Periarticular Bone Changes Research Articles

The Hippo-YAP Signaling Pathway in Osteoarthritis and Rheumatoid Arthritis.

Arthritis is the most prevalent joint disease and is characterized by articular cartilage degradation, synovial inflammation, and changes in periarticular and subchondral bone. Recent studies have reported that Yes-associated protein (YAP) and the transcriptional coactivator with PDZ-binding motif (TAZ) have significant effects on the proliferation, migration, and survival of chondrocytes and fibroblast-like synovial cells (FLSs). YAP/TAZ signaling pathway, as well as the related Hippo-YAP signaling pathway, are responsible for the condition of cells and articular cartilage in joints. They are tightly regulated to maintain metabolism in chondrocytes and FLSs because abnormal expression may result in cartilage damage. However, the roles and mechanisms of the Hippo-YAP pathway in arthritis remain largely unknown. This review summarizes the roles and key functions of YAP/TAZ and the Hippo-YAP signaling pathway in FLSs and chondrocytes for the induction of proliferation, migration, survival, and differentiation in rheumatoid arthritis (RA) and osteoarthritis (OA) research. We also discuss the therapeutic strategies involving YAP/TAZ and the related Hippo-YAP signaling pathway involved in OA.

Osteopontin, a bridge links osteoarthritis and osteoporosis.

Osteoarthritis (OA) is the most prevalent joint disease characterized by degradation of articular cartilage, inflammation, and changes in periarticular and subchondral bone of joints. Osteoporosis (OP) is another systemic skeletal disease characterized by low bone mass and bone mineral density (BMD) accompanied by microarchitectural deterioration in bone tissue and increased bone fragility and fracture risk. Both OA and OP are mainly affected on the elderly people. Recent studies have shown that osteopontin (OPN) plays a vital role in bone metabolism and homeostasis. OPN involves these biological activities through participating in the proliferation, migration, differentiation, and adhesion of several bone-related cells, including chondrocytes, synoviocytes, osteoclasts, osteoblasts, and marrow mesenchymal stem cells (MSCs). OPN has been demonstrated to be closely related to the occurrence and development of many bone-related diseases, such as OA and OP. This review summarizes the role of OPN in regulating inflammation activity and bone metabolism in OA and OP. Furthermore, some drugs that targeted OPN to treat OA and OP are also summarized in the review. However, the complex mechanism of OPN in regulating OA and OP is not fully elucidated, which drives us to explore the depth effect of OPN on these two bone diseases.

The Wnt signaling cascade in the pathogenesis of osteoarthritis and related promising treatment strategies.

Osteoarthritis (OA) is the most prevalent joint disease, characterized by the degradation of articular cartilage, synovial inflammation, and changes in periarticular and subchondral bone. Recent studies have reported that Wnt signaling cascades play an important role in the development, growth, and homeostasis of joints. The Wnt signaling cascade should be tightly regulated to maintain the homeostasis of cartilage in either the over-activation or the suppression of Wnt/β-catenin, as this could lead to OA. This review summarizes the role and mechanism of canonical Wnt cascade and noncanonical Wnt cascade experiments in vivo and in vitro. The Wnt cascade is controlled by several agonists and antagonists in the extracellular medium and the cytoplasm. These antagonists and agonists serve as key molecules in drug intervention into the Wnt pathway and may provide potential approaches for the treatment of OA. However, the complexity of the Wnt signaling cascade and the pharmaceutical effects on its mechanism are still not fully understood, which forces us to conduct further research and develop efficient therapeutic approaches to treat OA.

Study the Level of Collagen2-1NO2 (Coll2-1NO2) in Serum of Iraqi Patients with Osteoarthritis

