Structure of Human Serum Albumin at a Foam Surface

Proteins can be adsorbed on the air-water interface (AWI), and the structural changes in proteins at the AWI are closely related to the foaming properties of foods and beverages. However, how these structural changes in proteins at the AWI occur is not well understood. We developed a method for the structural assessment of proteins in the foam state using hydrogen/deuterium exchange mass spectrometry. Adsorption sites and structural changes in human serum albumin (HSA) were identified in situ at the peptide-level resolution. The N-terminus and the loop (E492-T506), which contains hydrophobic amino acids, were identified as adsorption sites. Both the structural flexibility and hydrophobicity were considered to be critical factors for the adsorption of HSA at the AWI. Structural changes in HSA were observed after more than one minute of foaming and were spread widely throughout the structure. These structural changes at the foam AWI were reversible.

Higher-Order Structure of Adeno-Associated Virus Serotype 8 by Hydrogen/Deuterium Exchange Mass Spectrometry

The higher-order structure (HOS) is a critical quality attribute of recombinant adeno-associated viruses (rAAVs). Evaluating the HOS of the entire rAAV capsid is challenging because of the flexibility and/or less folded nature of the VP1 unique (VP1u) and VP1/VP2 common regions, which are structural features essential for these regions to exert their functions following viral infection. In this study, hydrogen/deuterium exchange mass spectrometry (HDX-MS) was used for the structural analysis of full and empty rAAV8 capsids. We obtained 486 peptides representing 85% sequence coverage. Surprisingly, the VP1u region showed rapid deuterium uptake even though this region contains the phospholipase A2 domain composed primarily of α-helices. The comparison of deuterium uptake between full and empty capsids showed significant protection from hydrogen/deuterium exchange in the full capsid at the channel structure of the 5-fold symmetry axis. This corresponds to cryo-electron microscopy studies in which the extended densities were observed only in the full capsid. In addition, deuterium uptake was reduced in the VP1u region of the full capsid, suggesting the folding and/or interaction of this region with the encapsidated genome. This study demonstrated HDX-MS as a powerful method for probing the structure of the entire rAAV capsid.

Combined 100 keV Cryo-Electron Microscopy and Image Analysis Methods to Characterize the Wider Adeno-Associated Viral Products

Adeno-associated viruses (AAVs) are effective vectors for gene therapy. However, AAV drug products are inevitably contaminated with empty particles (EP), which lack a genome, owing to limitations of the purification steps. EP contamination can reduce the transduction efficiency and induce immunogenicity. Therefore, it is important to remove EPs and to determine the ratio of full genome-containing AAV particles to empty particles (F/E ratio). However, most of the existing methods fail to reliably evaluate F/E ratios that are greater than 90 %. In this study, we developed two approaches based on the image analysis of cryo-electron micrographs to determine the F/E ratios of various AAV products. Using our developed convolutional neural network (CNN) and morphological analysis, we successfully calculated the F/E ratios of various AAV products and determined the slight differences in the F/E ratios of highly purified AAV products (purity > 95 %). In addition, the F/E ratios calculated by analyzing more than 1000 AAV particles had good correlations with theoretical F/E ratios. Furthermore, the CNN reliably determined the F/E ratio with a smaller number of AAV particles than morphological analysis. Therefore, combining 100 keV cryo-EM with the developed image analysis methods enables the assessment of a wide range of AAV products.

Three-Dimensional Homodyne Light Detection (3D-HLD) for High-Throughput Submicron Particle Analysis in (Highly Concentrated) Protein Biopharmaceuticals, Viral Vectors, and LNPs

During biopharmaceutical development, particle monitoring and characterization are crucial. Notably, particles can be impurities considered as critical quality attribute, or active pharmaceutical ingredient (e.g., viral vectors) or drug delivery system (e.g., lipid nanoparticles) itself. Three-dimensional homodyne light detection (3D-HLD) is a novel technique that can characterize particles in the ∼0.2 µm to 2.0 µm size range. We evaluated 3D-HLD for the analysis of high concentration protein formulations (up to 200 mg/mL), where formulation refractive index and background noise became limiting factors with increasing protein concentration. Sample viscosity however did not impact 3D-HLD results, in contrast to comparative analyses with NTA and MRPS. We also applied 3D-HLD in high-throughput screenings at high protein concentration or of lipid nanoparticle and viral vector formulations, where impurities were analyzed in the presence of a small (<0.2 µm) particulate active pharmaceutical ingredient. 3D-HLD turned out to be in good agreement with or a good complement to other state-of-the-art particle characterization techniques, including BMI, MRPS, and DLS. The main application of 3D-HLD is high-throughput particle analysis at low sample volume. Follow-up investigation of the optimized particle sizing approach and of detection settings could further improve the understanding of the method and potentially increase ease of operation.

Prediction models for the flux decay profile and initial flux of microfiltration for therapeutic proteins

Microfiltration (MF) is an essential step during biopharmaceutical manufacturing. However, unexpected flux decay can occur. Although the flux decay profile and initial flux are important factors determining MF filterability, predicting them accurately is challenging, as the root cause of unexpected flux decay remains elusive. In this study, the methodology for developing a prediction model of flux decay profiles was established. First, the filtration profiles of different monodisperse polystyrene latex and silica beads of various sizes were evaluated. These results revealed that the size and surface electrostatic properties of the beads affect the flux decay profile. Taking the size and surface electrostatic properties of protein aggregates into account, we constructed a predictive model using model bead filtration profiles. We showed that this methodology was applicable to two different MF filters to predict the flux decay profile of therapeutic proteins. Because our proposed prediction model is based on normalized flux, the initial flux is required to predict the overall filtration profile. Then, we applied the Hagen-Poiseuille equation using sample viscosity values to estimate the initial flux. The developed prediction models can be used for effective MF scale-up assessment during the early stages of process development.

