1
|
Gertel S, Rokach M, Polachek A, Litinsky I, Anouk M, Elkayam O, Furer V. Anti-inflammatory effects of infliximab and methotrexate on peripheral blood and synovial fluid mononuclear cells: ex vivo study. Scand J Rheumatol 2024; 53:188-198. [PMID: 38275170 DOI: 10.1080/03009742.2023.2300887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVE To investigate the effects of methotrexate (MTX) and the tumour necrosis factor inhibitor infliximab (IFX) on immune cells derived from peripheral blood mononuclear cells (PBMCs) and synovial fluid mononuclear cells (SFMCs) of inflammatory arthritis patients. METHOD Phytohaemagglutinin (PHA)-induced proliferation of healthy donors' PBMCs and synovial intermediate monocytes (CD14+CD16+ cells) in SFMCs derived from psoriatic arthritis (PsA) and rheumatoid arthritis (RA) patients was determined by flow cytometry following co-culture with IFX and MTX. PHA-induced interferon-γ (IFN-γ) production in PBMCs was measured by enzyme-linked immunosorbent assay. The drugs' effect on mRNA expression in SFMCs was determined by quantitative polymerase chain reaction. RESULTS The combination of IFX 10 μg/mL + MTX 0.1 μg/mL had the strongest inhibitory effect on PBMC proliferation (91%), followed by MTX 0.1 μg/mL (86%) and IFX 10 μg/mL (49%). In PHA-stimulated PBMCs, IFN-γ production was reduced by IFX 10 μg/mL, MTX 0.1 μg/mL, and IFX 10 μg/mL + MTX 0.1 μg/mL by 68%, 90%, and 85%, respectively. In SFMCs, IFX 10 µg/mL significantly reduced CD14+CD16+ cells compared to medium (PsA 54%, p < 0.01; RA 46%, p < 0.05), while MTX had no effect on this population. IFX + MTX led to a similar suppression of CD14+CD16+ cells as achieved by IFX alone. The drugs had different impacts on SFMC gene expression. CONCLUSION Both IFX and MTX effectively inhibited PBMC proliferation and IFN-γ production, but only IFX reduced synovial monocytes and pro-inflammatory gene expression in SFMCs, suggesting a differential impact of IFX and MTX on critical inflammatory cell populations ex vivo.
Collapse
Affiliation(s)
- S Gertel
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Rokach
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Polachek
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - I Litinsky
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Anouk
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - O Elkayam
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - V Furer
- Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
2
|
Lina G, Cuixin Q, Xia Z, Jing Y, Zhirong L, Zirou O, Jiayiren L, Yulian Z, Qiuyue H, Qianqing L, Yan L, Pu Q, Bin Z, Jianhong Z. CCR9+CD4+ T cells are associated with disease activity in patients with rheumatoid arthritis. Medicine (Baltimore) 2024; 103:e37803. [PMID: 38640336 PMCID: PMC11030009 DOI: 10.1097/md.0000000000037803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/04/2024] [Accepted: 03/14/2024] [Indexed: 04/21/2024] Open
Abstract
An increase in CD4+ T cells in the synovium is closely linked to the pathogenesis of rheumatoid arthritis (RA). We aimed to identify the possible causes of the elevated CD4+ T cell levels and to explore the factors influencing disease activity in RA. Fifty-five RA patients, including 28 with active RA (ARA), 27 with inactive RA, and 22 healthy controls, were recruited for this study. The proportion of CCR9+CD4+ T cells and the expression of chemokine receptor 9 (CCR9) on CD4+ T cells were analyzed by flow cytometry. Enzyme-linked immunosorbent assay and chemiluminescent immunoassay were used to evaluate interleukin (IL)-17A and IL-6 levels, respectively. The proportion of CCR9+CD4+ T cells and the expression of CCR9 on CD4+ T cells increased significantly in peripheral blood (PB) and synovial fluid (SF) in ARA compared to those in inactive RA. Furthermore, SF contained more CCR9+CD4+ T cells, IL-6, and IL-17A than PB in RA patients. Moreover, CD4+ T cells in the PB of patients with RA, especially ARA, expressed more CCR9 and secreted more IL-6 and IL-17A after activation. Here, we also demonstrated that both the percentage of CCR9+ cells in CD4+ T cells and the expression of CCR9 on circulating CD4+ T cells were positively correlated with erythrocyte sedimentation rate, hypersensitive C-reactive protein, rheumatoid factor, and anti-cyclic citrullinated peptide antibody. CCR9+CD4+ T cells are elevated in PB and SF, and are associated with disease activity in patients with RA.
Collapse
Affiliation(s)
- Geng Lina
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Clinical Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Qiang Cuixin
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhang Xia
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Yang Jing
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Li Zhirong
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ouyang Zirou
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Li Jiayiren
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhang Yulian
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Huo Qiuyue
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Li Qianqing
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Liu Yan
- Department of Clinical Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Qin Pu
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhang Bin
- Department of Clinical Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei, China
| | - Zhao Jianhong
- Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| |
Collapse
|
3
|
Kim L, Lashnits E, Breitschwerdt EB, Elam A, Grade N, Miller J, Shikhman AR. Antibodies to Borrelia burgdorferi and Bartonella species in serum and synovial fluid from people with rheumatic diseases. Microbiol Spectr 2024; 12:e0165323. [PMID: 38483477 DOI: 10.1128/spectrum.01653-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 02/03/2024] [Indexed: 04/06/2024] Open
Abstract
Vector-borne infections may underlie some rheumatic diseases, particularly in people with joint effusions. This study aimed to compare serum and synovial fluid antibodies to B. burgdorferi and Bartonella spp. in patients with rheumatic diseases. This observational, cross-sectional study examined paired synovial fluid and serum specimens collected from 110 patients with joint effusion between October 2017 and January 2022. Testing for antibodies to B. burgdorferi (using CDC criteria) and Bartonella spp. via two indirect fluorescent antibody (IFA) assays was performed as part of routine patient care at the Institute for Specialized Medicine (San Diego, CA, USA). There were 30 participants (27%) with positive two-tier B. burgdorferi serology and 26 participants (24%) with IFA seroreactivity (≥1:256) to B. henselae and/or B. quintana. Both B. burgdorferi IgM and IgG were detected more frequently in synovial fluid than serum: 27% of patients were either IgM or IgG positive in synovial fluid, compared to 15.5% in serum (P = 0.048). Conversely, B. henselae and B. quintana antibodies were detected more frequently in serum than synovial fluid; overall only 2% of patients had positive IFA titers in synovial fluid, compared to 24% who had positive IFA titers in serum (P < 0.001). There were no significant associations between B. burgdorferi or Bartonella spp. seroreactivity with any of the clinical rheumatological diagnoses. This study provides preliminary support for the importance of synovial fluid antibody testing for documenting exposure to B. burgdorferi but not for documenting exposure to Bartonella spp. IMPORTANCE This study focuses on diagnostic testing for two common vector-borne diseases in an affected patient population. In it, we provide data showing that antibodies to B. burgdorferi, but not Bartonella spp., are more commonly found in synovial fluid than serum of patients with joint effusion. Since Lyme arthritis is a common-and sometimes difficult to diagnose-rheumatic disease, improving diagnostic capabilities is of utmost importance. While our findings are certainly not definitive for changes to practice, they do suggest that synovial fluid could be a useful sample for the clinical diagnosis of Lyme disease, and future prospective studies evaluating this claim are warranted.
Collapse
Affiliation(s)
- Lisa Kim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Erin Lashnits
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Edward B Breitschwerdt
- Intracellular Pathogens Research Laboratory and Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Amanda Elam
- Galaxy Diagnostics, Research Triangle, North Carolina, USA
| | - Neenah Grade
- Galaxy Diagnostics, Research Triangle, North Carolina, USA
| | | | | |
Collapse
|
4
|
Rosik J, Kulpa J, Szczepanik M, Pawlik A. The Role of Semaphorins in the Pathogenesis of Rheumatoid Arthritis. Cells 2024; 13:618. [PMID: 38607057 PMCID: PMC11011349 DOI: 10.3390/cells13070618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024] Open
Abstract
Rheumatoid arthritis (RA) is one of the most common autoimmune diseases. Inflammation of the synovial fluid propagates the pathological process of angiogenesis. Semaphorins play a crucial role in the context of endothelial cell function, and their pleiotropic nature has various effects on the further development of RA. This narrative review summarises the various roles of semaphorins in the pathology of RA and whether they could play a role in developing novel RA treatment options.
Collapse
Affiliation(s)
- Jakub Rosik
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (J.R.); (J.K.); (M.S.)
| | | | | | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (J.R.); (J.K.); (M.S.)
| |
Collapse
|
5
|
Nocera I, Sgorbini M, Meucci V, Gracia-Calvo LA, Tapio H, Camisi M, Sala G, Citi S. Procalcitonin and carbonylated protein concentrations in equine synovial fluid. Vet Res Commun 2024; 48:1263-1269. [PMID: 38127161 DOI: 10.1007/s11259-023-10280-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Early diagnosis of joint diseases is fundamental for prompt and appropriate management, particularly in septic arthritis. Procalcitonin (PCT) and protein carbonylated content (PCC) have been investigated in both human and veterinary medicine. An increase in PCT has been shown in infectious bacterial diseases, while higher levels of PCC have been shown in inflammatory pathologies characterized by oxidative damage. This study evaluated PCT and PCC in plasma and synovial fluid (SF), in healthy and pathological equine joints, affected by different types of arthropathy. Twenty-nine joints were evaluated and underwent orthopedic, radiographic, ultrasonographic and SF evaluation. The joints were divided in three groups: healthy, septic, and non-septic arthritis. PCT and PCC were measured in horse plasma and SF. Data distribution was evaluated and results were expressed as median, quartile values. Statistical differences in SF values among groups and correlations were assessed between plasma and SF of both PCT and PCC. The groups of joint disease included: 8/29 healthy, 13/29 non-septic and 8/29 septic. Significant differences were obtained for SF PCC and plasma PCT between healthy and septic joints, while no differences were found for plasma PCC and SF PCT. A positive correlation was found between plasma and SF PCT. To the best of our knowledge, this is the first study reporting PCT in equine SF. SF PCC could be a useful biomarker to differentiate between septic and healthy joints.
Collapse
Affiliation(s)
- Irene Nocera
- Institute of Health Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy.
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy.
| | - Micaela Sgorbini
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| | - Valentina Meucci
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| | | | - Heidi Tapio
- Veterinary Teaching Hospital, University of Helsinki, Helsinki, Finland
| | - Marcello Camisi
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| | - Giulia Sala
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| | - Simonetta Citi
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| |
Collapse
|
6
|
Mitterer JA, Frank BJH, Sebastian S, Guger M, Schoefberger L, Hofstaetter JG. The Value of Preoperative Ultrasound-Determined Fluid Film and Joint Aspiration in Revision Hip Arthroplasty. J Arthroplasty 2024; 39:1069-1074. [PMID: 37866461 DOI: 10.1016/j.arth.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/12/2023] [Accepted: 10/14/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Data regarding the diagnostic value of ultrasound (US)-determined fluid film and joint aspiration prior to revision total hip arthroplasty for suspected periprosthetic joint infections (PJIs) are limited. This study aimed to analyze the value of US-determined fluid film, characterized the preoperative and intraoperative microbiological spectrum and resistance patterns, and compared the concordance between preoperative synovial fluid and intraoperative culture results. METHODS We analyzed 366 US examinations from 324 patients prior to revision total hip arthroplasty. Selected cases were grouped into clearly infected, noninfected, and inconclusive cohorts, according to the International Consensus Meeting 2018 Criteria. For US-determined fluid film <1 mm, no aspiration was performed based on our institutional protocol. Patients were grouped into no aspiration (144 of 366; [39.3%]), dry tap (21 of 366; [5.7%]), and a successful tap (201 of 366; [54.9%]). The microbiological spectrum and antibiograms were compared between preoperative and intraoperative results. RESULTS The absence of US-determined fluid film showed no correlation with the presence of a hip PJI. Overall, 31.9% cases of the no-aspiration group had a PJI. In total, 13.5% discrepancies were found between successful taps and intraoperative cultures. The most prevalent microorganisms in preoperative synovial fluid were Staphylococcus epidermidis and Staphylococcus aureus (20.8%), while intraoperatively S. epidermidis (26.3%) and Cutibacterium acnes (14.5%) were leading. Additional microorganisms were identified in 32.5% of intraoperative cultures. There were no differences between resistance patterns of preoperative and intraoperative concordant microorganisms. CONCLUSIONS Absence of US-determined fluid film cannot rule out the presence of a hip PJI. Combined microbiological results from hip US aspirations and subsequent surgical procedures are crucial to design an effective treatment for suspected hip PJI.
Collapse
Affiliation(s)
- Jennyfer A Mitterer
- Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Speising, Vienna, Austria
| | - Bernhard J H Frank
- Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Speising, Vienna, Austria; 2nd Department, Orthopaedic Hospital Speising, Vienna, Austria
| | - Sujeesh Sebastian
- Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Speising, Vienna, Austria
| | - Matthias Guger
- Institute for Radiology, Orthopaedic Hospital Speising, Vienna, Austria
| | - Lukas Schoefberger
- Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Speising, Vienna, Austria
| | - Jochen G Hofstaetter
- Michael Ogon Laboratory for Orthopaedic Research, Orthopaedic Hospital Speising, Vienna, Austria; 2nd Department, Orthopaedic Hospital Speising, Vienna, Austria
| |
Collapse
|
7
|
Kupratis ME, Rahman A, Burris DL, Corbin EA, Price C. Enzymatic digestion does not compromise sliding-mediated cartilage lubrication. Acta Biomater 2024; 178:196-207. [PMID: 38428511 DOI: 10.1016/j.actbio.2024.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
Articular cartilage's remarkable low-friction properties are essential to joint function. In osteoarthritis (OA), cartilage degeneration (e.g., proteoglycan loss and collagen damage) decreases tissue modulus and increases permeability. Although these changes impair lubrication in fully depressurized and slowly slid cartilage, new evidence suggests such relationships may not hold under biofidelic sliding conditions more representative of those encountered in vivo. Our recent studies using the convergent stationary contact area (cSCA) configuration demonstrate that articulation (i.e., sliding) generates interfacial hydrodynamic pressures capable of replenishing cartilage interstitial fluid/pressure lost to compressive loading through a mechanism termed tribological rehydration. This fluid recovery sustains in vivo-like kinetic friction coefficients (µk<0.02 in PBS and <0.005 in synovial fluid) with little sensitivity to mechanical properties in healthy tissue. However, the tribomechanical function of compromised cartilage under biofidelic sliding conditions remains unknown. Here, we investigated the effects of OA-like changes in cartilage mechanical properties, modeled via enzymatic digestion of mature bovine cartilage, on its tribomechanical function during cSCA sliding. We found no differences in sliding-driven tribological rehydration behaviors or µk between naïve and digested cSCA cartilage (in PBS or synovial fluid). This suggests that OA-like cartilage retains sufficient functional properties to support naïve-like fluid recovery and lubrication under biofidelic sliding conditions. However, OA-like cartilage accumulated greater total tissue strains due to elevated strain accrual during initial load application. Together, these results suggest that elevated total tissue strains-as opposed to activity-mediated strains or friction-driven wear-might be the key biomechanical mediator of OA pathology in cartilage. STATEMENT OF SIGNIFICANCE: Osteoarthritis (OA) decreases cartilage's modulus and increases its permeability. While these changes compromise frictional performance in benchtop testing under low fluid load support (FLS) conditions, whether such observations hold under sliding conditions that better represent the joints' dynamic FLS conditions in vivo is unclear. Here, we leveraged biofidelic benchtop sliding experiments-that is, those mimicking joints' native sliding environment-to examine how OA-like changes in mechanical properties effect cartilage's natural lubrication. We found no differences in sliding-mediated fluid recovery or kinetic friction behaviors between naïve and OA-like cartilage. However, OA-like cartilage experienced greater strain accumulation during load application, suggesting that elevated tissue strains (not friction-driven wear) may be the primary biomechanical mediator of OA pathology.