Osteoarthritis, often known as OA, is characterized by the degeneration of articular cartilage, limited intraarticular inflammation with synovitis, and peri-articular and subchondral bone changes. This study measured Coll2-1NO2, CRP, ESR, Vitamin D3, Mg, Calcium, and Lipid profiles in OA patients. The current study contained a total of 130 participants, who were divided into two groups. Group1 contained 90 OA patients, and group 2 controls 40; the samples were extracted from females and males, the levels, Coll2-1 NO2, CRP, ESR , Vitamin D3 ,Mg, Calcium, Cholesterol, TG, VLDL, LDL, and HDL were calculated. The levels of Coll2-1NO2, CRP, and Vitamin D3 were evaluated using an enzyme-linked immunosorbent assay (ELISA), while the levels of Mg, Calcium, Cholesterol, TG, VLDL, LDL, and HDL were determined using a Human Reader HS Device. Westergren method was used to analyze the level of ESR . The result of Coll2-1NO2 shows a high significant change among OA patients and control. Serum vitamin D3 and CRP value have high significant change in their levels in OA patients. Serum levels of Triglyceride, HDL, Mg, Ca, ESR and VLDL showed a significant variation among OA patient and control. Cholesterol and LDL values have non-significant variation in their levels in OA patients in comparison with control. Conclusion: According to the presented results Coll2-1NO2, CRP, ESR, Vitamin D3, Mg, Calcium, T.G, VLDL, and HDL do affect by Osteoarthritis patients. LDL and cholesterol don’t affect osteoarthritis patients.

Quality of life and its relation to periarticular bone changes in psoriatic patients with or without joint involvement.

To assess periarticular bone changes in psoriasis patients with or without joint involvement and its effect on patients' quality of life (QoL). This cross-sectional study enrolled 50 patients with psoriasis (25 only with skin psoriasis (PsO) and 25 with psoriatic arthritis (PsA)), as well as 25 healthy controls. All participants were analyzed by high-resolution computed tomography (HR-CT) scans of the dominant hand (second and third metacarpophalangeal joints) for detection of new bone formation (enthesophytes) and erosions. Demographic, laboratory, clinical, and disease-specific data, including physical function and QoL, were collected. Physical function and QoL scores were significantly worse in the PsA patients than in the PsO patients. All 25 PsA patients (100%), 18 PsO patients (72%), and 5 healthy individuals (20%) had periarticular bone changes. Statistically significant higher erosion number and volume as well as higher enthesophyte number and height were found in PsA patients compared to both PsO patients and controls, and in PsO patients compared to controls. In PsO patients, the number of erosions and enthesophytes had a negative correlation with some Short Form (SF)-36 sub-scores. In the PsA patients, the number of erosions had a positive correlation with psoriasis disability index, while the number of enthesophytes had a negative correlation with the general health SF-36 sub-score. In PsO patients, there may be subclinical periarticular inflammation (erosions and enthesophytes) that raise the suspicion of occult PsA or the possibility of PsO transition to PsA and these periarticular bone changes may worsen QoL in PsO patients. Key Points • Skin psoriasis patients may have subclinical PsA. • Periarticular bone changes in PsO patients may be the early sign for uploading PsA disease. • Quality of life is highly affected in PsA than in PsO patients.

Peptide-biofunctionalization of biomaterials for osteochondral tissue regeneration in early stage osteoarthritis: challenges and opportunities.

Osteoarthritis is a degenerative joint disease characterized by the progressive deterioration of articular cartilage, synovial inflammation and changes in periarticular and subchondral bone, being a leading cause of disability. Conventional treatments present several side effects and can involve the use of painkillers and non-steroidal anti-inflammatory drugs. In this sense, researchers have shifted the focus of new therapeutics to biomolecular agents and/or their combination with cells. However, the efficacy of these molecules is dependent on their metabolization which can differ according to the administration route and delivery approach. Consequently, a tissue engineering strategy comprising the use of biomaterials can provide support for neo-tissue osteochondral repair/regeneration whilst conferring proper mechanical and functional features as well as protecting biomolecular agents from premature degradation. The current strategies and challenges used in biomaterials functionalization with peptides that can mimic ECM proteins or other natural soluble biomolecules, important to induce the complex interactions between cells and the ECM, are discussed herein. Many opportunities for treating OA are being explored by means of peptide-biofunctionalization of biomaterials which can be designed to be recognizable, induce differentiation, prevent infection, degrade at an intended rate or act as drug delivery systems for controlled release or even as simple triggers of cell behavior.

