Synovial Joints Research Articles

Arthroscopy With Adipose-Derived Stromal Vascular Fraction Using a Selective Tissue Engineering Photo-Stimulation Technique for the Treatment of Mild to Moderate Knee Osteoarthritis

Osteoarthritis (OA) is characterized by articular cartilage degeneration, synovial inflammation, and subchondral bone thickening, affecting the synovial joint as an organ and leading to pain and disability. Subcutaneous stromal vascular fraction is safe and relieves pain, improves function, and repairs cartilage defects in patients with knee OA. Our goal is to describe step-by-step the arthroscopic treatment of mild to moderate knee OA with photo-stimulated stromal vascular fraction harvested from the thigh using a selective tissue engineering photo-stimulation (“One S.T.E.P.”) technique.

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.

Chronic multiarticular tophaceous gout with abnormally large tophi, case of surgical intervention: a case report from Nepal

Introduction and importance: Gout is an inflammatory disease caused by the deposition of monosodium urate monohydrate crystals around the synovial joints, affecting the first metatarsophalangeal joints followed by ankle and knees. It is found to be more prevalent among men and older women. Tophi tends to develop if the acute phase of the disease is not controlled. In contrast, our patient had an unusual presentation of multiple tophi affecting several joints accompanied by deformities. Case presentation: Here, the authors present a case of a 63 years old male with chronic multiarticular tophaceous gout with a history of more than 30 years. He presented with multiple joint deformities and prior surgical history of excision of tophi. Laboratory reports revealed elevated serum uric acid, and X-ray showed joint deformities with tophi. However, the parameters of renal function test were normal. Surgical excision of the tophi was done. Clinical discussion: Gout is one of the most common inflammatory arthritis, which if untreated can progress to tophi formation. The diagnosis can be made clinically and by several investigations including serum uric acid estimation and aspiration of the joint to reveal monosodium urate monohydrate crystals. A long standing case of multiarticular tophi causing joint deformities does require surgical intervention. Conclusion: Early treatment and diagnosis of hyperuricemia prevent the progression to gouty arthritis and tophi formation. Long history of multiple tophaceous gout is an unusual presentation, which we intend to present here as a novel case report. Nevertheless, such cases require surgical interventions.

Efficacy of lymphatic pump treatment in conjunction with methotrexate on rats with adjuvant-induced arthritis

Abstract Rheumatoid Arthritis (RA) is an autoimmune disease targeting synovial joints in which self-reactive T cells release cytokines and B cells produce self-reactive antibodies resulting in an inflammatory response. Lymphatic pump treatment (LPT) promotes lymphatic flow resulting in a flushing out of the immune-complexes and cytokines. A rat mode on RA (AIA) was used to determine whether LPT in conjunction with the anti-rheumatic drug, methotrexate (MTX), enhanced its therapeutic impact on RA. A preventative study was performed in which MTX was given along with LPT (3 times a day for 7 days) . Ankles were assessed daily for signs of inflammation. Flow cytometry was performed on spleen and popliteal lymph nodes (PLN) to determine changes in leukocyte populations. Cytokine levels were determined on ankle lysates. The study showed that MTX treatment delayed the onset of arthritis. MTX reduced the spleen weights (p<0.05). LPT also reduced spleen weights but did not enhance the MTX reduction. LPT reduced PLN weights compared to MTX. MTX resulted in higher numbers of CD4+ T cells and lower numbers of CD8+ T cells and B cells in spleens. PLNs treated with MTX had reduced lymphocyte numbers. MTX treatment reduced CINC-1 and TNFa levels (p<0.05). LPT also reduced CINC-1 levels. In conclusion, MTX treatments delayed arthritis formation in AIA rats while LPT affected both spleen and PLN weights. Thus, the addition of LPT to RA treatment showed potential benefits without negative effects.