Collapse
Affiliation(s)
| | - Atia Rahman
- Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - David L Burris
- Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - Elise A Corbin
- Biomedical Engineering, University of Delaware, Newark, DE, USA; Materials Science & Engineering, University of Delaware, Newark, DE, USA
| | - Christopher Price
- Biomedical Engineering, University of Delaware, Newark, DE, USA; Mechanical Engineering, University of Delaware, Newark, DE, USA.
| |
Collapse
|
8
|
Kise T, Yokogawa N, Miyoshi Y, Utsunomiya M, Nagai Y, Shimada K. Synovial fluid crystal analysis with compensated polarization using a gout analyser in clinical practice. Mod Rheumatol 2024; 34:646-648. [PMID: 37329305 DOI: 10.1093/mr/road060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/17/2023] [Accepted: 06/13/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE To validate the gout analyzer as a clinical method of synovial fluid crystal analysis. METHODS Thirty knee synovial fluid samples with suspected calcium pyrophosphate (CPP) crystals were analyzed. Within 48 hours after collection, each non-centrifuged sample was examined blindly and independently by one or more rheumatologists in the following order: 1) with an optical microscope under ordinary light, 2) with the same microscope under compensated polarization provided by a gout analyzer, and 3) with a fully equipped compensated polarized microscope with a rotating stage as the gold standard. As a reference, laboratory technicians analyzed fresh, centrifuged synovial fluid using a gout analyzer. RESULTS Of the 30 samples analyzed, CPP and monosodium urate (MSU) crystals were detected in 11 and four, non-centrifuged samples, respectively, using a fully equipped compensated polarized microscope. The rheumatologists' detection rate of crystals in the non-centrifuged synovial fluid under ordinary light and with a gout analyzer was 73.3% and 80%, respectively. The laboratory technicians' detection rate in fresh centrifuged synovial fluid using a gout analyzer was 100%. CONCLUSION A gout analyzer may be used to diagnose gout and calcium pyrophosphate deposition disease definitively if a fully equipped compensated polarized microscope is unavailable.
Collapse
Affiliation(s)
- Takayasu Kise
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Naoto Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Yuji Miyoshi
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Masako Utsunomiya
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Yoshiki Nagai
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Kota Shimada
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| |
Collapse
|
9
|
Holub MN, Wahhab A, Rouse JR, Danner R, Hackner LG, Duris CB, McClune ME, Dressler JM, Strle K, Jutras BL, Edelstein AI, Lochhead RB. Peptidoglycan in osteoarthritis synovial tissue is associated with joint inflammation. Arthritis Res Ther 2024; 26:77. [PMID: 38532447 PMCID: PMC10967045 DOI: 10.1186/s13075-024-03293-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 02/22/2024] [Indexed: 03/28/2024] Open
Abstract
OBJECTIVES Peptidoglycan (PG) is an arthritogenic bacterial cell wall component whose role in human osteoarthritis is poorly understood. The purpose of this study was to determine if PG is present in synovial tissue of osteoarthritis patients at the time of primary total knee arthroplasty (TKA), and if its presence is associated with inflammation and patient reported outcomes. METHODS Intraoperative synovial tissue and synovial fluid samples were obtained from 56 patients undergoing primary TKA, none of whom had history of infection. PG in synovial tissue was detected by immunohistochemistry (IHC) and immunofluorescence microscopy (IFM). Synovial tissue inflammation and fibrosis were assessed by histopathology and synovial fluid cytokine quantification. Primary human fibroblasts isolated from arthritis synovial tissue were stimulated with PG to determine inflammatory cytokine response. RESULTS A total of 33/56 (59%) of primary TKA synovial tissue samples were positive for PG by IHC, and PG staining colocalized with markers of synovial macrophages and fibroblasts by IFM. Synovial tissue inflammation and elevated IL-6 in synovial fluid positively correlated with PG positivity. Primary human fibroblasts stimulated with PG secreted high levels of IL-6, consistent with ex vivo findings. Interestingly, we observed a significant inverse correlation between PG and age at time of TKA, indicating younger age at time of TKA was associated with higher PG levels. CONCLUSION Peptidoglycan is commonly found in synovial tissue from patients undergoing TKA. Our data indicate that PG may play an important role in inflammatory synovitis, particularly in patients who undergo TKA at a relatively younger age.
Collapse
Affiliation(s)
- Meaghan N Holub
- Department of Orthopaedic Surgery, Medical College of Wisconsin, BSB room 2850, Milwaukee, WI, 53226, USA
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Amanda Wahhab
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph R Rouse
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rebecca Danner
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Lauren G Hackner
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Christine B Duris
- Department of Pathology, Children's Hospital of Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mecaila E McClune
- Department of Biochemistry, Virginia Tech, Blacksburg, VA, USA
- Fralin Life Sciences Institute, Virginia Tech, Blacksburg, VA, USA
- Center for Emerging, Zoonotic, and Arthropod-borne Pathogens, Virginia Tech, Blacksburg, VA, USA
| | - Jules M Dressler
- Department of Biochemistry, Virginia Tech, Blacksburg, VA, USA
- Fralin Life Sciences Institute, Virginia Tech, Blacksburg, VA, USA
| | - Klemen Strle
- Department of Molecular Biology and Microbiology, Tufts University, Boston, MA, USA
| | - Brandon L Jutras
- Department of Biochemistry, Virginia Tech, Blacksburg, VA, USA
- Fralin Life Sciences Institute, Virginia Tech, Blacksburg, VA, USA
- Center for Emerging, Zoonotic, and Arthropod-borne Pathogens, Virginia Tech, Blacksburg, VA, USA
| | - Adam I Edelstein
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Robert B Lochhead
- Department of Orthopaedic Surgery, Medical College of Wisconsin, BSB room 2850, Milwaukee, WI, 53226, USA.
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA.
- Division of Rheumatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| |
Collapse
|
10
|
Zheng P, Zhang X, Feng C, Yu Y, Che G, Cao Z, Tian L, Huang Y. Alterations in articular cartilage frictional properties in the setting of acute gouty arthritis. PLoS One 2024; 19:e0298722. [PMID: 38512881 PMCID: PMC10956800 DOI: 10.1371/journal.pone.0298722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/29/2024] [Indexed: 03/23/2024] Open
Abstract
The tribological behaviour of articular cartilage plays a key role in joint motion; however, there is a gap in research on the effect of hyperuricemic joint fluid on cartilage friction behaviour in acute gouty arthritis. In this study, we carried out a fixed-load scratch experiment to compare the friction and wear of articular cartilage under the lubrication of gouty arthritis arthritic fluid and normal human arthritic fluid, and the results showed that the cartilage friction coefficient of patients with acute gouty arthritis was significantly larger than that of normal human beings, and that the cartilage friction coefficient decreased with the elevation of normal load and sliding speed, and the change with the sliding speed varied more differently from that of normal human beings, and that the cartilage surface wear was more severe after prolonged friction. The wear and tear of the cartilage surface is more severe after prolonged friction. Patients with gouty arthritis should reduce the sudden speed changes such as fast running and variable speed running to maintain the stability of the cartilage surface friction coefficient.
Collapse
Affiliation(s)
- Pai Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xueer Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chengcheng Feng
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuhong Yu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guangwei Che
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhihong Cao
- Key Laboratory of Testing Technology for Manufacturing Process in Ministry of Education, Southwest University of Science and Technology, Mianyang, China
| | - Li Tian
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yong Huang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
11
|
Li C, Chen B, Zhang R, Zhang Q. Comparative study of clinical and MRI features of TMD patients with or without joint effusion: a retrospective study. BMC Oral Health 2024; 24:314. [PMID: 38461246 PMCID: PMC10924403 DOI: 10.1186/s12903-024-04065-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND The relationship between joint effusion and temporomandibular disorders (TMD) remains unclear. The purpose of this study was to investigate the correlation among joint effusion, clinical features and MRI imaging features of TMD. METHODS A total of 1532 temporomandibular joints (TMJs) from 766 patients (605 females and 161 males) with the mean age of 31.68 ± 13.71 years from January 2022 to June 2023 were included in the study. Clinical and MRI features were collected and analyzed. Chi-Square test, Spearman correlation coefficient and binary logistic regression analysis were performed. RESULTS Patients with joint effusion were significantly older and had smaller value of MIO (p < 0.001). There were significant differences in the distribution of joint sounds (with or without), joint pain (with or without), disc morphology (biconcave, contracture, irregular and lengthened) and disc position between joint effusion group (JE) and non-joint effusion group (NA) (P < 0.05).The odds of having joint effusion were 1.726 higher in patients with joint sounds when compared to those without joint sounds. The odds of having joint effusion were 8.463 higher in patients with joint pain when compared to those without joint pain. The odds of having joint effusion were 2.277 higher in patients with contracture when compared to those with biconcave. The odds of having joint effusion were 1.740 higher in patients with anterior disc displacement with reduction (ADDWR) when compared to those with normal disc position. The prediction accuracy of this model is 74.9%, and the area under curve (AUC) is 79.5%, indicating that it can be used for the prediction and the judgment effect is average. CONCLUSIONS The results demonstrated that joint sounds, joint pain, contracture, and ADDWR are high risk factors for joint effusion, especially joint pain. TRIAL REGISTRATION This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics Committee of Affiliated Stomatology Hospital of Guangzhou Medical University (LCYJ2022014).
Collapse
Affiliation(s)
- Chuanjie Li
- Department of Temporomandibular Joint Surgery, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510000, China
| | - Benyi Chen
- School of Stomatology, Guangzhou Medical University, Guangzhou, China
| | - Rong Zhang
- Department of Temporomandibular Joint Surgery, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510000, China.
| | - Qingbin Zhang
- Department of Temporomandibular Joint Surgery, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510000, China.
| |
Collapse
|
12
|
Zhou Z, Zhou X, Jiang X, Yang B, Lu X, Fei Y, Zhao L, Chen H, Zhang L, Si X, Liang N, Wang Y, Yang D, Peng Y, Yang Y, Yao Z, He Y, Wu X, Zhang W, Wang M, Yang H, Zhang X. Single-cell profiling identifies IL1B hi macrophages associated with inflammation in PD-1 inhibitor-induced inflammatory arthritis. Nat Commun 2024; 15:2107. [PMID: 38453911 PMCID: PMC10920757 DOI: 10.1038/s41467-024-46195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 02/14/2024] [Indexed: 03/09/2024] Open
Abstract
Inflammatory arthritis (IA) is a common rheumatic adverse event following immune checkpoint inhibitors treatment. The clinical disparities between IA and rheumatoid arthritis (RA) imply disease heterogeneity and distinct mechanisms, which remain elusive. Here, we profile CD45+ cells from the peripheral blood or synovial fluid (SF) of patients with PD-1-induced IA (PD-1-IA) or RA using single-cell RNA sequencing. We report the predominant expansion of IL1Bhi myeloid cells with enhanced NLRP3 inflammasome activity, in both the SF and peripheral blood of PD-1-IA, but not RA. IL1Bhi macrophages in the SF of PD-1-IA shared similar inflammatory signatures and might originate from peripheral IL1Bhi monocytes. Exhausted CD8+ T cells (Texs) significantly accumulated in the SF of patients with PD-1-IA. IL1Bhi myeloid cells communicated with CD8+ Texs possibly via the CCR1-CCL5/CCL3 and CXCL10-CXCR3 axes. Collectively, these results demonstrate different cellular and molecular pathways in PD-1-IA and RA and highlight IL1Bhi macrophages as a possible therapeutic target in PD-1-IA.
Collapse
Affiliation(s)
- Ziyue Zhou
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Xiaoxiang Zhou
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021, Beijing, China
| | - Xu Jiang
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- National Infrastructure for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Bo Yang
- Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Xin Lu
- Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Yunyun Fei
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Lidan Zhao
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Hua Chen
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Li Zhang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Xiaoyan Si
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Naixin Liang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Yadong Wang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Dan Yang
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Yezi Peng
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Yiying Yang
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Zhuoran Yao
- Department of Thoracic Oncology, Cancer Center, and Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Yangzhige He
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- National Infrastructure for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Xunyao Wu
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Wen Zhang
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China
| | - Min Wang
- Department of Rheumatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Clinical Immunology Center, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Huaxia Yang
- Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases, the Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China.
- Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China.
