular injections of corticosteroids, and dietary supplements), which are effective in pain relief but not in reversing damage, and are frequently associated with adverse events. Alternatively, disease-modifying drugs provide promising alternatives for the management of OA. The development of these emerging OA therapeutic agents requires a comprehensive understanding of the pathophysiology of OA progression. The process of cartilage anabolism/catabolism, subchondral bone remodeling and synovial inflammation are identified as potential targets. These emerging OA drugs such as bone morphogenetic protein-7 (BMP-7), fibroblast growth factor-18 (FGF-18), human serum albumin (HSA), interleukin-1 (IL-1) inhibitor, β-Nerve growth factor (β-NGF) antibody, matrix extracellular phosphoglycoprotein (MEPE) and inverse agonist of retinoic acid-related orphan receptor alpha (RORα) etc. have shown potential to modify progression of OA with minimal adverse effects. However, large-scale randomized controlled trials (RCTs) are needed to investigate the safety and efficacy before translation from bench to bedside.
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Affiliation(s)
- Wei Zhang
- School of Medicine, Southeast University, Nanjing, China
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - William Brett Robertson
- Australian Institute of Robotic Orthopaedics, Perth, WA, Australia
- School of Surgery, The University of Western Australia, Perth, WA, Australia
- School of Science, Faculty of Science and Engineering, Curtin University, Perth, WA, Australia
- Department of Materials Science and Engineering, College of Engineering, University of North Texas, Denton, TX, United States
| | - Jinmin Zhao
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Weiwei Chen
- Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory of Regenerative Medicine, Guangxi Medical University, Nanning, China
- *Correspondence: Weiwei Chen
| | - Jiake Xu
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
- Jiake Xu
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10
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Rael LT, Bar-Or R, Banton KL, Mains CW, Roshon M, Tanner AH, Lieser MJ, Acuna DL, Bar-Or D. The anti-inflammatory effect of LMWF5A and N-acetyl kynurenine on macrophages: Involvement of aryl hydrocarbon receptor in mechanism of action. Biochem Biophys Rep 2018; 15:61-67. [PMID: 30073204 PMCID: PMC6068081 DOI: 10.1016/j.bbrep.2018.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 05/25/2018] [Accepted: 06/26/2018] [Indexed: 11/04/2022] Open
Abstract
After a traumatic insult, macrophages can become activated leading to general inflammation at the site of injury. Activated macrophages are partially regulated by the aryl hydrocarbon receptor (AhR) which when activated suppresses inflammation by limiting the secretion of pro-inflammatory cytokines and promoting the over expression of immuno-modulatory mediators. This study aims to determine whether the low molecular weight fraction of 5% human serum albumin (LMWF5A) and N-acetyl kynurenine (NAK), an N-acetyl tryptophan (NAT) breakdown product in LMWF5A, can regulate inflammation by inhibiting macrophage activation through the AhR since kynurenine is a known AhR agonist. Using LCMS, we demonstrate that NAT is non-enzymatically degraded during accelerated aging of LMWF5A with high heat accelerating degradation. More importantly, NAK is a major degradation product found in LMWF5A. THP-1 monocytes were differentiated into macrophages using phorbol 12-myristate 13-acetate (PMA) and pre-treated with 2-fold dilutions of LMWF5A or synthetic NAK with or without an AhR antagonist (CH223191) prior to overnight stimulation with lipopolysaccharide (LPS). Treatment with LMWF5A caused a 50–70% decrease in IL-6 release throughout the dilution series. A dose-response inhibition of IL-6 release was observed for NAK with maximal inhibition (50%) seen at the highest NAK concentration. Finally, an AhR antagonist partially blocked the anti-inflammatory effect of LMWF5A while completely blocking the effect of NAK. A similar inhibitory effect was observed for CXCL-10, but the AhR antagonist was not effective suggesting additional mechanisms for CXCL-10 release. These preliminary findings suggest that LMWF5A and NAK partially promote the suppression of activated macrophages via the AhR receptor. Therefore, LMWF5A, which contains NAK, is potentially a useful therapeutic in medical conditions where inflammation is prevalent such as trauma, sepsis, and wound healing. LMWF5A contains degradation products of N-acetyl tryptophan (NAT). A major degradation product of NAT in LMWF5A is N-acetyl kynurenine (NAK). LMWF5A and NAK decrease IL-6 and CXCL-10 release from activated macrophages. AhR is partially involved in the mechanism of action for LMWF5A and NAK. The anti-inflammatory properties of LMWF5A are also AhR-independent.
