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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Kerkhof HJ, Meulenbelt I, Akune T, Arden NK, Aromaa A, Bierma-Zeinstra SM, Carr A, Cooper C, Dai J, Doherty M, Doherty SA, Felson D, Gonzalez A, Gordon A, Harilainen A, Hart DJ, Hauksson VB, Heliovaara M, Hofman A, Ikegawa S, Ingvarsson T, Jiang Q, Jonsson H, Jonsdottir I, Kawaguchi H, Kloppenburg M, Kujala UM, Lane NE, Leino-Arjas P, Lohmander S, Luyten FP, Malizos KN, Nakajima M, Nevitt MC, Pols HA, Rivadeneira F, Shi D, Slagboom E, Spector TD, Stefansson K, Sudo A, Tamm A, Tamm AE, Tsezou A, Uchida A, Uitterlinden AG, Wilkinson JM, Yoshimura N, Valdes AM, van Meurs JB. Recommendations for standardization and phenotype definitions in genetic studies of osteoarthritis: the TREAT-OA consortium. Osteoarthritis Cartilage 2011; 19:254-64. [PMID: 21059398 PMCID: PMC3236091 DOI: 10.1016/j.joca.2010.10.027] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 10/15/2010] [Accepted: 10/26/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To address the need for standardization of osteoarthritis (OA) phenotypes by examining the effect of heterogeneity among symptomatic (SOA) and radiographic osteoarthritis (ROA) phenotypes. METHODS Descriptions of OA phenotypes of the 28 studies involved in the TREAT-OA consortium were collected. We investigated whether different OA definitions result in different association results by creating various hip OA definitions in one large population based cohort (the Rotterdam Study I (RSI)) and testing those for association with gender, age and body mass index using one-way ANOVA. For ROA, we standardized the hip-, knee- and hand ROA definitions and calculated prevalence's of ROA before and after standardization in nine cohort studies. This procedure could only be performed in cohort studies and standardization of SOA definitions was not feasible at this moment. RESULTS In this consortium, all studies with SOA phenotypes (knee, hip and hand) used a different definition and/or assessment of OA status. For knee-, hip- and hand ROA five, four and seven different definitions were used, respectively. Different hip ROA definitions do lead to different association results. For example, we showed in the RSI that hip OA defined as "at least definite joint space narrowing (JSN) and one definite osteophyte" was not associated with gender (P =0.22), but defined as "at least one definite osteophyte" was significantly associated with gender (P=3×10(-9)). Therefore, a standardization process was undertaken for ROA definitions. Before standardization a wide range of ROA prevalence's was observed in the nine cohorts studied. After standardization the range in prevalence of knee- and hip ROA was small. CONCLUSION Phenotype definitions influence the prevalence of OA and association with clinical variables. ROA phenotypes within the TREAT-OA consortium were standardized to reduce heterogeneity and improve power in future genetics studies.
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Affiliation(s)
- Hanneke J.M. Kerkhof
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands,The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands
| | - Ingrid Meulenbelt
- The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Toru Akune
- Department of Clinical Motor System Medicine, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan
| | - Nigel K. Arden
- MRC Epidemiology Resource Centre University of Southampton, Southampton General Hospital, Southampton, United Kingdom,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford England Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, United Kingdom
| | - Arpo Aromaa
- The National Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - Andrew Carr
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford England Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, United Kingdom
| | - Cyrus Cooper
- MRC Epidemiology Resource Centre University of Southampton, Southampton General Hospital, Southampton, United Kingdom,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford England Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, United Kingdom
| | - Jin Dai
- Center of Diagnosis and Treatment for Joint Disease, Nanjing DrumTower Hospital, The affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Michael Doherty
- Academic Rheumatology, Clinical Sciences Building, Nottingham City Hospital Hucknall Road, Nottingham, United Kingdom
| | - Sally A. Doherty
- Academic Rheumatology, Clinical Sciences Building, Nottingham City Hospital Hucknall Road, Nottingham, United Kingdom
| | - David Felson
- Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, United States of America
| | - Antonio Gonzalez
- Laboratorio Investigacion and Rheumatology Unit, Hospital Clinico Universitario Santiago, Santiago de Compostela, Spain
| | - Andrew Gordon
- Academic Unit of Bone Metabolism, Department of Human Metabolism, University of Sheffield, Sheffield, United Kingdom,Sheffield NIHR Bone Biomedical research Unit, Centre for Biomedical Research, Northern General Hospital, Sheffield, United Kingdom
| | - Arsi Harilainen
- ORTON Orthopedic Hospital, Invalid Foundation, Helsinki, Finland
| | - Deborah J. Hart
- Department of Twin Research and Genetic Epidemiology, St. Thomas' Hospital, King's College London, London, United Kingdom
| | | | - Markku Heliovaara
- The National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Albert Hofman
- The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, Center for Genomic Medicine, RIKEN, Japan
| | - Thorvaldur Ingvarsson
- FSA University Hospital, Institution of Health Science, University of Akureyri, Akureyri, Iceland
| | - Qing Jiang
- Center of Diagnosis and Treatment for Joint Disease, Nanjing DrumTower Hospital, The affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Helgi Jonsson
- Department of Medicine, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE Genetics, Reykjavik, Iceland,Department of Medicine, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hiroshi Kawaguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Urho M. Kujala
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Nancy E. Lane
- University of California at San Francisco and University of California at Davis, Sacramento, United States of America
| | | | - Stefan Lohmander
- Department of Orthopedics, Clinical Sciences, Lund University, Lund, Sweden
| | - Frank P. Luyten
- Laboratory for Skeletal Development and Joint Disorders, Division of Rheumatology, Katholieke Universiteit Leuven, Belgium
| | | | - Masahiro Nakajima
- Laboratory for Bone and Joint Diseases, Center for Genomic Medicine, RIKEN, Japan
| | - Michael C. Nevitt
- University of California at San Francisco and University of California at Davis, Sacramento, United States of America
| | - Huibert A.P. Pols
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands,The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dongquan Shi
- Center of Diagnosis and Treatment for Joint Disease, Nanjing DrumTower Hospital, The affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Eline Slagboom
- The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, St. Thomas' Hospital, King's College London, London, United Kingdom
| | - Kari Stefansson
- deCODE Genetics, Reykjavik, Iceland,Department of Medicine, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Japan
| | - Agu Tamm
- Department of Internal Medicine, University of Tartu, Estonia
| | - Ann E. Tamm
- Department of Sport Medicine and Rehabilitation, Univerity of Tartu, Estonia
| | - Aspasia Tsezou
- Department of Biology and Genetics, University of Thessaly, Larissa, Greece
| | - Atsumasa Uchida
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Japan
| | - André G. Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands,The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands,Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jeremy Mark Wilkinson
- Academic Unit of Bone Metabolism, Department of Human Metabolism, University of Sheffield, Sheffield, United Kingdom,Sheffield NIHR Bone Biomedical research Unit, Centre for Biomedical Research, Northern General Hospital, Sheffield, United Kingdom
| | - Noriko Yoshimura
- Department of Joint Disease Research, 22nd Century Medical and Research Center, The University of Tokyo Hospital, The University of Tokyo, Tokyo, Japan
| | - Ana M. Valdes
- Department of Twin Research and Genetic Epidemiology, St. Thomas' Hospital, King's College London, London, United Kingdom
| | - Joyce B.J. van Meurs
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands,The Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging (NGI-NCHA), Rotterdam/Leiden, the Netherlands
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