Applications and Limitations of Equilibrium Density Gradient Analytical Ultracentrifugation for the Quantitative Characterization of Adeno-Associated Virus Vectors

Adeno-associated virus (AAV) vectors are produced as a mixture of the desired particle (full particle, FP), which is filled with the designed DNA, product-related impurities such as particle without DNA (empty particle, EP), and aggregates. Cesium chloride or iodixanol equilibrium density gradient ultracentrifugation (DGE-UC) has been used for the purification of AAV vectors. DGE-UC can separate FP from impurities based on the difference in their buoyant densities. Here, we report the applications and limitations of equilibrium density gradient analytical ultracentrifugation (DGE-AUC) using a modern AUC instrument that employs DGE-UC principles for the characterization and quantitation of AAV vectors. We evaluated the quantitative ability of DGE-AUC in comparison with sedimentation velocity AUC (SV-AUC) or band sedimentation AUC (BS-AUC) using AAVs with different DNA lengths and different serotypes. DGE-AUC enabled the accurate quantification of the ratio of FP to EP when the AAV vector primarily contains these particles. Furthermore, we developed a new workflow to identify the components of separated peaks in addition to FP and EP. Ultraviolet absorption spectra obtained by multiwavelength detection can also support peak assignment following component identification. DGE-AUC experiments for AAV vectors have limitations with regard to minor components with low absorption at the detected wavelength or those with a density similar to that of major components of AAV vectors. DGE-AUC is the only analytical method that can evaluate particle density heterogeneity; therefore, SV-AUC or BS-AUC and DGE-AUC are complementary methods for reliable assessment of the purity of AAV vectors.

Enhancement of recombinant adeno-associated virus activity by improved stoichiometry and homogeneity of capsid protein assembly

Studies of recombinant adeno-associated virus (rAAV) revealed the mixture of full particles with different densities in rAAV. There are no conclusive results because of the lack of quantitative stoichiometric viral proteins, encapsidated DNA, and particle level analyses. We report the first comprehensive characterization of low- and high-density rAAV serotype 2 particles. Capillary gel electrophoresis showed high-density particles possessing a designed DNA encapsidated in the capsid composed of (VP1 + VP2)/VP3 = 0.27, whereas low-density particles have the same DNA but with a different capsid composition of (VP1 + VP2)/VP3 = 0.31, supported by sedimentation velocity-analytical ultracentrifugation and charge detection-mass spectrometry. In vitro analysis demonstrated that the low-density particles had 8.9% higher transduction efficacy than that of the particles before fractionation. Further, based on our recent findings of VP3 clip, we created rAAV2 single amino acid variants of the transcription start methionine of VP3 (M203V) and VP3 clip (M211V). The rAAV2-M203V variant had homogeneous particles with higher (VP1+VP2)/VP3 values (0.35) and demonstrated 24.7% higher transduction efficacy compared with the wild type. This study successfully provided highly functional rAAV by the extensive fractionation from the mixture of rAAV2 full particles or by the single amino acid replacement.

Optimization of Flow Imaging Microscopy Setting Using Spherical Beads with Optical Properties Similar to Those of Biopharmaceuticals

Flow imaging microscopy (FIM) is widely used to characterize biopharmaceutical subvisible particles (SVPs). The segmentation threshold, which defines the boundary between the particle and the background based on pixel intensity, should be properly set for accurate SVP quantification. However, segmentation thresholds are often subjectively and empirically set, potentially leading to variations in measurements across instruments and operators. In the present study, we developed an objective method to optimize the FIM segmentation threshold using poly(methyl methacrylate) (PMMA) beads with a refractive index similar to that of biomolecules. Among several candidate particles that were evaluated, 2.5-µm PMMA beads were the most reliable in size and number, suggesting that the PMMA bead size analyzed by FIM could objectively be used to determine the segmentation threshold for SVP measurements. The PMMA bead concentrations measured by FIM were highly consistent with the indicative concentrations, whereas the PMMA bead size analyzed by FIM decreased with increasing segmentation threshold. The optimal segmentation threshold where the analyzed size was closest to the indicative size differed between an instrument with a black-and-white camera and that with a color camera. Inter-instrument differences in SVP concentrations in acid-stressed recombinant adeno-associated virus (AAV) and protein aggregates were successfully minimized by setting an optimized segmentation threshold specific to the instrument. These results reveal that PMMA beads can aid in determining a more appropriate segmentation threshold to evaluate biopharmaceutical SVPs using FIM.

Size Distribution Analysis of the Adeno-Associated Virus Vector by the c(s) Analysis of Band Sedimentation Analytical Ultracentrifugation with Multiwavelength Detection

Adeno-associated virus (AAV) vector is a promising platform for in vivo gene therapy. The accurate assessment of distribution state of particles contained in AAV vector samples is one of the most important and challenging matters and is necessary because the product-related impurities with the capsid structure (empty particles, intermediate particles, and aggregates) could be a possible cause of reducing the therapeutic efficacy and enhancing the unfavorable immune response. In this study, we report an effective approach for size distribution analysis with component identification. A small amount of AAV vectors were used by the analytical zone centrifugation c(s) analysis of band sedimentation analytical ultracentrifugation (BS-AUC) with multiwavelength detection. Using PBS/H₂¹⁸O, the concentration of each component could be determined in BS-AUC with high resolution. Compared with the sedimentation velocity AUC (SV-AUC), which generally requires 2 × 10¹² vg of AAV vectors, BS-AUC could be performed with about 1/25 of the AAV vector amount at 260 nm detection and ideally with about 1/50 of the AAV vector amount at 230 nm detection (4 × 10¹⁰ vg), depending on the extinction coefficient of the AAV sample at each wavelength. According to the limit of quantification of this BS-AUC, 6.3 × 10¹¹ cp mL^-1 of empty particle (EP) and 4.4 × 10¹¹ vg mL^-1 of full particle (FP) could be quantified for 4 × 10¹⁰ vg in 15 µL of AAV8-CMV-EGFP. These results demonstrated that proposed BS-AUC approach we established here can compensate for the drawback in terms of the sample amount of SV-AUC.