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Affiliation(s)
- Leonard T Rael
- Swedish Medical Center, Englewood, CO 80113, USA.,St. Anthony Hospital, Lakewood, CO 80228, USA.,Medical City Plano, Plano, TX 75075, USA.,Penrose Hospital, Colorado Springs, CO 80907, USA.,Research Medical Center, Kansas City, MO 64132, USA.,Wesley Medical Center, Wichita, KS 67214, USA
| | - Raphael Bar-Or
- Swedish Medical Center, Englewood, CO 80113, USA.,St. Anthony Hospital, Lakewood, CO 80228, USA.,Medical City Plano, Plano, TX 75075, USA.,Penrose Hospital, Colorado Springs, CO 80907, USA.,Research Medical Center, Kansas City, MO 64132, USA.,Wesley Medical Center, Wichita, KS 67214, USA.,Ampio Pharmaceuticals, Inc., Englewood, CO 80112, USA
| | | | | | | | | | | | | | - David Bar-Or
- Swedish Medical Center, Englewood, CO 80113, USA.,St. Anthony Hospital, Lakewood, CO 80228, USA.,Medical City Plano, Plano, TX 75075, USA.,Penrose Hospital, Colorado Springs, CO 80907, USA.,Research Medical Center, Kansas City, MO 64132, USA.,Wesley Medical Center, Wichita, KS 67214, USA.,Ampio Pharmaceuticals, Inc., Englewood, CO 80112, USA.,Rocky Vista University, Parker, CO 80134, USA
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11
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Salottolo K, Cole B, Bar-Or D. Intra-articular injection of the anti-inflammatory compound LMWF-5A in adults with severe osteoarthritis: a double-blind prospective randomized controlled multi-center safety and efficacy trial. Patient Saf Surg 2018; 12:11. [PMID: 29910837 PMCID: PMC5985594 DOI: 10.1186/s13037-018-0158-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 04/20/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There are limited efficacious treatment options for severe osteoarthritis of the knee (OAK). The Low Molecular Weight Fraction of 5% human serum Albumin (LMWF-5A) is in development to treat severe OAK. This study evaluated the safety and efficacy of LMWF-5A for the signs and symptoms of OAK. METHODS This 12-week randomized, double-blind, controlled clinical trial was conducted at thirteen sites across the United States. Patients with symptomatic, severe OAK (Kellgren-Lawrence grade 4 disease) who were fully ambulatory and had no other conditions interfering with the study knee were randomized to a single 4 ml intra-articular injection of LMWF-5A or saline, randomized 6:1. The primary endpoint was Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responder rate (%), examined with a one-sided exact binomial test compared to a clinically meaningful response rate of 30%. Efficacy of LMWF-5A was also evaluated as controlled responder (%), defined as 20% improvements in both pain and function, compared to historical saline control from three previous trials. Safety was examined as the incidence and severity of adverse events (AEs). This trial was registered (clinicaltrials.gov identifier: NCT03182686). RESULTS In total, 168 patients were randomized; 144 subjects treated with LMWF-5A were analysed. Overall, 71% (95% CI: 63.4%-78.3%) of subjects treated with LMWF-5A met the OMERACT-OARSI responder criteria, exceeding the 30% threshold (p < 0.001). There were also significantly more responders at week 12 in the LMWF-5A arm than historical saline control (65% vs. 43%, p < 0.001). There were no drug-related serious AEs reported and no deaths or withdrawals due to adverse events. CONCLUSION LMWF-5A provides relief for the signs and symptoms of severe osteoarthritis, and may be an alternative therapeutic treatment option for patients with severe osteoarthritis of the knee.