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730, Beijing, China.
| | - Xuan Zhang
- Department of Rheumatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Clinical Immunology Center, Chinese Academy of Medical Sciences, 100730, Beijing, China.
| |
Collapse
|
13
|
Theil C, Moellenbeck B, Schwarze J, Puetzler J, Klingebiel S, Bockholt S, Gosheger G. Can the Current Thresholds for Synovial Cell Count and Neutrophil Percentage to Diagnose Prosthetic Joint Infection be Applied to Metal-on-Metal Rotating Hinge Total Knee Arthroplasty? J Arthroplasty 2024; 39:801-805. [PMID: 37648100 DOI: 10.1016/j.arth.2023.08.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Synovial leukocyte count analysis is an important tool in the diagnosis of PJI. However, results can be poor if metallosis is present. The issue of metallosis was established for some rotating hinge knee arthroplasty designs. METHODS This was a retrospective single-center analysis that included 108 patients who had a single-design metal-on-metal rotating hinge knee arthroplasty who underwent revision surgery and had prior synovial fluid analysis performed. The diagnostic accuracy of leukocyte count and the percentage of polymorphonuclear neutrophiles (% PMN) were investigated. RESULTS Patients who had a PJI had a higher median leukocyte count and % PMN compared to aseptic revisions (7,905/μL (interquartile range (IQR) 2,419 to 37,400) and 85% (IQR 70.3 to 93.8) versus 450 (IQR 167 to 1,215) and 46% (IQR 28.5 to 67.4%), P < .001). The respective areas under the curves were 0.916 (95% confidence interval 0.862 to 0.970) for leukocyte count and 0.821 (95% confidence interval 0.739 to 0.902) for % PMN. We calculated an optimal cut-off value of 1,200 leukocytes/μL (Sensitivity 94.5%/specificity 75.5%) and 63% PMN (Sensitivity 85.5%/specificity 73.6%) to define PJI. Established thresholds were less sensitive, but more specific. The "infection likely" scenario of the European Bone and Joint Infection Society (EBJIS) definition was closest to the calculated thresholds. CONCLUSION Currently used thresholds for leukocyte cell count and %PMN to define PJI were less sensitive and specific in the diagnosis of PJI in metal-on-metal RHK knees. Surgeons must consider lower cut-off values when evaluating such implants for PJI.
Collapse
Affiliation(s)
- Christoph Theil
- Department of General Orthopedics and Tumour Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Burkhard Moellenbeck
- Department of General Orthopedics and Tumour Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Jan Schwarze
- Department of General Orthopedics and Tumour Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Jan Puetzler
- Department of General Orthopedics and Tumour Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Sebastian Klingebiel
- Department of General Orthopedics and Tumour Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Sebastian Bockholt
- Department of General Orthopedics and Tumour Orthopedics, Muenster University Hospital, Muenster, Germany
| | - Georg Gosheger
- Department of General Orthopedics and Tumour Orthopedics, Muenster University Hospital, Muenster, Germany
| |
Collapse
|
14
|
Maroun G, Fissoun C, Villaverde M, Brondello JM, Pers YM. Senescence-regulatory factors as novel circulating biomarkers and therapeutic targets in regenerative medicine for osteoarthritis. Joint Bone Spine 2024; 91:105640. [PMID: 37739212 DOI: 10.1016/j.jbspin.2023.105640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
Recent discoveries reveal that the chronic presence of senescent cells in osteoarticular tissues provides a focal point of disease development for osteoarthritis (OA). Nevertheless, senescence-regulatory factors associated with OA still need to be identified. Furthermore, few diagnostic- and prognostic-validated biochemical markers (biomarkers) are currently used in clinics to evaluate OA patients. In the future, alongside imaging and clinical examination, detecting senescence-regulatory biomarkers in patient fluids could become a prospective method for disease: diagnosis, monitoring, progression and prognosis following treatment. This review summarizes a group of circulating OA biomarkers recently linked to senescence onset. Remarkably, these factors identified in proteomics, metabolomic and microRNA studies could also have deleterious or protective roles in osteoarticular tissue homeostasis. In addition, we discuss their potentially innovative modulation in combination with senotherapeutic approaches, for long-lasting OA treatment.
Collapse
Affiliation(s)
- Georges Maroun
- Institute for Regenerative Medicine and Biotherapy, University of Montpellier, INSERM UMR 1183, 34298 Montpellier, France
| | - Christina Fissoun
- Institute for Regenerative Medicine and Biotherapy, University of Montpellier, INSERM UMR 1183, 34298 Montpellier, France
| | - Marina Villaverde
- Institute for Regenerative Medicine and Biotherapy, University of Montpellier, INSERM UMR 1183, 34298 Montpellier, France; HCS Pharma, Biocentre Fleming, 250, rue Salvador-Allende, Bat A, 59120 Loos, France
| | - Jean-Marc Brondello
- Institute for Regenerative Medicine and Biotherapy, University of Montpellier, INSERM UMR 1183, 34298 Montpellier, France
| | - Yves-Marie Pers
- Institute for Regenerative Medicine and Biotherapy, University of Montpellier, INSERM UMR 1183, 34298 Montpellier, France; Clinical immunology and osteoarticular diseases Therapeutic Unit, Lapeyronie University Hospital, CHU Montpellier, IRMB, University of Montpellier, INSERM, Montpellier, France.
| |
Collapse
|
15
|
Hubert J, Ritter J, Krüger L, Simon A, Beil FT, Jandl NM, Rolvien T. Are Synovial Inflammatory Markers Increased in Patients Who Have Aseptic Total Hip Arthroplasty Dislocation Indicated for Revision? J Arthroplasty 2024; 39:787-794.e1. [PMID: 37611677 DOI: 10.1016/j.arth.2023.08.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Previous studies have speculated on elevated synovial inflammatory markers in patients undergoing surgical revision for total hip arthroplasty (THA) dislocation. However, this assumption is based on small patient series and a full investigation according to International Consensus Meeting (ICM) criteria has not yet been performed. METHODS Patients who had aseptic THA dislocation indicated for revision surgery were identified retrospectively. Only patients who had available diagnostic workup according to ICM 2018 criteria, including preoperative and intraoperative parameters, were included. For comparison, we analyzed a matched cohort of patients indicated for aseptic THA revision for other conditions. The 2 cohorts each consisted of 55 patients and were not different regarding age, sex, BMI, or implant fixation. RESULTS There was no difference in synovial white blood cell count (2,238 ± 2,544 versus 2,533 ± 3,448 c/μL; P = .601), alpha-defensin quotient (0.14 ± 0.11 versus 0.19 ± 0.28; P = .207), or polymorphonuclear neutrophil percentage (% PMN) (36.7 ± 22.6 versus 31.3 ± 24.5%; P = .312) between the groups. In the dislocation cohort, 20% of patients had a synovial white blood cell count of 3,000 c/μL or higher, compared with 18% in the control cohort. However, all patients in the dislocation cohort were below the cutoff for alpha-defensin or % PMN. CONCLUSION In patients who have aseptic THA dislocation, synovial inflammatory markers are not elevated compared with patients undergoing aseptic revision for other complications. A detailed preoperative analysis of synovial inflammatory markers using ICM criteria appears critical in patients who have a THA dislocation to exclude periprosthetic joint infection. LEVEL OF EVIDENCE Level III, retrospective, comparative study.
Collapse
Affiliation(s)
- Jan Hubert
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jacob Ritter
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lara Krüger
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Simon
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Timo Beil
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nico Maximilian Jandl
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim Rolvien
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
16
|
Offerhaus C, Leutheuser S, Jaecker V, Shafizadeh S, Bardtke L, Wisplinghoff H, Jazmati N. Evidence of Bacterial Metabolism in Synovial Fluid of Patients With Graft Failure After Anterior Cruciate Ligament Reconstruction: A Microbiological Comparison of Primary Anterior Cruciate Ligament and Hamstring Tendon Autograft Ruptures. Arthroscopy 2024; 40:400-408. [PMID: 37437788 DOI: 10.1016/j.arthro.2023.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE To investigate whether the bacterial presence in a primary ruptured native anterior cruciate ligament (ACL) differs from that in a ruptured hamstrings ACL autograft and whether low-grade infections cumulatively can be detected in the case of graft failure. METHODS In a retrospective case-control study with prospectively collected data, synovial fluid aspirates and tissue samples of failed ACL grafts were examined for evidence of bacterial colonization and compared to samples of the native ACL in primary ACL reconstruction (ACLR) using microbiological culture, 16S rRNA-PCR and histopathological examination. Furthermore, synovial fluid aspiration was investigated for possible future biomarkers for a low-grade infection. RESULTS A total of 112 consecutive patients undergoing primary ACLR without history of previous surgeries to the affected knee (n = 59) and revision ACLR after reconstruction with a hamstring tendon autograft (n = 53) were recruited from one center. No patient had a history or showed clinical signs of infection. A total of 389 samples were analyzed by culture. Bacteria were detected in 9.4% of patients with a graft rupture (n = 5/53) compared to 3.4% of patients with a primary ACL rupture (n = 2/59) showing no statistical difference (P = .192). One patient with a "true" low-grade infection was found in our study population, resulting in a prevalence of 1.9% (1/53) in the graft group. The percentage of polymorphonuclear leukocytes (PMN%) as a highly sensitive marker for joint infections was significantly higher in aspirated synovial fluid of graft ruptures (27% ± 3% vs 20% ± 4%; P = .032), as well as glucose levels were significantly lower (83 mg/dL ± 2 mg/dL vs 88 mg/dL ± 2 mg/dL; P = .042). CONCLUSIONS Synovial fluid obtained before revision ACLR showed a higher percentage of polymorphonuclear leukocytes and lower glucose levels compared with primary ACLR, suggesting bacterial metabolism and demonstrating that the intra-articular milieu changes significantly after ACLR. Tissue samples of ACL grafts revealed a low-grade infection in one case, although overall cultivable bacterial presence did not differ significantly when compared to samples of a native ACL. LEVEL OF EVIDENCE Level III, retrospective case-control study.
Collapse
Affiliation(s)
- Christoph Offerhaus
- Department of Orthopedic Surgery and Sports Traumatology, Witten/Herdecke University, Sana Medical Centre, Cologne, Germany.
| | - Sebastian Leutheuser
- Department of Orthopedic Surgery and Sports Traumatology, Witten/Herdecke University, Sana Medical Centre, Cologne, Germany
| | - Vera Jaecker
- Department of Trauma Surgery, Orthopaedic Surgery and Sports Traumatology, Witten/Herdecke University, Cologne Merheim Medical Centre, Cologne, Germany
| | - Sven Shafizadeh
- Department of Orthopedic Surgery and Sports Traumatology, Witten/Herdecke University, Sana Medical Centre, Cologne, Germany
| | | | - Hilmar Wisplinghoff
- Labor Dr. Wisplinghoff, Cologne, Germany; Institute for Virology and Microbiology, Witten/Herdecke University, Witten, Germany
| | - Nathalie Jazmati
- Labor Dr. Wisplinghoff, Cologne, Germany; Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany
| |
Collapse
|
17
|
Siddiqui H, Jasiak A, Doub JB. Do All Prosthetic Joint Infection Clinical Isolates Form Aggregates in Synovial Fluid That Are Resistant to Antibiotic Agents? Surg Infect (Larchmt) 2024; 25:71-76. [PMID: 38150525 DOI: 10.1089/sur.2023.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023] Open
Abstract
Background: Chronic prosthetic joint infections (PJI) are associated with substantial morbidity because conventional antibiotic agents lack activity to bacteria in biofilms that necessitates prosthetic removal to attempt definitive cure. However, these are complex infections that go beyond biofilms and bacteria can be present in various other different states such as synovial fluid aggregates. Consequently, the purpose of this study was to assess the propensity of historically preserved PJI clinical isolates to form synovial fluid aggregates and if aggregation occurred then what is proclivity to be tolerant to high doses of antibiotic agents. Patients and Methods: Historically preserved chronic PJI clinical isolates from 2021 were evaluated for their ability to form synovial fluid aggregates under static and dynamic conditions in 24-microwell plates. Tolerance to vancomycin, gentamicin, or amphotericin was conducted by adding high concentrations of these antibiotic agents to synovial fluid microbial aggregates. Results: All clinical isolates formed synovial fluid aggregates under dynamic conditions, which with the use of scanning electron microscopy showed dense collections of bacteria with synovial fluid polymers. However, under static conditions only Staphylococcus aureus formed aggregates. Importantly, all the microbes in these aggregates were tolerant to high concentrations of antibiotic agents. Conclusions: This study demonstrates that synovial fluid aggregation occurred with all bacterial and fungal species assessed. Therefore, the findings here have important clinical ramifications given the extent that this phenomenon occurs across microbial species and the propensity for the microbes in these aggregates to be tolerant to antibiotic agents.
Collapse
Affiliation(s)
- Hamda Siddiqui
- The Doub Laboratory of Translational Bacterial Research, Baltimore, Maryland, USA
- Division of Clinical Care and Research, Institute of Human Virology, Baltimore, Maryland, USA
| | - Adam Jasiak
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - James B Doub
- The Doub Laboratory of Translational Bacterial Research, Baltimore, Maryland, USA
- Division of Clinical Care and Research, Institute of Human Virology, Baltimore, Maryland, USA
| |
Collapse
|
18
|
Erxleben DA, Dodd RJ, Day AJ, Green DE, DeAngelis PL, Poddar S, Enghild JJ, Huebner JL, Kraus VB, Watkins AR, Reesink HL, Rahbar E, Hall AR. Targeted Analysis of the Size Distribution of Heavy Chain-Modified Hyaluronan with Solid-State Nanopores. Anal Chem 2024; 96:1606-1613. [PMID: 38215004 PMCID: PMC11037269 DOI: 10.1021/acs.analchem.3c04387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
The glycosaminoglycan hyaluronan (HA) plays important roles in diverse physiological functions where the distribution of its molecular weight (MW) can influence its behavior and is known to change in response to disease conditions. During inflammation, HA undergoes a covalent modification in which heavy chain subunits of the inter-alpha-inhibitor family of proteins are transferred to its structure, forming heavy chain-HA (HC•HA) complexes. While limited assessments of HC•HA have been performed previously, determining the size distribution of its HA component remains a challenge. Here, we describe a selective method for extracting HC•HA from mixtures that yields material amenable to MW analysis with a solid-state nanopore sensor. After demonstrating the approach in vitro, we validate extraction of HC•HA from osteoarthritic human synovial fluid as a model complex biological matrix. Finally, we apply our technique to pathophysiology by measuring the size distributions of HC•HA and total HA in an equine model of synovitis.