Relationship between aggregation of therapeutic proteins and agitation parameters: Acceleration and frequency

An increase in protein aggregates during transportation should be suppressed in therapeutic protein products because the aggregates have a potential risk of immunogenicity. In this study, three protein solutions in vials were exposed to tri-axial vibration with various combinations of frequency and acceleration using a transportation test system to investigate the relationship between low g-force stresses and protein aggregate generation. The number concentration of micron aggregates detected by flow imaging analysis increased markedly when the acceleration and frequency of agitation were within a specific range, in other words, above a threshold. This threshold was common among the three protein solutions. The suppression of micron aggregate formation by adding a surfactant suggested that agitation above the threshold increased micron aggregates mainly via interface-mediated routes. Notably, agitation, including agitation below the threshold, accelerated spontaneous oligomerization (nanometer aggregate generation) of proteins in bulk solution even in the presence of the surfactant. Studies of stability against mechanical stresses (e.g., a random vibration test to simulate actual shipment, with a time-compressed setting by increasing acceleration) need to be performed and discussed with careful consideration of the threshold for generating micron aggregates.

Utility of Three Flow Imaging Microscopy Instruments for Image Analysis in Evaluating four Types of Subvisible Particle in Biopharmaceuticals

Subvisible particles (SVPs) are a critical quality attribute of parenteral and ophthalmic products. United States Pharmacopeia recommends the characterizations of SVPs which are classified into intrinsic, extrinsic, and inherent particles. Flow imaging microscopy (FIM) is useful as an orthogonal method in both the quantification and classification of SVPs because FIM instruments provide particle images. In addition to the conventionally used FlowCam (Yokogawa Fluid Imaging Technologies) and Micro-Flow Imaging (Bio-Techne) instruments, the iSpect DIA-10 (Shimadzu) instrument has recently been released. The three instruments have similar detection principles but different optical settings and image processing, which may lead to different results of the quantification and classification of SVPs based on the information from particle images. The present study compares four types of SVP (protein aggregates, silicone oil droplets, and surrogates for solid free-fatty-acid particles, milled-lipid particles, and sprayed-lipid particles) to compare the results of size distributions and classification abilities obtained using morphological features and a deep-learning approach. Although the three FIM instruments were effective in classifying the four types of SVP through convolutional neural network analysis, there was no agreement on the size distribution for the same protein aggregate solution, suggesting that using the classifiers of the FIM instruments could result in different evaluations of SVPs in the field of biopharmaceuticals.

A Collaborative Study on the Classification of Silicone Oil Droplets and Protein Particles Using Flow Imaging Method

In this study, we conducted a collaborative study on the classification between silicone oil droplets and protein particles detected using the flow imaging (FI) method toward proposing a standardized classifier/model. We compared four approaches, including a classification filter composed of particle characteristic parameters, principal component analysis, decision tree, and convolutional neural network in the performance of the developed classifier/model. Finally, the points to be considered were summarized for measurement using the FI method, and for establishing the classifier/model using machine learning to differentiate silicone oil droplets and protein particles.

The Fab portion of immunoglobulin G has sites in the CL domain that interact with Fc gamma receptor IIIa

The interaction between IgG and Fc gamma receptor IIIa (FcγRIIIa) is essential for mediating immune responses. Recent studies have shown that the antigen binding fragment (Fab) and Fc are involved in IgG-FcγRIII interactions. Here, we conducted bio-layer interferometry (BLI) and isothermal titration calorimetry to measure the kinetic and thermodynamic parameters that define the role of Fab in forming the IgG-FcγRIII complex using several marketed therapeutic antibodies. Moreover, hydrogen/deuterium exchange mass spectrometry (HDX-MS) and crosslinking mass spectrometry (XL-MS) were used to clarify the interaction sites and structural changes upon formation of these IgG-FcγRIII complexes. The results showed that Fab in IgG facilitates the interaction via slower dissociation and a larger enthalpy gain. However, a larger entropy loss led to only a marginal change in the equilibrium dissociation constant. Combined HDX-MS and XL-MS analysis revealed that the CL domain of Fab in IgG was in close proximity to FcγRIIIa, indicating that this domain specifically interacts with the extracellular membrane-distal domain (D1) and membrane-proximal domain (D2) of FcγRIIIa. Together with previous studies, these results demonstrate that IgG-FcγRIII interactions are predominantly mediated by the binding of Fc to D2, and the Fab-FcγRIII interaction stabilizes complex formation. These interaction schemes were essentially fucosylation-independent, with Fc-D2 interactions enhanced by afucosylation and the contribution of Fab slightly reduced. Furthermore, the influence of antigen binding on IgG-FcγRIII interactions was also investigated. Combined BLI and HDX-MS results indicate that structural alterations in Fab caused by antigen binding facilitate stabilization of IgG-FcγRIII interactions. This report provides a comprehensive understanding of the interaction between IgG and FcγRIII.

Reduction of Recombinant Adeno-Associated Virus Vector Adsorption on Solid Surfaces by Polyionic Hydrophilic Complex Coating

Recombinant adeno-associated virus (rAAV) vectors have proven efficacy as gene therapy vehicles. However, non-specific adsorption of these vectors on solid surfaces is encountered during production, storage, and administration, as well as in quantification processes. Such adsorption has been reported to result in the loss of up to 90% of vector particles and can also result in high variability in vector genome quantification. In this study, we demonstrate the effective decrease of recombinant adeno-associated virus vector adsorption by application of a polyionic hydrophilic complex polymer coating on the surfaces of the tools used in viral vector quantification analyses [i.e., pipette tips, cryotube vials, and quantitative polymerase chain reaction (qPCR) plates]. qPCR analyses showed efficient recovery of vector particles from tools with this coating, with up to 95% of vector particle loss being prevented, leading to a higher transduction efficiency in vitro. Thus, the tested coating has the potential to be widely used in material processing in the gene therapy field.