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Affiliation(s)
- Kristin Salottolo
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Ave Rm 4-454, Englewood, CO 80113 USA
| | - Brian Cole
- Department of Orthopedics, Rush University Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612 USA
| | - David Bar-Or
- Trauma Research Department, Swedish Medical Center, 501 E. Hampden Ave Rm 4-454, Englewood, CO 80113 USA
- Ampio Pharmaceuticals, Inc., 373 Inverness Parkway, Englewood, CO 80112 USA
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12
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Schwappach J, Schultz J, Salottolo K, Bar-Or D. Incidence of total knee replacement subsequent to intra-articular injection of the anti-inflammatory compound LMWF-5A versus saline: a long-term follow-up study to a randomized controlled trial. Patient Saf Surg 2018; 12:14. [PMID: 29881459 PMCID: PMC5985578 DOI: 10.1186/s13037-018-0162-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/21/2018] [Indexed: 01/08/2023] Open
Abstract
Background The disease modifying potential of osteoarthritis therapies are of increasing interest, including their effects on delaying total knee replacement (TKR). To date, there have been no studies to determine the effect of LMWF-5A, a novel anti-inflammatory compound derived from human serum albumin, on delaying TKR. Methods We evaluated time to TKR three years after patients participated in a randomized trial of three intra-articular injections of LMWF-5A or saline. Patients were contacted via last known phone number and were asked to participate in a short nine item telephone questionnaire; verbal consent was obtained. The primary endpoint was incidence of TKR (%). Results In total, 39 of 45 patients responded (87% response rate). The overall incidence of TKR was 38.5% (15/39). TKR rates were higher in patients with more severe osteoarthritis defined by Kellgren-Lawrence grade 4, compared to patients with moderate osteoarthritis defined by Kellgren-Lawrence grade 3 (56% vs. 26%, p = 0.06). Overall, there were no differences in TKR rates by treatment arm (39% LMWF-5A vs. 38% saline, p = 0.92). In the severe osteoarthritis subset (n = 16), treatment with LMWF-5A resulted in a lower incidence of TKR compared to saline vehicle arm (40% vs. 83%, p = 0.15). TKR rates were significantly lower with LMWF-5A in patients who responded to treatment (14% with LMWF-5A, vs. 100% with saline, p = 0.03). Conclusion This study demonstrates significant delays in TKR for patients with severe osteoarthritis treated with LMWF-5A, suggesting that LMWF-5A has the potential to provide structure modifying/preserving therapy in this population.