Knowledge and Awareness of Rheumatoid Arthritis among the Population of Al Qunfudhah, Saudi Arabia: A Cross-sectional Study

Abstract Introduction: Rheumatoid arthritis (RA), a chronic autoimmune ailment, incites inflammation and degradation of joint synovium, predominantly impacting hands, wrists, and knees. It elicits joint pain, swelling, and potential complications such as deformities, carpal tunnel syndrome, pericarditis, pleuritis, anemia, and uveitis. Evaluating RA knowledge in Al Qunfudhah, Saudi Arabia, this study aims to discern its preventive implications. Methods: A descriptive cross-sectional study encompassing individuals aged 18 years and above in Al Qunfudhah, Saudi Arabia, was undertaken. An online questionnaire, informed by literature and expert consultation, covered socioeconomic–demographic details, RA history, and participant comprehension regarding disease aspects such as risk factors, symptoms, and treatment. Results: A total of 441 eligible participants completed the study questionnaire. Participants’ ages ranged from 18 to 60 years with a mean age of 31.2 ± 12.8 years old. Exact of 250 (56.7%) participants were females. A total of 229 (51.9%) had an overall good knowledge of RA and 212 (48.1%) had a poor knowledge level. High education showed a significant association with participants’ knowledge level (P < 0.05). Conclusion: Approximately half of the study participants demonstrated a sufficient understanding of RA, notably among those with higher education, especially in the health-care sector. The majority accurately identified key symptoms and risk factors and acknowledged the pivotal role of rheumatologists in disease management.

Identification of Drug Related Problems (DRPs) in Rheumatoid Arthritis Patients at Palembang City Hospital

Background: Rheumatoid arthritis is a chronic systemic inflammatory arthritis disease that affects mainly synovial joints. The incident of RA can lead to the emergence of complications or comorbidities, which then allows patients to receive a variety of therapies that can trigger the incidence of DRPs during the treatment. The prevalence of RA in Indonesia itself in 2018 has reached 7.30%, with the highest percentage occurring in the elderly age group and more prevalent in women. Objective: This study aimed to determine the incidence of DRPs in RA patients in Palembang city hospitals based on the category of DRPs identified as related to drug selection and dose selection problems, as the relationship between demographic factors and the incidence of DRPs. Methods: This research is non-experimental study conducted with a retrospective cross-sectional survey. Data collection was carried out by looking at patient medical record data at X and Y Hospital in Palembang from January 2021 to March 2023. Results: The results showed that the most frequent drps in the drug selection category were drug interactions (72.03%), while in the dose selection category were insufficient dosage regimens (60.74%). The results of bivariate analysis between the incidence of DRPs and gender (p=0.809), age (p=0.879), the number of drugs used (p=0.001), and comorbidities (p=0.089). Conclusion: There is no relationship between demographic factors and comorbidities with the incidence of DRPs, and there is a relationship between the number of drugs and the incidence of DRPs.

Autoimmunity to stromal-derived autoantigens in rheumatoid ectopic germinal centers exacerbates arthritis and affects clinical response.

Ectopic lymphoid structures (ELSs) in the rheumatoid synovial joints sustain autoreactivity against locally expressed autoantigens. We recently identified recombinant monoclonal antibodies (RA-rmAbs) derived from single, locally differentiated rheumatoid arthritis (RA) synovial B cells, which specifically recognize fibroblast-like synoviocytes (FLSs). Here, we aimed to identify the specificity of FLS-derived autoantigens fueling local autoimmunity and the functional role of anti-FLS antibodies in promoting chronic inflammation. A subset of anti-FLS RA-rmAbs reacting with a 60 kDa band from FLS extracts demonstrated specificity for HSP60 and partial cross-reactivity to other stromal autoantigens (i.e., calreticulin/vimentin) but not to citrullinated fibrinogen. Anti-FLS RA-rmAbs, but not anti-neutrophil extracellular traps rmAbs, exhibited pathogenic properties in a mouse model of collagen-induced arthritis. In patients, anti-HSP60 antibodies were preferentially detected in RA versus osteoarthritis (OA) synovial fluid. Synovial HSPD1 and CALR gene expression analyzed using bulk RNA-Seq and GeoMx-DSP closely correlated with the lympho-myeloid RA pathotype, and HSP60 protein expression was predominantly observed around ELS. Moreover, we observed a significant reduction in synovial HSP60 gene expression followed B cell depletion with rituximab that was strongly associated with the treatment response. Overall, we report that synovial stromal-derived autoantigens are targeted by pathogenic autoantibodies and are associated with specific RA pathotypes, with potential value for patient stratification and as predictors of the response to B cell-depleting therapies.