US Evaluation of Juvenile Idiopathic Arthritis and Osteoarticular Infection

Juvenile idiopathic arthritis (JIA) and osteoarticular infection can cause nonspecific articular and periarticular complaints in children. Although contrast material-enhanced magnetic resonance imaging is the reference standard imaging modality, musculoskeletal ultrasonography (US) is emerging as an important adjunct imaging modality that can provide valuable information relatively quickly without use of radiation or the need for sedation. However, diagnostic accuracy requires a systemic approach, familiarity with various US techniques, and an understanding of maturation-related changes. Specifically, the use of dynamic, Doppler, and/or multifocal US assessments can help confirm sites of disease, monitor therapy response, and guide interventions. In patients with JIA, ongoing synovial inflammation can lead to articular and periarticular changes, including synovitis, tenosynovitis, cartilage damage, bone changes, and enthesopathy. Although these findings can manifest in adult patients with rheumatoid arthritis, important differences and pitfalls exist because of the unique changes associated with an immature and maturing skeleton. In patients who are clinically suspected of having osteoarticular infection, the inability of US to evaluate the bone marrow decreases its sensitivity. Therefore, the US findings should be interpreted with caution because juxtacortical inflammation is suggestive, but neither sensitive nor specific, for underlying osteomyelitis. Similarly, the absence of a joint effusion makes septic arthritis extremely unlikely but not impossible. US findings of JIA and osteoarticular infection often overlap. Although certain clinical scenarios, laboratory findings, and imaging appearances can favor one diagnosis over the other, fluid analysis may still be required for definitive diagnosis and optimal treatment. US is the preferred modality for fluid aspiration and administering intra-articular corticosteroid therapy. © RSNA, 2017.

Automated assessment of bone changes in cross-sectional micro-CT studies of murine experimental osteoarthritis.

ObjectiveThe degradation of articular cartilage, which characterises osteoarthritis (OA), is usually paired with excessive bone remodelling, including subchondral bone sclerosis, cysts, and osteophyte formation. Experimental models of OA are widely used to investigate pathogenesis, yet few validated methodologies for assessing periarticular bone morphology exist and quantitative measurements are limited by manual segmentation of micro-CT scans. The aim of this work was to chart the temporal changes in periarticular bone in murine OA by novel, automated micro-CT methods.MethodsOA was induced by destabilisation of the medial meniscus (DMM) in 10-week old male mice and disease assessed cross-sectionally from 1- to 20-weeks post-surgery. A novel approach was developed to automatically segment subchondral bone compartments into plate and trabecular bone in micro-CT scans of tibial epiphyses. Osteophyte volume, as assessed by shape differences using 3D image registration, and by measuring total epiphyseal volume was performed.ResultsSignificant linear and volumetric structural modifications in subchondral bone compartments and osteophytes were measured from 4-weeks post-surgery and showed progressive changes at all time points; by 20 weeks, medial subchondral bone plate thickness increased by 160±19.5 μm and the medial osteophyte grew by 0.124±0.028 μm3. Excellent agreement was found when automated measurements were compared with manual assessments.ConclusionOur automated methods for assessing bone changes in murine periarticular bone are rapid, quantitative, and highly accurate, and promise to be a useful tool in future preclinical studies of OA progression and treatment. The current approaches were developed specifically for cross-sectional micro-CT studies but could be applied to longitudinal studies.

High-resolution Peripheral Quantitative Computed Tomography Imaging in the Assessment of Periarticular Bone of Metacarpophalangeal and Wrist Joints.

To synthesize descriptions of periarticular findings at the metacarpophalangeal (MCP) and wrist joints in different types of arthritis and in the normal state imaged by high-resolution peripheral quantitative computed tomography (HR-pQCT); to assemble the literature reporting on the ability of HR-pQCT to detect findings relative to other imaging modalities; and to collate results on the reproducibility of image interpretation. A systematic literature review was performed using terms for HR-pQCT and MCP or wrist joints using medical literature databases and conference abstracts. Any study describing predefined pathology findings, comparison to another radiographic technique, or a measure of reproducibility was included with no limitation by disease state. We identified 44 studies meeting inclusion criteria from the 1901 articles identified by our search. All 44 reported on pathology findings, including erosions (n = 31), bone microarchitecture (n = 10) and bone mineral density (n = 10) variables, joint space evaluation (n = 7), or osteophyte characterization (n = 7). Seventeen of the studies compared HR-pQCT findings to either plain radiography (n = 9), ultrasound (n = 4), magnetic resonance imaging (n = 5), or microcomputed tomography (n = 2), with HR-pQCT having high sensitivity for erosion detection. Twenty-four studies included an assessment of reproducibility with good to excellent metrics, and highlighting the critical importance of positioning when assessing joint space variables. Despite high sensitivity for erosion detection and good reproducibility, more research is required to determine where HR-pQCT can be applied to enhance our understanding of periarticular bone changes in a variety of arthritis conditions.