Collapse
Affiliation(s)
- Dorothea A. Erxleben
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Rebecca J. Dodd
- Wellcome Centre for Cell-Matrix Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PT, United Kingdom
| | - Anthony J. Day
- Wellcome Centre for Cell-Matrix Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PT, United Kingdom
- Lydia Becker Institute of Immunology and Inflammation, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, United Kingdom
| | - Dixy E. Green
- Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Paul L. DeAngelis
- Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Suruchi Poddar
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Jan J. Enghild
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus, C 8000, Denmark
| | - Janet L. Huebner
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA
| | - Virginia B. Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA
| | - Amanda R. Watkins
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Heidi L. Reesink
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Elaheh Rahbar
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Adam R. Hall
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
- Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| |
Collapse
|
19
|
Marquez-Florez K, Arroyave-Tobon S, Tadrist L, Linares JM. Elbow dimensions in quadrupedal mammals driven by lubrication regime. Sci Rep 2024; 14:2177. [PMID: 38272957 PMCID: PMC10810906 DOI: 10.1038/s41598-023-50619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Synovial joints, such as the elbow, experience different lubrication regimes, ranging from fluid film to boundary lubrication, depending on locomotion conditions. We explore the relationship between the elbow lubrication regime and the size of quadrupedal mammals. We use allometry to analyze the dimensions, contact stress, and sliding speed of the elbow in 110 quadrupedal mammals. Our results reveal that the average diameter and width of the distal humerus are scaled [Formula: see text], which allowed us to estimate a consistent contact pressure and sliding speed across mammals. This consistency likely promotes fluid film lubrication regardless of body mass. Further, the ratio between the diameter and width is about 0.5 for all analyzed taxa, which is a good compromise between loading capacity and size. Our study deepens our understanding of synovial joints and their adaptations, with implications for the development of treatments, prostheses, and bioinspired joint designs.
Collapse
Affiliation(s)
| | | | - Loïc Tadrist
- Aix Marseille Univ, CNRS, ISM, Marseille, France
| | | |
Collapse
|
20
|
Sallai I, Turiák L, Sugár S, Drahos L, Skaliczki G. [Proteome of extracellular vesicles from synovial fluid and their possible function in periprosthetic infections]. Orv Hetil 2024; 165:98-109. [PMID: 38245904 DOI: 10.1556/650.2024.32886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/01/2023] [Indexed: 01/23/2024]
Abstract
Bevezetés: A periprotetikus infekciók ellátása jelentős kihívás
elé állítja az operáló orvost, mind diagnosztikai, mind terápiás tekintetben. Az
utóbbi években a mozgásszervi kutatások során egyre növekvő figyelmet kaptak az
extracellularis vesiculák. Az extracellularis vesiculák által szállított
fehérjék tömegspektrometrián alapuló azonosítása fontos lépés, mely segíthet
megérteni a védekezési folyamatban betöltött biológiai funkcióikat.
Célkitűzés: Vizsgálatunk célja volt az akut és a krónikus
fertőzött mintákból izolált extracellularis vesiculák fehérjetartalmának
megismerése, azonosságok és különbségek keresése – az „egy legjobb biomarker”
megtalálása helyett a lehető legtöbb, detektálható mennyiségben jelen lévő
extracellularis vesiculába zárt fehérje vizsgálata és biológiai folyamatokba
illesztése. Módszer: Prospektív, monocentrikus vizsgálatot
végeztünk, a beválasztási kritériumok a 2018-as MSIS-kritériumokon alapultak. A
vizsgálatba 13 (n = 13) beteget vontunk be, minden beteg periprotetikus infekció
miatt került műtétre. 6 (n = 6) betegnél akut purulens (akut csoport)
folyamatot, míg 7 (n = 7) betegnél ’low-grade’ infekciót (krónikus csoport)
igazoltunk. Az extracellularis vesiculák izolálása minden esetben a protézist
körülvevő synovialis folyadékból történt. A tömegspektrometriai vizsgálattal
azonosított fehérjék funkcionális alapú klaszterezésére a STRING, KEGG, Gene
Ontology adatbázisokat használtuk. A végleges vizualizáció Cytoscape 3.9.1.
szoftverrel történt. Eredmények: Az extracellularis vesiculák
feltárása után 222 db fehérjét azonosítottunk, melyek vagy az akut, vagy a
krónikus minták valamelyikének több mint felében fordultak elő. Csak az akut
minták több mint felében 50 db fehérjét; csak a krónikus minták több mint
felében 33 db fehérjét; egyszerre mindkét csoport több mint felében 86 db
fehérjét azonosítottunk. Ezek alapján készültek a funkcionális klaszterek.
Megbeszélés: A protézisfertőzések diagnosztikájában régóta
megvan a törekvés, hogy megtalálják az „egy legjobb biomarkert”, amely biztosan
különbséget tud tenni fertőzött és nem fertőzött protézislazulás között.
Következtetés: Vizsgálatunk célja nem egy újabb biomarker
kiválasztása volt, hanem az extracellularis vesiculákban szállított fehérjék
biológiai folyamatokban betöltött szerepének ábrázolása, leírása, amellyel
jobban betekinthetünk a periprotetikus infekció során zajló folyamatokba. Orv
Hetil. 2024; 165(3): 98–109.
Collapse
Affiliation(s)
- Imre Sallai
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Ortopédiai Klinika Budapest, Üllői út 78/b, 1082 Magyarország
| | - Lilla Turiák
- 2 Természettudományi Kutatóközpont, MS Proteomika Kutatócsoport Budapest Magyarország
| | - Simon Sugár
- 2 Természettudományi Kutatóközpont, MS Proteomika Kutatócsoport Budapest Magyarország
| | - László Drahos
- 2 Természettudományi Kutatóközpont, MS Proteomika Kutatócsoport Budapest Magyarország
| | - Gábor Skaliczki
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Ortopédiai Klinika Budapest, Üllői út 78/b, 1082 Magyarország
| |
Collapse
|
21
|
Thorarinsdottir K, McGrath S, Forslind K, Agelii ML, Ekwall AKH, Jacobsson LTH, Rudin A, Mårtensson IL, Gjertsson I. Cartilage destruction in early rheumatoid arthritis patients correlates with CD21 -/low double-negative B cells. Arthritis Res Ther 2024; 26:23. [PMID: 38225658 PMCID: PMC10789032 DOI: 10.1186/s13075-024-03264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/09/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Involvement of B cells in the pathogenesis of rheumatoid arthritis (RA) is supported by the presence of disease-specific autoantibodies and the efficacy of treatment directed against B cells. B cells that express low levels of or lack the B cell receptor (BCR) co-receptor CD21, CD21-/low B cells, have been linked to autoimmune diseases, including RA. In this study, we characterized the CD21+ and CD21-/low B cell subsets in newly diagnosed, early RA (eRA) patients and investigated whether any of the B cell subsets were associated with autoantibody status, disease activity and/or joint destruction. METHODS Seventy-six eRA patients and 28 age- and sex-matched healthy donors were recruited. Multiple clinical parameters were assessed, including disease activity and radiographic joint destruction. B cell subsets were analysed in peripheral blood (PB) and synovial fluid (SF) using flow cytometry. RESULTS Compared to healthy donors, the eRA patients displayed an elevated frequency of naïve CD21+ B cells in PB. Amongst memory B cells, eRA patients had lower frequencies of the CD21+CD27+ subsets and CD21-/low CD27+IgD+ subset. The only B cell subset found to associate with clinical factors was the CD21-/low double-negative (DN, CD27-IgD-) cell population, linked with the joint space narrowing score, i.e. cartilage destruction. Moreover, in SF from patients with established RA, the CD21-/low DN B cells were expanded and these cells expressed receptor activator of the nuclear factor κB ligand (RANKL). CONCLUSIONS Cartilage destruction in eRA patients was associated with an expanded proportion of CD21-/low DN B cells in PB. The subset was also expanded in SF from established RA patients and expressed RANKL. Taken together, our results suggest a role for CD21-/low DN in RA pathogenesis.
Collapse
Affiliation(s)
- Katrin Thorarinsdottir
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
- Department of Rheumatology, Center for Rheumatology Research, University Hospital of Iceland, Reykjavík, Iceland
- Department of Immunology, University Hospital of Iceland, Reykjavík, Iceland
| | - Sarah McGrath
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Kristina Forslind
- Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Lund, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Monica Leu Agelii
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Anna-Karin Hultgård Ekwall
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
- Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lennart T H Jacobsson
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Anna Rudin
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
- Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inga-Lill Mårtensson
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden
| | - Inger Gjertsson
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden.
- Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| |
Collapse
|
22
|
Richter A, Altemeier A, Hold M, Lenhof S, Stauss R, Ettinger M, Omar M. Drain fluid cultures can rule in but cannot rule out infection persistence after surgical treatment of periprosthetic joint infections. J Orthop Sci 2024; 29:177-182. [PMID: 36462996 DOI: 10.1016/j.jos.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/28/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Periprosthetic joint infection (PJI) is one of the most common reason for implant failure in arthroplasty. Surgical therapy is essential but there is no standardized guideline to determine infection eradication in multiple-step revision surgery. To date, clinical and laboratory inflammation markers and preoperative arthrocentesis are controversial to evaluate the infection status before reimplantation and therefore are often combined. Drain fluid cultures enable a microbiological analysis without need for further invasive procedure after revision surgery. This retrospective study evaluates the diagnostic performance of drain fluid cultures in diagnosing infection persistence according to the MSIS definition of PJI. METHODS Drain samples have been taken after every revision surgery for microbiological testing. Afterwards, the results have been assigned to the infection status according to the diagnostic criteria of the MSIS definition of PJI. RESULTS 1084 revision surgeries in 183 patients have been included, resulting in a total sample size of 1552 drain fluid cultures. Overall sensitivity was 36.0%, specificity was 90.7% and ROC-AUC was 0.63. CONCLUSION Due to a high specificity and a low sensitivity drain fluid cultures can rule in but cannot rule out infection persistence in PJI.
Collapse
Affiliation(s)
- Alena Richter
- Orthopaedic Department - DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany.
| | - Anna Altemeier
- Orthopaedic Department - DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany.
| | - Mara Hold
- Orthopaedic Department - DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany.
| | - Stefan Lenhof
- Trauma Department - Hannover Medical School, Carl-Neuberg-Str 130625 Hannover, Germany.
| | - Ricarda Stauss
- Trauma Department - Hannover Medical School, Carl-Neuberg-Str 130625 Hannover, Germany.
| | - Max Ettinger
- Orthopaedic Department - DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany.
| | - Mohamed Omar
- Trauma Department - Hannover Medical School, Carl-Neuberg-Str 130625 Hannover, Germany.
| |
Collapse
|
23
|
Ishizaki J. Assessment of Musculoskeletal Ultrasound of Rheumatoid Arthritis. Methods Mol Biol 2024; 2766:335-342. [PMID: 38270893 DOI: 10.1007/978-1-0716-3682-4_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Musculoskeletal ultrasound (MSUS) is a valuable tool that is used in outpatient clinics or at the bedside to assess multiple joint sites, including small joints. It provides detailed images of structures commonly observed in rheumatoid arthritis (RA), such as synovitis, tenosynovitis, bone erosions, cartilage damage, and synovial fluid accumulation. MSUS is frequently used in the management of RA and provides more objective information for an early diagnosis and disease activity assessment through imaging findings.
Collapse
Affiliation(s)
- Jun Ishizaki
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
| |
Collapse
|
24
|
Vita S, Mascia C, Kertusha B, Marocco R, Sauzullo I, Mengoni F, Pozzetto I, Scalzi A, Nijhawan P, Savinelli S, Fondaco L, Carraro A, Del Borgo C, Mastroianni CM, Lichtner M. TB specific intracellular cytokines production in Synovial liquid for diagnosis of tuberculous arthritis. J Infect Dev Ctries 2023; 17:1829-1833. [PMID: 38252716 DOI: 10.3855/jidc.12618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 02/20/2021] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Skeletal tuberculosis (TB) accounts for about 10 to 35% of extrapulmonary cases and the knee is the most frequent site after the spine and hip. The diagnosis is difficult and largely clinical. CASE PRESENTATION This is a case of a young Pakistani man with a history of joint pain for about 4 years, who was diagnosed with chronic arthritis of the right knee. Microscopy of synovial fluid and conventional diagnostic tests to identify Mycobacterium tuberculosis were negative, while a non-classical method based on intracellular cytokine flow cytometry response of CD4 T-cells in synovial fluid helped us to address the diagnosis, which was subsequently confirmed by Polymerase Chain Reaction (PCR). CONCLUSIONS Thanks to an innovative immunological approach, supported by PCR for detection of M. tuberculosis DNA, we were able to diagnose tuberculous arthritis of the knee, which allowed prompt initiation of treatment to reduce morbidity and mortality.
Collapse
Affiliation(s)
- Serena Vita
- Infectious Disease Unit, Santa Maria Goretti Hospital, Latina, Italy
| | | | | | - Raffaella Marocco
- Infectious Disease Unit, Santa Maria Goretti Hospital, Latina, Italy
| | | | - Fabio Mengoni
- Infectious Disease Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - Irene Pozzetto
- Infectious Disease Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - Alessandro Scalzi
- Orthopedics and Traumatology, Santa Maria Goretti Hospital, Latina, Italy
| | | | - Stefano Savinelli
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland
| | | | | | - Cosmo Del Borgo
- Infectious Disease Unit, Santa Maria Goretti Hospital, Latina, Italy
| | | | - Miriam Lichtner
- Infectious Disease Unit, Santa Maria Goretti Hospital, Latina, Italy
| |
Collapse
|
25
|
Oliviero F, Baggio C, Favero M, Damasco AC, Boscaro C, Tietto D, Albiero M, Doria A, Ramonda R. Synovial Fluid from Patients with Osteoarthritis Shows Different Inflammatory Features Depending on the Presence of Calcium Pyrophosphate Crystals. Int J Mol Sci 2023; 25:393. [PMID: 38203564 PMCID: PMC10778695 DOI: 10.3390/ijms25010393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
The role of calcium pyrophosphate (CPP) crystals in osteoarthritis (OA) is still a matter of debate. With this study we aimed to investigate the inflammatory features of synovial fluid (SF) collected from patients with OA with CPP crystals compared with those without crystals. We also explored the effect of OA SF on monocytes response. SFs were collected from adult patients with OA and subdivided according to the presence of crystals. Local cellular and humoral inflammatory mediators were analysed in the SF samples. The expression levels of IL-1β, IL-18, CASP-1, NLRP3, and GAPDH were measured by RT-PCR in the cells obtained by pelleting the SF samples. For the in vitro study, a monocytic cell line was treated with selected SF samples. SF with CPP crystals showed a significant increase in inflammatory cellular indices and higher levels of IL-1β, IL-8, and caspase-1 transcript with respect to SF without crystals. Higher concentrations of VEGF were also observed in the early stages of the whole OA patients. THP-1 cells stimulated with OA SF released a significant amount of IL-1 β in culture supernatants. This study demonstrated that SF collected from patients with OA shows different inflammatory features depending on the presence of CPP crystals.
