Course Of Osteoarthritis Research Articles

Clinical and instrumental characteristics of osteoarthritis in hyperuricemia

Objective: to investigate in a multicentre single-stage study the relationships between hyperuricemia (HU) and clinical, instrumental and laboratory parameters of osteoarthritis (OA).Material and methods. The study included 200 patients aged 40 to 75 years with a definite diagnosis of knee (KN) OA that met ACR criteria, with stage I–III OA by Kellgren–Lawrence. The mean age of the patients was 55.9±10.3 years and the body mass index (BMI) was 29.4±6.2 kg/m2. An individual chart was completed for each patient, including anthropometric parameters, medical history and clinical examination data, visual analogue scale (VAS) assessment of KN pain, WOMAC, patient's general health assessment (GHA) and information on comorbidities. All patients underwent standard radiography and magnetic resonance imaging (MRI) of the KN (WORMS), dual-energy X-ray absorptiometry of the lumbar spine and femoral neck, and laboratory examination.Results and discussion. HU was diagnosed in 57 (28.5) patients when the serum uric acid (UA) level was above 360 μmol/L. Patients were divided into two groups according to the presence or absence of HU. The age of the patients in the two groups was comparable, but they differed significantly in terms of disease duration, BMI, waist and hip circumference, which were greater in the HU group (p <0.05). Statistically significant differences were also found in the assessment of the severity of OA course: there were higher pain indices according to VAS, WOMAC total score and its components (pain and functional impairment, FI), GHA in the HU group. On MRI, osteitis was more common in the medial aspect of the tibia (odds ratio 5.75; 95% confidence interval 1.29–25.6; p=0.03). Patients with HU had higher concentrations of CRP, COMP, leptin, insulin, triglycerides and creatinine (p <0.05 for all values).Spearman correlation analysis confirmed the association between HU and duration and radiological stage of OA, the presence of osteitis in the medial aspect of tibia detected by MRI, pain according to VAS and WOMAC, FI according to WOMAC and GHA (p<0.05).Conclusion. At high UA levels, pain values according to VAS and WOMAC are higher, GHA is worse, and CRP and COMP levels are elevated. MRI shows more frequent osteitis in the medial aspect of the tibia in patients with HU. Deciphering the mechanisms that determine the relationship between HU and OA is important for the development of new methods for the prevention and treatment of these diseases.

CHANGES IN LIPID AND CARBOHYDRATE METABOLISM IN PATIENTS WITH OSTEOARTHRITIS WITH ACCOMPANYING ARTERIAL HYPERTENSION AND TYPE 2 DIABETES, DEPENDING ON BSMI VDR GENE POLYMORPHISM

It is known that Osteoarthritis (OA) is a common chronic disease of the musculoskeletal system, which leads to a significant loss of working capacity and disability of people of working age, which worsens the quality of life of the population and causes economic burden and losses to all countries of the world. In addition, OA is known as a disease with an inherent high level of comorbidity. Scientists single out diseases of cardiovascular diseases, digestive systems and metabolic disorders as those that are most often combined with OA and complicate the course of each other in manifestations, diagnostic and treatment processes. Today, modern science needs to understand the presence of a common genetic origin. It is known that the polymorphic variant of the VDR vitamin D receptor gene has a predisposition to common osteochondral diseases. However, the issue of participation in pathogenetic mechanisms of development and progression remains controversial. A polymorphic variant of the VDR gene has a predisposition to osteochondral diseases. However, its involvement in the pathogenetic mechanisms of the development and progression of osteoarthritis remains controversial, therefore The aim of the study is to investigate the specifics of the impact of comorbid pathology on carbohydrate and lipid metabolism and the state of the vascular wall in patients with osteoarthritis, taking into account the polymorphic variant of the VDR gene (Bsml, rs1544410). Object and research methods. 100 patients were examined and also divided into groups: 1st group – patients with OA; II – OA with arterial hypertension; ІІІ – OA, arterial hypertension (AG) and type 2 diabetes mellitus, a blood sample was taken and, depending on age, comorbidity, the presence of the polymorphic variant BsmI (rs1544410) of the VDR gene, indicators of carbohydrate and lipid metabolism, the level of end metabolites of nitric oxide and endothelin-1 were studied and the impact on radiological changes and the functional state of the knee joints was evaluated. Control – 30 people. Results of the study and their discussion. It has been established that osteoarthritis is characteristic of persons of working age. With increasing age, it is characteristic to be burdened by comorbid pathologies with worsening of the course of the main disease. Expected violation of carbohydrate metabolism was observed in the III group of patients, although dynamic probable changes were also in the II group (p<0.05). Lipid metabolism in the I group was probably higher than the group of control, but was within the physiological norm, while groups II and III had significant pathological changes compared to the indicators of the I group and practically healthy persons. Hypercholesterolemia became a trigger for a decrease in the total level of stable total nitrogen monoxide metabolites and an increase in endothelin-1, which forms endothelial dysfunction and leads to the progression of AG and worsening of the course of OA. After the genotyping and division into genotypes of the polymorphic variant BsmI of the VDR gene, conclusions were obtained about the unfavorable allele A in the exchange processes of the above indicators. Conclusions. Features of violations of carbohydrate and lipid metabolism, the condition of the endothelium, against the background of comorbidity and the presence of an unfavorable allele A of the BsmI polymorphic variant of the VDR gene should be taken into account in the complex diagnostic and treatment process of patients with OA.