Mobility and anthropometry of the sacroiliac joint: range of motion and morphological characteristics.

The sacroiliac joint (SIJ), a synovial joint with irregular surfaces, is crucial for stabilizing the body and facilitating daily activities. However, recent studies have reported that 15-30% of lower back pain can be attributed to instability in the SIJ, a condition collectively referred to as sacroiliac joint dysfunction (SIJD). The aim of this study is to investigate how the morphological characteristics of the auricular surface may influence the SIJ range of motion (ROM) and to examine differences in SIJ ROM between females and males, thereby contributing to the enhancement of SIJD diagnosis and treatment. We measured SIJ ROM using motion-analysis cameras in 24 fresh cadavers of Korean adults (13 males and 11 females). Using three-dimensional renderings of the measured auricular surface, we investigated the correlations between the morphological characteristics of the auricular surface and the ROM of the SIJ. The SIJ ROM was between 0.2° and 6.7° and was significantly greater in females (3.58° ± 1.49) compared with males (1.38° ± 1.00). Dividing the participants into high-motion (3.87° ± 1.19) and low-motion (1.13° ± 0.62) groups based on the mean ROM (2.39°) showed no significant differences in any measurements. Additionally, bone defects around the SIJ were identified using computed tomography of the high-motion group. In the low-motion group, calcification between auricular surfaces and bone bridges was observed. This suggests that the SIJ ROM is influenced more by the anatomical structures around the SIJ than by the morphological characteristics of the auricular surface.

Comparison of knee joint and temporomandibular joint development in pig embryos

Although the knee joint (KNJ) and temporomandibular joint (TMJ) all belong to the synovial joint, there are many differences in developmental origin, joint structure and articular cartilage type. Studies of joint development in embryos have been performed, mainly using poultry and rodents. However, KNJ and TMJ in poultry and rodents differ from those in humans in several ways. Very little work has been done on the embryonic development of KNJ and TMJ in large mammals. Several studies have shown that pigs are ideal animals for embryonic development research. Embryonic day 30 (E30), E35, E45, E55, E75, E90, Postnatal day 0 (P0) and Postnatal day 30 (P30) embryos/fetuses from the pigs were used for this study. The results showed that KNJ develops earlier than TMJ. Only one mesenchymal condensate of KNJ is formed on E30, while two mesenchymal condensates of TMJ are present on E35. All structures of KNJ and TMJ were formed on E45. The growth plate of KNJ begins to develop on E45 and becomes more pronounced from E55 to P30. From E75 to E90, more and more vascular-rich cartilage canals form in the cartilage regions of both joints. The cartilaginous canal of the TMJ divides the condyle into sections along the longitudinal axis of the condyle. This arrangement of cartilaginous canal was not found in the KNJ. The chondrification of KNJ precedes that of TMJ. Ossification of the knee condyle occurs gradually from the middle to the periphery, while that of the TMJ occurs gradually from the base of the mandibular condyle. In the KNJ, the ossification of the articular condyle is evident from P0 to P30, and the growth plate is completely formed on P30. In the TMJ, the cartilage layer of condyle becomes thinner from P0 to P30. There is no growth plate formation in TMJ during its entire development. There is no growth plate formation in the TMJ throughout its development. The condyle may be the developmental center of the TMJ. The chondrocytes and hypertrophic chondrocytes of the growth plate are densely arranged. The condylar chondrocytes of TMJ are scattered, while the hypertrophic chondrocytes are arranged. Embryonic development of KNJ and TMJ in pigs is an important bridge for translating the results of rodent studies to medical applications.

