Degenerative Articular Disease Research Articles

Therapeutic Potential of Traditional Chinese Medicine Against Osteoarthritis: Targeting the Wnt Signaling Pathway.

Osteoarthritis (OA) is a chronic degenerative articular disease that leads to physical disability and reduced quality of life. The key pathological events in OA are cartilage degradation and synovial inflammation. Conventional therapies often lead to adverse effects that some patients are unwilling to endure. Traditional Chinese Medicines (TCMs) have long been known for their efficacy in treating OA with minimal side effects. The wingless-type (Wnt) signaling pathway is believed to play a role in OA progression, but there is still a lack of comprehensive understanding on how TCM may treat OA via the Wnt signaling pathway. This study aims to fill this gap by reviewing relevant research on the association between the Wnt signaling pathway and cartilage degradation and synovial inflammation in OA. Meanwhile, we also summarized and categorized TCMs and their active components, such as alkaloids, polysaccharides, flavonoids, sesquiterpene lactones, etc., which have shown varying efficacy in treating OA through modulation of the Wnt/[Formula: see text]-catenin signaling pathway. This work underscores the pivotal role of the Wnt signaling pathway in OA pathogenesis and progression, suggesting that targeting this pathway holds promise as a prospective therapeutic strategy for OA management in the future. TCMs and their active components have the potential to alleviate OA by modulating the Wnt signaling cascade. Harnessing TCMs and their active components to regulate the Wnt signaling pathway presents an encouraging avenue for delivering substantial therapeutic benefits to individuals with OA.

Correlation of Circulating Dickkopf-1 Level with Sonographic Findings and Radiographic Grading in Primary Knee Osteoarthritis

Abstract Background: Osteoarthritis (OA) is a frequently complex joint disease that involves all joint components, including cartilage degeneration and new bone development. Dickkopf-1 (Dkk-1) regulates bone growth and repair in OA. The purpose of this study is to determine Dkk-1 blood levels in individuals with primary knee joint OA, as well as their associations with disease progression and severity. Methods: This study included 45 individuals with primary OA of the knee and 45 healthy participants. Demographic data, body mass index, Visual Analog Scale, and Western Ontario and McMaster Universities Arthritis questionnaire scores were gathered. On radiography, the Kellgren and Lawrence score was acquired. The knee joint ultrasonography results were documented. The blood level of Dkk-1 was determined using the enzyme-linked immunosorbent assay method. Results: Dkk-1 levels in the blood were substantially higher in patients with OA than in healthy persons. Serum Dkk-1 levels appeared to have a significantly inverted relationship with radiological OA grades in knee OA (P < 0.001). Dkk-1 serum levels were significantly lower in individuals with ultrasonographic knee effusion (median = 3.2, interquartile range [IQR] = 3.1–4.16) than in those without effusion (median = 4.79, IQR = 4.04–5.09). Furthermore, there was a strong correlation between Dkk-1 levels and ultrasonographically measured femoral cartilage thickness. Conclusion: Dkk-1 is an interesting radiological indicator associated with degenerative articular joint disease. It may have a crucial function in slowing the process of degeneration in knee OA and reflecting the disease’s radiographic and clinical severity.

Synovial Lipomatosis With Extra-articular Extension in the Arthritic Wrist: An Unexpected Diagnosis.

Synovial lipomatosis is a rare condition characterized by adipocyte proliferation within joint synovial tissue. It most commonly affects the knee and is typically intra-articular. Only 5 published case reports describe extra-articular synovial lipomatosis of the wrist. We present a case of a sexagenarian patient seen for his wrist arthropathy. His x-ray revealed pan-wrist arthritis and inflammatory soft tissue swelling. The patient was slated for a wrist fusion and Darrach procedure. Following the dorsal skin incision in the operating room, an unusual adipose mass was identified infiltrating all extensor compartments: midcarpal, radiocarpal, and distal radioulnar joints. The mass was excised and sent to pathology prior to proceeding with the slated surgery. Synovial lipomatosis was diagnosed postoperatively based on histopathology. Six weeks postoperatively, the wrist fusion had healed clinically and radiographically, and his pain had improved. There was no evidence of recurrence. Synovial lipomatosis is a rare entity that may imitate multiple other pathologies. It is possible that synovial lipomatosis may represent a secondary occurrence following degenerative articular disease or trauma in older patients. This is the first case report to date describing synovial lipomatosis of the wrist with extra-articular extension in the setting of pan-carpal wrist arthritis.