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Affiliation(s)
| | | | - Kristin Salottolo
- 2Trauma Research Department, Swedish Medical Center, 501 E. Hampden Ave Rm 4-454, Englewood, CO 80113 USA
| | - David Bar-Or
- 2Trauma Research Department, Swedish Medical Center, 501 E. Hampden Ave Rm 4-454, Englewood, CO 80113 USA.,Ampio Pharmaceuticals, Inc, 373 Inverness Parkway, Englewood, CO 80112 USA
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13
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14
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Cole B, McGrath B, Salottolo K, Bar-Or D. LMWF-5A for the Treatment of Severe Osteoarthritis of the Knee: Integrated Analysis of Safety and Efficacy. Orthopedics 2018; 41:e77-e83. [PMID: 29156068 DOI: 10.3928/01477447-20171114-05] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/03/2017] [Indexed: 02/03/2023]
Abstract
The low-molecular-weight fraction of 5% human serum albumin (LMWF-5A) is being developed to treat the signs and symptoms of severe osteoarthritis of the knee. This study was a post hoc pooled analysis of 3 randomized placebo-controlled trials of a single intra-articular injection of LMWF-5A, focusing on the subset of patients with severe osteoarthritis of the knee (Kellgren-Lawrence grade 4). Patients were randomized 1:1 to receive a single 4-mL intra-articular knee injection of either LMWF-5A or saline. Safety was assessed as the incidence and severity of adverse events. Efficacy was assessed as the change from baseline to week 12 on the Western Ontario and McMaster Universities Osteoarthritis Index pain (primary outcome), stiffness, and physical function subscores and on patient global assessment scores and was presented as the least squares mean difference and 95% confidence interval. The proportion of responders was defined with the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria for scenario D and examined with Pearson's chi-square test. For 417 patients with severe osteoarthritis of the knee, treatment with LMWF-5A resulted in a significant decrease in pain at 12 weeks compared with saline (mean difference, -0.19; 95% confidence interval, -0.34 to -0.04; P=.016), with improvements in function (mean difference, -0.15; 95% confidence interval, -0.31 to 0.01) and patient global assessment (mean difference, -0.30; 95% confidence interval, -0.49 to -0.12) and higher responder rates (64.25% vs 50.90%, P=.006). No drug-related serious adverse events and no deaths occurred, and the incidence and severity of adverse events were similar across treatment groups. This pooled analysis supports the use of LMWF-5A as a safe therapeutic agent for relief of the signs and symptoms of severe osteoarthritis of the knee. [Orthopedics. 2018; 41(1):e77-e83.].
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15
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Shyam H, Singh SK, Kant R, Saxena SK. Mesenchymal stem cells in regenerative medicine: a new paradigm for degenerative bone diseases. Regen Med 2017; 12:111-114. [PMID: 28244826 DOI: 10.2217/rme-2016-0162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Hari Shyam
- Department of Stem Cell & Cell Culture, Centre for Advance Research (CFAR), King George's Medical University, Lucknow 226003, India
| | - Satyendra K Singh
- Department of Stem Cell & Cell Culture, Centre for Advance Research (CFAR), King George's Medical University, Lucknow 226003, India
| | - Ravi Kant
- Department of Stem Cell & Cell Culture, Centre for Advance Research (CFAR), King George's Medical University, Lucknow 226003, India
| | - Shailendra K Saxena
- Department of Stem Cell & Cell Culture, Centre for Advance Research (CFAR), King George's Medical University, Lucknow 226003, India.,CSIR-Centre for Cellular & Molecular Biology, Uppal Road, Hyderabad 500007, India
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16
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Thomas GW, Rael LT, Hausburg M, Frederick ED, Brody E, Bar-Or D. The low molecular weight fraction of commercial human serum albumin induces acetylation of α-tubulin and reduces transcytosis in retinal endothelial cells. Biochem Biophys Res Commun 2016; 478:1780-5. [DOI: 10.1016/j.bbrc.2016.09.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 09/05/2016] [Indexed: 02/08/2023]
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17