Collapse
Affiliation(s)
- Francesca Oliviero
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (C.B.); (M.F.); (A.C.D.); (A.D.)
| | - Chiara Baggio
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (C.B.); (M.F.); (A.C.D.); (A.D.)
| | - Marta Favero
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (C.B.); (M.F.); (A.C.D.); (A.D.)
- Medicine Unit 1, Ca’ Foncello Hospital, 31100 Treviso, Italy
| | - Amelia Carmela Damasco
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (C.B.); (M.F.); (A.C.D.); (A.D.)
| | - Carlotta Boscaro
- Department of Medicine, University of Padova, 35128 Padova, Italy;
- Experimental Diabetology Lab, Veneto Institute of Molecular Medicine, 35129 Padova, Italy;
| | | | - Mattia Albiero
- Experimental Diabetology Lab, Veneto Institute of Molecular Medicine, 35129 Padova, Italy;
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (C.B.); (M.F.); (A.C.D.); (A.D.)
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (C.B.); (M.F.); (A.C.D.); (A.D.)
| |
Collapse
|
26
|
Cichos KH, Ruark RJ, Ghanem ES. Isothermal microcalorimetry improves accuracy and time to bacterial detection of periprosthetic joint infection after total joint arthroplasty. J Clin Microbiol 2023; 61:e0089323. [PMID: 37947408 PMCID: PMC10729692 DOI: 10.1128/jcm.00893-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023] Open
Abstract
Isothermal microcalorimetry (IMC) was evaluated compared to conventional cultures to determine the clinical performance for diagnosing periprosthetic joint infection (PJI) of hip/knee replacements. We prospectively collected three to five deep tissue samples per patient from 152 patients undergoing conversion or revision hip/knee arthroplasty from July 2020 to November 2022. Cultures and IMC for each sample were compared for concordance, median time to detection (TTD), and diagnostic performance based on 2013 Musculoskeletal Infection Society criteria. Secondary analyses involved patients on antibiotics at sampling. The 152 total patients had 592 tissue samples (mean 3.9 ± 0.3) with sample concordance between cultures and IMC of 90%. IMC demonstrated a sensitivity of 83%, specificity of 100%, negative predictive value (NPV) of 89%, and positive predictive value (PPV) of 100% for PJI. Cultures resulted in 69% sensitivity, 100% specificity, 81% NPV, and 100% PPV. The accuracy of IMC was 93% compared to 87% for cultures (P < 0.001). The median TTD of PJI by cultures was 51 (21-410) hours compared to 10 (0.5-148) hours for IMC (P < 0.001). For 39 patients on chronic antibiotics, sensitivity in PJI detection was 93%, specificity 100%, NPV 85%, and PPV 100% by IMC compared to 79% sensitivity, 100% specificity, 65% NPV, and 100% PPV for cultures. The accuracy was 95% for IMC compared to 85% for cultures (P < 0.001) with median TTD of 12 (0.5-127) hours compared to 52 (21-174) hours (P < 0.001). Utilizing IMC for PJI detection improves TTD by nearly 2 days while improving diagnostic accuracy compared to cultures, particularly in patients on chronic antibiotics.
Collapse
Affiliation(s)
- Kyle H. Cichos
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Hughston Foundation, Columbus, Georgia, USA
- Hughston Clinic, Columbus, Georgia, USA
| | | | - Elie S. Ghanem
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, USA
| |
Collapse
|
27
|
Chakraborty S, Gupta R, Kubatzky KF, Kar S, Kraus FV, Souto-Carneiro MM, Lorenz HM, Kumar P, Kumar V, Mitra DK. Negative impact of Interleukin-9 on synovial regulatory T cells in rheumatoid arthritis. Clin Immunol 2023; 257:109814. [PMID: 37879380 DOI: 10.1016/j.clim.2023.109814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/05/2023] [Accepted: 10/21/2023] [Indexed: 10/27/2023]
Abstract
In Rheumatoid Arthritis (RA), regulatory T cells (Tregs) have been found to be enriched in the synovial fluid. Despite their accumulation, they are unable to suppress synovial inflammation. Recently, we showed the synovial enrichment of interleukin-9 (IL-9) producing helper T cells and its positive correlation with disease activity. Therefore, we investigated the impact of IL-9 on synovial Tregs in RA. Here, we confirmed high synovial Tregs in RA patients, however these cells were functionally impaired in terms of suppressive cytokine production (IL-10 and TGF-β). Abrogating IL-9/ IL-9 receptor interaction could restore the suppressive cytokine production of synovial Tregs and reduce the synovial inflammatory T cells producing IFN-γ, TNF-α, IL-17. However, blocking these inflammatory cytokines failed to show any effect on IL-9 producing T cells, highlighting IL-9's hierarchy in the inflammatory network. Thus, we propose that blocking IL-9 might dampen synovial inflammation by restoring Tregs function and inhibiting inflammatory T cells.
Collapse
Affiliation(s)
- Sushmita Chakraborty
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi 110029, India; Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Ranjan Gupta
- Department of Rheumatology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Katharina F Kubatzky
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Santanu Kar
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Franziska V Kraus
- Division of Rheumatology, Department of Internal Medicine 5 Hematology-Oncology-Rheumatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, Heidelberg 69120, Germany
| | - M Margarida Souto-Carneiro
- Division of Rheumatology, Department of Internal Medicine 5 Hematology-Oncology-Rheumatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, Heidelberg 69120, Germany
| | - Hanns-Martin Lorenz
- Division of Rheumatology, Department of Internal Medicine 5 Hematology-Oncology-Rheumatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, Heidelberg 69120, Germany
| | - Pankaj Kumar
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Vijay Kumar
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Dipendra Kumar Mitra
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi 110029, India.
| |
Collapse
|
28
|
de Roy L, Eichhorn K, Faschingbauer M, Schlickenrieder K, Ignatius A, Seitz AM. Impact of hyaluronic acid injection on the knee joint friction. Knee Surg Sports Traumatol Arthrosc 2023; 31:5554-5564. [PMID: 37843587 PMCID: PMC10719131 DOI: 10.1007/s00167-023-07602-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE The purpose of this in vitro study was to investigate whether or not hyaluronic acid supplementation improves knee joint friction during osteoarthritis progression under gait-like loading conditions. METHODS Twelve human cadaveric knee joints were equally divided into mild and moderate osteoarthritic groups. After initial conservative preparation, a passive pendulum setup was used to test the whole joints under gait-like conditions before and after hyaluronic acid supplementation. The friction-related damping properties given by the coefficient of friction µ and the damping coefficient c (in kg m2/s) were calculated from the decaying flexion-extension motion of the knee. Subsequently, tibial and femoral cartilage and meniscus samples were extracted from the joints and tested in an established dynamic pin-on-plate tribometer using synthetic synovial fluid followed by synthetic synovial fluid supplemented with hyaluronic acid as lubricant. Friction was quantified by calculating the coefficient of friction. RESULTS In the pendulum tests, the moderate OA group indicated significantly lower c0 values (p < 0.05) under stance phase conditions and significantly lower µ0 (p = 0.01) values under swing phase conditions. No degeneration-related statistical differences were found for µend or cend. Friction was not significantly different (p > 0.05) with regard to mild and moderate osteoarthritis in the pin-on-plate tests. Additionally, hyaluronic acid did not affect friction in both, the pendulum (p > 0.05) and pin-on-plate friction tests (p > 0.05). CONCLUSION The results of this in vitro study suggested that the friction of cadaveric knee joint tissues does not increase with progressing degeneration. Moreover, hyaluronic acid viscosupplementation does not lead to an initial decrease in knee joint friction.
Collapse
Affiliation(s)
- Luisa de Roy
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research, Ulm University Medical Center, Helmholtzstraße 14, 89081, Ulm, Germany
| | - Kerstin Eichhorn
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research, Ulm University Medical Center, Helmholtzstraße 14, 89081, Ulm, Germany
| | - Martin Faschingbauer
- Department of Orthopedic Surgery, RKU, Ulm University Medical Center, Ulm, Germany
| | - Klaus Schlickenrieder
- Faculty of Production Engineering and Management, Ulm University of Applied Sciences, Ulm, Germany
| | - Anita Ignatius
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research, Ulm University Medical Center, Helmholtzstraße 14, 89081, Ulm, Germany
| | - Andreas Martin Seitz
- Institute of Orthopedic Research and Biomechanics, Center for Trauma Research, Ulm University Medical Center, Helmholtzstraße 14, 89081, Ulm, Germany.
| |
Collapse
|
29
|
Okolo CC, Emejuo NT, Udeagbala NG, Emeto UE, Ezema AS, Omeje OV, Nweze NE. Effect of dipotassium-ethylenediaminetetraacetic acid or lithium-heparin treatments and storage times on selected clinicopathologic analytes in equine synovial fluid. Vet Clin Pathol 2023; 52:638-645. [PMID: 37495547 DOI: 10.1111/vcp.13287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/01/2023] [Accepted: 06/25/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Sample processing methods and storage time affect the outcome of biochemical analysis. OBJECTIVES We aimed to assess the effects of dipotassium-ethylenediaminetetraacetic acid (K2-EDTA) and lithium-heparin treatments and storage times on selected analytes in equine synovial fluid (SF). METHODS Approximately 2 mL of SF from each horse (n = 7) were collected via femoropatellar joint arthrocentesis into K2-EDTA-treated bottles (K2-EDTA group), lithium-heparin-treated bottles (heparin group), and plain bottles (control group). The pH was determined using an electronic bench pH meter. The total nucleated cell count (TNCC) of samples was determined by hemocytometer method, while total protein (TP) concentrations, and lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) activities of the samples were determined spectrophotometrically at 2, 8, 24, 48, and 168 hours postcollection while being maintained at approximately 4°C. RESULTS TP concentrations in the anticoagulant-treated groups remained stable for 48 hours. TNCCs were stable for 8 hours. However, after 2 hours, ALP, LDH, and pH varied significantly (P < 0.05). At 2 hours, mean ALP and LDH activities were significantly elevated in the lithium-heparin treatment samples, while the activity of these analytes was similar in the K2-EDTA and control groups. At 8 hours, the TNCC and pH were significantly elevated in K2-EDTA treated groups, while values were similar in lithium-heparin and control groups. No significant variation was seen in TP values at 2 hours, irrespective of treatment. CONCLUSIONS The analytes-except for TP-became unstable within a few hours postcollection. Lithium-heparin and K2-EDTA treatments significantly altered ALP, LDH, TNCCs, and pH but not the TP concentrations of equine SF. Studies establishing reference intervals for these analytes based on the anticoagulant used are warranted to limit misinterpretations in clinical or research settings.
Collapse
Affiliation(s)
- Chukwuemeka C Okolo
- Department of Veterinary Medicine, University of Nigeria, Enugu State, Nigeria
| | - Nnenna T Emejuo
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University of Nigeria, Enugu State, Nigeria
| | | | - Uzochukwu E Emeto
- Department of Veterinary Medicine, University of Nigeria, Enugu State, Nigeria
| | - Arinzechukwu S Ezema
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University of Nigeria, Enugu State, Nigeria
| | - Okonkwo V Omeje
- Department of Veterinary Medicine, University of Nigeria, Enugu State, Nigeria
| | - Nwakaego E Nweze
- Department of Veterinary Medicine, University of Nigeria, Enugu State, Nigeria
| |
Collapse
|
30
|
Goncu Y, Ay N. Boron Nitride's Morphological Role in the Design of Injectable Hyaluronic Acid Based Hybrid Artificial Synovial Fluid. ACS Biomater Sci Eng 2023; 9:6345-6356. [PMID: 37847245 DOI: 10.1021/acsbiomaterials.3c01121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
The treatment process of osteoarthritis (OA) is challenging as it affects not only cartilage but also subchondral bone, ligament attachment capsules, synovium, and surrounding muscle tissue. Therefore, the search for preventive treatment or methods to slow the onset of the condition. Hexagonal boron nitride (hBN) has a graphite-like lamellar structure and is thought to facilitate cartilage movement for biomedical applications, just like in bearing systems. Hyaluronic acid (HA) is one of the natural polymers that can be used to transport boron nitride and maintain its presence in joints for a long time. In this study, hybrid hydrogels were formulated by using boron nitride nanoparticles and nanosheets. The rheological properties of the hydrogels were evaluated according to the structural differences of hBN. Characterizations have shown that hybrid hydrogels can be produced in injectable form, and the rheological properties are strongly related to the structural properties of the added particle. It has been determined that hBN added to the hydrogel structure reduces the dynamic viscosity of the zero-shear point and the deformation rate of the hydrogel and also changes the viscoelastic properties of the hydrogel depending on boron nitride's structural differences. The suggested mechanism is the hybrid hydrogel that exhibits lower viscosity as the layers detach from each other or disperses the agglomerates under applied shear stress. hBN, which has been proposed as a new strategy for joint injections, is thought to be a promising candidate for the treatment of OA due to its lamellar structures.
Collapse
Affiliation(s)
- Yapıncak Goncu
- Department of Biomedical Engineering, Eskisehir Osmangazi University, Engineering Architecture Faculty, Meselik Campus, Eskisehir 26480, Turkiye
| | - Nuran Ay
- Department of Material Science and Engineering, Eskisehir Technical University, Engineering Faculty, Ikieylul Campus, Eskisehir 26555, Turkiye
| |
Collapse
|
31
|
Kilcoyne I, Nieto J, Magdesian KG, Nottle BF. Effects of a 10% dimethyl sulfoxide solution on radiocarpal joint amikacin pharmacokinetics during intravenous regional limb perfusion in standing sedated horses. Vet Surg 2023; 52:1171-1179. [PMID: 37280731 DOI: 10.1111/vsu.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/28/2023] [Accepted: 05/08/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine the effect of a 10% dimethyl sulfoxide (DMSO) solution on the peak concentration (CMAX ) of amikacin in the radiocarpal joint (RCJ) during intravenous regional limb perfusion (IVRLP) compared with 0.9% NaCl. STUDY DESIGN Randomized crossover study. ANIMALS Seven healthy adult horses. METHODS The horses underwent IVRLP with 2 g of amikacin sulfate diluted to 60 mL using a 10% DMSO or 0.9% NaCl solution. Synovial fluid was collected from the RCJ at 5, 10, 15, 20, 25, and 30 minutes after IVRLP. The wide rubber tourniquet placed on the antebrachium was removed after the 30 min sample. Amikacin concentrations were quantified by a fluorescence polarization immunoassay. The mean CMAX and time to peak concentration (TMAX ) of amikacin within the RCJ were determined. A one-sided paired t-test was used to determine the differences between treatments. The significance level was p < .05. RESULTS The mean ± SD CMAX in the DMSO group was 1361.8 ± 593 μg/mL and in the 0.9% NaCl group it was 860 ± 481.6 μg/mL (p = .058). Mean TMAX using the 10% DMSO solution was 23 and 18 min using the 0.9% NaCl perfusate (p = .161). No adverse effects were associated with use of the 10% DMSO solution. CONCLUSION Although there were higher mean peak synovial concentrations using the 10% DMSO solution no difference in synovial amikacin CMAX between perfusate type was detected (p = .058). CLINICAL SIGNIFICANCE Use of a 10% DMSO solution in conjunction with amikacin during IVRLP is a feasible technique and does not negatively affect the synovial amikacin levels achieved. Further research is warranted to determine other effects of using DMSO during IVRLP.