Treatment of trapeziometacarpal osteoarthritis with a pyrocarbon implant: Long-term results

ObjectiveTrapeziometacarpal osteoarthritis is the second most common degenerative articular disease. Although initial therapy should be conservative, surgical treatment is often required. Several surgical techniques have been described, but none has proved to be a gold-standard. The objective of this study was to evaluate the long-term clinical and radiological results of trapeziometacarpal interposition arthroplasty with the PyroDisk implant (Integra LifeSciences). MethodsA retrospective long-term study of all patients who underwent trapeziometacarpal interposition arthroplasty with a pyrocarbon implant at our institution was performed. ResultsTwenty-four patients who underwent PyroDisk (Integra LifeSciences). arthroplasty at our institution were identified; 7 were lost to follow-up; 17 patients were evaluated, for 20 arthroplasties. Mean follow-up was 13.5 years (range: 12–15 years). Disability in daily living activities was low (mean Disabilities of the Arm, Shoulder and Hand score, 29.6), with a mean pain score of 0.22. Mean Kapandji score at 13.5 years was 8.63. Mean grip strength was 18.5 kg and key-pinch strength 2.84 kg. Two patients had implant dislocation, needing revision surgery for implant removal. Implant survival rate was 88.9% at 13.5 years. ConclusionsOur study confirmed that good clinical results can be expected after interposition arthroplasty with PyroDisk (Integra LifeSciences). Regarding radiological findings, peri-implant osteolysis was present in 12 of the patients, but had no influence on the clinical outcome.

A Zebrafish Mutant in the Extracellular Matrix Protein Gene efemp1 as a Model for Spinal Osteoarthritis.

Osteoarthritis is a degenerative articular disease affecting mainly aging animals and people. The extracellular matrix protein Efemp1 was previously shown to have higher turn-over and increased secretion in the blood serum, urine, and subchondral bone of knee joints in osteoarthritic patients. Here, we use the zebrafish as a model system to investigate the function of Efemp1 in vertebrate skeletal development and homeostasis. Using in situ hybridization, we show that the efemp1 gene is expressed in the brain, the pharyngeal arches, and in the chordoblasts surrounding the notochord at 48 hours post-fertilization. We generated an efemp1 mutant line, using the CRISPR/Cas9 method, that produces a severely truncated Efemp1 protein. These mutant larvae presented a medially narrower chondrocranium at 5 days, which normalized later at day 10. At age 1.5 years, µCT analysis revealed an increased tissue mineral density and thickness of the vertebral bodies, as well as a decreased distance between individual vertebrae and ruffled borders of the vertebral centra. This novel defect, which has, to our knowledge, never been described before, suggests that the efemp1 mutant represents the first zebrafish model for spinal osteoarthritis.

Stromal cell-derived factor-1α regulates chondrogenic differentiation via activation of the Wnt/β-catenin pathway in mesenchymal stem cells