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Frederick ED, Hausburg MA, Thomas GW, Rael LT, Brody E, Bar-Or D. The low molecular weight fraction of human serum albumin upregulates COX2, prostaglandin E2, and prostaglandin D2 under inflammatory conditions in osteoarthritic knee synovial fibroblasts. Biochem Biophys Rep 2016; 8:68-74. [PMID: 28955943 PMCID: PMC5613771 DOI: 10.1016/j.bbrep.2016.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/10/2016] [Accepted: 08/10/2016] [Indexed: 11/24/2022] Open
Abstract
Background The ability to decrease inflammation and promote healing is important in the intervention and management of a variety of disease states, including osteoarthritis of the knee (OAK). Even though cyclooxygenase 2 (COX2) has an established pro-inflammatory role, evidence suggests it is also critical to the resolution that occurs after the initial activation phase of the immune response. In this study, we investigated the effects of the low molecular weight fraction of 5% human serum albumin (LMWF-5A), an agent that has proven to decrease pain and improve function in OAK patients after intra-articular injection, on the expression of COX2 and its downstream products, prostaglandins (PGs). Methods Fibroblast-like synoviocytes from the synovial membrane of OAK patients were treated with LMWF-5A or saline as a control with or without the addition of interleukin-1β (IL-1β) or tumor necrosis factor α (TNFα) to elicit an inflammatory response. Cells were harvested for RNA and protein at 2, 4, 8, 12, and 24 h, and media was collected at 24 h for analysis of secreted products. COX2 mRNA expression was determined by qPCR, and COX2 protein expression was determined by western blot analysis. Levels of prostaglandin E2 (PGE2) and prostaglandin D2 (PGD2) in the media were quantified by competitive ELISA. Results In the presence of either IL-1β or TNFα, LMWF-5A increased the expression of both COX2 mRNA and protein, and this increase was significant compared to that observed with IL-1β- or TNFα-stimulated, saline-treated cells. Downstream of COX2, the levels of PGE2 were increased only in TNFα-stimulated, LMWF-5A-treated cells; however, in both IL-1β- and TNFα-stimulated cells, LMWF-5A increased the release of the anti-inflammatory prostaglandin PGD2. Conclusion LMWF-5A appears to trigger increased anti-inflammatory PG signaling, and this may be a primary component of its therapeutic mode of action in the treatment of OAK. Proposed mechanism of action for biologic drug to treat osteoarthritis of the knee. LMWF-5A affects the COX2 pathway in primary synoviocytes from osteoarthritic knees. LMWF-5A may promote resolution of inflammation, healing, and cartilage regeneration.
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Key Words
- 15d-PGJ2, 15-deoxy-Δ12,14-prostaglandin J2
- COX, cyclooxygenase
- Cyclooxygenase 2
- DMEM/F12, Dulbecco’s Modified Eagle Medium/Nutrient Mixture F-12
- ELISA, enzyme-linked immunosorbent assay
- FBS, fetal bovine serum
- HSA, human serum albumin
- HSF-OAs, human synovial fibroblasts from patients with osteoarthritis
- Human serum albumin
- IL, interleukin
- IgG, immunoglobulin G
- Inflammation
- LMWF-5A, molecular weight fraction of human serum albumin under 5000 Da
- LOD, limit of detection
- NF-κB, nuclear factor-κB
- NSAIDs, non-steroidal anti-inflammatory drugs
- OA, osteoarthritis
- OAK, osteoarthritis of the knee
- Osteoarthritis
- PBMCs, peripheral blood mononuclear cells
- PG, prostaglandin
- PGD2, prostaglandin D2
- PGE2, prostaglandin E2
- PGH2, prostaglandin H2
- PPARγ, peroxisome proliferator-activated receptor γ
- PVDF, polyvinylidene fluoride
- Prostaglandin
- SDS-PAGE, sodium dodecyl sulfate-polyacrylamide gel electrophoresis
- SEM, standard error of the mean
- Synovial fibroblast
- TNF, tumor necrosis factor
- hMSCs, human mesenchymal stem cells
- qPCR, quantitative real-time polymerase chain reaction
- ΔΔCT, comparative threshold cycle
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Affiliation(s)
- Elizabeth D Frederick
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA
| | - Melissa A Hausburg
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA
| | - Gregory W Thomas
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA
| | - Leonard T Rael
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA
| | - Edward Brody
- SomaLogic Inc., 2945 Wilderness Place, Boulder, CO 80301, USA
| | - David Bar-Or