Collapse
Affiliation(s)
- Isabelle Kilcoyne
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Los Angeles, California, USA
| | - Jorge Nieto
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Los Angeles, California, USA
| | - K Gary Magdesian
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Los Angeles, California, USA
| | - Bridget F Nottle
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| |
Collapse
|
32
|
Michael BNR, Mariaselvam CM, Kavadichanda CG, Negi VS. Synovial-fluid-derived microparticles express vimentin and GRP78 in their surface and exhibit an in vitro stimulatory effect on fibroblast-like synoviocytes in rheumatoid arthritis. Int J Rheum Dis 2023; 26:2183-2194. [PMID: 37695005 DOI: 10.1111/1756-185x.14912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/29/2022] [Accepted: 08/30/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES To investigate the hypothesis that microparticles (MP) may be a source of autoantigens and drive disease progression in rheumatoid arthritis (RA) synovium. METHODS Synovial fluid (SF) was collected from the knee joints of 41 disease-modifying anti-rheumatic drug-naive RA patients and 30 osteoarthritis (OA) patients. Samples were stained with either anti-vimentin-AlexaFluor-488 or anti-glucose-regulated protein-78-Dylight-488 (GRP78) and Annexin-V-allophycocyanin for flow cytometry analysis. RA and OA fibroblast-like synoviocytes (FLS) were co-cultured with respective SF-derived MP in vitro for 24 h. Supernatant and cell-free SF was assayed for pro-inflammatory analytes by multiplex assays. RESULTS Elevated percentages of AnnexinV+ Vimentin+ MP (median 0.8, interquartile range [IQR] 1.30) and AnnexinV+ GRP78+ MP (median 0.3, IQR 0.28) were present in RA compared with OA patients. We observed that CXCL6 and CCL8 were secreted in excess by RA-FLS stimulated with RA-SF-MP but not by stimulation with MP-free RA-SF. CONCLUSIONS Microparticles express vimentin and GRP78 on their surface and stimulate synoviocytes to produce inflammatory molecules, thus sustaining local inflammation in the synovium in RA.
Collapse
Affiliation(s)
- Benita Nancy Reni Michael
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Christina Mary Mariaselvam
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Chengappa G Kavadichanda
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Vir Singh Negi
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| |
Collapse
|
33
|
Birckhead EM, Das S, Tidd N, Raidal SL, Raidal SR. Visualizing neutrophil extracellular traps in septic equine synovial and peritoneal fluid samples using immunofluorescence microscopy. J Vet Diagn Invest 2023; 35:751-760. [PMID: 37661696 PMCID: PMC10621558 DOI: 10.1177/10406387231196552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Septic synovitis and peritonitis are routinely diagnosed in horses based on clinical examination findings and laboratory assessment of synoviocentesis and abdominocentesis samples, respectively. Diagnosis is difficult in some cases because of an overlap in laboratory results for septic and non-septic inflammation. Neutrophil extracellular trap (NET) formation is part of the innate immune response against pathogens. Identifying and quantifying NETs, which have not been explored in clinical samples from horses with septic synovitis and peritonitis, to our knowledge, may be helpful in detecting infectious processes. Our main objective was to determine whether NETs could be visualized in septic equine synovial and peritoneal fluid cytology samples using immunofluorescence with antibodies against citrullinated histone H3 (Cit-H3) and myeloperoxidase (MPO). We analyzed 9 synovial and 4 peritoneal fluid samples. NET percentages were quantified using a simple counting technique, which is suitable for high-quality, well-preserved, and stained cytospin smears. NETs were evident in all septic samples and were absent in a non-septic sample; NETs were better visualized with Cit-H3 than with MPO immunolabeling. Overall, we believe that there is the potential for NETs and associated markers to be used to investigate and understand septic inflammation in horses.
Collapse
Affiliation(s)
- Emily M. Birckhead
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Shubhagata Das
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Naomie Tidd
- Veterinary Diagnostic Laboratory, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Sharanne L. Raidal
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Shane R. Raidal
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, NSW, Australia
| |
Collapse
|
34
|
Yang L, Ma J, Niu P, Zhang B, Wang Z. Synovial inducible costimulator is correlated with severity in knee osteoarthritis. Scand J Immunol 2023; 98:e13315. [PMID: 38441341 DOI: 10.1111/sji.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 03/07/2024]
Abstract
Osteoarthritis (OA) is a joint disease characterized by articular cartilage loss, which afflicts many people worldwide. Knowing the disease severity can improve the recovery rate of OA. Antibody array technology was utilized for protein expression profiling of synovial fluid from eight mild knee OA patients, eight severe knee OA patients and 16 healthy persons. Subsequently, 48 mild OA patients, 56 severe OA patients and 24 healthy controls were utilized for validation by ELISA. In the protein expression profiling, inducible costimulator (ICOS) levels were markedly higher in OA patients compared with those in the healthy population, and were significantly higher in severe OA than those in mild OA. Furthermore, ICOS levels were shown to be significantly correlated with WOMAC, MRI-MOAKS and MRI-UTE-T2* scores. The multivariate logistic regression analysis indicated that higher levels of ICOS could significantly increase the risk of severe OA. Synovial ICOS levels were positively correlated with the radiographic severity of OA. ICOS may represent a biomarker for predicting the OA severity and may be involved in the development and progression of knee OA.
Collapse
Affiliation(s)
- Lvlin Yang
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia Province, China
| | - Jun Ma
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia Province, China
| | - Pengying Niu
- Department of Medical Imaging Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia Province, China
| | - Bowen Zhang
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia Province, China
| | - Zhiyan Wang
- Department of Emergency, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia Province, China
| |
Collapse
|
35
|
Mutti M, Moreno DS, Restrepo-Córdoba M, Visram Z, Resch G, Corsini L. Phage activity against Staphylococcus aureus is impaired in plasma and synovial fluid. Sci Rep 2023; 13:18204. [PMID: 37875544 PMCID: PMC10598271 DOI: 10.1038/s41598-023-45405-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023] Open
Abstract
S. aureus is a pathogen that frequently causes severe morbidity and phage therapy is being discussed as an alternative to antibiotics for the treatment of S. aureus infections. In this in vitro and animal study, we demonstrated that the activity of anti-staphylococcal phages is severely impaired in 0.5% plasma or synovial fluid. Despite phage replication in these matrices, lysis of the bacteria was slower than phage propagation, and no reduction of the bacterial population was observed. The inhibition of the phages associated with a reduction in phage adsorption, quantified to 99% at 10% plasma. S. aureus is known to bind multiple coagulation factors, resulting in the formation of aggregates and blood clots that might protect the bacterium from the phages. Here, we show that purified fibrinogen at a sub-physiological concentration of 0.4 mg/ml is sufficient to impair phage activity. In contrast, dissolution of the clots by tissue plasminogen activator (tPA) partially restored phage activity. Consistent with these in vitro findings, phage treatment did not reduce bacterial burdens in a neutropenic mouse S. aureus thigh infection model. In summary, phage treatment of S. aureus infections inside the body may be fundamentally challenging, and more investigation is needed prior to proceeding to in-human trials.
Collapse
Affiliation(s)
| | | | | | | | - Grégory Resch
- Center for Research and Innovation in Clinical Pharmaceutical Sciences (CRISP), Lausanne Hospital (CHUV), Lausanne, Switzerland
| | | |
Collapse
|
36
|
Bok EY, Kim SB, Thakur G, Choe YH, Oh SJ, Hwang SC, Ock SA, Rho GJ, Lee SI, Lee WJ, Lee SL. Insensitive Effects of Inflammatory Cytokines on the Reference Genes of Synovial Fluid Resident-Mesenchymal Stem Cells Derived from Rheumatoid Arthritis Patients. Int J Mol Sci 2023; 24:15159. [PMID: 37894839 PMCID: PMC10607131 DOI: 10.3390/ijms242015159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Mesenchymal stem cells derived from rheumatoid arthritis patients (RA-MSCs) provide an understanding of a variety of cellular and immunological responses within the inflammatory milieu. Sustained exposure of MSCs to inflammatory cytokines is likely to exert an influence on genetic variations, including reference genes (RGs). The sensitive effect of cytokines on the reference genes of RA-SF-MSCs may be a variation factor affecting patient-derived MSCs as well as the accuracy and reliability of data. Here, we comparatively evaluated the stability levels of nine RG candidates, namely GAPDH, ACTB, B2M, EEF1A1, TBP, RPLP0, PPIA, YWHAZ, and HPRT1, to find the most stable ones. Alteration of the RG expression was evaluated in MSCs derived from the SF of healthy donors (H-SF-MSCs) and in RA-SF-MSCs using the geNorm and NormFinder software programs. The results showed that TBP, PPIA, and YWHAZ were the most stable RGs for the normalization of H-SF-MSCs and RA-SF-MSCs using RT-qPCR, whereas ACTB, the most commonly used RG, was less stable and performed poorly. Additionally, the sensitivity of RG expression upon exposure to proinflammatory cytokines (TNF-α and IL-1β) was evaluated. RG stability was sensitive in the H-SF-MSCs exposed to TNF-α and IL-1β but insensitive in the RA-SF-MSCs. Furthermore, the normalization of IDO expression using ACTB falsely diminished the magnitude of biological significance, which was further confirmed with a functional analysis and an IDO activity assay. In conclusion, the results suggest that TBP, PPIA, and YWHAZ can be used in SF-MSCs, regardless of their exposure to inflammatory cytokines.
Collapse
Affiliation(s)
- Eun-Yeong Bok
- College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea; (E.-Y.B.); (S.-B.K.); (G.T.); (Y.-H.C.); (S.-J.O.); (G.-J.R.)
| | - Saet-Byul Kim
- College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea; (E.-Y.B.); (S.-B.K.); (G.T.); (Y.-H.C.); (S.-J.O.); (G.-J.R.)
| | - Gitika Thakur
- College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea; (E.-Y.B.); (S.-B.K.); (G.T.); (Y.-H.C.); (S.-J.O.); (G.-J.R.)
| | - Yong-Ho Choe
- College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea; (E.-Y.B.); (S.-B.K.); (G.T.); (Y.-H.C.); (S.-J.O.); (G.-J.R.)
| | - Seong-Ju Oh
- College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea; (E.-Y.B.); (S.-B.K.); (G.T.); (Y.-H.C.); (S.-J.O.); (G.-J.R.)
| | - Sun-Chul Hwang
- Department of Orthopaedic Surgery, Gyeongsang National University, School of Medicine and Hospital, Jinju 52727, Republic of Korea;
| | - Sun-A. Ock
- Animal Biotechnology Division, National Institute of Animal Science (NIAS), Rural Development Administration (RDA), 1500, Kongjwipatjwi-ro, Isero-myeon, Wanju-gun 565851, Republic of Korea;
| | - Gyu-Jin Rho
- College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea; (E.-Y.B.); (S.-B.K.); (G.T.); (Y.-H.C.); (S.-J.O.); (G.-J.R.)
- Research Institute of Life Sciences, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Sang-Il Lee
- Department of Internal Medicine and Institute of Health Sciences, Gyeongsang National University School of Medicine and Hospital, Jinju 52727, Republic of Korea;
| | - Won-Jae Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Sung-Lim Lee
- College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea; (E.-Y.B.); (S.-B.K.); (G.T.); (Y.-H.C.); (S.-J.O.); (G.-J.R.)
- Research Institute of Life Sciences, Gyeongsang National University, Jinju 52828, Republic of Korea
| |
Collapse
|
37
|
Varela L, van de Lest CHA, Boere J, Libregts SFWM, Lozano-Andrés E, van Weeren PR, Wauben MHM. Acute joint inflammation induces a sharp increase in the number of synovial fluid EVs and modifies their phospholipid profile. Biochim Biophys Acta Mol Cell Biol Lipids 2023; 1868:159367. [PMID: 37473834 DOI: 10.1016/j.bbalip.2023.159367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023]
Abstract
Inflammation is the hallmark of most joint disorders. However, the precise regulation of induction, perpetuation, and resolution of joint inflammation is not entirely understood. Since extracellular vesicles (EVs) are critical for intercellular communication, we aim to unveil their role in these processes. Here, we investigated the EVs' dynamics and phospholipidome profile from synovial fluid (SF) of healthy equine joints and from horses with lipopolysaccharide (LPS)-induced synovitis. LPS injection triggered a sharp increase of SF-EVs at 5-8 h post-injection, which started to decline at 24 h post-injection. Importantly, we identified significant changes in the lipid profile of SF-EVs after synovitis induction. Compared to healthy joint-derived SF-EVs (0 h), SF-EVs collected at 5, 24, and 48 h post-LPS injection were strongly increased in hexosylceramides. At the same time, phosphatidylserine, phosphatidylcholine, and sphingomyelin were decreased in SF-EVs at 5 h and 24 h post-LPS injection. Based on the lipid changes during acute inflammation, we composed specific lipid profiles associated with healthy and inflammatory state-derived SF-EVs. The sharp increase in SF-EVs during acute synovitis and the correlation of specific lipids with either healthy or inflamed states-derived SF-EVs are findings of potential interest for unveiling the role of SF-EVs in joint inflammation, as well as for the identification of EV-biomarkers of joint inflammation.
