An update of murine models and their methodologies in immune-mediated joint damage and pain research

Murine models have played an indispensable role in the understanding of rheumatic and musculoskeletal disorders (RMD), elucidating the genetic, endocrine and biomechanical pathways involved in joint pathology and associated pain. To date, the available models in RMD can be classified as induced or spontaneous, both incorporating transgenic alternatives that improve specific insights. It is worth noting that the selection of the most appropriate model together with the evaluation of their specific characteristics and technical capabilities are crucial when designing the experiments. Furthermore, it is also imperative to consistently adhere to the ethical standards concerning animal experimentation. Recognizing the inherent limitation that any model can entirely encapsulates the complexity of the pathophysiology of these conditions, the aim of this review is to provide an updated overview on the methodology of current murine models in major arthropathies and their immune-mediated pathways, addressing to basic, translational and pharmacological research in joint damage and pain.

Equine Autologous Conditioned Serum and Autologous Protein Solution

Orthobiologics are used with increasing frequency in equine musculoskeletal disease to improve the quality of the repair tissue and prevent reinjury. Autologous blood-based products, or hemoderivatives, are made by processing the patient's blood using different systems to produce a final therapeutic product. Autologous conditioned serum (ACS) and autologous protein solution (APS) are commonly used to treat joint disorders and can also be used treat tendon and ligament injuries. Hemoderivatives contain increased concentrations of anti-inflammatory and immunomodulatory cytokines, and growth factors that help direct tissue healing and repair. The specifics of ACS and APS for treatment of musculoskeletal injuries are discussed.

The association between knee muscle performance and clinical outcomes of knee function 1-4 years after a sport-related knee joint injury

OBJECTIVE

Estimate the association between index leg knee muscle strength and rate of torque development (RTD), and self-reported and performance-based (i.e., hop) knee function in persons 1-4 years after a sport-related knee joint injury.

METHODS

Data were collected at baseline of a clinical trial. Assessments included the Knee injury and Osteoarthritis Outcome Score Sport & Recreation subscale (KOOSsport), 6-m timed hop (TH), and peak concentric isokinetic knee extensor and flexor torque and isometric RTD. Associations between peak torque and RTD with KOOSsport and TH were assessed using multivariable regression with nonlinear transformations.

RESULTS

53 participants (64.2% female) were included. Knee extensor peak torque was nonlinearly related to TH time, with a strong inverse relationship at lower torque values that changed as torque increased. Results were inconsistent for flexor peak torque, extensor RTD and flexor RTD, with inconsistencies in relationship shape and estimates of association between primary and sensitivity analyses. There was no association between strength/RTD and KOOSsport.

CONCLUSION

There was a nonlinear relationship between knee extensor strength and hop function, with lower strength being associated with a stronger relationship. As strength values increased, the relationship attenuated. Knee extensor and flexor strength, or RTD, were not associated with self-reported function.

[Sports injuries : What type of imaging is required?]

BACKGROUND

Imaging is of great importance in sports injuries, since the indication for conservative and surgical therapy depends on precise knowledge of the extent of the damage.

OBJECTIVES

Typical sports injuries and their imaging requirements are to be presented as examples.

CONCLUSIONS

In order to detect the often subtle pathologies, imaging must be adapted to the clinical diagnosis that is specifically suspected.

A Mouse Model of Acute Cartilage Injury and Repair

Chondral defects are common and disabling. The development of pharmacological approaches for cartilage repair requires the availability of in vivo models which are amenable for gain and loss of function and ideally to genetic modification. In this chapter, we describe a method to induce full-thickness cartilage defects which, in young DBA/1 mice, heal spontaneously, but fail to heal in C57BL/6 mice of the same age or in aged DBA/1 mice. This model (or variants) has been used for genetic screenings to identify genes associated to repair capacity, to study stem cells involved in cartilage repair, and to study the function of molecules involved in repair mechanisms.