- Swedish Medical Center, 501 E. Hampden Ave, Englewood, CO 80113, USA.,Ampio Pharmaceuticals Inc., 373 Inverness Pkwy, Englewood, CO 80112, USA.,St. Anthony Hospital, Trauma Research Department, 11600 W. 2nd Pl, Lakewood, CO 80228, USA.,Medical Center of Plano, Trauma Research Department, 3901 W. 15th St., Plano, TX 75075, USA.,Rocky Vista University, 8401 S. Chambers Rd., Parker, CO 80134, USA.,Penrose Hospital, 2417 Cascade Ave, Colorado Springs, CO 80907, USA
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18
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Chang YH, Liu HW, Wu KC, Ding DC. Mesenchymal Stem Cells and Their Clinical Applications in Osteoarthritis. Cell Transplant 2016; 25:937-50. [DOI: 10.3727/096368915x690288] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis is a chronic degenerative joint disorder characterized by articular cartilage destruction and osteophyte formation. Chondrocytes in the matrix have a relatively slow turnover rate, and the tissue itself lacks a blood supply to support repair and remodeling. Researchers have evaluated the effectiveness of stem cell therapy and tissue engineering for treating osteoarthritis. All sources of stem cells, including embryonic, induced pluripotent, fetal, and adult stem cells, have potential use in stem cell therapy, which provides a permanent biological solution. Mesenchymal stem cells (MSCs) isolated from bone marrow, adipose tissue, and umbilical cord show considerable promise for use in cartilage repair. MSCs can be sourced from any or all joint tissues and can modulate the immune response. Additionally, MSCs can directly differentiate into chondrocytes under appropriate signal transduction. They also have immunosuppressive and anti-inflammatory paracrine effects. This article reviews the current clinical applications of MSCs and future directions of research in osteoarthritis.
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Affiliation(s)
- Yu-Hsun Chang
- Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Hwan-Wun Liu
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
- Department of Occupational Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Kun-Chi Wu
- Department of Orthopedics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Dah-Ching Ding
- Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
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19
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Thomas GW, Rael LT, Hausburg M, Frederick ED, Mains CW, Slone D, Carrick MM, Bar-Or D. The low molecular weight fraction of human serum albumin upregulates production of 15d-PGJ2 in Peripheral Blood Mononuclear Cells. Biochem Biophys Res Commun 2016; 473:1328-1333. [PMID: 27095392 DOI: 10.1016/j.bbrc.2016.04.072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 04/15/2016] [Indexed: 11/25/2022]
Abstract
Activation of the innate immune system involves a series of events designed to counteract the initial insult followed by the clearance of debris and promotion of healing. Aberrant regulation can lead to systemic inflammatory response syndrome, multiple organ failure, and chronic inflammation. A better understanding of the innate immune response may help manage complications while allowing for proper immune progression. In this study, the ability of several classes of anti-inflammatory drugs to affect LPS-induced cytokine and prostaglandin release from peripheral blood mononuclear cells (PBMC) was evaluated. PBMC were cultured in the presence of dexamethasone (DEX), ibuprofen (IBU), and the low molecular weight fraction of 5% albumin (LMWF5A) followed by stimulation with LPS. After 24 h, TNFα, PGE2, and 15d-PGJ2 release was determined by ELISA. Distinct immunomodulation patterns emerged following LPS stimulation of PBMC in the presence of said compounds. DEX, a steroid with strong immunosuppressive properties, reduced TNFα, PGE2, and 15d-PGJ2 release. IBU caused significant reduction in prostaglandin release while TNFα release was unchanged. An emerging biologic with known anti-inflammatory properties, LMWF5A, significantly reduced TNFα release while enhancing PGE2 and 15d-PGJ2 release. Incubating LMWF5A together with IBU negated this observed increased prostaglandin release without affecting the suppression of TNFα release. Additionally, LMWF5A caused an increase in COX-2 transcription and translation. LMWF5A exhibited a unique immune modulation pattern in PBMC, disparate from steroid or NSAID administration. This enhancement of prostaglandin release (specifically 15d-PGJ2), in conjunction with a decrease in TNFα release, suggests a switch that favors resolution and decreased inflammation.