Characterization of Adeno-Associated Virus Capsid Proteins with Two Types of VP3-Related Components by Capillary Gel Electrophoresis and Mass Spectrometry

Recombinant adeno-associated virus is a leading platform in human gene therapy. The adeno-associated virus (AAV) capsid is composed of three viral proteins (VPs): VP1, VP2, and VP3. To ensure the safety of AAV-based gene therapy products, the stoichiometry of VPs of AAV vector should be carefully monitored. In this study, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, capillary gel electrophoresis (CGE), and liquid chromatography-UV-mass spectrometry (LC-UV-MS) were performed to evaluate the VP components of AAV1, AAV2, and AAV6. Two types of VP3-related components, VP3 variant and VP3 fragment, were identified. The VP3 variant was the N-terminal shorter VP3, of which the translation started at M211, not at the conventional initiation codon, M203. The VP3 variant could be generated by leaky scanning of the first initiation codon of VP3. We also showed that the VP3 variant was identified in a minor peak before VP3 in CGE measurement. Meanwhile, the VP3 fragment was the C-terminal cleaved VP3, of which the sequence of VP3 ended at D590 or D626, indicating that cleavage occurred between D590 and P591, or D626 and G627. The cause of the cleavage of the DP or DG sequence was hydrolysis due to low pH of the mobile phase and high temperature of the column oven in the LC system, which was necessary to clearly separate the peak of VPs. VP3 fragments, detected only in LC-UV-MS in small amount account with less than 3% of total peak area, should be included in the quantification of VP3. Finally, the relationship of VP stoichiometry determined by the above three methods was discussed. From this study, we proposed that the VP components of AAV should be complementarily evaluated by CGE and LC-UV-MS.

Comprehensive Size Distribution and Composition Analysis of Adeno-Associated Virus Vector by Multiwavelength Sedimentation Velocity Analytical Ultracentrifugation

During the manufacturing of recombinant adeno-associated virus vectors, it is generally difficult to purify out vectors that lack nucleic acids (empty particles, EPs), contain incomplete nucleic acids (intermediate particles, IPs) or aggregates. These impurities may cause side effects and therefore it is essential to both quantify and reduce them; however, comprehensive identification of the size distribution and components of virus vectors have been lagging. We developed multiwavelength sedimentation velocity analytical ultracentrifugation to characterize EPs, full particles, IPs, and aggregates in adeno-associated virus vector samples. The wavelength-dependent ultraviolet (UV) absorption of capsid protein and encapsulated single-stranded DNA could be deduced from the multiwavelength detection followed by size distribution analysis and peak area integration. Subsequently, a spectral deconvolution analysis using the wavelength-dependent UV absorption data enabled the identification of the protein-nucleic acid ratio of all species. A comprehensive approach for quantifying the viral vector particles and related impurities was established.

Development of syringes and vials for delivery of biologics: current challenges and innovative solutions

INTRODUCTION

Several new biopharmaceutical dosage forms have developed over time, such as lyophilized vial, liquid vial, and liquid prefilled syringe formulations. This review summarizes major pharmaceutical dosage forms and their advantages, disadvantages, and countermeasures against the shortcomings of each formulation. The appropriate combination of active pharmaceutical ingredients, excipients, and containers should be selected for the safe and less burdensome administration to the patients. Finally, we note certain opinions on the future development of not only therapeutic proteins but also gene therapeutics.

AREAS COVERED

This review is to discuss the challenges of the development of dosage forms to improve pharmaceutical stability and how they can be overcome.

EXPERT OPINION

Silicone oil-free syringes are highly preferable for minimizing subvisible particles in the drug. It can be proposed that materials with less protein adsorption property are preferable for the suppression of protein aggregation. It is required to minimize adverse effects of biopharmaceuticals through proper quality control of the drug in a container, based on the understating of physicochemical stability of the protein in solution, the physicochemical properties of the container, and their combinations.

Recent Achievements and Current Interests in Research on the Characterization and Quality Control of Biopharmaceuticals in Japan

As reported in the previous commentary (Ishii-Watabe et al., J Pharm Sci 2017), the Japanese biopharmaceutical research group is promoting collaborative multilaboratory studies to evaluate and standardize new methodologies for biopharmaceutical characterization and quality control. We have conducted the studies and held 2 annual meetings in 2018 and 2019. At the 2018 meeting, Dr. Rukman DeSilva of the U.S. Food and Drug Administration and Dr. Srivalli Telikepalli of the National Institute of Standards and Technology participated as guest speakers. At the 2019 meeting, we invited Prof. John Carpenter of the University of Colorado, Prof. Gerhard Winter and Prof. Wolfgang Friess of Ludwig Maximilian University of Munich, and Dr. Tim Menzen of Coriolis Pharma Research, as guest commentators. In both meetings, the main research topic was strategies for the characterization and control of protein aggregates/subvisible particles in drug products. Specifically, the use of the light obscuration method for insoluble particulate matter testing with reduced injection volumes, and a comparison of analytical performance between flow imaging and light obscuration were discussed. Other topics addressed included host cell protein analysis, bioassay, and quality control strategies. In this commentary, the recent achievements of the research group, meeting discussions, and future perspectives are summarized.