Exosomal microRNA-140-3p from human umbilical cord mesenchymal stem cells attenuates joint injury of rats with rheumatoid arthritis by silencing SGK1

OBJECTIVE

Over the years, microRNAs (miRNAs) have been involved in the pathogenesis of rheumatoid arthritis (RA). We aim to investigate the role of human umbilical cord mesenchymal stem cells (HUCMSCs)-derived exosomal miR-140-3p in RA development.

METHODS

Exosomes(exo) were isolated from human umbilical cord-derived mesenchymal stem cells (HUCMSCs), and this isolation was followed by the transfer of miR-140-3p. RA rat models were constructed by collagen II adjuvant and respectively treated with HUCMSCs-exo or HUCMSCs-exo carrying miR-140-3p mimic/inhibitor, and expression of miR-140-3p and serum- and glucocorticoid-inducible kinase 1 (SGK1) was assessed. Then, RA score and inflammation scoring, fibrosis degree and apoptosis, serum inflammatory response and oxidative stress in joint tissues were determined. The RA synovial fibroblasts (RASFs) were extracted from rats and identified. Conducted with relative treatment, the migration, proliferation and apoptosis in RASFs were determined.

RESULTS

MiR-140-3p was decreased while SGK1 was increased in RA rats. HUCMSCs-exo or upregulated exosomal miR-140-3p improved pathological changes and suppressed inflammation, oxidative stress and fibrosis in RA rats, and also constrained and RASF growth. Overexpression of SGK1 reversed the inhibition of RASF growth caused by overexpression of miR-140-3p.

CONCLUSION

Upregulated exosomal miR-140-3p attenuated joint injury of RA rats by silencing SGK1. This research provided further understanding of the role of exosomal miR-140-3p in RA development.

The microbiome mediates epiphyseal bone loss and metabolomic changes after acute joint trauma in mice

OBJECTIVE

To compare the early responses to joint injury in conventional and germ-free mice.

DESIGN

Post-traumatic osteoarthritis (PTOA) was induced using a non-invasive anterior cruciate ligament rupture model in 20-week old germ-free (GF) and conventional C57BL/6 mice. Injury was induced in the left knees of n = 8 GF and n = 10 conventional mice. To examine the effects of injury, n = 5 GF and n = 9 conventional naïve control mice were used. Mice were euthanized 7 days post-injury, followed by synovial fluid recovery for global metabolomic profiling and analysis of epiphyseal trabecular bone by micro-computed tomography (μCT). Global metabolomic profiling assessed metabolic differences in the joint response to injury between GF and conventional mice. Magnitude of trabecular bone volume loss measured using μCT assessed early OA progression in GF and conventional mice.

RESULTS

μCT found that GF mice had significantly less trabecular bone loss compared to conventional mice, indicating that the GF status was protective against early OA changes in bone structure. Global metabolomic profiling showed that conventional mice had greater variability in their metabolic response to injury, and a more distinct joint metabolome compared to their corresponding controls. Furthermore, differences in the response to injury in GF compared to conventional mice were linked to mouse metabolic pathways that regulate inflammation associated with the innate immune system.

CONCLUSIONS

These results suggest that the gut microbiota promote the development of PTOA during the acute phase following joint trauma possibly through the regulation of the innate immune system.

Relationship Between Neutrophil Activity, Oxidative Stress, Acute Phase Response, and Lameness Grade in Naturally Occurring Acute and Chronic Joint Disorders in Horses

We hypothesized that in horses with naturally occurring joint disorders, the neutrophil response, acute phase response (APR), and oxidative stress parameters elevated significantly and are markers of increased inflammatory response in these conditions. Therefore, the first aim of the study was to evaluate neutrophil response, oxidative status, and APR. The neutrophil activity was assessed on the basis of elastase, myeloperoxidase (MPO), and alkaline phosphatase release, whereas free radical generation was assessed on the basis of nitric oxide and superoxide production. Acute phase response was estimated on the basis of fibrinogen or haptoglobin plasma concentration and oxidative stress on the basis of malondialdehyde plasma concentration. Then, these parameters were compared with lameness grade, and correlation coefficients between them were calculated. The study was conducted on 43 horses divided on control group of healthy horses (n = 17), acute lameness (AL) group (11 horses), and chronic lameness (CL) group (15 horses). The neutrophil activity from horses of both groups of joint disorders (AL and CL) was significantly (P < .01) higher in comparison with healthy horses. Elastase release was 67.28 ± 1.89% of maximal activity in AL group in comparison with 51.72 ± 1.75% in healthy horses and 62.61 ± 1.54% in CL group. The highest values of other enzymes were also noted in AL group. Moreover, in AL group release of elastase and MPO positively correlated (P < .01) with grades of lameness. These findings revealed the mutual relation between studied parameters and obtained results may be useful in the development of new therapeutic strategies in the treatment of acute and chronic joint disorders in horses.