The Miao medicine Sidaxue alleviates rheumatoid arthritis in rats possibly by downregulating matrix metalloproteinases

To explore the inhibitory effect of Sidaxue, a traditional Miao herbal medicine formula, on articular bone and cartilage destruction and synovial neovascularization in rats with collagen-induced arthritis (CIA). In a SD rat model of CIA, we tested the effects of daily gavage of Sidaxue at low, moderate and high doses (10, 20, and 40 g/kg, respectively) for 21 days, with Tripterygium glycosides (GTW) as the positive control, on swelling in the hind limb plantar regions by arthritis index scoring. Pathologies in joint synovial membrane of the rats were observed with HE staining, and serum TNF-α and IL-1β levels were detected with ELISA. The expressions of NF-κB p65, matrix metalloproteinase 1 (MMP1), MMP2 and MMP9 at the mRNA and protein levels in the synovial tissues were detected using real-time PCR and Western blotting. Network pharmacology analysis was conducted to identify the important target proteins in the pathways correlated with the therapeutic effects of topical Sidaxue treatment for RA, and the core target proteins were screened by topological analysis. Treatment with GTW and Sidaxue at the 3 doses all significantly alleviated plantar swelling, lowered arthritis index scores, improved cartilage and bone damage and reduced neovascularization in CIA rats (P<0.05), and the effects of Sidaxue showed a dose dependence. Both GTW and Sidaxue treatments significantly lowered TNF-α, IL-1β, NF-κB p65, MMP1, MMP2, and MMP9 mRNA and protein expressions in the synovial tissues of CIA rats (P<0.05). Network pharmacological analysis identified MMPs as the core proteins associated with topical Sidaxue treatment of RA. Sidaxue alleviates articular bone and cartilage damages and reduces synovial neovascularization in CIA rats possibly by downregulating MMPs via the TNF-α/IL-1β/NF-κB-MMP1, 2, 9 signaling pathway, and MMPs probably plays a key role in mediating the effect of Sidaxue though the therapeutic pathways other than oral administration.

A novel entity of massive multifocal osteolyses in the elderly

Osteolyses are common findings in elderly patients and most frequently represent malignant or locally aggressive bone tumors, infection, inflammatory and endocrine disorders, histiocytoses, and rare diseases such as Gorham-Stout syndrome. We here report on a novel entity of massive multifocal osteolyses in both shoulders, the right hip and left knee joint and the dens of an 83-year-old patient not relatable to any previously known etiopathology of bone disorders. The soft tissue mass is of myxoid stroma with an unspecific granulomatous inflammatory process, aggressively destroying extensive cortical and cancellous bone segments and encroaching on articulating bones in diarthrodial large joints. Radiological, nuclear medical, serological, histological, and immunohistochemical analyses were incapable of further classifying the disease pattern within the existing scheme of pathology. Quantitative polymerase chain reaction and next generation sequencing revealed that mutations are not suggestive of any known hereditary or acquired bone disease. Possible treatment options include radionuclide therapy for pain palliation and percutaneous radiation to arrest bone resorption while surgical treatment is inevitable for pathological fractures. This case study shall increase the awareness of the musculoskeletal community and motivate to collect further information on this rare but mutilating disorder.

Single-cell characterisation of tissue homing CD4 + and CD8 + T cell clones in immune-mediated refractory arthritis

BackgroundImmune-mediated arthritis is a group of autoinflammatory diseases, where the patient’s own immune system attacks and destroys synovial joints. Sustained remission is not always achieved with available immunosuppressive treatments, warranting more detailed studies of T cell responses that perpetuate synovial inflammation in treatment-refractory patients.MethodsIn this study, we investigated CD4 + and CD8 + T lymphocytes from the synovial tissue and peripheral blood of patients with treatment-resistant immune-mediated arthritis using paired single-cell RNA and TCR-sequencing. To gain insights into the trafficking of clonal families, we compared the phenotypes of clones with the exact same TCRß amino acid sequence between the two tissues.ResultsOur results show that both CD4 + and CD8 + T cells display a more activated and inflamed phenotype in the synovial tissue compared to peripheral blood both at the population level and within individual T cell families. Furthermore, we found that both cell subtypes exhibited clonal expansion in the synovial tissue.ConclusionsOur findings suggest that the local environment in the synovium drives the proliferation of activated cytotoxic T cells, and both CD4 + and CD8 + T cells may contribute to tissue destruction and disease pathogenesis.

Quantification of Cartilage Poroelastic Material Properties Via Analysis of Loading-Induced Cell Death.