The Fab portion of immunoglobulin G contributes to its binding to Fcγ receptor III

Most cells active in the immune system express receptors for antibodies which mediate a variety of defensive mechanisms. These receptors interact with the Fc portion of the antibody and are therefore collectively called Fc receptors. Here, using high-speed atomic force microscopy, we observe interactions of human, humanized, and mouse/human-chimeric immunoglobulin G1 (IgG1) antibodies and their cognate Fc receptor, FcγRIIIa. Our results demonstrate that not only Fc but also Fab positively contributes to the interaction with the receptor. Furthermore, hydrogen/deuterium exchange mass spectrometric analysis reveals that the Fab portion of IgG1 is directly involved in its interaction with FcγRIIIa, in addition to the canonical Fc-mediated interaction. By targeting the previously unidentified receptor-interaction sites in IgG-Fab, our findings could inspire therapeutic antibody engineering.

MR appearance of paraganglioma of the cauda equina: Case reports

Purpose: To investigate the value of MR imaging for preoperative diagnosis of paraganglioma of the cauda equina.

Material and Methods: A retrospective review of 2 cases of paraganglioma of the cauda equina examined with MR imaging was undertaken. Features assessed included the homogeneity of the lesions, presence or absence of serpiginous flow void and thin hypointense margins.

Results: In case 1, the tumor was hyperintense on the postcontrast examination and serpiginous flow void suggested vessels in the upper pole of the tumor. In case 2, the tumor was encapsulated by a thin hypointense margin on both T1- and T2-weighted images, which suggested hemosiderin.

Conclusion: The MR appearance may be of great value in the preoperative diagnosis of paraganglioma of the cauda equina.

Osteoclast differentiation factor induces synovial macrophage-osteoclast differentiation in rheumatoid arthritis

Abstract The aim of this study was to clarify the role of osteoclast differentiation factor (ODF) and osteoprotegerin (OPG) in synovial macrophage-osteoclast differentiation. Synovial macrophages were cultured in the presence of macrophage-colony-stimulating factor (M-CSF) and/or ODF. OPG was added to cocultures of synovial macrophages and UMR106. The cultures on glass coverslips were stained with osteoclast-associated markers, tartrate-resistant acid phosphatase (TRAP), and vitronectin receptor (VNR), as well as macrophage-associated markers CD11b and CD14. Functional evidence of osteoclast formation was determined by a resorption pit assay. To investigate whether rheumatoid arthritis (RA) synovial cells expressed messenger RNA (mRNA) for ODF, OPG, and the receptor activator of NF-κB (RANK), we performed a polymerase chain reaction (PCR) analysis. The addition of M-CSF or ODF alone induced TRAP-positive multinucleated cell formation. Resorption pits were rarely detected with M-CSF alone. ODF was capable of inducing bone resorption and enhancing osteoclastogenesis, as well as bone resorption in the presence of M-CSF. In the coculture system, both osteoclast formation and bone resorption were inhibited by OPG in a dose-dependent manner. In all experiments, synovial cells, including macrophages and fibroblasts, expressed the mRNA for RANK, ODF, and OPG. Our findings suggest that ODF plays a role in regulating RA synovial macrophage-osteoclast differentiation, and that synovial cells might have the ability to produce ODF. OPG might be further developed as a new strategy for treating bone destruction in RA joints.

Measurement of dynamic bite force during mastication

Efficient mastication of different types and size of food depends on fast integration of sensory information from mechanoreceptors and central control mechanisms of jaw movements and applied bite force. The neural basis underlying mastication has been studied for decades but little progress in understanding the dynamics of bite force has been made mainly due to technical limitations of bite force recorders. The aims of this study were to develop a new intraoral bite force recorder which would allow the study of natural mastication without an increase in the occlusal vertical dimension and subsequently to analyze the relation between electromyographic (EMG) activity of jaw-closing muscles, jaw movements and bite force during mastication of five different types of food. Customized force recorders based on strain gauge sensors were fitted to the upper and lower molar teeth on the preferred chewing side in fourteen healthy and dentate subjects (21-39 years), and recordings were carried out during voluntary mastication of five different kinds of food. Intraoral force recordings were successively obtained from all subjects. anova showed that impulse of bite force as well as integrated EMG was significantly influenced by food (P<0·05), while time-related parameters were significantly affected by chewing cycles (P<0·001). This study demonstrates that intraoral force recordings are feasible and can provide new information on the dynamics of human mastication with direct implications for oral rehabilitation. We also propose that the control of bite force during mastication is achieved by anticipatory adjustment and encoding of bolus characteristics.

Anticipation and motor control on repetitive tooth tapping produced by open-close jaw movements

This study was designed to evaluate the relationship between the temporal anticipation effects and motor control on repetitive tooth tapping movements (tooth tapping produced by open-close jaw movements) commanded by six frequencies of acoustic signals. Ten dentulous young adults were asked to perform tooth tapping movements to acoustic command signals at constant frequencies of 0.3, 0.8, 1.3, 1.8, 2.3 and 2.8 Hz. Surface electromyograms of the Masseter muscles, vertical component of the Mandibular kinesiograph, and acoustic signals were simultaneously recorded. Some parameters were measured for tappings at the last signal (TL) and surplus tappings without signals after the last signal (TL(n)) in each frequency command signal. The results showed that changes in the strategy for tapping movement controls occurred between 0.3 and 0.8 Hz. Between 0.8 and 2.8 Hz, each tooth tapping was automatically initiated before the confirmation of the signal; initiation and control of repetitive tapping movements were apparently based on effector anticipation (predicting the duration of internal processes for a planned movement so that it can be made coincidental to some anticipated external event) and receptor anticipation (anticipation of the arrival of a stimulus due to sensory information about its time of arrival). However, at 0.3 Hz, the movement initiation was delayed, such that each tooth tapping was initiated after the confirmation of the signal. Therefore, tappings at 0.3 Hz showed less dependence on receptor anticipation. These changes in motor control strategy are considered to be a reasonable way to prevent incorrect movements and to minimize erroneous movements.