Collapse
Affiliation(s)
- Laura Varela
- Division Equine Sciences, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands; Division Cell Biology, Metabolism & Cancer, Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Chris H A van de Lest
- Division Equine Sciences, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands; Division Cell Biology, Metabolism & Cancer, Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Janneke Boere
- Division Equine Sciences, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands; Department of Orthopaedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Sten F W M Libregts
- Division Cell Biology, Metabolism & Cancer, Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Estefanía Lozano-Andrés
- Division Cell Biology, Metabolism & Cancer, Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands; Division of Infectious Diseases & Immunology, Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - P René van Weeren
- Division Equine Sciences, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Marca H M Wauben
- Division Cell Biology, Metabolism & Cancer, Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
| |
Collapse
|
38
|
Fuentes-Braesch M, Tuijthof GJM, Emans PJ, Emanuel KS. The preferred technique for knee synovium biopsy and synovial fluid arthrocentesis. Rheumatol Int 2023; 43:1767-1779. [PMID: 36513849 DOI: 10.1007/s00296-022-05256-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
For knee osteoarthritis and related conditions, analysis of biomarkers hold promise to improve early diagnosis and/or offer patient-specific treatment. To compare biomarker analyses, reliable, high-quality biopsies are needed. The aim of this work is to summarize the literature on the current best practices of biopsy of the synovium and synovial fluid arthrocentesis. Therefore, PubMed, Embase and Web of Science were systematically searched for articles that applied, demonstrated, or evaluated synovial biopsies or arthrocentesis. Expert recommendations and applications were summarized, and evidence for superiority of techniques was evaluated. Thirty-one studies were identified for inclusion. For arthrocentesis, the superolateral approach in a supine position, with a 0°-30° knee flexion was generally recommended. 18-gage needles, mechanical compression and ultrasound-guidance were found to give superior results. For blind and image-guided synovial biopsy techniques, superolateral and infrapatellar approaches were recommended. Single-handed tools were preconized, including Parker-Pearson needles and forceps. Sample quantity ranged approximately from 2 to 20. Suggestions were compiled for arthrocentesis regarding approach portal and patient position. Further evidence regarding needle size, ultrasound-guidance and mechanical compression were found. More comparative studies are needed before evidence-based protocols can be developed.
Collapse
Affiliation(s)
- Marie Fuentes-Braesch
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
- Department of Orthopedic Surgery, Maastricht UMC+, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Gabriëlle J M Tuijthof
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Pieter J Emans
- Department of Orthopedic Surgery, Maastricht UMC+, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Kaj S Emanuel
- Department of Orthopedic Surgery, Maastricht UMC+, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands.
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| |
Collapse
|
39
|
Elías-Llumbet A, Tian Y, Reyes-San-Martin C, Reina-Mahecha A, Damle V, Morita A, van der Veen HC, Sharma PK, Sandovici M, Mzyk A, Schirhagl R. Quantum Sensing for Real-Time Monitoring of Drug Efficacy in Synovial Fluid from Arthritis Patients. Nano Lett 2023; 23:8406-8410. [PMID: 37676737 PMCID: PMC10540259 DOI: 10.1021/acs.nanolett.3c01506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/29/2023] [Indexed: 09/09/2023]
Abstract
Diamond-based T1 relaxometry is a new technique that allows nanoscale magnetic resonance measurements. Here we present its first application in patient samples. More specifically, we demonstrate that relaxometry can determine the free radical load in samples from arthritis patients. We found that we can clearly differentiate between osteoarthritis and rheumatoid arthritis patients in both the synovial fluid itself and cells derived from it. Furthermore, we tested how synovial fluid and its cells respond to piroxicam, a common nonsteroidal anti-inflammatory drug (NSAID). It is known that this drug leads to a reduction in reactive oxygen species production in fibroblast-like synoviocytes (FLS). Here, we investigated the formation of free radicals specifically. While FLS from osteoarthritis patients showed a drastic decrease in the free radical load, cells from rheumatoid arthritis retained a similar radical load after treatment. This offers a possible explanation for why piroxicam is more beneficial for patients with osteoarthritis than those with rheumatoid arthritis.
Collapse
Affiliation(s)
- Arturo Elías-Llumbet
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
- Laboratory
of Genomic of Germ Cells, Biomedical Sciences Institute, Faculty of
Medicine, University of Chile, 1027 Independencia, Santiago, Chile
| | - Yuchen Tian
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| | - Claudia Reyes-San-Martin
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| | - Alejandro Reina-Mahecha
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| | - Viraj Damle
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| | - Aryan Morita
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| | - Hugo C. van der Veen
- Department
of Orthopaedic Surgery, University of Groningen,
University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| | - Prashant K. Sharma
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| | - Maria Sandovici
- Department
of Rheumatology and Clinical Immunology, University Medical Center Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| | - Aldona Mzyk
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
- Institute
of Metallurgy and Materials Science, Polish
Academy of Sciences, Reymonta 25, 30-059 Cracow, Poland
| | - Romana Schirhagl
- Department
of Biomedical Engineering, University of
Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW Groningen, The Netherlands
| |
Collapse
|
40
|
Furuoka H, Endo K, Sekiya I. Mesenchymal stem cells in synovial fluid increase in number in response to synovitis and display more tissue-reparative phenotypes in osteoarthritis. Stem Cell Res Ther 2023; 14:244. [PMID: 37679780 PMCID: PMC10485949 DOI: 10.1186/s13287-023-03487-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Synovial fluid mesenchymal stem cells (SF-MSCs) originate in the synovium and contribute to the endogenous repair of damaged intra-articular tissues. Here, we clarified the relationship between their numbers and joint structural changes during osteoarthritis (OA) progression and investigated whether SF-MSCs had phenotypes favorable for tissue repair, even in an OA environment. METHODS Partial medial meniscectomy (pMx) and sham surgery were performed on both knees of rats. SF and knee joints were collected from intact rats and from rats at 2, 4, and 6 weeks after surgery. SF was cultured for 1 week to calculate the numbers of colony-forming cells and colony areas. Joint structural changes were evaluated histologically to investigate their correlation with the numbers and areas of colonies. RNA sequencing was performed for SF-MSCs from intact knees and knees 4 weeks after the pMx and sham surgery. RESULTS Colony-forming cell numbers and colony areas were greater in the pMx group than in the intact and sham groups and peaked at 2 and 4 weeks, respectively. Synovitis scores showed the strongest correlation with colony numbers (R = 0.583) and areas (R = 0.456). RNA sequencing revealed higher expression of genes related to extracellular matrix binding, TGF-β signaling, and superoxide dismutase activity in SF-MSCs in the pMx group than in the sham group. CONCLUSION The number of SF-MSCs was most closely correlated with the severity of synovitis in this rat OA model. Tissue-reparative gene expression patterns were observed in SF-MSCs from OA knees, but not from knees without intra-articular tissue damage.
Collapse
Affiliation(s)
- Hideto Furuoka
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan
| | - Kentaro Endo
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan
| |
Collapse
|
41
|
Liu F, Su F, Zhang T, Liu R, Liu N, Dong T. Relationship between knee osteophytes and calcitonin gene-related peptide concentrations of serum and synovial fluid in knee of osteoarthritis. Medicine (Baltimore) 2023; 102:e34691. [PMID: 37657066 PMCID: PMC10476791 DOI: 10.1097/md.0000000000034691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/20/2023] [Indexed: 09/03/2023] Open
Abstract
To explore the relationship between knee osteophytes of osteoarthritic knee and calcitonin gene-related peptide (CGRP) concentrations of serum and synovial fluid (SF). 65 patients with knee medial compartment osteoarthritis (OA) were recruited and examined with weight-bearing radiographs of the entire lower limb. The concentrations of CGRP in serum/SF were also detected in surgery. The relationship between the concentrations of CGRP in serum/SF and osteophyte scores were detected with Spearman rank correlation coefficient. CGRP concentrations in serum and SF were significantly correlated with osteophyte score of overall knee respectively (R = 0.462, P < .001; R = 0.435, P < .001). In addition, a correlation tended to be observed about the relationship between CGRP concentrations in serum and SF and osteophyte scores of medial compartment (R = 0.426, P < .001; R = 0.363, P = .003), and osteophyte scores of lateral compartment (R = 0.429, P < .001; R = 0.444, P < .001). In this study, the relationship between CGRP in serum/SF and knee osteophyte scores in different subregions were explored, which showed significant positive correlations, that possibly reflecting the contribution of CGRP influencing osteophyte formation. Positive correlations between osteophyte scores and CGRP suggest that CGRP promote the growth of osteophyte formation. It has the potential to be selected as a biomarker for the assessment of severity in knee OA patients and predict the progression of knee OA. It also provides a potential therapeutic target to delay the progression and relieve the symptom of OA.
Collapse
Affiliation(s)
- Fan Liu
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Fan Su
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Tao Zhang
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Rui Liu
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Na Liu
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Tianhua Dong
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| |
Collapse
|
42
|
Catalan D, Jaraquemada D, Aguillón JC. Response to: Correspondence on "HLA-DR 'naturally' presented peptides: you will find what you have pulsed with" by Roudier. Ann Rheum Dis 2023; 82:e204. [PMID: 35595389 DOI: 10.1136/annrheumdis-2022-222758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Diego Catalan
- Immune Regulation and Tolerance Research Group, Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Dolores Jaraquemada
- Immunology Unit, Cell Biology, Physiology and Immunology Department, Institut de Biotecnologia i Biomedicina, Universitat de Barcelona, Barcelona, Spain
| | - Juan C Aguillón
- Immune Regulation and Tolerance Research Group, Programa Disciplinario de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| |
Collapse
|
43
|
Kimura A, Takagi T, Thamamongood T, Sakamoto S, Ito T, Seki I, Okamoto M, Aono H, Serada S, Naka T, Imataka H, Miyake K, Ueda T, Miyanokoshi M, Wakasugi K, Iwamoto N, Ohmagari N, Iguchi T, Nitta T, Takayanagi H, Yamashita H, Kaneko H, Tsuchiya H, Fujio K, Handa H, Suzuki H. Extracellular aaRSs drive autoimmune and inflammatory responses in rheumatoid arthritis via the release of cytokines and PAD4. Ann Rheum Dis 2023; 82:1153-1161. [PMID: 37400117 DOI: 10.1136/ard-2023-224055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/23/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVES Recent studies demonstrate that extracellular-released aminoacyl-tRNA synthetases (aaRSs) play unique roles in immune responses and diseases. This study aimed to understand the role of extracellular aaRSs in the pathogenesis of rheumatoid arthritis (RA). METHODS Primary macrophages and fibroblast-like synoviocytes were cultured with aaRSs. aaRS-induced cytokine production including IL-6 and TNF-α was detected by ELISA. Transcriptomic features of aaRS-stimulated macrophages were examined using RNA-sequencing. Serum and synovial fluid (SF) aaRS levels in patients with RA were assessed using ELISA. Peptidyl arginine deiminase (PAD) 4 release from macrophages stimulated with aaRSs was detected by ELISA. Citrullination of aaRSs by themselves was examined by immunoprecipitation and western blotting. Furthermore, aaRS inhibitory peptides were used for inhibition of arthritis in two mouse RA models, collagen-induced arthritis and collagen antibody-induced arthritis. RESULTS All 20 aaRSs functioned as alarmin; they induced pro-inflammatory cytokines through the CD14-MD2-TLR4 axis. Stimulation of macrophages with aaRSs displayed persistent innate inflammatory responses. Serum and SF levels of many aaRSs increased in patients with RA compared with control subjects. Furthermore, aaRSs released PAD4 from living macrophages, leading to their citrullination. We demonstrate that aaRS inhibitory peptides suppress cytokine production and PAD4 release by aaRSs and alleviate arthritic symptoms in a mouse RA model. CONCLUSIONS Our findings uncovered the significant role of aaRSs as a novel alarmin in RA pathogenesis, indicating that their blocking agents are potent antirheumatic drugs.
Collapse
Affiliation(s)
- Akihiro Kimura
- Dep of Immunology and Pathology, Research Center for Hepatitis and Immunology, Research Institute, National Center for Global Health and Medicine, Ichikawa-shi, Chiba, Japan
| | - Takeshi Takagi
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Kanagawa, Japan
| | - Thiprampai Thamamongood
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Satoshi Sakamoto
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Kanagawa, Japan
| | - Takumi Ito
- Center for Future Medical Research, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Iwao Seki
- Research and Development Department, AYUMI Pharmaceutical Corporation, Chuo-ku, Tokyo, Japan
| | - Masahiro Okamoto
- Research and Development Department, AYUMI Pharmaceutical Corporation, Chuo-ku, Tokyo, Japan
| | - Hiroyuki Aono
- Research and Development Department, AYUMI Pharmaceutical Corporation, Chuo-ku, Tokyo, Japan
| | - Satoshi Serada
- Institute for Biomedical Sciences Molecular Pathophysiology, Iwate Medical University, Morioka, Iwate, Japan
| | - Tetsuji Naka
- Institute for Biomedical Sciences Molecular Pathophysiology, Iwate Medical University, Morioka, Iwate, Japan
| | - Hiroaki Imataka
- Department of Applied Chemistry, Graduate School of Engineering, University of Hyogo, Himeji, Hyogo, Japan
| | - Kensuke Miyake
- Division of Innate Immunity, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo, Japan
| | - Takuya Ueda
- Department of Integrative Bioscience and Biomedical Engineering, Graduate School of Science and Engineering, Waseda University, Shinjuku-ku, Tokyo, Japan
| | - Miki Miyanokoshi
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Meguro-ku, Tokyo, Japan
| | - Keisuke Wakasugi
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Meguro-ku, Tokyo, Japan
| | - Noriko Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Takahiro Iguchi
- Department of Immunology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takeshi Nitta
- Department of Immunology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Takayanagi
- Department of Immunology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroyuki Yamashita
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Kaneko
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Haruka Tsuchiya
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Handa
- Center for Future Medical Research, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Harumi Suzuki
- Dep of Immunology and Pathology, Research Center for Hepatitis and Immunology, Research Institute, National Center for Global Health and Medicine, Ichikawa-shi, Chiba, Japan
| |
Collapse
|
44
|
Antonios JK, Lim ES, Chang YHH, Bingham JS, Clarke HD, Spangehl MJ, Schwartz AJ. The Fate of the Inconclusive Periprosthetic Joint Infection Workup and Reliability of Data Points. Orthopedics 2023; 46:e291-e297. [PMID: 36921226 DOI: 10.3928/01477447-20230310-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
In 2018, periprosthetic joint infection (PJI) criteria were revised to include a new category labeled "inconclusive." The purpose of this study was to characterize and describe the fate of the inconclusive PJI workup and to analyze preoperative factors associated with outcomes. We reviewed all PJI workups at our institution during a 3-year period (426 patients). Patients were labeled "infected," "not infected," or "inconclusive" according to 2018 PJI preoperative criteria. In addition to standard diagnostic variables, the presence or absence of clinical elements that increase the pretest probability of infection were collected. Patients with any missing preoperative diagnostic test results and those with clinical follow-up less than 30 days were excluded. Logistic regression was used to identify the factors associated with infection. Two hundred ninety-six workups remained after exclusion criteria were applied, consisting of 66 (22.2%) with a preoperative score of 6 or greater defined as infected, 52 (17.6%) inconclusive (score 2-5), and 178 (60.1%) not infected (score 0-1). Postoperative re-scoring of the inconclusive group based on intraoperative findings as per the 2018 criteria identified 6 of 52 (11.5%) as infected, 12 (23.1%) inconclusive, and 34 (65.4%) not infected. Among those preoperatively scored as inconclusive, variables statistically correlated with the presence of infection included history of PJI, factors that increase skin barrier penetration (eg, psoriasis and venous stasis), and presence of comorbidities predisposing to infection. For patients labeled inconclusive, clinical elements of the pretest probability for infection (eg, history of prior PJI) were as reliable as any diagnostic test, including alpha-defensin, in the diagnosis of PJI. [Orthopedics. 2023;46(5):e291-e297.].