Mesenchymal stem cells (MSCs) have been applied to treat degenerative articular diseases, and stromal cell-derived factor-1α (SDF-1α) may enhance their therapeutic efficacy. However, the regulatory effects of SDF-1α on cartilage differentiation remain largely unknown. Identifying the specific regulatory effects of SDF-1α on MSCs will provide a useful target for the treatment of degenerative articular diseases.To explore the role and mechanism of SDF-1α in cartilage differentiation of MSCs and primary chondrocytes.The expression level of C-X-C chemokine receptor 4 (CXCR4) in MSCs was assessed by immunofluorescence. MSCs treated with SDF-1α were stained for alkaline phosphatase (ALP) and with Alcian blue to observe differentiation. Western blot analysis was used to examine the expression of SRY-box transcription factor 9, aggrecan, collagen II, runt-related transcription factor 2, collagen X, and matrix metalloproteinase (MMP)13 in untreated MSCs, of aggrecan, collagen II, collagen X, and MMP13 in SDF-1α-treated primary chondrocytes, of glycogen synthase kinase 3β (GSK3β) p-GSK3β and β-catenin expression in SDF-1α-treated MSCs, and of aggrecan, collagen X, and MMP13 in SDF-1α-treated MSCs in the presence or absence of ICG-001 (SDF-1α inhibitor).Immunofluorescence showed CXCR4 expression in the membranes of MSCs. ALP stain was intensified in MSCs treated with SDF-1α for 14 d. The SDF-1α treatment promoted expression of collagen X and MMP13 during cartilage differentiation, whereas it had no effect on the expression of collagen II or aggrecan nor on the formation of cartilage matrix in MSCs. Further, those SDF-1α-mediated effects on MSCs were validated in primary chondrocytes. SDF-1α promoted the expression of p-GSK3β and β-catenin in MSCs. And, finally, inhibition of this pathway by ICG-001 (5 µmol/L) neutralized the SDF-1α-mediated up-regulation of collagen X and MMP13 expression in MSCs.SDF-1α may promote hypertrophic cartilage differentiation in MSCs by activating the Wnt/β-catenin pathway. These findings provide further evidence for the use of MSCs and SDF-1α in the treatment of cartilage degeneration and osteoarthritis.

Exosomes derived from bone marrow mesenchymal stem cells pretreated with decellularized extracellular matrix enhance the alleviation of osteoarthritis through miR-3473b/PTEN axis.

Osteoarthritis (OA) is a prevalent degenerative articular disease for which there is no effective treatment. Progress has been made in MSC-based therapy in OA, and the efficacy has been demonstrated to be due to paracrine exosomes from MSCs. Decellularized extracellular matrix (dECM) provides an optimum microenvironment for the expansion of MSCs. In this study, we aimed to investigate whether exosomes isolated from bone marrow mesenchymal stem cells (BMSCs) with dECM pretreatment (dECM-BMSC-Exos) enhance the amelioration of OA. Exosomes from BMSCs with or without dECM pretreatment were isolated. We measured and compared the effect of the BMSC-Exo and dECM-BMSC-Exo on IL-1β-induced chondrocytes by analyzing proliferation, anabolism and catabolism, migration and apoptosis in vitro. The in vivo experiment was performed by articular injection of exosomes into DMM mice, followed by histological evaluation of cartilage. miRNA sequencing of exosomes was performed on BMSC-Exo and dECM-BMSC-Exo to investigate the underlying mechanism. The function of miR-3473b was validated by the rescue studies in vitro and in vivo using antagomir-3473b. IL-1β-treated chondrocytes treated with dECM-BMSC-Exos showed enhanced proliferation, anabolism, migration and anti-apoptosis properties compared with BMSC-Exos. DMM mice injected with dECM-BMSC-Exo showed better cartilage regeneration than those injected with BMSC-Exo. Interestingly, miR-3473b was significantly elevated in dECM-BMSC-Exos and was found to mediate the protective effect in chondrocytes by targeting PTEN, which activated the PTEN/AKT signaling pathway. dECM-BMSC-Exo can enhance the alleviation of osteoarthritis via promoting migration, improving anabolism, and inhibiting apoptosis of chondrocytes by upregulating miR-3473b , which targets PTEN.