The regenerative effect of human umbilical cord blood mesenchymal stem cells in a rabbit model of osteoarthritis

Osteoarthritis (OA) is a degenerative disorder characterized by changes in subchondral and periarticular bone. The limited number of therapeutic choices for articular injury and disease has increased the need for stem cells as a biological replacement for damaged cartilage. Umbilical cord (UC) blood cells are easily available and less immunogenic than other sources of stem cells, and there are no ethical concerns surrounding their use. These cells are isolated from young donors. Human umbilical cord blood mesenchymal stem cells (HUCB-MSCs) appear to be an ideal candidate for cartilage regeneration. The aim of the study was to investigate the regenerative effect of HUCB stem cells on degenerated articular cartilage in New Zealand white rabbits experimentally induced with OA. This study was performed on 42 New Zealand white rabbits. They were surgically induced with OA in the left knees by cutting the anterior cruciate ligament. After confirmation of the development of OA histopathologically, we delivered a single dose of HUCB-MSCs directly intra-articularly in the cell-treated groups. Controls were injected with only suspension media. Histopathological tests were performed 8 and 24 weeks after injection. Histopathologically, 8 weeks after the injection, cell-treated rabbits showed better cartilage quality and lower degree of degeneration, whereas 24 weeks after the injection all parameters in the cell-treated groups were significantly better. HUCB-MSCs are a promising stem cell source for cartilage tissue formation and can decrease the development of OA in rabbits.

A4.2 IL4–10 synerkine for the treatment of osteoarthritis

Background and objectives Osteoarthritis (OA) is a degenerative joint disease, clinically characterised by joint pain and disability. Underlying structural changes are degeneration of articular cartilage, intra-articular inflammation with synovitis and changes in peri-articular and subchondral bone. The ideal drug to treat OA should have analgesic, anti-inflammatory and cartilage protective effects. To date, no such drug has been described. In human and animal in and ex-vivo models, the immunoregulatory cytokines interleukin 4 (IL-4) and interleukin 10 (IL-10), especially in combination therapy, can prevent joint degeneration effectively. To use the combined activities of both IL-4 and IL-10, we developed IL4–10 synerkine, preserving the functional activity of each cytokine. In several well-established animal models, we have shown the potential of IL4–10 synerkine to inhibit inflammatory pain in animal models. In this study, we evaluated the potential of the synerkine to reduce inflammation and to provide cartilage protection in an ex vivo model for human OA. Materials and methods Osteoarthritic cartilage (n = 8) and synovium (n = 6) was obtained at joint replacement surgery and was cultured for 72 h in conditioned medium, in the presence or absence of equimolar concentrations of IL-4 (10 ng/ml), IL-10 (10 ng/ml), the combination of IL-4 and IL-10 (10 ng/ml + 10 ng/ml) and IL4-10 synerkine (20 ng/ml). After culture, cartilage was selected to study changes in proteoglycan (PG) synthesis and release. Supernatants of both cartilage and synovium cultures were collected for measurement of a broad spectrum of inflammatory mediators. Results In both synovium and cartilage cultures, elevated levels of pro-inflammatory mediators like IL-6 (resp. 7.5 µg/mg and 531 µg/mg) and IL-8 (resp. 2.6 µg/mg and 142 µg/mg) were measured. These levels were strongly inhibited by the IL4-10 synerkine (about 80%; all p Conclusions IL4-10 synerkine directly affects proteoglycan turnover and cytokine production of OA cartilage, combined with reduced secretion of inflammatory cytokines and proteases by OA synovial tissue. The immunoregulatory and cartilage protective effects in combination with it’s analgesic effects, suggest that the synerkine is an effective disease modifying drug in the treatment of osteoarthritis.