New insights into the mechanisms and therapeutic strategies of chondrocyte autophagy in osteoarthritis.

Osteoarthritis (OA) is a chronic joint disease with an unclear cause characterized by secondary osteophytes and degenerative changes in the articular cartilage. More than 250 million people are expected to be affected by it by 2050, putting a tremendous socioeconomic strain on the entire world. OA cannot currently be treated with any effective medications that change the illness. Over time, chondrocytes undergo gradual metabolic, structural, and functional changes as a result of aging or abuse. The degenerative progression of osteoarthritis is significantly influenced by the imbalance of chondrocyte homeostasis. By continuously recycling and rebuilding macromolecules or organelles, autophagy functions as a crucial regulatory system to maintain homeostasis during an individual's growth and development. This review uses chondrocytes as its starting point and establishes a strong connection between autophagy and osteoarthritis in order to thoroughly examine the mechanisms behind chondrocyte autophagy in osteoarthritis. Biomarkers of chondrocyte autophagy will be identified, and prospective targeted medications and novel treatment approaches for slowing or preventing the course of OA will be developed based on chondrocyte senescence, autophagy, and apoptosis in OA. KEY MESSAGES: Currently, OA has not been treated with any drugs that can effectively cure it. We hope that by exploring specific targets in the course of osteoarthritis, we can promote the progress of treatment strategies. The degenerative progression of osteoarthritis is significantly influenced by the imbalance of chondrocyte balance. Through the continuous recovery and reconstruction of macromolecules or organelles, autophagy is an important regulatory system for maintaining homeostasis during individual growth and development. In this paper, the close relationship between autophagy and osteoarthritis was established with chondrocytes as the starting point, in order to further explore the mechanism of chondrocyte autophagy in osteoarthritis. The development process of osteoarthritis was studied from the perspective of chondrocytes, and the change of autophagy level had a significant impact on osteoarthritis. Chondrocyte autophagy is mainly determined by intracellular mitochondrial autophagy, so we are committed to finding relevant molecules. Through PI3K/AKT- and MAPK-related pathways, the biomarkers of chondrocyte autophagy were identified, and chondrocyte senescence, autophagy, and apoptosis based on osteoarthritis provided a constructive idea for the development of prospective targeted drugs and new therapies to slow down or prevent the progression of osteoarthritis.

Bioinformatic analysis combined with immune infiltration to explore osteoarthritis biomarkers and drug prediction.