Changes in masseter muscle blood flow during voluntary isometric contraction in humans

The effect of jaw clenching on local blood flow in the masseter muscle was measured using the hydrogen clearance method in 13 healthy subjects. Sustained isometric masseter-muscle contraction levels of 25 and 50% of maximum voluntary contraction (MVC) were investigated. The blood flow at 25% MVC before contraction, during contraction and after contraction was 12.3 +/- 10.9, 19.2 +/- 12.1 and 78.8 +/- 63.9 mL min(-1) (100 g)(-1) (mean +/- s.d.), respectively. At 50% MVC, it was 14.2 +/- 12.9, 18.6 +/- 10.0 and 80.1 +/- 61.8, respectively. The volume of blood flow was significantly greater after contraction as compared with before contraction at both levels (P < 0.0001) and there was no significant difference between before and during contraction periods (P = 0.17: 25% MVC; P = 0.38: 50% MVC). At 50% MVC blood flow before contraction and the difference in blood flow before and during contraction showed significant negative correlation (r = -0.636, P < 0.02). When the volume of blood flow was low before contraction it tended to increase during contraction and decreased when it was high before contraction. These findings indicate that blood flow in the masseter muscle during sustained isometric contraction is affected by the condition of contraction and may be influenced by the muscle region. It was also indicated that the blood flow during high level contraction was influenced by the volume of blood flow before contraction. Clinically, our findings may help to understand pathological changes which may lead to chronic masticatory muscle pain.

Three-dimensional finite element analysis of unicompartmental knee arthroplasty--the influence of tibial component inclination

Aseptic loosening and failure of a tibial component are recognized problems in unicompartmental knee arthroplasty (UKA). Excessive stress on the supporting cancellous bone is thought to contribute to the loosening and failure. Of factors that could influence supporting cancellous bone stresses, we focused on the inclination of a unicompartmental tibial component by analyzing the effect of coronal plane and sagittal plane inclination. Detailed geometrically accurate, three-dimensional finite element models were constructed from computed tomography (CT) data of a typical adult male proximal tibia. The material properties for the models were obtained directly from the CT data to simulate the inhomogeneous distribution of cancellous bone properties. Placing the component in slight valgus inclination in the coronal plane reduced the cancellous bone stresses. Posterior inclination in the sagittal plane caused a moderate increase in the stresses. Our results suggest that slight valgus inclination of a UKA tibial component may be preferable to varus or square inclination in the coronal plane. An excessive posterior slope of a tibial component should be avoided.

Does the self-centering mechanism of bipolar hip endoprosthesis really work in vivo?

PURPOSES

To examine radiographically the component motion in a bipolar prosthesis and to determine whether the self-centering mechanism really works in vivo.

METHODS

38 patients with 41 bipolar hip endoprostheses (30 for coxarthrosis and 11 for osteonecrosis of femoral head) were included in this study. Two radiographs of each case were taken to evaluate the self-centering mechanism. The first anteroposterior radiograph of both hip joints was taken at the maximum abduction while the patient standing on the endoprosthetic leg. The second radiograph was taken after the patient returned to neutral position while standing on 2 legs. In the present study, the order in which the radiographs were taken differed from previously reported studies. The radiographs were analysed using the method similar to that of Drinker and Murray. The adductive motion from abduction to a neutral position is within the range of inner bearing oscillation.

RESULTS

The outer head alignment changed from 23 degrees to 12 degrees in the patients with osteonecrosis. However, the valgus position of the outer head (36 degrees) remained unchanged in the patients with coxarthrosis standing on 2 legs in the neutral position.

CONCLUSION

The self-centering mechanism of the bipolar endoprosthesis functioned in the patients with osteonecrosis, but did not work in the coxarthrosis group.

Debridement and continuous irrigation for the treatment of pyogenic arthritis caused by the use of intra-articular injection in the osteoarthritic knee: indications and outcomes

PURPOSE

To discuss the indications and therapeutic outcomes of synovectomy, debridement, and continuous irrigation for the treatment of pyogenic arthritis caused by intra-articular injection used in the treatment of osteoarthritis of the knee.

METHODS

Records of 41 patients with infectious arthritis of the knee who presented to our hospital from 1981 were reviewed. 11 of them had a history of intra-articular injection. They underwent synovectomy, debridement, and continuous irrigation using a Salem double-lumen tube after confirmation that one side of the femorotibial joint cartilage was basically healthy.

RESULTS

The infection was successfully treated in 9 of the 11 patients. Of these 9 patients, one died after 3 years and 2 underwent total knee arthroplasty after 3 and 8 years. The remaining 6 patients were followed up for 5 to 15 years. Five of them had deteriorating arthropathy, and the condition was unchanged in the others. Two of these 6 patients had pain while walking, and their Japanese Orthopaedic Association scores were 70. The remaining 4 had good knee function and reduction of pain, with a mean Japanese Orthopaedic Association score of 91 and a mean range of motion of 131 degrees.

CONCLUSION

Arthrodesis is frequently considered the treatment for osteoarthritis if the joint destruction has affected the weight-bearing surface. However, in our experience, even when inflammatory granulation develops in the cartilage surface of one side of the femorotibial joint, good results can still be obtained by synovectomy, debridement, and continuous irrigation. After the pyogenic arthritis has subsided, if osteoarthritis has advanced and bowleg has exacerbated, further treatment options are available, such as tibial resection and even joint replacement. Continuous irrigation should be considered a feasible treatment option for pyogenic arthritis.