Collapse
|
45
|
Hoang-Dinh A, Vuong Thu H, Ma MH, Ly KH, Huynh-Van K, Minh Duc N. Value of ultrasound-guided synovial biopsy for the diagnosis of infectious arthritis. Clin Ter 2023; 174:426-431. [PMID: 37674452 DOI: 10.7417/ct.2023.2460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Objectives To determine the value of ultrasound (US)-guided synovial biopsy for the diagnosis of infectious arthritis that could not be detected by other modalities. Material and methods This descriptive study was conducted among 37 patients with arthritis (3 with shoulder arthritis, 2 with elbow arthritis, 7 with wrist arthritis, 15 with hip arthritis, 4 with knee arthritis, and 5 with ankle arthritis) who underwent US-guided synovial biopsy at Hanoi Medical University Hospital for the diagnosis of infec-tious arthritis that could not be detected by infection laboratory tests, imaging, and/or joint fluid culture. The results of US-guided synovial biopsy were positive for infectious arthritis when those of pathologi-cal analyses, bacterial cultures, and/or polymerase chain reaction test for tuberculosis were positive. The final diagnosis established when the patients were discharged from the hospital was compared with the US-guided synovial biopsy results to calculate the sensitivity and specificity for the diagnosis of infectious arthritis. Results The median age of the patients was 60 years (range: 22-79 years), and two thirds were women. Infectious arthritis was determined as the final diagnosis in 18 patients. There was no significant difference in the infection laboratory test results, synovial thickness, or magnetic resonance imaging features apart from soft tissue abscess between the infectious and non-infectious arthritis groups (P > 0.05). The US-guided synovial biopsy results were positive in 17 patients. Compared with the sensitivity and specificity of the final diagnosis, those of the US-guided synovial biopsy results for the diagnosis of infectious arthritis were 94.4% and 100%, respectively. The Numerical Rating Scale score was ≤3 in most patients. There were neither vascular nor neurologic complications among the patients. Conclusion Imaging features and laboratory test results are non-specific for infectious arthritis. US-guided synovial biopsy is a well-tolerated, safe method that has a high value for the diagnosis of infectious arthritis. This modality should then be recommended for patients with unclassified arthritis.
Collapse
Affiliation(s)
- A Hoang-Dinh
- Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - H Vuong Thu
- Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - M H Ma
- Radiology Center, Hanoi Medical University Hospital, Hanoi, Vietnam
- Department of Radiology, Hanoi Medical University, Hanoi, Vietnam
| | - K H Ly
- Department of Rheumatology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - K Huynh-Van
- Department of Rheumatology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - N Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| |
Collapse
|
46
|
Hantouly AT, Alzobi O, Toubasi AA, Zikria B, Al Dosari MAA, Ahmed G. Higher sensitivity and accuracy of synovial next-generation sequencing in comparison to culture in diagnosing periprosthetic joint infection: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2023; 31:3672-3683. [PMID: 36244018 PMCID: PMC10435641 DOI: 10.1007/s00167-022-07196-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/02/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE The purpose of this meta-analysis was to compare the diagnostic parameters of synovial next-generation sequencing (NGS) and cultures in diagnosing periprosthetic joint infections (PJI). METHODS PubMed, Web of Science, Cochrane, and Google Scholar were searched from inception until 8 Jan 2022 for literature investigating the role of NGS in comparison to culture in the diagnosis of PJI. The studies were included if they investigated the diagnostic value of culture and NGS in diagnosing PJIs against the Musculoskeletal Infection Society (MSIS) criteria. Diagnostic parameters, such as sensitivity, specificity, positive predictive value, negative predictive value, positive-likelihood ratio, negative-likelihood ratio, accuracy, and area under the curve (AUC), were calculated for the included studies to evaluate the performance of NGS in comparison to culture in PJI diagnosis. RESULTS The total number of the included patients was 341 from seven articles. The pooled sensitivity, specificity, and diagnostic odds ratio of NGS were 94% (95% CI 91-97%), 89% (95% CI 82-95%), and 138.5 (95% CI 49.1-390.5), respectively. NGS has positive- and negative-likelihood ratios of 7.9 (95% CI 3.99-15.6) and 0.1 (95% CI 0.0-0.1), respectively. On the other hand, the pooled sensitivity, specificity, and diagnostic odds ratio of culture were 70% (95% CI 61-79%), 94% (95% CI 88-98%), and 28.0 (95% CI 12.6-62.2), respectively. The SROC curve for NGS showed that the accuracy (AUC) was 91.9%, and that the positive and negative predictive values were 8.6 (95% CI 5.0-19.5) and 0.1 (95% CI 0.0-0.1), respectively. While, culture SROC curve demonstrated that the accuracy (AUC) was 80.5% and the positive- and negative-likelihood ratio were 12.1 (95% CI 4.5-49.6) and 0.3 (95% CI 0.2-0.4). CONCLUSIONS NGS has a potential role in diagnosing hip and knee PJIs due to its high sensitivity, specificity, and accuracy. However, the sensitivity and specificity reported by the studies varied according to the time of synovial sampling (preoperative, postoperative, or mixed).
Collapse
Affiliation(s)
- Ashraf T Hantouly
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar
| | - Osama Alzobi
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar
| | | | - Bashir Zikria
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | - Ghalib Ahmed
- Department of Orthopedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
| |
Collapse
|
47
|
Døssing A, Conaghan PG, K Stamp L, M McCarthy G, Henriksen M, Christensen R, Terslev L, Ellegaard K, Henrik Søe N, Juul L, Hansen P, Radev DI, Nybing JD, Boesen M, Bliddal H. Pain in hand osteoarthritis is associated with crystals in the synovial fluid: a cross-sectional study of people with hand osteoarthritis undergoing surgery. RMD Open 2023; 9:e003319. [PMID: 37620112 PMCID: PMC10450056 DOI: 10.1136/rmdopen-2023-003319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/26/2023] Open
Affiliation(s)
- Anna Døssing
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Lisa K Stamp
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Geraldine M McCarthy
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Marius Henriksen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Robin Christensen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Karen Ellegaard
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Søe
- Department of Orthopedic Surgery, Division of Hand Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lars Juul
- Department of Rheumatology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Philip Hansen
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Dimitar Ivanov Radev
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Janus Damm Nybing
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Boesen
- Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bliddal
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
48
|
Abdul TY, Hawse GP, Smith J, Sellon JL, Abdel MP, Wells JW, Coenen MJ, Evans CH, De La Vega RE. Prevalence of AAV2.5 neutralizing antibodies in synovial fluid and serum of patients with osteoarthritis. Gene Ther 2023; 30:587-591. [PMID: 35260797 PMCID: PMC9598672 DOI: 10.1038/s41434-022-00326-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/09/2022]
Abstract
Osteoarthritis (OA) is a leading cause of disability with no cure and only supportive therapy. Adeno-associated virus (AAV) serotype 2.5 is being used in a Phase I clinical trial to deliver the interleukin-1 receptor antagonist into knee joints with OA. Neutralizing antibodies (Nab) directed against AAV2.5, if present, could inhibit gene transfer. Here, we report the prevalence of AAV2.5 Nab in the sera and synovial fluids of patients with OA. Nab titers were measured by their ability to inhibit in vitro transduction by AAV2.5 encoding GFP. Of 44 synovial fluids from patients with mid-stage and advanced OA, 43% had undetectable Nab; 25% had low titers (<1:100), 16% had medium titers (1:100-1:1000) and 16% had high titers (>1:1000) of Nab. Titers of AAV2.5 Nabs correlated with those of AAV2, but not with those of AAV5. Serum titers of AAV2.5 Nab correlated positively with titers in synovial fluid, and were never less than the matched synovial fluid titers. These findings suggest that high titers of Nab against AAV2.5 are uncommon in the synovial fluids of patients with OA, and individuals with high synovial fluid Nab titers can be identified by measuring titers in the serum.
Collapse
Affiliation(s)
- Temilola Y Abdul
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Gresin P Hawse
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA
| | - Jay Smith
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA
| | - Jacob L Sellon
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Matthew P Abdel
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - James W Wells
- The University of Queensland Diamantina Institute, Faculty of Medicine, The University of Queensland, Woolloongabba, Woolloongabba, Australia
| | - Michael J Coenen
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA
| | - Christopher H Evans
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA.
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
| | - Rodolfo E De La Vega
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Cellular Biology Inspired Tissue Engineering, MERLN Institute, Maastricht University, Maastricht, the Netherlands
| |
Collapse
|
49
|
Vanni A, Mazzoni A, Semeraro R, Capone M, Maschmeyer P, Lamacchia G, Salvati L, Carnasciali A, Farahvachi P, Giani T, Simonini G, Filocamo G, Romano M, Liotta F, Mashreghi MF, Cosmi L, Cimaz R, Magi A, Maggi L, Annunziato F. Clonally expanded PD-1-expressing T cells are enriched in synovial fluid of juvenile idiopathic arthritis patients. Eur J Immunol 2023; 53:e2250162. [PMID: 37086046 DOI: 10.1002/eji.202250162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/23/2023] [Accepted: 04/17/2023] [Indexed: 04/23/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic condition in childhood. The disease etiology remains largely unknown; however, a key role in JIA pathogenesis is surely mediated by T cells. T-lymphocytes activity is controlled via signals, known as immune checkpoints. Delivering an inhibitory signal or blocking a stimulatory signal to achieve immune suppression is critical in autoimmune diseases. However, the role of immune checkpoints in chronic inflammation and autoimmunity must still be deciphered. In this study, we investigated at the single-cell level the feature of T cells in JIA chronic inflammation, both at the transcriptome level via single-cell RNA sequencing and at the protein level by flow cytometry. We found that despite the heterogeneity in the composition of synovial CD4+ and CD8+ T cells, those characterized by PD-1 expression were clonally expanded tissue-resident memory (Trm)-like cells and displayed the highest proinflammatory capacity, suggesting their active contribution in sustaining chronic inflammation in situ. Our data support the concept that novel therapeutic strategies targeting PD-1 may be effective in the treatment of JIA. With this approach, it may become possible to target overactive T cells regardless of their cytokine production profile.
Collapse
Affiliation(s)
- Anna Vanni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
| | - Alessio Mazzoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
- Flow Cytometry Diagnostic Center and Immunotherapy, Careggi University Hospital, Florence, Tuscany, Italy
| | - Roberto Semeraro
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
| | - Manuela Capone
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
| | - Patrick Maschmeyer
- Institute of Health (BIH) at Charité, Universitätsmedizin Berlin, Berlin, Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Institute for Medical Systems Biology (BIMSB), Berlin, Berlin, Germany
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Berlin, Berlin, Germany
| | - Giulia Lamacchia
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
| | - Lorenzo Salvati
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
| | - Alberto Carnasciali
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
| | - Parham Farahvachi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
| | | | | | - Giovanni Filocamo
- Pediatric Rheumatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano IT and University of Milan, Milan, Lombardy, Italy
| | - Micol Romano
- University of Western Ontario, London, Ontario, Canada
| | - Francesco Liotta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
- Immunology and Cell Therapy Unit, Careggi University Hospital, Florence, Tuscany, Italy
| | - Mir-Farzin Mashreghi
- Deutsches Rheuma-Forschungszentrum (DRFZ), Institute of the Leibniz Association, Berlin, Berlin, Germany
| | - Lorenzo Cosmi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
- Immunoallergology Unit, Careggi University Hospital, Florence, Tuscany, Italy
| | - Rolando Cimaz
- Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan, Milan, Lombardy, Italy
| | - Alberto Magi
- Department of Information Engineering, University of Florence, Florence, Tuscany, Italy
| | - Laura Maggi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Tuscany, Italy
- Flow Cytometry Diagnostic Center and Immunotherapy, Careggi University Hospital, Florence, Tuscany, Italy
| |
Collapse
|
50
|
Abstract
PURPOSE OF REVIEW To summarize recently discovered novel cell states in rheumatoid arthritis (RA) synovium that could have important implications for disease treatment. RECENT FINDINGS The use of multiomic technologies, including single-cell and spatial transcriptomics and mass cytometry, has led to the discovery of several novel cell states, which could have important implications for the treatment of RA. These cells can be found in patient blood, synovial fluid, or synovial tissue and span several immune cell subsets as well as stromal cell types. These diverse cell states may represent the targets of current or future therapeutics, while their fluctuations may inform the ideal timing for therapy. Future efforts are needed to implicate how each cell state functions in the pathophysiologic network within affected joints and how medications perturb each cell state and ultimately the tissue. SUMMARY Multiomic molecular technologies have afforded the discovery of numerous novel cellular states in RA synovium; the next challenge will be to link these states to pathophysiology and treatment response.
Collapse
Affiliation(s)
- Ian Mantel
- Weill Cornell Medicine Graduate School
- Hospital for Special Surgery Research Institute, New York, New York, USA
| | - Miriam R Fein
- Hospital for Special Surgery Research Institute, New York, New York, USA
| | - Laura T Donlin
- Weill Cornell Medicine Graduate School
- Hospital for Special Surgery Research Institute, New York, New York, USA
| |
Collapse
|