Along with global aging, osteoarthritis (OA) appears to have a high incidence and disability rate, which seriously affects the quality of life of patients, making age a major risk factor. However, the pathology of OA is under-researched, and there is no obvious and effective treatment. Research has demonstrated the importance of aging, inflammation, and immunology in the onset and course of OA. This study aims to anticipate therapeutic drugs based on critical genes associated with OA and to elucidate the roles of genes and possible biomarkers associated with inflammation, immunology, and cellular senescence in OA. The OA gene expression matrix was first obtained from the Gene Expression Omnibus database. Screening for OA significant differentially expressed genes by bioinformatics identification. Specific biological processes and related signaling pathways of the differential genes were enriched. Then elucidate the status of immune cell involvement in OA based on immune infiltration analysis. Finally predict therapeutic agents based on pivotal genes. A total of 198 differentially expressed genes were identified in OA, and TP53, EGFR, TGFB1, LEP, CD4, MAPK8, SCARB1, ADIPOQ, JAK2, and SERPINE1 were further identified as important hub genes. The enrichment results showed that the development of arthritis was mainly related to immune cell differentiation, amino acid metabolism and cellular senescence process. The validation of immune infiltration results indicated that NK_cells, CD4_Tcells, Macrophages, Monocytic_lineage, Dendritic_cells, Basophils, CD8+_naive_T-cells may play an important role in the immune process of OA. Key Drug Prediction of Hub Genes found that Halicin, Ruxolitinib, Tofacitinib, Clenoliximab, Baricitinib may be a key drug or component in the treatment of OA.

ACL and Graft Choices in the Aging Athlete

Anterior cruciate ligament reconstruction (ACLR) is a well-established procedure utilized in the setting of ACL injuries in patients under age 40. The management of ACL injuries in older populations is controversial as best practices are not clear with regard to candidacy for surgery, graft choice, fixation, and rehabilitation.In this review, we examined the body of literature surrounding controversies in management of ACL tears in older patients. Specific foci include nonoperative management, clinical course of osteoarthritis with ACLR, graft choice, graft fixation, complications, and alternative surgical options.The aging athlete with ACL-deficiency may benefit from non-operative management with rehabilitation if they are low demand, have minimal instability, and do not have moderate to severe or multi-compartmental osteoarthritis. Prehabilitation may also be beneficial to patients in the to determine if they can recover from injury to achieve an acceptable state of function before deciding upon surgery. ACLR is a viable option in older patient populations with minimal osteoarthritis and instability who have failed conservative management. Patients undergoing ACLR are likely to develop worsening radiographic OA. Despite this radiographic OA, majority of patients have improvements in PROMs and return to function. Given the risks of TKA after ACLR, shared clinical decision making should be prioritized with each patient regarding pursuit of ACLR versus conservative management.

Cartilage Collagen Neoepitope C2C Expression in the Articular Cartilage and Its Relation to Joint Tissue Damage in Patients with Knee Osteoarthritis.

Pathological cleavage of type II collagen (Col2) and generation of Col2 neoepitopes can serve as useful molecular markers of the progression of osteoarthritis (OA). One of such potential biomarkers is type II collagen neoepitope C2C. The aim of this study was to correlate the degree of articular cartilage damage in OA patients with C2C expression in histological samples of tissues removed during total knee replacement. Cartilage samples were obtained from 27 patients ranging in age from 55 to 66 years. In each patient, medial and lateral tibia plateau samples were analyzed according to the OARSI histopathology grading system. The C2C expression was evaluated on histological slides by semi-quantitative analysis using ImageJ Fiji 2.14.0 software. Spearman's rank correlation analysis revealed a positive weak correlation (rho = 0.289, p = 0.0356) between the histological grade of tissue damage and the percentage of C2C staining. In addition, a highly significant positive correlation (rho = 0.388, p = 0.0041) was discovered between the osteoarthritis score (combining the histological grade of damage with the OA macroscopic stage) and the percentage of C2C staining in the samples. The C2C expression was detected in all the regions of the articular cartilage (i.e., the superficial zone, mid zone, deep zone and tidemark area, and the zone of calcified cartilage). Our findings imply that local expression of C2C correlates with the articular cartilage damage in OA-affected knees. This confirms that C2C can be used as a prospective marker for assessing pathological changes in the OA course and OA clinical trials.

A rapid VEGF-gene-sequence photoluminescence detector for osteoarthritis.