Analysis of periarticular bone changes in patients with cutaneous psoriasis without associated psoriatic arthritis

ObjectivesTo search for structural bone changes in the joints of psoriasis patients without psoriatic arthritis (PsA).Methods55 psoriasis patients without any current or past symptoms of arthritis or enthesitis and 47...

FRI0227 Analysis of Periarticular Bone Changes in Patients with Cutaneous Psoriasis without Associated Psoriatic Arthritis

BackgroundSkin disease predates the onset of psoriatic arthritis (PsA) in about 60% of cases [1]. The transition from skin disease to joint involvement is only partially characterized. Erosive changes and...

SAT0546 The Regenerative Effect of Human Umbilical Cord Blood Mesenchymal Stem Cells in A Rabbit Model of Osteoarthritis

SAT0546 The Regenerative Effect of Human Umbilical Cord Blood Mesenchymal Stem Cells in A Rabbit Model of Osteoarthritis

Catabolic and anabolic periarticular bone changes in patients with rheumatoid arthritis: a computed tomography study on the role of age, disease duration and bone markers.

IntroductionThe aim of this study was to determine the factors, including markers of bone resorption and bone formation, which determine catabolic and anabolic periarticular bone changes in patients with rheumatoid arthritis (RA).MethodsForty RA patients received high-resolution peripheral quantitative computed tomography (HR-pQCT) analysis of the metacarpophalangeal joints II and III of the dominantly affected hand at two sequential time points (baseline, one year follow-up). Erosion counts and scores as well as osteophyte counts and scores were recorded. Simultaneously, serum markers of bone resorption (C-terminal telopeptide of type I collagen (CTX I), tartrate-resistant acid phosphatase 5b (TRAP5b)), bone formation (bone alkaline phosphatase (BAP), osteocalcin (OC)) and calcium homeostasis (parathyroid hormone (PTH), 25-hydroxyvitamin D3 (Vit D)) were assessed. Bone biomarkers were correlated to imaging data by partial correlation adjusting for various demographic and disease-specific parameters. Additionally, imaging data were analyzed by mixed linear model regression.ResultsPartial correlation analysis showed that TRAP5b levels correlate significantly with bone erosions, whereas BAP levels correlate with osteophytes at both time points. In the mixed linear model with erosions as the dependent variable, disease duration (P <0.001) was the key determinant for these catabolic bone changes. In contrast, BAP (P = 0.001) as well as age (P = 0.018), but not disease duration (P = 0.762), were the main determinants for the anabolic changes (osteophytes) of the periarticular bone in patients with RA.ConclusionsThis study shows that structural bone changes assessed with HR-pQCT are accompanied by alterations in systemic markers of bone resorption and bone formation. Besides, it can be shown that bone erosions in RA patients depend on disease duration, whereas osteophytes are associated with age as well as serum level of BAP. Therefore, these data not only suggest that different variables are involved in formation of bone erosions and osteophytes in RA patients, but also that periarticular bone changes correlate with alterations in systemic markers of bone metabolism, pointing out BAP as an important parameter.

Alterations in periarticular bone and cross talk between subchondral bone and articular cartilage in osteoarthritis

The articular cartilage and the subchondral bone form a biocomposite that is uniquely adapted to the transfer of loads across the diarthrodial joint. During the evolution of the osteoarthritic process biomechanical and biological processes result in alterations in the composition, structure and functional properties of these tissues. Given the intimate contact between the cartilage and bone, alterations of either tissue will modulate the properties and function of the other joint component. The changes in periarticular bone tend to occur very early in the development of OA. Although chondrocytes also have the capacity to modulate their functional state in response to loading, the capacity of these cells to repair and modify their surrounding extracellular matrix is relatively limited in comparison to the adjacent subchondral bone. This differential adaptive capacity likely underlies the more rapid appearance of detectable skeletal changes in OA in comparison to the articular cartilage. The OA changes in periarticular bone include increases in subchondral cortical bone thickness, gradual decreases in subchondral trabeular bone mass, formation of marginal joint osteophytes, development of bone cysts and advancement of the zone of calcified cartilage between the articular cartilage and subchondral bone. The expansion of the zone of calcified cartilage contributes to overall thinning of the articular cartilage. The mechanisms involved in this process include the release of soluble mediators from chondrocytes in the deep zones of the articular cartilage and/or the influences of microcracks that have initiated focal remodeling in the calcified cartilage and subchondral bone in an attempt to repair the microdamage. There is the need for further studies to define the pathophysiological mechanisms involved in the interaction between subchondral bone and articular cartilage and for applying this information to the development of therapeutic interventions to improve the outcomes in patients with OA.