Musculoskeletal injuries in athletes from five modalities: a cross-sectional study

Background

Musculoskeletal injuries (MSK-I) are a serious problem in sports medicine. Modifiable and non-modifiable factors are associated with susceptibility to these injuries. Thus, the aim of this study was to describe the prevalence of and identify the factors associated with MSK-I, including tendinopathy and joint and muscle injuries, in athletes.

Methods

In this cross-sectional observational study, 627 athletes from rugby (n = 225), soccer (n = 172), combat sports (n = 86), handball (n = 82) and water polo (n = 62) were recruited at different sports training centres and competitions. Athlete profiles and the prevalence of MSK-I were assessed using a self-reported questionnaire. Only previous MSK-I with imaging confirmation and/or a positive physical exam by a specialized orthopaedist were considered. The association of the epidemiological, clinical and sports profiles of athletes with MSK-I was evaluated by a logistic regression model.

Results

The mean age was 25 ± 6 years, and 60% of the athletes were male. The epidemiological, clinical and sports profiles of the athletes were different for the five sport groups. The MSK-I prevalence among all athletes was 76%, with 55% of MSK-I occurring in a joint, 48% occurring in a muscle and 30% being tendinopathy, and 19% of athletes had three investigated injuries. The MSK-I prevalence and injury locations were significantly different among sport groups. There was a predominance of joint injury in combat sports athletes (77%), muscle injury in handball athletes (67%) and tendinopathy in water polo athletes (52%). Age (≥30 years) was positively associated with joint (OR = 5.2 and 95% CI = 2.6–10.7) and muscle (OR = 4.9 and 95% CI = 2.4–10.1) injuries and tendinopathy (OR = 4.1 and 95% CI = 1.9–9.3).

Conclusion

There is a high prevalence of tendinopathy and joint and muscle injuries among rugby, soccer, combat sports, handball and water polo athletes. The analysis of associated factors (epidemiological, clinical and sports profiles) and the presence of MSK-I in athletes suggests an approximately 4–5-fold increased risk for athletes ≥30 years of age. The identification of modifiable and non-modifiable factors can contribute to implementing surveillance programmes for MSK-I prevention.

Inhibition of early response genes prevents changes in global joint metabolomic profiles in mouse post-traumatic osteoarthritis

OBJECTIVE

Although joint injury itself damages joint tissues, a substantial amount of secondary damage is mediated by the cellular responses to the injury. Cellular responses include the production and activation of proteases (MMPs, ADAMTSs, Cathepsins), and the production of inflammatory cytokines. The trajectory of cellular responses is driven by the transcriptional activation of early response genes, which requires Cdk9-dependent RNA Polymerase II phosphorylation. Our objective was to determine whether inhibition of cdk9-dependent early response gene activation affects changes in the joint metabolome.

DESIGN

To model post-traumatic osteoarthritis, we subjected mice to non-invasive Anterior Cruciate Ligament (ACL)-rupture joint injury. Following injury, mice were treated with flavopiridol - a potent and selective inhibitor of Cdk9 kinase activity - to inhibit Cdk9-dependent transcriptional activation, or vehicle control. Global joint metabolomics were analyzed 1 h after injury.

RESULTS

We found that injury induced metabolomic changes, including increases in Vitamin D3 metabolism, anandamide, and others. Inhibition of primary response gene activation immediately after injury largely prevented the global changes in the metabolomics profiles. Cluster analysis of joint metabolomes identified groups of injury-induced and drug-responsive metabolites.