Osteoarthritis (OA) has become a serious problem to the human society for years due to its high economic burden, disability, pain, and severe impact on the patient's lifestyle. The importance of current clinical imaging modalities in the assessment of the onset and progression of OA is well recognized by clinicians, but these modalities can only detect OA in the II stage with significant structural deterioration and clinical symptoms. Blood vessel formation induced by vascular endothelial growth factor (VEGF) occurs in the early stage and throughout the entire course of OA, enables VEGF relating gene sequence to act as a biomarker in the field of early diagnosis and monitoring of the disease. Here in, a facile rapid detection of VEGF relating ssDNA sequence was developed, in which manganese-based zeolitic imidazolate framework nanoparticles (Mn-ZIF-NPs) were synthesized by a simple coprecipitation strategy, followed by the introduction and surficial absorption of probe ssDNAs and the CRISPR/Cas12a system components. Furthermore, fluorescence experiments demonstrated that the biosensor displayed a low detection limit of 2.49nM, a good linear response to the target ssDNA ranging from 10nM to 500nM, and the ability of distinguishing single nucleotide polymorphism. This finding opens a new window for the feasible and rapid detection of ssDNA molecules for the early diagnose of OA.

Pancreatic exocrine insufficiency impact on the course of osteoarthritis in comorbidity

Pancreatic exocrine insufficiency impact on the course of osteoarthritis in comorbidity

Mechanical and histological properties of native medial menisci compared to allograph medial menisci in the osteoarthritic knee.

This study was designed to provide information on how the menisci change over the course of osteoarthritis, particularly with regard to their mechanical properties. The aim was to determine the difference between healthy menisci (fresh frozen meniscal transplants) and menisci harvested during total knee arthroplasty. The latter allows the grading of age-related and osteoarthritic changes in the menisci on macroscopic and microscopic levels. A total of 10 menisci from arthritic knee joints (medial) harvested during total knee arthroplasty were used and compared with 10 medial fresh frozen meniscal transplants. The mechanical measurements were carried out on a Mach-1 testing machine using indentation testing to determine the instantaneous modulus and the thickness of the menisci. The specimens were then embedded in paraffin, sectioned on a microtome, and stained with hematoxylin-eosin and safranin-O. All measurements were divided into the anterior horn, pars intermedia, and posterior horn. There was no significant difference in the instantaneous modulus for the posterior horn in the fresh frozen menisci with 0.27 ± 0.1MPa compared to the arthritic menisci with 0.18 ± 0.03MPa. No significant difference could be determined for the meniscus thicknesses. There was a significant difference in the safranin-O staining. There were also significant differences in the Pauli score: the arthrosis menisci showed a sum score that was, on average, four times higher than the sum score of the fresh frozen menisci. In the present study, it could be shown very well that there are significant differences in the mechanical properties as well as in the macroscopic and histopathological scores, such as the Pauli score, between the fresh frozen meniscus allografts considered healthy and osteoarthritic menisci resulting from total knee arthroplasty. With a degradation score of 3 (Pauli), the instantaneous modulus was reduced by more than 50% compared to healthy controls. More importantly, however, the fresh frozen menisci only show a grade 2 when converting the sum values into grades, where a grade 2 indicates slight degeneration. This is interesting because fresh frozen meniscus transplants were always considered healthy in previous publications and should, therefore, actually have a grade 1.

Role of Infrapatellar Fat Tissue in the Pathogenesis of Knee Osteoarthritis: A Review