DEGENERATIVE ARTICULAR CARTILAGE DISEASE, OSTEOARTHROSIS

Introduction: Osteoarthrosis (OA), degenerative articular cartilage disease is a chronic inflammatory arthropathy involving joint elements (subchondral bone, synovial membrane, hyaline cartilage and others). It is due to a disorder in the regulation between degradation and synthesis of the extracellular matrix of cartilage, involving bone and synovial membrane in a biochemical process mediated by growth factors and cytokines which, in turn, intervene in the course of bone remodeling and joint destruction. Objective: to detail the current information related to osteoarthrosis, description, etiology, classification, imaging classification, management and current treatments. Methodology: a total of 52 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 38 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: arthrosis, osteoartrose, bones, osteoartrosis, articular cartilage. Results: The prevalence of osteoarthrosis increases directly with age 25-35 years 0.1 % 35-65 years 30 % and over 80 years 80-100 %. An improvement of pain and sensitivity is observed with local treatment with capsaicin. Paracetamol can be considered as the basic analgesic in the treatment of most chronic osteoarticular pain in doses of 1 gram four times/day. Opioids have an analgesic effect that almost completely eliminates all kinds of pain regardless of its intensity or site of affection. Short-term and long-term parenteral corticosteroid use is effective in controlling pain and stiffness. Systemic use of corticosteroids in OA is not warranted and only intra-articular injections are advised. Diacerein decreases IL 1Beta production in cartilage as well as nitric oxide levels by antagonizing the catabolic process and stimulates the anabolic process of cartilage. Chondroitin sulfate does not present a clinically relevant effect on joint pain or joint space reduction. Conclusions: osteoarthritis should be considered as a chronic, irreversible and progressive lesion. There are factors that aggravate its prognosis. Many measures are recommended to the patient and his family, especially if it is an elderly patient, in order to avoid the progression of joint damage. Surgical treatment is reserved for patients with severe pain or marked deformity, which occurs in advanced OA. Among the most frequently used procedures are: valgus osteotomy of the proximal tibia, arthroplasty, arthrodesis and amniotic membrane implantation. Bone tissue regenerative currents using tetracyclines that prevent the activation of metalloproteases, autologous chondrocyte implants, hypoxia inducible factor (HIF-1/2a), parathyroid hormone that stimulates chondrocyte multiplication and the use of in situ stem cells, cartilage regeneration and a better understanding of the developmental protein ancestor of osteogenesis, will be part of the medical management protocol, being a promising therapy for future therapy. KEY WORDS: Osteoarthrosis, osteoartrose, bones, osteoartrosis, articular cartilage.

Association of DVWA rs11718863 Gene Polymorphism with Knee Osteoarthritis in Iraqi Patients

Background: Osteoarthritis (OA) is a complex degenerative articular disease that has an ambiguous pathogeny because variant risk factors participate in the process of cartilage deterioration. Genetic factors may have a role in the onset and progression of OA. Objective: To investigate potential association between severity of knee OA (KOA) and Double von Willebrand factor A domains DVWA rs11718863 gene polymorphism. Methods: One hundred and twenty Iraqi patients diagnosed with KOA, aged (45 years and above) and sixty healthy people (control) at the same age range, with no family history of OA were evaluated at Al-Imamein Al-Kadhimein Medical City (Rheumatology Department). The degree of severity of KOA was assessed by clinical and radiographic assessment. DVWA rs11718863 genotyping was performed using DNA sequencing (Sanger’s method). Results: Two different genotypes wild homozygote (TT) genotype and heterozygote (AT) appeared by genotyping of DVWArs:11718863. Highly significant difference (p<0.001) was found in distribution of the two genotypes in the three study groupsl the genotype (TT) was more frequent in control group (95.0%). Also, high significant difference (p<0.001) was noted in the two alleles (A, T) frequencies between control group and KOA patients group giving odd ratio 6.437 with 95% confidence intervals of (1.93-21.42). Conclusion: Iraqi subjects carrying AT genotype of DVWA rs11718863 gene are mostly susceptible for developing of KOA and the allele A of Tyr169Asn polymorphism are more frequent in those patients indicating that allele A may be a risk factor of onset of this disease. Age and body mass index are considered risk factors of onset and progression of KOA. Keywords: Double von Willebrand factor A domains (DVWA), single nucleotide polymorphism (SNP), body mass index, Knee osteoarthritis, KOA Citation: Hasan NN, Alwasiti EA, Ahmed MH. Association of DVWA rs11718863 gene polymorphism with knee osteoarthritis in Iraqi patients. Iraqi JMS. 2022; 20(2): 207-216. doi: 10.22578/IJMS.20.2.7