CONCLUSIONS

Metabolomic profiling provides an instantaneous snapshot of biochemical activity representing cellular responses. We identified two sets of metabolites that change acutely after joint injury: those that require transcription of primary response genes, and those that do not. These data demonstrate the potential for inhibition of early response genes to alter the trajectory of cell-mediated degenerative changes following joint injury, which may offer novel targets for cell-mediated secondary joint damage.

Altered postural control variability in older-aged individuals with a history of lateral ankle sprain

The current study aimed to examine postural control performance during a single-leg balance task in elderly individuals with and without a previous history of lateral ankle sprain (LAS). Eighteen adults with a previous history of LAS (mean age = 66 years old) and 12 healthy controls (mean age = 65 years old) were included in the study. Participants performed three trials of a single-leg balance task during an eyes-opened condition for 20-s. Center of pressure (COP) trajectories in the anteroposterior (AP) and mediolateral (ML) directions were collected with a force plate. The following postural control measures were calculated in the AP and ML directions: 1) Sample Entropy (SampEn); 2) Approximate Entropy (ApEn); 3) mean of Time-to-Boundary minima (mean TTB); and 4) COP velocity (COPV). Older-age participants with a history LAS exhibited lower ApEn-AP, SampEn-AP, and SampEn-ML values compared to healthy controls (p < 0.05). The information gained from this investigation indicates more rigid postural control patterns, less adaptability, and more difficulty maintaining COP during a single-leg balance task in adults with a previous history of LAS. Our data suggest that there is a need to consider history of musculoskeletal injury when evaluating factors for postural control and fall risk in the elderly. Future investigations are needed to assess the effect of LAS on age-related declines in postural control and discern associations between potential risk factors of fall-related injuries and LAS in an elderly population.

Bone marrow contribution to synovial hyperplasia following joint surface injury

Background

Joint surface injury, a known risk factor for osteoarthritis, triggers synovial hyperplasia, which involves proliferation of mesenchymal stromal/stem cells (MSCs). Whether these proliferative MSCs are resident synovial cells or move into the tissue from elsewhere is not known. The aim of this study was to determine the contribution of bone marrow-derived cells to synovial hyperplasia following joint surface injury.

Methods

Lethally irradiated mice were transplanted with green fluorescent protein (GFP)-labelled bone marrow, and MSC chimerism was determined by the colony-forming unit fibroblast (CFU-F) assay and phenotypic analysis. To label host slow-cycling cells prior to bone marrow transplant, mice received iododeoxyuridine for 3 weeks. Mice then were subjected to GFP⁺ bone marrow transplant, underwent joint surface injury and received chlorodeoxyuridine (CldU) for 7 days to label cells proliferating after injury. GFP- and nucleoside-labelled cells in normal and injured knee joint synovium were quantified in situ by immunofluorescence staining of paraffin-embedded tissue sections. The phenotype of GFP-labelled cells was determined by co-staining for the haematopoietic marker CD16/CD32 and the MSC/fibroblast marker platelet-derived growth factor receptor α (Pdgfrα).

Results

CFU-F assay and phenotypic analysis demonstrated successful bone marrow mesenchymal lineage chimerism in mice that underwent transplants. Bone marrow reconstitution preceded the detection of GFP-labelled cells in synovium. The percentage of GFP⁺ cells in synovium increased significantly in response to injury, while the proportion of GFP⁺ cells that were labelled with the proliferation marker CldU did not increase, suggesting that the expansion of the GFP⁺ cell population in synovium was due mainly to bone marrow cell infiltration. In contrast, proliferation of host slow-cycling cells was significantly increased in the hyperplastic synovium. In both control and injured knee joints, the majority of marrow-derived GFP⁺ cells in the synovium were haematopoietic (CD16/32⁺), while a minority of cells expressed the pan-fibroblast/MSC marker Pdgfrα.