Osteoarthritis (OA) is one of the most common joint diseases in the adult population. The role of indolent inflammation and predominance of catabolic cytokines over anabolic ones in OA has now been proven. The influence of obesity on the development of OA by releasing inflammatory mediators by fat tissue has been confirmed. Infrapatellar fat tissue (Hoffa’s fat pad) is a potential donor of proinflammatory cytokines, including specific fat tissue proinflammatory cytokines - adipokines. In a healthy person, infrapatellar fat tissue contributes to the distribution of mechanical load on the joint and metabolism of the synovial fluid. Infiltration of infrapatellar fat tissue by macrophages and lymphocytes leads not only to the production of proinflammatory cytokines with chondrolytic properties, but also to the maintenance of chronic inflammation in the synovial membrane, articular cartilage, and subchondral bone. Morphologic changes in Hoffa’s fat pad can be both an indicator of the inflammatory process in the joint cavity and a predictor of pathologic changes of the joint. Among histological changes, infiltration with macrophages and lymphocytes, fibrosis, thickening of the interlobular septa, reduction in the size of fat lobules and adipocytes, and increased vascularization are important for the course of OA. Morphologic changes can be assessed using a non-invasive method - magnetic resonance imaging, which makes it possible to evaluate the presence and severity of synovitis, thickening of the synovial membrane, edema, thickening of the interlobular septa, and a decrease in the volume of Hoffa’s fat pad. Histologic and tomographic signs can potentially be used to assess the severity of OA and develop prognostic scales. Infrapatellar fat tissue is also a source of mesenchymal stem cells phenotypically similar to chondrocytes, which can be used for regeneration of joint cartilage tissue with minimally invasive intervention to harvest them.

Increased level of C3 in synovial fluid in patients with activated osteoarthritis as a diagnostic and therapeutic target – pilot group of patients from the Rheumatology Department at UMHAT Burgas

The clinical course of osteoarthritis (OA) indicates the role of low-grade synovitis as the main driver of the degenerative process. Components of the extracellular matrix, fibronectin isoforms, and fragments of hyaluronic acid are presumed ligands for DAMPs (particularly TLR). Complement fractions bind to the corresponding receptors on the cell membranes of chondrocytes and synoviocytes through TLR. Does the complement cascade play a role only as a clearing system and/or a leading pathogenetic factor in activated OA? The aim of this study is to answer this question. The study included 50 patients with activated OA of the knee joint. We examined the levels of C3 and C4 complement fractions in the blood plasma and synovial fluid. We found that the values of these proteins in synovial fluid were on average 34.90% for C3 and 30.97% for C4 of their values in blood plasma, with a generally accepted norm of 10% for complement levels in a healthy joint. The observation regarding the strength of correlation between the above results and the radiological stage confirmed a stronger correlation of the obtained results in the earlier stages of the disease when the activity of the repair processes is more pronounced. In this way, we objectified the pathogenetic role of complement in the arthritic process, as well as its role in clearing the joint space from degradation products. The question arises whether pharmacological intervention to balance complement activation could represent a future therapeutic strategy in the treatment of OA and prevent its progression.

Остеоартрит и коморбидные заболевания: патогенетические связи

Secondary inflammatory processes, primarily synovitis, accompany the course of osteoarthritis, play a significant role in the formation of both clinical manifestations of the disease and further destruction of articular structures. In a patient with osteoarthritis over the age of 50, more than 5 diseases coexist simultaneously and there are practically no persons who do not have concomitant somatic diseases. Atherosclerosis refers to inflammatory diseases in which inflammation is associated with dyslipidemia and chronic immune dysregulation. It has been established that one of the main elements of atherothrombosis is an increase in the synthesis of proinflammatory cytokines. Common risk factors for primary osteoarthritis and cardiovascular diseases: age, overweight, heredity, metabolic disorders (high cholesterol, glucose tolerance, diabetes mellitus).

Osteoarthritis—The Role of Mesenchymal Stem Cells in Cartilage Regeneration

Osteoarthritis (OA) is a condition that can cause substantial pain, loss of joint function, and a decline in quality of life in patients. Numerous risk factors, including aging, genetics, and injury, have a role in the onset of OA, characterized by structural changes within the joints. Most therapeutic approaches focus on the symptoms and try to change or improve the structure of the joint tissues. Even so, no treatments have been able to stop or slow the progression of OA or give effective and long-lasting relief of symptoms. In the absence of disease-modifying drugs, regenerative medicine is being investigated as a possible treatment that can change the course of OA by changing the structure of damaged articular cartilage. In regenerative therapy for OA, mesenchymal stem cells (MSCs) have been the mainstay of translational investigations and clinical applications. In recent years, MSCs have been discovered to be an appropriate cell source for treating OA due to their ability to expand rapidly in culture, their nontumorigenic nature, and their ease of collection. MSCs’ anti-inflammatory and immunomodulatory capabilities may provide a more favorable local environment for the regeneration of injured articular cartilage, which was thought to be one of the reasons why they were seen as more suited for OA. In addition to bone marrow, MSCs have also been isolated from adipose tissue, synovium, umbilical cord, cord blood, dental pulp, placenta, periosteum, and skeletal muscle. Adipose tissue and bone marrow are two of the most essential tissues for therapeutic MSCs. Positive preclinical and clinical trial results have shown that, despite current limitations and risks, MSC-based therapy is becoming a promising approach to regenerative medicine in treating OA.