Cross-talk between subchondral bone and articular cartilage in osteoarthritis

The interest in the relationship between articular cartilage and the structural and functional properties of peri-articular bone relates to the intimate contact that exists between these tissues in diarthrodial joints. Much of the interest and continuing controversy regarding the relationship between these tissues dates back to the original suggestion by Radin and Rose that alterations in the mechanical properties of subchondral bone could adversely affect the functional state of chondrocytes and the integrity of the overlying cartilage. They hypothesized that the deterioration in articular cartilage associated with the osteoarthritic process was secondary to an initial increase in subchondral bone stiffness induced by repetitive mechanical loading. Numerous approaches have been used to establish that the changes in periarticular bone occur very early in the development of OA. Although chondrocytes also have the capacity to modulate their functional state in response to loading, the capacity of these cells to repair and modify their surrounding extracellular matrix is relatively limited in comparison to the adjacent subchondral bone. This differential adaptive capacity likely underlies the more rapid appearance of detectable skeletal changes in OA in comparison to the articular cartilage. Given the intimate mechanical and biological interaction between the articular cartilage and subchondral bone it is likely that alterations in the composition and/or structural organization of either tissue will modulate the properties and function of the other joint component. An additional factor that affects the interaction between these tissues is the gradual expansion of the zone of calcified cartilage and advancement of the tidemark that occurs with aging and progression of OA and contributes to overall thinning of the articular cartilage. The precise mechanisms involved in this process have not been definitively established and could include the release of pro-angiogenic factors from chondrocytes in the deep zones of the articular cartilage that have undergone hypertrophy and/or the influences of microcracks that have initiated focal remodeling in the calcified cartilage in an attempt to repair the microdamage. In addition, this process markedly increases the mechanical stresses in the deep zones of the cartilage matrix, which likely contributes to the acceleration in OA cartilage deterioration. In summary, there is the need for further studies to define the pathophysiological mechanisms involved in the interaction between subchondral bone and articular cartilage and for applying this information to the development of therapeutic interventions to improve the outcomes in patients with OA.

371 MRI-BASED CARTILAGE THICKNESS LOSS AND JOINT SPACE NARROWING IN AN OAI CORE PROGRESSION SAMPLE, AND THEIR RELATIONSHIP WITH AGE, SEX, AND BMI