RADIOLOGICAL ASSESSMENT OF KNEE JOINT WIDTH DIFFERENCES IN OLDER ADULTS WITH SYMPTOMATIC MEDIAL KNEE OSTEOARTHRITIS

Knee osteoarthritis (OA) is a degenerative articular disease. The knee joint space width (JSW) is used for grading the severity of knee OA. However, there is a lack of research on differences in the widths of knee joints between both lower limbs in unilateral OA. The purpose of this research was to examine the radiological difference in the affected knee joint and contralateral knee joint by analyzing unilateral older adults with medial knee OA using both knees’ JSW differences. Twenty-five subjects with unilateral medial knee OA participated. X-ray radiographs were used to assess knee JSW, and the paired [Formula: see text]-test was performed to assess the knee joint gap width between the affected side and the unaffected side in the respective medial and lateral sides. The independent [Formula: see text]-test compared the differences between the lateral and medial knee JSWs on the affected side and unaffected side. The paired [Formula: see text]-test did not show a significant difference in the medial and lateral knee JSW on the affected side compared to the unaffected side ([Formula: see text]; 0.11). Meanwhile, the independent [Formula: see text]-test revealed a significant difference between the affected and unaffected sides ([Formula: see text]). This study showed no significant changes in affected knee JSWs compared to unaffected sides, but the difference between the lateral and medial JSWs was significant between the knees affected and unaffected by OA in the older adults with medial knee OA.

810 nm Low-intensity laser in the treatment of degenerative articular disease associated with kinesiotherapy and condroprotectors – Case report

Degenerative Joint Disease (DJD), also known as Osteoarthritis (OA), is a chronic disease of progressive degeneration for which there is no cure, which can occur in one or more joints in the body, usually caused by overweight of the animal, longevity, instability, incongruence or by injury to the articular cartilage itself. Adult and senile dogs may be affected by this disease as a result of obesity, hormonal disease, natural wear of the joints. In this case, the most affected joint processes are in the pelvic limbs, in the knees and in the hip joint, in the thoracic limbs and in the elbow joints. This work aims to describe the Low Intensity Laser (LIL) efficacy of treatments associated with kinesiotherapy and chondroprotective drugs, performed on a female canine dog affected by this disease in her hip joint and to evaluate this methodology as one of the therapeutic choices more appropriate and less aggressive for the treatment of this disease.

Effect of Low dose Naltrexone versus Naproxen Extended-release for Pain Relief in knee osteoarthritis, a Triple-blinded, Non-inferiority Phase II Randomized Controlled Trial (FREEDOM) - Study Protocol

Background and objectives: Osteoarthritis (OA) is a degenerative articular disease that affects approximately 240 million people worldwide, with knee OA accounting for 80% of this burden. One of the aims of pharmacological treatment in OA is to reduce pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are effective for pain relief in OA but have considerable renal, hepatic, cardiovascular, and gastrointestinal adverse effects, with the resultant increase in morbidity and mortality. Naltrexone is an orally activated opioid antagonist that has varied dose-dependent pharmacodynamic effects: Analgesic and anti-inflammatory effects are exhibited only at low dosage ranges of 0.5mg to 4.5mg (Low Dose Naltrexone LDN) while retaining a favorable adverse effect profile. This study aims to test the non-inferiority of LDN against Naproxen. Methodology: This is a prospective phase II triple-blinded, two-arm, parallel-group, non-inferiority randomized controlled trial. The intervention group will receive low dose naltrexone 4.5 mg once daily, and the control group will receive extended-release naproxen 1000 mg once daily during the 12 week trial duration. Our sample size will be 118 patients recruited from a single Orthopedic referral center in the USA. Discussion: The use of LDN for pain relief in osteoarthritis (OA) may be beneficial due to its favorable adverse effect profile. To the best of our knowledge, there is no published data on LDN use in OA even though preliminary evidence has documented its safety and tolerability in a variety of chronic pain conditions.