An Osteocartilaginous 3D Printing Implant Using a Biocompatible Polymer and Pre-Differentiated Mesenchymal Stem Cells in Sheep

(1) Background: Currently, there are no pharmacological treatments that can modify the course of osteoarthritis (OA). For this reason, the present work is focused on generating knowledge for the development of new therapeutic alternatives for the treatment of OA. The objective of this work was to develop an articular hybrid implant with mesenchymal stem cells (MSCs) from sheep. The cells were differentiated into cartilage and bone using a bioabsorbable polymer with 3D printing Technology. (2) Methods: MSCs pre-differentiated to chondrocytes and osteoblasts were seeded on the 3D-printed scaffolds using polylactic acid (PLA). These were later implanted for 3 months in the thoracic ribs area and for 6 months inside the femoral head and outside of the joint capsule. After recovery, we analyzed the expressions of specific markers for bone and cartilage in the implants (3) Results: After 3 months, in lateral implants, the expression for bone markers (OPN, RUNX2) was similar to that of the control; at 6 months, we obtained a higher expression of bone markers in the implants with pre-differentiated MCS to osteoblasts outside and inside the joint. For cartilage markers, three months after the placement of the lateral implant, the expressions of Aggrecan and SOX9 COL2A1 were similar to those of the control, but the expression of COL2A1 was less; at 6 months, the three cartilage markers SOX9, Aggrecan, and COL2A1 showed significant expressions in the implant inside joint with pre-differentiated MCS to chondrocytes. (4) Conclusions: In this study, we demonstrated that the presence of pre-differentiated MSCs in the implants was a determinant factor for the expression of bone- and cartilage-specific markers at three and six months. We managed to generate a practical and easy-to-implement articular surface repair model.

Depression development in patients with OA, and its impact on treatment outcome - a literature review

Introduction and aim of the study: Osteoarthritis (OA) and depression are leading causes of disease burden worldwide and important public health problems. A number of recent studies reported depression as a comorbidity of OA and its impact on reduced quality of life and worse treatment outcome of OA patients. The clinical management strategies of those patients still haven’t been developed, which is a challenge of future research on this topic. The aim of this review is to shed a light on important aspects of depression relationship with OA including its prevalence among OA patients and its influence on course and treatment of OA with a purpose of increasing awareness of this problem among physicians which may subsequently lead to a better overall medical care of patients with OA and depression. Methods and materials: This literature review is based on articles published in the PubMed database, GoogleScholar, ScienceDirect, and available medical textbooks. Conclusions: Recent literature reports a higher prevalence of depression among OA patients when compared to general population and its impact on osteoarthritis course, both on psychological and biomolecular level. Future research may lead to a better understanding of molecular background of depression and OA interrelation and to more complex and individualized management strategies which may result in a better outcome of treatment and improved life quality of osteoarthritis patients. Therefore, in order to optimize management of OA patients, physicians should pay more attention to depression and use multidisciplinary approach including assessment of mental health status to develop a more effective strategies of medical care in osteoarthritis.