Articular cartilage (AC) is a load-bearing tissue that covers long bones in synovial joints. The biphasic/poroelastic mechanical properties of AC help it to protect joints by distributing loads, absorbing impact forces, and reducing friction. Unfortunately, alterations in these mechanical properties adversely impact cartilage function and precede joint degeneration in the form of osteoarthritis (OA). Thus, understanding what factors regulate the poroelastic mechanical properties of cartilage is of great scientific and clinical interest. Transgenic mouse models provide a valuable platform to delineate how specific genes contribute to cartilage mechanical properties. However, the poroelastic mechanical properties of murine articular cartilage are challenging to measure due to its small size (thickness ∼ 50 microns). In the current study, our objective was to test whether the poroelastic mechanical properties of murine articular cartilage can be determined based solely on time-dependent cell death measurements under constant loading conditions. We hypothesized that in murine articular cartilage subjected to constant, sub-impact loading from an incongruent surface, cell death area and tissue strain are closely correlated. We further hypothesized that the relationship between cell death area and tissue strain can be used-in combination with inverse finite element modeling-to compute poroelastic mechanical properties. To test these hypotheses, murine cartilage-on-bone explants from different anatomical locations were subjected to constant loading conditions by an incongruent surface in a custom device. Cell death area increased over time and scaled linearly with strain, which rose in magnitude over time due to poroelastic creep. Thus, we were able to infer tissue strain from cell death area measurements. Moreover, using tissue strain values inferred from cell death area measurements, we applied an inverse finite element modeling procedure to compute poroelastic material properties and acquired data consistent with previous studies. Collectively, our findings demonstrate in the key role poroelastic creep plays in mediating cell survival in mechanically loaded cartilage and verify that cell death area can be used as a surrogate measure of tissue strain that enables determination of murine cartilage mechanical properties.

The Effects of Splayed Lipid Molecules on Lubrication by Lipid Bilayers

The outstanding lubrication of articular cartilage in the major synovial joints such as hips and knees, essential for the joint well-being, has been attributed to boundary layers of lipids at the outer cartilage surfaces, which have very low friction mediated by the hydration lubrication mechanism at their highly hydrated exposed headgroups. However, the role of spontaneously present lipid splays—lipids with an acyl tail in each of the opposing bilayers—in modulating the frictional force between lipid bilayers has not, to date, been considered. In this study, we perform all-atom molecular dynamics simulations to quantitatively assess the significance of splayed molecules within the framework of lubricating lipid bilayers. We demonstrate that, although transient, splayed molecules significantly increase the inter-membrane friction until their retraction back into the lamellar phase, with this effect more steadily occurring at lower sliding velocities that are comparable to the physiological velocities of sliding articular cartilage.

Effect of Integrated Naturopathy Interventions on Systemic Inflammatory Markers and Quality of Life in Patients With Active Rheumatoid Arthritis: A Randomized Controlled Trial.

Rheumatoid arthritis (RA) is a chronic, systemic, polyarticular autoimmune inflammatory disease that destroys the capsule and synovial lining of joints. Antirheumatic treatment reduces disease activity and inflammation, but not all patients respond to treatment. Naturopathy, a research-based complementary and alternative medicine, may be useful in these patients, but there is little data on the effect of Naturopathy interventions on inflammation and disease activity in RA. To explore the effect of 12 weeks of integrated naturopathy interventions on disease-specific inflammatory markers and quality of life in RA patients. A total of 100 RA patients were randomized into two groups: the naturopathy group (integrated naturopathy interventions with routine medical therapy) and the control group (only with routine medical therapy). Blood samples were collected pre- and post-intervention for primary outcome measurements of systemic inflammatory markers (ESR, CRP, and IL-6). Disease activity score (DAS-28) and quality of life were used to assess disease activity and functional status using SF-36, respectively, at pre- and post-intervention time points. The results of the present study show a notable decrease in disease activity after 12 weeks of naturopathy intervention. As such, a significant decrease was found in levels of systemic inflammatory markers such as ESR (p = 0.003)and IL-6 (p < 0.001), RA disease activity score (DAS-28) (p = 0.02), and most of the components of health-related quality of life (SF 36 scores) (p < 0.05) except in vitality (p = 0.06). Conclusions: The findings of the present study suggest that integrated naturopathy treatments may have the ability to control persistent inflammation, maintain immune homeostasis, and lower disease activity.