3M integral bipolar cup system for dysplastic osteoarthritis. Clinical and radiographic review with five- to seven-year follow-up

Between 1995 and 1997 we undertook 40 bipolar hip arthroplasties in 35 patients with dysplastic osteoarthritis. The steep and shallow acetabulum was excavated and the bipolar socket was placed high with an adjustment of leg-length. At follow-up of between five and seven years, there were 19 excellent, 16 good and five fair results according to the scoring system of Merle d'Aubigné and Postel. The mean radiographic superior migration of the bipolar socket was 2.1 mm (0 to 10). Osteolysis was noted in three hips within three years of the operation. Abduction on weight-bearing was recorded in 24 hips and the bipolar system was found to be functioning predominantly between the inner bearing and the metal femoral head in 20.

3M integral bipolar cup system for dysplastic osteoarthritis

Between 1995 and 1997 we undertook 40 bipolar hip arthroplasties in 35 patients with dysplastic osteoarthritis. The steep and shallow acetabulum was excavated and the bipolar socket was placed high with an adjustment of leg-length. At follow-up of between five and seven years, there were 19 excellent, 16 good and five fair results according to the scoring system of Merle d’Aubigné and Postel. The mean radiographic superior migration of the bipolar socket was 2.1 mm (0 to 10). Osteolysis was noted in three hips within three years of the operation. Abduction on weight-bearing was recorded in 24 hips and the bipolar system was found to be functioning predominantly between the inner bearing and the metal femoral head in 20.

Menatetrenone (vitamin K2) acts directly on circulating human osteoclast precursors

It is still not certain what the direct effect of menatetrenone is on osteoclast precursors. In the present study, we investigated whether menatetrenone has a direct effect on circulating osteoclast precursors to influence osteoclast differentiation. Monocytes isolated from human peripheral blood were cultured with receptor-activated NF-kappaB ligand (RANKL) and macrophage colony-stimulating factor (M-CSF). Menatetrenone or vitamin K1 was then added to the cultures. Geranylgeraniol or phytol (the respective side chain) was also added to the cultures instead of menatetrenone or vitamin K1, respectively. After 7 and 14 days incubation, cultures were evaluated for cytochemical and functional evidence of osteoclast formation. The number of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells (MNCs) and the percentage area of lacunar resorption induced by RANKL and M-CSF were decreased when menatetrenone or geranylgeraniol was added to the cultures. Dose-dependent inhibition of osteoclast formation and lacunar resorption was seen when the cultures were treated with menatetrenone or geranylgeraniol. In contrast, vitamin K1 or phytol did not affect the number of TRAP-positive MNCs nor the percentage area of lacunar resorption. These results indicate that menatetrenone not only influences osteoclast formation via bone stromal cells but also acts directly on circulating osteoclast precursors to influence osteoclast differentiation. These findings also suggest that geranylgeraniol, the side chain of menatetrenone, plays an important role in this inhibitory effect.

Anticipatory and reflexive neck muscle activities during voluntary rapid jaw opening and passive jaw depression in humans

The characteristics of head movement during voluntary rapid jaw opening movement and passive jaw depression were investigated using accelerometers and electromyographs (EMG) on eight healthy examinees. Passive depressions were executed by means of load on the lower jaw, initiated either by examinees themselves or an experimenter. In the depression initiated by examinees, a head-extension movement that preceded the load to the lower jaw and anticipatory activities in the nuchal region of the trapezius muscle were observed. In the depression initiated by the experimenter, the anticipatory activities were not observed. In both of these cases, stretch reflexes were induced in the trapezius muscle. During voluntary rapid jaw opening, a head-extension movement nearly synchronized with the opening movement in the lower jaw acceleration, and dorsal-neck muscle activities accompanying the synchronized movement were observed. The peak timing of these neck-muscle activities preceded the latencies of the stretch-reflex activities observed in the jaw-depressed tasks, but no anticipatory activities were observed in the dorsal-neck muscles. We conclude that neither the anticipatory activities nor the reflex activities observed in the passive depressions have effects on the initial part of the dorsal-neck muscle activities, which are related to the head-extension synchronized with the voluntary lower-jaw opening movement.

The effects of tibial component inclination on bone stress after unicompartmental knee arthroplasty

Unlike the case with total knee arthroplasty, the femorotibial angle (FTA) after unicompartmental knee arthroplasty (UKA) does not directly depend on the inclination of the tibial component when the height of the joint line is maintained. This study analyzed the effects of the inclination of the tibial component in the coronal plane on the contact pressure of the implant-bone surface and the stresses on the proximal tibia. A two-dimensional, coronal plane model of the proximal tibia was subjected to finite-element analysis. Sixteen patterns of finite-element models of equal FTA were developed in which the inclination of tibial components ranged from 5 degrees valgus to 10 degrees varus in increments of 1 degrees. Stress concentration at the proximal medial diaphyseal cortex gradually increased as the inclination changed from valgus to varus. Maximum contact pressure on the metal-bone interface similarly changed and shifted from the lateral edge to the medial edge of the implant as the inclination changed to varus. It was found that even without changing FTA, the inclination of the tibial component might affect stress concentration and contact pressure in the proximal tibia after UKA. The results suggested that slight valgus inclination of the tibial component might be preferable to varus and even to 0 degrees (square) inclination so far as the stress distribution is concerned.