Cartilaginous glycoprotein‑39 as laboratory marker of dynamics of course and effectiveness of treatment in patients with osteoarthritis

Backgrounds. Osteoarthritis (OA) occupies the first rank among diseases of the musculoskeletal system and accounts for 18.4% of the structure of this pathology. Currently, OA is considered as a disease in which there is a violation of the processes of remodeling (degradation and synthesis) of cartilage tissues, subchondral bone, joint capsule, tendon-ligamentous and muscular apparatus. An increased concentration of cartilage glycoprotein-39 (CGP-39) in the circulation is associated with inflammatory diseases and the processes of active tissue restructuring. To date, CGP-39 is a marker of chondrocyte activation and a sign of progressive OA, which determines its clinical significance. Along with this, the role of this biomarker in evaluating the effectiveness of anti-inflammatory therapy is relevant.The purpose. Comparative assessment of the quantitative content of CGP-39 in patients with knee joint OA, depending on the severity of inflammatory changes in the joints, the dynamics of the disease and the effectiveness of therapy.Methods. The study included 36 patients with OA and 30 practically healthy volunteers, identical in gender and age to the examined patients. The mean age of patients was 64 years, the average duration of the disease was 6 years. The diagnosis was determined according to the diagnostic criteria of the American College of Rheumatology (ACR, 1991). Along with the generally accepted clinical, laboratory and instrumental diagnosis of OA, in all patients and in control persons the levels of circulating CGP-39 were measured by enzyme immunoassay (ELISA). All examined patients received Ambene® Bio for 20 days, followed by repeated determination of the level of CGP-39. For statistical processing of the obtained data, we have used the programs Microsoft Excel 2007 and Statistica 10.0. Using the application program KRelRisk 1.1, the relative risk indicator for the studied factor was determined.Results. In the blood of patients with OA, a significant increase in the levels of CGP-39 has been found in comparison with the group of healthy individuals, which indicates increased degradation of articular cartilage in OA. As the severity of knee OA increased, the concentration of CGP-39 in the blood serum significantly raised, including in comparison with the control group. Reliable direct correlations were found between CGP-39 and clinical indices of knee OA severity. The content of CGP-39 in serum in patients with stage III radiological OA was significantly higher than in patients with stage I–II. The highest level of CGP-39 in patients with OA is associated with the presence of synovitis. TThe level of CGP-39 significantly decreased in patients with knee OA after a course of Ambene® Bio therapy, which confirms the participation of CGP-39 in inflammation on the one hand and the possibility of its use as an indicator of the effectiveness of anti-inflammatory therapy on the other hand.Conclusions. CGP-39 as a marker of inflammation and degradation of articular cartilage reflects the severity of the course of OA. The investigation of this biomarker is useful not only for diagnostic purposes, but also to assess the response to anti-inflammatory treatment in patients with knee OA.

Cartilage-Related Collagens in Osteoarthritis and Rheumatoid Arthritis: From Pathogenesis to Therapeutics.

Collagens serve essential mechanical functions throughout the body, particularly in the connective tissues. In articular cartilage, collagens provide most of the biomechanical properties of the extracellular matrix essential for its function. Collagen plays a very important role in maintaining the mechanical properties of articular cartilage and the stability of the ECM. Noteworthily, many pathogenic factors in the course of osteoarthritis and rheumatoid arthritis, such as mechanical injury, inflammation, and senescence, are involved in the irreversible degradation of collagen, leading to the progressive destruction of cartilage. The degradation of collagen can generate new biochemical markers with the ability to monitor disease progression and facilitate drug development. In addition, collagen can also be used as a biomaterial with excellent properties such as low immunogenicity, biodegradability, biocompatibility, and hydrophilicity. This review not only provides a systematic description of collagen and analyzes the structural characteristics of articular cartilage and the mechanisms of cartilage damage in disease states but also provides a detailed characterization of the biomarkers of collagen production and the role of collagen in cartilage repair, providing ideas and techniques for clinical diagnosis and treatment.