Microenvironmental Enzyme-Responsive Methotrexate Modified Quercetin Micelles for the Treatment of Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease involving synovial inflammation and joint destruction. Although therapeutic drugs for RA have some efficacy, they usually cause severe side effects and are expensive. RA is characterized by synovial hyperplasia, intra-articular hypoxia, upregulated expression of matrix metalloproteinases, and excessive accumulation of reactive oxygen species. The adverse microenvironment further aggravates activated macrophage infiltration. Therefore, controlling the microenvironment of diseased tissues and targeting the activated macrophages have become new therapeutic targets in RA patients. Here, microenvironment-targeting micelles (PVGLIG-MTX-Que-Ms) were synthesized using the thin film hydration method. In the inflammatory microenvironment, PVGLIG was cleaved by the highly expressed MMP-2, PEG5000 was eliminated, MTX was exposed, macrophage activation was targeted, and Que enrichment was enhanced. The cytotoxicity, targeting, antioxidant, and anti-inflammatory properties of drug-loaded micelles were tested in vitro. The drug-loaded micelles were used to treat CIA rats. In vivo targeting, expression of serum inflammatory factors, immunohistochemistry of the articular cartilage, and changes in immunofluorescence staining were observed. The developed micelles had a particle size of (89.62 ±1.33) nm and a zeta potential of (-4.9 ±0.53) mV. The IC50 value of PVGLIG-MTX-Que-Ms (185.90 ±6.98) μmol/L was significantly lower than that of free Que (141.10 ±6.39) μmol/L. The synthesized micelles exhibited slow-release properties, low cytotoxicity, strong targeting abilities, and significant anti-inflammatory effects in vitro. In vivo, the drug-loaded micelles accumulated at the joint site for a long time. PVGLIG-MTX-Que-Ms significantly reduced joint swelling, improved bone destruction, and decreased the expression of serum inflammatory factors in CIA rats. The smart-targeting micelles PVGLIG-MTX-Que-Ms with strong targeting, anti-inflammatory, cartilage-protective, and other multiple positive effects are a promising new tool for RA treatment.

Nuciferine alleviates collagen-induced arthritic in rats by inhibiting the proliferation and invasion of human arthritis-derived fibroblast-like synoviocytes and rectifying Th17/Treg imbalance

Rheumatoid arthritis (RA) is a chronic autoimmune disorder marked by persistent synovial inflammation and joint degradation, posing challenges in the development of effective treatments. Nuciferine, an alkaloid found in lotus leaf, has shown promising anti-inflammatory and anti-tumor effects, yet its efficacy in RA treatment remains unexplored. This study investigated the antiproliferative effects of nuciferine on the MH7A cell line, a human RA-derived fibroblast-like synoviocyte, revealing its ability to inhibit cell proliferation, promote apoptosis, induce apoptosis, and cause G1/S phase arrest. Additionally, nuciferine significantly reduced the migration and invasion capabilities of MH7A cells. The therapeutic potential of nuciferine was further evaluated in a collagen-induced arthritis (CIA) rat model, where it markedly alleviated joint swelling, synovial hyperplasia, cartilage injury, and inflammatory infiltration. Nuciferine also improved collagen-induced bone erosion, decreased pro-inflammatory cytokines and serum immunoglobulins (IgG, IgG1, IgG2a), and restored the balance between T helper (Th) 17 and regulatory T cells in the spleen of CIA rats. These results indicate that nuciferine may offer therapeutic advantages for RA by decreasing the proliferation and invasiveness of FLS cells and correcting the Th17/Treg cell imbalance in CIA rats.

Anti-gouty arthritis and anti-inflammatory effects of curcumin nanoparticles in monosodium urate crystals induced Balb/C mice.