Bilateral pyelonephritis due to Escherichia coli infection in a captive jaguar (Panthera onca)

ABSTRACT: Extraintestinal pathogenic Escherichia coli (ExPEC) is a highly diverse pathotype of E. coli which colonizes the intestine, and it is considered an important etiological agent associated with bacteremia and other systemic infections, among them urinary tract infection. Retrospective studies evaluating morbidity and mortality of nondomestic felids have demonstrated that urinary tract diseases are among the main causes of death for geriatric animals. Also, mesenchymal neoplasms of the uterus are common in wild felids, and they possess variable morphologic characteristics related to invasiveness and malignancy. This report describes a case of bilateral pyelonephritis due to extraintestinal uropathogenic E. coli infection in a captive jaguar (Panthera onca). The diagnosis was confirmed through pathological, bacterial and immunohistochemical findings. According to molecular analysis, this E. coli strain was classified in the phylogroup F, possessing the following virulence-associated genes: usp, cnf-1, hlyA, papC and sfa. Additionally, this E. coli was highly resistant to β-lactams and first-generation cephalosporin. This jaguar also presented a uterine leiomyoma with distinct distribution, and severe degenerative articular disease, both of them described as frequently seen lesions in geriatric animals from the Panthera genus.

What Is the Survivorship After Hip Arthroscopy for Femoroacetabular Impingement? A Large-database Study.

Patients with femoroacetabular impingement (FAI) may experience lasting clinical improvement after hip arthroscopy; however, some patients will still eventually undergo early conversion to THA due to unresolved symptoms and progression of arthritis. However, the risk of this has been only incompletely characterized in prior studies. Using a large healthcare claims database over a 5-year period (2011-2016), we asked: (1) What is the survivorship free from THA after arthroscopic osteoplasty performed for FAI? (2) What identifiable demographic factors and patient characteristics are associated with early conversion to THA after hip arthroscopy performed for FAI? We included all patients who underwent hip arthroscopy for FAI, between the ages of 12 years and 63 years, with 3 months of claims data before hip arthroscopy and minimum 2-year follow-up. A total of 4730 hip arthroscopy patients from 2011 to 2014 were retrieved from a US commercial claims database. Hip arthroscopy incidence doubled over time from 1.2 to 2.1 persons per 100,000. Temporal trends, patient demographics, diagnoses at time of arthroscopy, and patient comorbidities were retrieved and logistic regression performed. Survivorship analysis on 11,323 patients (lifting the 2-year follow-up requirement) was also performed to identify independent variables associated with early risk of conversion to THA. In patients undergoing hip arthroscopy for FAI, the overall proportion of conversion to THA within 2 years after hip arthroscopy was 7% (338 of 4730). After controlling for confounding variables such as sex, obesity, and depression, we found the following were independently associated with increased odds of conversion to THA: older age (odds ratio 1.08 [95% CI 1.01 to 1.10]; p < 0.001), osteoarthritis (OR 2.91 [95% CI 2.27 to 3.77]; p < 0.001), joint inflammation (OR 1.89 [95% CI 1.16 to 3.09]; p = 0.01), and a history of opioid use (OR 2.17 [95% CI 1.69 to 2.79]; p < 0.001). Survivorship analysis similarly revealed that older age (hazard ratio 1.08 [95% CI 1.07 to 1.09]; p < 0.001), osteoarthritis (HR 2.53 [95% CI 2.13 to 3.01]; p < 0.001), joint inflammation (HR 1.53 [95% CI 1.10 to 2.11]; p = 0.01), a history of opioid use (HR 2.02 [95% CI 1.71 to 2.38]; p < 0.001), and smoking (HR 1.55 [95% CI 1.14 to 2.11]; p = 0.005), were independently associated with increased odds of conversion to THA within 2 years after hip arthroscopy for FAI. Although the findings of this study are limited and should not be taken in isolation, patients with FAI who are older, carry diagnoses of inflammatory or degenerative articular disease, or who use opioids or smoke should be counseled about a potentially increased risk of undergoing early conversion to THA after hip arthroscopy. Future studies to further examine the effect of these diagnoses in prospectively collected cohorts, incorporating radiographic and patient-reported outcome measures, are needed. Level III, prognostic study.