New pharmaconutraceutical Chondroguard®TRIO for the prevention of musculoskeletal diseases and nutritional support for patients with osteoarthritis and nonspecific back pain: an assessment of clinical options. Resolution of the Multidisciplinary Expert Council

In recent decades, there has been an increase in the prevalence and medical and social burden of osteoarthritis (OA) and nonspecific back pain in all countries of the world. The First Multidisciplinary Bilateral Russia-Uzbekistan Expert Council presented innovations in the prognosing, personalized prevention and adjuvant therapy of degenerative-dystrophic diseases of the joints and spine, the evidence base for the effectiveness and safety of the use of drugs that modify the course of OA (Disease-modifying osteoarthritis drugs, DMOADs): chondroitin sulfate, glucosamine sulfate, undenatured type II collagen for adjuvant pharmaconutraceutical support – prevention and adjuvant therapy (treatment) of OA and nonspecific lumbosacral pain. The expert counsil resolution presents an optimized algorithm for the management, prevention and adjuvant therapy of OA and non-specific back pain, maintaining the function of healthy joints after intense physical activity with the inclusion of the drug Chondroguard solution for intra-articular and intramuscular administration (INN – chondroitin sulfate) and a new pharmaconutraceutical from the DMOADs group – TRIO trademark Chondroguard® (Chondroguard®TRIO).

The mechanism of palmatine-mediated intestinal flora and host metabolism intervention in OA-OP comorbidity rats.

ErXian decoction is a Chinese herbal compound that can prevent and control the course of osteoarthritis (OA) and osteoporosis (OP). OP and OA are two age-related diseases that often coexist in elderly individuals, and both are associated with dysregulation of the gut microbiome. In the initial study, Palmatine (PAL) was obtained by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and network pharmacological screening techniques, followed by 16S rRNA sequencing and serum metabolomics of intestinal contents, to explore the mechanism of PAL in the treatment of OA and OP. The rats selected for this study were randomly divided into three groups: a sham group, an OA-OP group and a PAL group. The sham group was intragastrically administered normal saline solution, and the PLA group was treated with PAL for 56 days. Through microcomputed tomography (micro-CT), ELISA, 16S rRNA gene sequencing and non-targeted metabonomics research, we explored the potential mechanism of intestinal microbiota and serum metabolites in PAL treatment of OA-OP rats. Palmatine significantly repair bone microarchitecture of rat femur in OA-OP rats and improved cartilage damage. The analysis of intestinal microflora showed that PAL could also improve the intestinal microflora disorder of OA-OP rats. For example, the abundance of Firmicutes, Bacteroidota, Actinobacteria, Lactobacillus, unclassified_f_Lachnospiraceae, norank_f_Muribaculaceae, Lactobacillaceae, Lachnospiraceae and Muribaculaceae increased after PAL intervention. In addition, the results of metabolomics data analysis showed that PAL also change the metabolic status of OA-OP rats. After PAL intervention, metabolites such as 5-methoxytryptophol, 2-methoxy acetaminophen sulfate, beta-tyrosine, indole-3-carboxylic acid-O-sulfate and cyclodopa glucoside increased. Association analysis of metabolomics and gut microbiota (GM) showed that the communication of multiple flora and different metabolites played an important role in OP and OA. Palmatine can improve cartilage degeneration and bone loss in OA-OP rats. The evidence we provided supports the idea that PAL improves OA-OP by altering GM and serum metabolites. In addition, the application of GM and serum metabolomics correlation analysis provides a new strategy for uncovering the mechanism of herbal treatment for bone diseases.

Intra-Articular Collagen Injections for Osteoarthritis: A Narrative Review

Osteoarthritis (OA) is the most frequent degenerative progressive joint disease worldwide, with the hand, hip, and knee being the most-affected joints. Actually, no treatment can alter the course of OA, and therapy is directed at reducing pain and improving function. The exogenous administration of collagen has been investigated as a possible symptomatic adjuvant or stand-alone treatment for OA. The aim of this review is to assess if intra-articular collagen administration can be considered as a valid and safe therapeutic option for OA. A search in the main scientific electronic databases to identify the available scientific articles about the effects of intra-articular collagen as an OA treatment was performed. The results of the seven included studies showed that the intra-articular administration of collagen may stimulate chondrocytes to produce hyaline cartilage and hinder the normal inflammatory response leading to fibrous tissue formation, reducing symptoms, and improving functionality. The use of type-I collagen as an intra-articular treatment for knee OA was found not only to be effective, but also safe with negligible side effects. The reported findings are strongly promising, highlighting the need for further high-quality research to confirm the consistency of these findings.