An assessment of histopathological criteria for infection in joint arthroplasty in rheumatoid synovium

Intraoperative frozen section is reported to be a reliable means of identifying occult infection for preoperative evaluation of arthroplasty. The aim of this study was to determine whether the reported histopathological criteria--the existence of more than 10 polymorphonuclear cells (PMN) per high-power field--is valuable for determination of infection during the arthroplasty of patients with rheumatoid arthritis (RA). The permanent histological sections of RA synovium were analysed to study the degree of infiltration of PMNs. Furthermore, in order to examine the penetrative distribution of PMNs within the synovial tissues, immunohistochemical staining of PMNs was performed. In addition, the clinical history, from the postoperative period to the present, was investigated in 46 patients (60 joints). The presence of early- and/or late-stage postoperative infection, the development of postoperative fever, the progression of erythrocyte sedimentation rate (ESR) (more than 30 mm per hour) and the changes in CRP (more than 10 mg per litre) were further examined and compared with the histopathological tissue analyses and findings. The results demonstrated the presence of more than five PMNs per high-power field, excluding surface fibrin and inflammatory exudate in at least five separate microscopic fields in 10 joints (16.7%) of nine patients, out of 60 joints of 46 patients, in which no postoperative infection was evident. As to the magnitude of penetrative distribution of PMNs in 10 joints, there was a trend of deepening infiltration among the patients with intensive PMN infiltration. In addition, no development of postoperative fever, CRP or continuous indications of high ESR values were evident in this group. As the existence of more than 10 PMN per high-power field was not absolutely indicative of occult infection, investigation of frozen section during arthroplasty should be carefully managed.

Head movement properties during voluntary rapid jaw movement in humans

The purpose of this study was to determine whether the start of the synchronized head movement during mandibular movement is evoked by the peripheral reflexes following mandibular movement (i.e. stretch or trigemino-neck reflexes), or, alternatively, is started by pre-programmed central command. Head movement accompanying voluntary rapid jaw opening movement was studied using accelerometers fixed to the upper and lower incisors, as well as electromyographs (EMGs) of the neck muscles. The direction of head acceleration at the upper incisor was towards head extension at the beginning of jaw opening movement in 89.2% of all trials, opposite to the direction of lower jaw acceleration. The onset of head acceleration was later than that of the lower jaw acceleration by averages of 6.2-10.7 ms, and the onset of electromyographic activities of the sternocleidomastoid (SCM) muscle preceded that of head acceleration by an average of 12.5-24.3 ms. These findings suggest that head movement during mandibular movement is not started by peripheral reflexes but by pre-programmed central commands. This may be relevant to muscular discomfort in the neck and shoulder regions of patients with stomatognathic disorders.

Effect of particle size on macrophage-osteoclast differentiation in vitro

To determine whether particle size affects macrophage-osteoclast differentiation in vitro, latex beads of 0.1, 1, and 10 microm in diameter were added to a murine macrophage-UMR106 osteoblast-like cell coculture system. The extent of osteoclast differentiation was determined by assessing the number of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells on glass coverslips and the extent of lacunar resorption on dentine slices. The addition of particles, 1 and 10microm in size, to the cocultures resulted in a significant increase in the number of TRAP-positive osteoclast-like cells and in the resorption pit surface area compared with findings in control cultures to which no particles had been added. Particles 0.1 microm in size also stimulated osteoclast formation relative to the control; however, the difference was not significant. These results indicate that particles, particularly these 1 and 10microm in size, sizes which were phagocytosable, significantly enhanced the process of macrophage-osteoclast differentiation and suggest that particle size plays an important role in periprosthetic osteolysis.

Influence on force curve exerted by jaw tapping force

The purpose of this study, which made use of visual biofeedback, was to determine how methods of regulating jaw tapping force differed depending on the strength of the tapping, using the force curve as an index. Nine healthy examinees were asked to make 30-35 jaw tapping movements, reproducing the defined target tapping force as accurately as possible. We measured the duration of the tooth contact phase, the time to peak force, the first time derivative of force (peak dF/dt), and the time to peak dF/dt. The results indicated that the duration of the tooth contact phase and the time to peak force increased with the target value (P < 0.01). As the target rose, the peak dF/dt increased significantly (P < 0.01), but the time to peak dF/dt was not significant (P=0.134). We found that the higher the target value, the greater the degree of dependency on feedback information. We also found that both the peak dF/dt and the time to peak dF/dt were determined for each examinee prior to movement.

The effect of macrophage-colony stimulating factor and other humoral factors (interleukin-1, -3, -6, and -11, tumor necrosis factor-alpha, and granulocyte macrophage-colony stimulating factor) on human osteoclast formation from circulating cells

Macrophage-colony stimulating factor (M-CSF) is an essential requirement for human osteoclast formation, but its effect on the proliferation and differentiation of circulating osteoclast precursor cells is unknown. Other growth factors and cytokines are also known to support/stimulate osteoclast formation from mouse marrow precursors, but it is not certain whether these factors similarly influence human osteoclast formation. In this study, human monocytes were cocultured with osteoblast-like UMR-106 cells on coverslips and dentine slices for up to 21 days in the presence of 1,25 dihydroxyvitamin D(3) (10(-7) mol/L), dexamethasone (10(-8) mol/L), and various concentrations of either M-CSF or other humoral factors (interleukin [IL]-1beta, IL-3, IL-6, and IL-11; tumor necrosis factor-alpha [TNF-alpha]; and granulocyte macrophage [GM]-CSF). The effect on osteoclast formation was assessed by tartrate-resistant acid phosphatase (TRAP) and vitronectin receptor staining and lacunar bone resorption. The results of time-course and proliferation studies showed that M-CSF stimulated both the proliferative and differentiation stages of human osteoclast formation from circulating osteoclast precursors in a dose-dependent manner. A high concentration of M-CSF (100 ng/mL) did not inhibit osteoclast formation. IL-3 and GM-CSF were also capable of stimulating human osteoclast formation, although these growth factors were much less potent than M-CSF. IL-3- and GM-CSF-stimulated osteoclast formation was inhibited by an antibody specific for human M-CSF. Osteoclast formation and lacunar resorption was not seen when either TNF-alpha, IL-1beta, IL-6 (+ soluble IL-6 receptor), or IL-11 was substituted for M-CSF during coculture. These results confirm that M-CSF is essential for human osteoclast formation from circulating mononuclear precursors, and also shows that IL-3 and GM-CSF may support osteoclast differentiation via the stimulation of M-CSF production by human monocytes.