Conclusions

Our findings indicate that synovial hyperplasia following joint surface injury involves proliferation of resident slow-cycling cells, with a contribution from infiltrating bone marrow-derived cells. Understanding the process of synovial hyperplasia may reveal ways to restore homeostasis in injured joints and prevent secondary osteoarthritis.

Impaired muscle function in a mouse surgical model of post-traumatic osteoarthritis

OBJECTIVES

Using a mouse surgical model of post-traumatic osteoarthritis (OA), we sought to determine if muscle function is altered following acute joint injury and whether this relates to OA progression.

DESIGN

Male C57BL/6 mice underwent surgical transection of the medio-meniscal tibial ligament destabilisation of the medial meniscus (DMM) or sham surgery on one knee. Tibialis anterior (TA) muscle function was assessed in situ at 1, 4 and 8 weeks post-surgery. Cartilage damage and joint inflammation were assessed by histologic scoring. Muscle mRNA expression was quantified by qRT-PCR.

RESULTS

Tetanic and twitch force production between DMM and sham muscle did not differ at 1 week post-surgery. Muscle function improved in both groups with time, but specific force production in DMM muscles was 18% and 22% lower than sham muscles at 4 and 8 weeks post-surgery respectively. At 8 weeks post-surgery, DMM muscles had a 40% slower relaxation rate and reduced expression of sarcoplasmic/endoplasmic reticulum Ca(2+) ATPase (Serca) pump mRNA compared to sham muscles; both observations indicate likely alterations in muscle Ca(2+) handling. There were no histologic signs of muscle atrophy or inflammation in DMM TA muscles. Specific force production in both sham and DMM mice showed a negative correlation with the severity of joint inflammation.

CONCLUSIONS

Acute knee injury in the DMM model of post-traumatic OA leads to a persistent deficit in TA muscle function that occurs in the absence of muscle atrophy. This study highlights that the impact of acute knee injury is unlikely to be limited to the muscles controlling knee movement.

Altered joint tribology in osteoarthritis: Reduced lubricin synthesis due to the inflammatory process. New horizons for therapeutic approaches

Osteoarthritis (OA) is the most common form of joint disease. This review aimed to consolidate the current evidence that implicates the inflammatory process in the attenuation of synovial lubrication and joint tissue homeostasis in OA. Moreover, with these findings, we propose some evidence for novel therapeutic strategies for preventing and/or treating this complex disorder. The studies reviewed support that inflammatory mediators participate in the onset and progression of OA after joint injury. The flow of pro-inflammatory cytokines following an acute injury seems to be directly associated with altered lubricating ability in the joint tissue. The latter is associated with reduced level of lubricin, one of the major joint lubricants. Future research should focus on the development of new therapies that attenuate the inflammatory process and restore lubricin synthesis and function. This approach could support joint tribology and synovial lubrication leading to improved joint function and pain relief.

Inflammation in joint injury and post-traumatic osteoarthritis

Inflammation is a variable feature of osteoarthritis (OA), associated with joint symptoms and progression of disease. Signs of inflammation can be observed in joint fluids and tissues from patients with joint injuries at risk for development of post-traumatic osteoarthritis (PTOA). Furthermore, inflammatory mechanisms are hypothesized to contribute to the risk of OA development and progression after injury. Animal models of PTOA have been instrumental in understanding factors and mechanisms involved in chronic progressive cartilage degradation observed after a predisposing injury. Specific aspects of inflammation observed in humans, including cytokine and chemokine production, synovial reaction, cellular infiltration and inflammatory pathway activation, are also observed in models of PTOA. Many of these models are now being utilized to understand the impact of post-injury inflammatory response on PTOA development and progression, including risk of progressive cartilage degeneration and development of chronic symptoms post-injury. As evidenced from these models, a vigorous inflammatory response occurs very early after joint injury but is then sustained at a lower level at the later phases. This early inflammatory response contributes to the development of PTOA features including cartilage erosion and is potentially modifiable, but specific mediators may also play a role in tissue repair. Although the optimal approach and timing of anti-inflammatory interventions after joint injury are yet to be determined, this body of work should provide hope for the future of disease modification tin PTOA.