Gout is a metabolic condition characterized by the accumulation of urate crystals in the synovial joints. These crystal depositions result in joint swelling and increased concentration of serum uric acid in blood. The commercially available drugs lower serum uric acid levels and reduce inflammation, but these standard therapies have many side effects.This study aimed to investigate anti-gout and anti-inflammatory properties of curcumin nanoparticles (CNPs). For this purpose, CNPs were prepared by dissolving curcumin into dichloromethane. Then, gout was induced by injecting monosodium urate crystals (MSU) in the ankle joint and in the intra-peritoneal cavity which caused ankle swelling and increased blood uric acid levels. CNPs in different concentrations (5, 10, and 20ppm) and allopurinol were orally administered. The MSU crystals increased the xanthine oxidase levels both in serum and the liver. Moreover, MSU crystals increased the serum levels of interleukin 1β, interleukin-6, tumor necrosis factor-alpha, liver function tests markers, renal function tests markers, and lipid profiles. However, the administration of CNPs decreased the levels of all these variables. CNPs increased the serum high-density lipoprotein and interleukin-10 levels. Moreover, CNPs also reduced ankle swelling significantly. Hence, the levels ofxanthine oxidase, uric acid and ankle swelling were reduced significantly by oral administration of CNPs. Our findingsindicate that CNPs through their anti-inflammatory properties significantly alleviate gouty arthritis. Thus, the study concluded that CNPs can be developed as an efficient anti-gout agent with minimal side effects.

EROSIVE OSTEOARTHRITIS: A RARE CASE REPORT

Osteoarthritis, also known as OA, is a type of joint degeneration characterized by changes in the morphology and biochemistry of the synovial membrane and joint capsule, as well as degradation of cartilage joint and expansion of the marginal bone. Inflammation causes the joints to deteriorate in a subtype of osteoarthritis called erosive OA. DIP (distal interphalangeal), PIP (proximal interphalangeal), CMC (carpometacarpal) and metacarpophalangeal (MCP) joints are the most often affected joints in the hand. Other joints in other body regions are extremely seldom affected. Our patient’s diagnosis report suggests erosive osteoarthritis and seronegative arthritis as negative anti-RF factors.

Effect of Docetaxel on Matrix Metalloproteinase 1 Expression in Freund’s Adjuvant Induced Arthritis

Rheumatoid arthritis is an autoimmune disorder that affects the synovial joints. It lead to inflammatory changes occur in synovial tissue, cartilage, bone, and, less frequently, extra-articular structures. Docetaxel, is an anti-neoplastic drug. Methotrexate is a treatment for early-stage rheumatoid arthritis but have 30% failure in treatment within the first year due to resistance or side effects. Matrix metalloproteinase 1 is the proteinase primarily in charge of the irreversible degradation of cartilage, bone, and tendons in the joints, which are induced by cytokines. This study aims to evaluate the effects of docetaxel and methotrexate on Matrix metalloproteinase 1 in the structure of the induced arthritis joints. Methods: To induce the disease, complete Freund's adjuvant is injected subcutaneously into rats. From the 40 male Wister rats, five groups of eight were formed. The control group is composed of non-diseased rats. The second group is induced by complete Freund's adjuvant and 0.5 ml of normal saline was administered intraperitoneally to both the control and induction groups. After being induced by complete Freund's adjuvant, the third group is administered 1 mg/kg/ on alternate day of Docetaxel based on a preliminary experiment. The fourth group is induced and given 1 mg/kg/week of Methotrexate intraperitoneally. The fifth group receives a half dose of Methotrexate and Docetaxel simultaneously. Serum level of Anti Cyclical citrullinated Peptide Antibody, tissue homogenate level of tumor necrosis factor-alpha, knee joint circumference and Immunohistochemical of Matrix metalloproteinase 1 measurements were applied. Results: Significant decreased in the Serum level of Anti-Cyclic citrullinated Peptide Antibody, tissue homogenate level of tumor necrosis factor-alpha &amp; Knee joint circumference in the Docetaxel group. significant lowering in the expression of Matrix metalloproteinase 1 immunoreactivities in Docetaxel and Methotrexate groups with almost absent spots of positive reaction with the matrix of synovial tissue, hyaline cartilage &amp; articular surface. Conclusion: This study showed that Docetaxel may have anti-arthritic effect through their significant lowering expression of Matrix metalloproteinase 1 immunoreactivities.&#x0D; &#x0D;