The Role of Inflammatory Cytokine and Inflammatory Regulator Protein Related to Severity of Joint Effusion in Osteoarthritis

BACKGROUND: Osteoarthritis (OA) is an inflammatory degenerative articular disease characterized by damage narrowing the joint gap, pain, and loss of joint function. Joint effusion is a clinical feature often found in OA patients and believed to be directly proportional to the levels of pro-inflammatory cytokine, tumor necrosis factor (TNF)-alpha, and interleukin 1B (IL-1B), and various other regulatory proteins such as transcription factor proteins, nuclear factor of activated T-cells 1 (NFATC1), and chromosome 1 open reading frame 38 (C1orf38).&#x0D; AIM: The aim of the study was to explore the role of pro-inflammatory cytokine expression (TNF-alpha and IL-1B) and transcription regulatory proteins (NFATC1 and C1orf38) with the severity of joint effusion in OA patients.&#x0D; METHODS: This study was an observational study with a case series study approach. A total of 80 study subjects with OA joint effusions were included in the study. The diagnosis of OA was based on clinical and radiologic assessment from American College of Rheumatology. Data of clinical severity were assessed with Kellgren-Lawrence criteria, stroke test score, and Tegner Lysholm Knee Scoring Scale. Random blood examination was performed to obtain erythrocyte sedimentation rate (ESR) and qualitative C-reactive protein to evaluate the level of inflammation in the body. TNF-alpha, IL-1B, NFATC1, and C1orf38 levels were assessed in joint fluid using the enzyme-linked immunosorbent assay method. The correlation was analyzed with the Pearson correlation test (p = 0.05).&#x0D; RESULTS: The severity of OA joint effusion was not correlated to ESR (p adjusted = 0.169; r = 0.078), TNF-alpha (p adjusted = 0.112; r = −0.087), IL-1B (p adjusted = 0.136, r = −0.078), C1orf38 (p adjusted = 0.121; r = −0.088), and NFATC1 (p adjusted = 0.102; r = −0.081).&#x0D; CONCLUSION: Pro-inflammatory cytokines of TNF-alpha and IL-1B, and the transcription factors of pro-inflammatory cytokines gene expression, NFATC1, and C1orf38, did not correlate with the severity of joint effusion in OA.

Cocktail of Hyaluronic Acid and Human Amniotic Mesenchymal Cells Effectively Repairs Cartilage Injuries in Sodium Iodoacetate-Induced Osteoarthritis Rats.

Osteoarthritis (OA) is one of the most common refractory degenerative articular cartilage diseases. Human amniotic mesenchymal cells (hAMSCs) have emerged as a promising stem cell source for cartilage repair, and hyaluronic acid (HA) has proven to be a versatile regulator for stem cell transplantation. Herein, an effective and straightforward intra-articular injection therapy using a cocktail of hAMSCs and HA was developed to treat knee OA in a rat model. The injured cartilage was remarkably regenerated, yielding results comparable to normal cartilage levels after 56 days of treatment. Both hAMSCs and HA were indispensable organic components in this therapy, in which HA could synergistically enhance the effects of hAMSCs on cartilage repair. The regenerative mechanism was attributed to the fact that the addition of HA comprehensively enhances the activities of hAMSCs, including chondrogenic differentiation, proliferation, colonization, and regenerative modulation. This cocktail paves a new avenue for injection therapy to treat OA, holding the potential to realize rapid clinical translation.

Chondro-protective effects of celastrol on osteoarthritis through autophagy activation and NF-κB signaling pathway inhibition.

Osteoarthritis (OA) is a degenerative articular cartilage disease accompanied by superfluous apoptosis of chondrocytes in the elderly. Celastrol is a potent bioactive medicine which can exert anti-inflammatory and anti-oxidative effects in various diseases. This study aimed to elucidate the possible role of celastrol in OA as well as the specific mechanism of celastrol in vitro and in vivo. Autophagy-related biomarkers and apoptotic molecules were evaluated by PCR, Western blot and immunofluorescence staining. The level of autophagy was assessed by MDC staining and transmission electron microscopy. To study the downstream signaling pathway, nuclear factor kappa B (NF-κB) signaling pathway-related proteins were examined by Western blot. Moreover, an anterior cruciate ligament transection (ACLT) rat model was established to observe the protective effect of celastrol on rat cartilage. We found celastrol ameliorated IL-1β-induced chondrocyte apoptosis and increased the expression of LC3-II and Beclin-1. In addition, the suppression of celastrol-induced autophagy by 3-methyladenine (3MA) prevented the protective effect of celastrol in chondrocytes. Moreover, celastrol decreased the IL-1β-stimulated phosphorylation degree of IκBα and P65. We also found PDTC (a known NF-κB pathway inhibitor) can promote the activation of autophagy and attenuate the apoptosis of chondrocytes. Meanwhile, the results of rat ACLT model revealed the same effect as in vitro experiments. In summary, celastrol protected against chondrocyte apoptosis by promoting autophagy and inhibiting NF-κB signaling pathway in vitro and in vivo.