Purpose: Recent evidence suggests that peri-articular bone changes are integral to knee osteoarthritis (OA) pathophysiology. Peri-articular trabecular morphology changes have been associated with radiographic knee OA severity and may identify individuals at risk for knee OA progression. However, it is unclear how patient characteristics are associated with peri-articular trabecular morphology in knees with OA. The purpose of this study was to evaluate the association between patient characteristics and trabecular morphology in knees with OA. Methods: The sample comprised a convenience sample of 337 participants in the Osteoarthritis Initiative (OAI) progression cohort who at the 30or 36-month OAI visit had 3-tesla magnetic resonance imaging that included coronal 3D Fast Imaging with Steady State Precession (FISP) trabecular morphometry sequences. We used a trabecular morphometry program with a modified algorithm (calcDCN, University of CaliforniaSan Francisco) to evaluate 4 peri-articular trabecular morphology measures: bone volume fraction (BVF), trabecular number (tb.n), spacing (tb.sp), and thickness (tb.th). The four measures were calculated for 20 consecutive central slices within a 15mm x 3.75mm region of interest placed in the peri-articular medial tibia and then averaged. Intratester reproducibility was high (ICC = 0.99). The association between demographic data or knee-specific data (from the 24-month OAI visit) and trabecular morphometry were evaluated with independent sample t-tests or Wilcoxon rank-sum tests (when applicable) and Spearman correlations. Among a subset of 285 patients with 24-month joint space narrowing (JSN) scores, four forward-selection multiple linear regression models were used to further evaluate the associations between patient characteristics and each trabecular morphometry measure. Results: Participants were 66±9 years of age, body mass index 29.6±4.8 kg/m, and 50% female. Peri-articular trabecular morphometry was averaged (± standard deviation) for the cohort: BVF = 0.12±0.08, tb.sp = 1.53±1.25mm, tb.n = 0.86±0.39mm−1, and tb.th = 0.13±0.03mm. Peri-articular trabecular morphometry was not significantly different (p > 0.05) between participants with or without college degrees (n = 208, n = 127; respectively), with or without history of smoking (n =147, n = 188; respectively), and with or without knee symptoms at the 24month OAI visit (n = 191, n = 145; respectively). Many variables were associated with trabecular morphometry (see table). Age correlated with BVF (r = −0.16), tb.n (r = −0.18), and tb.sp (r = 0.17), but not tb.th (r = −0.08). Body mass index also correlated with BVF (r = 0.12), tb.n (r = 0.14), and tb.sp (r = −0.14), but not tb.th (r = 0.07). The 400-meter walk time (24-month visit) was related to tb.sp (r = 0.12). In multiple linear regression models, the presence of medial JSN and female gender were associated with all 4 trabecular morphometry measures. Three patient characteristics were associated with select measures: age (associated with tb.sp, tb.n), history of knee injury/surgery (associated with BVF, tb.th), and race (associated with tb.th).

A comparative study of periarticular bone lesions in rheumatoid arthritis and psoriatic arthritis

BackgroundPsoriatic arthritis (PsA) and rheumatoid arthritis (RA) are both destructive arthritides but may differ substantially in their periarticular bone changes.ObjectivesTo investigate the differences in the structural changes of periarticular bone...

The combination of the biomarkers urinary C‐terminal telopeptide of type II collagen, serum cartilage oligomeric matrix protein, and serum chondroitin sulfate 846 reflects cartilage damage in hemophilic arthropathy

Hemophilic arthropathy, with characteristics of inflammatory (rheumatoid arthritis) and degenerative (osteoarthritis) joint damage, occurs at an early age, is associated with minor comorbidity, and is restricted to 3 pairs of large joints. The aim of this study was to determine whether commonly used serum and/or urinary biomarkers of cartilage and bone turnover for which assay kits are commercially available are associated with the severity of joint damage in patients with various degrees of hemophilic arthropathy and, thus, whether this disease could be useful in the identification and evaluation of such biomarkers. Blood and urine samples were collected from 36 patients with various degrees of hemophilic arthropathy. Commercially available assays for the most frequently investigated serum and urine biomarkers were performed: urinary C-terminal telopeptide of type I collagen (CTX-I), urinary CTX-II, serum CTX-I, serum CTX-II, serum cartilage oligomeric matrix protein (COMP), serum cartilage cleavage products C1,2C and C2C, and serum chondroitin sulfate 846 (CS-846). Radiographs of the ankles, knees, and elbows in all patients were evaluated for the degree of joint damage according to the Pettersson score, which is based on cartilage and periarticular bone changes and is specific for hemophilic arthropathy. Urinary CTX-II, serum C1,2C, and serum CS-846 levels correlated with the overall Pettersson score and with the joint space narrowing component. Regression analysis showed that combined indexes of different markers increased the degree of correlation for the combination of urinary CTX-II, serum COMP, and serum CS-846. Bone-specific markers (urinary/serum CTX-I and serum C1,2C) did not correlate with specific bone-related items of the Pettersson score (osteoporosis and erosions). These results support the idea that a combination of biomarkers relates significantly better to the severity of joint damage than do individual biomarkers. The combination of urinary CTX-II, serum COMP, and serum CS-846 correlated best with the degree of arthropathy. Because of its specific characteristics and restricted involvement, hemophilic arthropathy may prove useful in the screening of newly developed biomarkers of joint damage.