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Affiliation(s)
- Gregory W Thomas
- Swedish Medical Center, 501 E. Hampden Ave., Englewood, CO 80113, USA; St. Anthony Hospital, 11600 W. 2nd, Pl., Lakewood, CO 80228, USA; The Medical Center of Plano, 3901 W. 15th, St., Plano, TX 75075, USA.
| | - Leonard T Rael
- Swedish Medical Center, 501 E. Hampden Ave., Englewood, CO 80113, USA; St. Anthony Hospital, 11600 W. 2nd, Pl., Lakewood, CO 80228, USA; The Medical Center of Plano, 3901 W. 15th, St., Plano, TX 75075, USA.
| | - Melissa Hausburg
- Swedish Medical Center, 501 E. Hampden Ave., Englewood, CO 80113, USA; St. Anthony Hospital, 11600 W. 2nd, Pl., Lakewood, CO 80228, USA; The Medical Center of Plano, 3901 W. 15th, St., Plano, TX 75075, USA.
| | - Elizabeth D Frederick
- Swedish Medical Center, 501 E. Hampden Ave., Englewood, CO 80113, USA; St. Anthony Hospital, 11600 W. 2nd, Pl., Lakewood, CO 80228, USA; The Medical Center of Plano, 3901 W. 15th, St., Plano, TX 75075, USA.
| | - Charles W Mains
- St. Anthony Hospital, 11600 W. 2nd, Pl., Lakewood, CO 80228, USA.
| | - Denetta Slone
- Swedish Medical Center, 501 E. Hampden Ave., Englewood, CO 80113, USA.
| | - Matthew M Carrick
- The Medical Center of Plano, 3901 W. 15th, St., Plano, TX 75075, USA.
| | - David Bar-Or
- Swedish Medical Center, 501 E. Hampden Ave., Englewood, CO 80113, USA; St. Anthony Hospital, 11600 W. 2nd, Pl., Lakewood, CO 80228, USA; The Medical Center of Plano, 3901 W. 15th, St., Plano, TX 75075, USA; Rocky Vista University, 8401 S. Chambers Rd., Parker, CO 80134, USA.
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20
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Lin ZL, Zheng GW, Zhang L, Zheng JT, Chen H. RETRACTED: Effect of transplantation of BMMSCs on pathological change of gastric precancerous lesions of rats. ASIAN PAC J TROP MED 2015; 8:1060-1063. [PMID: 26706680 DOI: 10.1016/j.apjtm.2015.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 10/20/2015] [Accepted: 11/03/2015] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To build the rat model of gastric precancerous lesions and discuss the effect of transplantation of mesenchymal stem cells (BMMSCs) on the pathological change. METHODS The rat model of gastric precancerous lesions was built using N-methyl-N'-nitro-N'-nitrosoguanidine. After the intravenous transplantation of BMMSCs, the migration and colonization location was then observed, as well as its effect on the related factors of gastric precancerous lesions, including VEGF, IL-10 and IFN-γ. RESULTS BMMSCs were mainly colonized in the gastric body and gastric antrum, which could be differentiated into the epithelial and interstitial cells. The expression of VEGF in the transplantation group and non-transplantation group was significantly higher than that in the control group (P < 0.05); while the expression of VEGF in the transplantation group was significantly higher than that in the non-transplantation group (t = 3.88, P < 0.001). The expression of serum IL-10 and IFN-γ in the transplantation group and non-transplantation group was significantly higher than that in the control group (P < 0.05), while the expression of IL-10 and IFN-γ in the transplantation group was significantly lower than that in the non-transplantation group (t = 3.03, P = 0.004; t = 3.80, P < 0.001). CONCLUSIONS BMMSCs can be directionally differentiated into the epithelial and interstitial cells and can also regulate the related growth factors and inflammatory factors to reduce the injury of inflammation, relieve or reverse the process of gastric precancerous lesions.
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Affiliation(s)
- Zhen-Lv Lin
- Department of Emergency Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China
| | - Guang-Wei Zheng
- Department of Emergency Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China
| | - Lin Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China.
| | - Jian-Tao Zheng
- Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China
| | - Hui Chen
- Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China
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