Effects of combination therapy and infrared radiation on pain, physical function, and quality of life in subjects with knee osteoarthritis: A randomized controlled study.

Background:Knee osteoarthritis (KOA) is a common degenerative articular disease that causes disability and poor quality of life (QoL) of the individuals. Electrotherapeutic agents such as therapeutic ultrasound (US), interferential current (IFC), and infrared radiation are used in the treatment. It is not clear which of these agents is the best in improving these variables.Objective:The study aimed to compare the effects of the combined application of US and IFC therapies and infrared radiation on pain, functional activities, and QoL in people with KOA.Methods:In a randomized controlled study, 60 participants were randomized into two groups, the combination therapy group (CTG) and the infrared radiation group (IRG). Each group received 15-min treatment three times per week for 12 weeks. The visual analog scale (VAS) was used to assess the pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functional activities and the Short Form Health Survey questionnaire for QoL.Results:Participants in the CTG had a significant reduction in pain and significant improvement in functional activities and QoL compared to the IRG.Conclusion:The results of this study support the use of the combination of IFC and US therapies to reduce pain and improve function and QoL for KOA patients.

Thumbs up: Imagined hand movements counteract the adverse effects of post-surgical hand immobilization. Clinical, behavioral, and fMRI longitudinal observations.

Motor imagery (M.I.) training has been widely used to enhance motor behavior. To characterize the neural foundations of its rehabilitative effects in a pathological population we studied twenty-two patients with rhizarthrosis, a chronic degenerative articular disease in which thumb-to-fingers opposition becomes difficult due to increasing pain while the brain is typically intact. Before and after surgery, patients underwent behavioral tests to measure pain and motor performance and fMRI measurements of brain motor activity.After surgery, the affected hand was immobilized, and patients were enrolled in a M.I. training. The sample was split in those who had a high compliance with the program of scheduled exercises (T+, average compliance: 84%) and those with low compliance (T−, average compliance: 20%; cut-off point: 55%). We found that more intense M.I. training counteracts the adverse effects of immobilization reducing pain and expediting motor recovery. fMRI data from the post-surgery session showed that T+ patients had decreased brain activation in the premotor cortex and the supplementary motor area (SMA); meanwhile, for the same movements, the T− patients exhibited a reversed pattern. Furthermore, in the post-surgery fMRI session, pain intensity was correlated with activity in the ipsilateral precentral gyrus and, notably, in the insular cortex, a node of the pain matrix.These findings indicate that the motor simulations of M.I. have a facilitative effect on recovery by cortical plasticity mechanisms and optimization of motor control, thereby establishing the rationale for incorporating the systematic use of M.I. into standard rehabilitation for the management of post-immobilization syndromes characteristic of hand surgery.

Effectiveness of behaviour change techniques in physiotherapy interventions to promote physical activity adherence in patients with osteoarthritis: a systematic review

Purpose: Osteoarthritis is a common degenerative articular disease, the highest cause of individual level disability and a significant socio-economic burden to healthcare services in the United Kingdom. Patient education and physical activity prescription are recommended components of interventions in several healthcare guidelines. However, these interventions lack long term clinical effectiveness. Patient adherence to physical activity prescription requires patients to modify their physical activity behaviour and appears critical in maintaining symptomatic improvements. Physiotherapists are the largest healthcare provider of exercise prescription in the National Health Service and well placed to provide physical activity interventions incorporating behaviour change techniques (BCTs). The objective of this study was to identify BCTs used in physiotherapy interventions to improve physical activity adherence in lower limb osteoarthritis patients and evaluate their effectiveness.