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Type X collagen expression in osteoarthritic and rheumatoid articular cartilage.

Type X collagen is a short chain, non-fibril-forming collagen synthesized primarily by hypertrophic chondrocytes in the growth plate of fetal cartilage. Previously, we have also identified type X collagen in the extracellular matrix of fibrillated, osteoarthritic but not in normal articular cartilage using biochemical and immunohistochemical techniques (von der Mark et al. 1992a). Here we compare the expression of type X with types I and II collagen in normal and degenerate human articular cartilage by in situ hybridization. Signals for cytoplasmic alpha 1(X) collagen mRNA were not detectable in sections of healthy adult articular cartilage, but few specimens of osteoarthritic articular cartilage showed moderate expression of type X collagen in deep zones, but not in the upper fibrillated zone where type X collagen was detected by immunofluorescence. This apparent discrepancy may be explained by the relatively short phases of type X collagen gene activity in osteoarthritis and the short mRNA half-life compared with the longer half-life of the type X collagen protein. At sites of newly formed osteophytic and repair cartilage, alpha 1(X) mRNA was strongly expressed in hypertrophic cells, marking the areas of endochondral bone formation. As in hypertrophic chondrocytes in the proliferative zone of fetal cartilage, type X collagen expression was also associated with strong type II collagen expression.

Arthritis, Rheumatoid↗

Repair of articular cartilage defects: part II. Treatment options.

Articular cartilage injuries result in numerous clinical symptoms, such as pain and decreased functional levels. Current therapeutic options being used include articular surface debridement, such as chondral shaving, abrasion chondroplasty, and subchondral perforation; soft-tissue arthroplasties, such as perichondrial and periosteal grafts; and osteochondral transplantation. None of these therapies, however, has resulted in the successful regeneration of a hyaline-like tissue that withstands normal joint loading and activity over prolonged periods. As a result, research is also being conducted on alternative therapeutic procedures to enhance the repair process and to stimulate the regeneration of a repair tissue with hyaline-like structural and biologic properties. Part I of this paper, which was published in January, discussed the basic science of cartilage healing. Part II presents the treatment options.

Animals↗

The accuracy and reliability of a novel handheld dynamic indentation probe for analysing articular cartilage.

This study investigates the accuracy and reliability of a novel handheld indentation system designed to ascertain the dynamic biomechanical properties of articular cartilage. A series of standard elastomers were assessed with both the handheld indentation system and a bench-top dynamic indentation system to assess the accuracy of the instrument. Interoperator and intraoperator experiments were undertaken to investigate the reliability of the system when used by an individual operator and by five different operators. Intraclass coefficients (Rho) were derived using a random effects model. The system was then used to ascertain the topographical variation in the shear moduli and phase lag of articular cartilage across normal ovine tibial plateaux. The system was shown to be highly accurate (R2 = 0.97), and had excellent reliability when measuring the dynamic shear modulus of articular cartilage (interoperator Rho = 0.75, intraoperator Rho = 0.79). Measurement of static shear modulus was less reliable (interoperator Rho = 0.15, intraoperator Rho = 0.52), but may be improved by monitoring the load applied to the instrument by the operator. The instrument was used to differentiate between different regions of cartilage and generated a topographical map of an ovine tibial plateau. The cartilage located beneath the menisci was 200-500% stiffer than the cartilage that was not covered by the menisci, while the phase lag was almost constant (10+/-2 SD) over the entire tibial plateau. The system was shown to be an accurate and reliable tool for rapidly assessing the dynamic biomechanical properties of articular cartilage, while being small enough to be used arthroscopically.

Animals↗

[MR imaging of the articular cartilage].

MR imaging has evolved to the best non-invasive method for the evaluation of articular cartilage. MR imaging helps to understand the structure and physiology of cartilage, and to diagnose cartilage lesions. Numerous studies have shown high accuracy and reliability concerning detection of cartilage lesions and early changes in both structure and biochemistry. High contrast-to-noise ratio and high spatial resolution are essential for analysis of articular cartilage. Fat-suppressed 3D-T1 weighted gradient echo and T2-weighted fast spin echo sequences with or without fat suppression are recommended for clinical routine. In this article the anatomy and pathology of hyaline articular cartilage and the complex imaging characteristics of hyaline cartilage will be discussed.

Arthrography↗

Does protein kinase R mediate TNF-alpha- and ceramide-induced increases in expression and activation of matrix metalloproteinases in articular cartilage by a novel mechanism?

We investigated the role of the proinflammatory cytokine TNF-alpha, the second messenger C2-ceramide, and protein kinase R (PKR) in bovine articular cartilage degradation. Bovine articular cartilage explants were stimulated with C2-ceramide or TNF-alpha for 24 hours. To inhibit the activation of PKR, 2-aminopurine was added to duplicate cultures. Matrix metalloproteinase (MMP) expression and activation in the medium were analysed by gelatin zymography, proteoglycan release by the dimethylmethylene blue assay, and cell viability by the Cytotox 96(R) assay. C2-ceramide treatment of cartilage explants resulted in a significant release of both pro- and active MMP-2 into the medium. Small increases were also seen with TNF-alpha treatment. Incubation of explants with 2-aminopurine before TNF-alpha or C2-ceramide treatment resulted in a marked reduction in expression and activation of both MMP-2 and MMP-9. TNF-alpha and C2-ceramide significantly increased proteoglycan release into the medium, which was also inhibited by cotreatment with 2-aminopurine. A loss of cell viability was observed when explants were treated with TNF-alpha and C2-ceramide, which was found to be regulated by PKR. We have shown that C2-ceramide and TNF-alpha treatment of articular cartilage result in the increased synthesis and activation of MMPs, increased release of proteoglycan, and increased cell death. These effects are abrogated by treatment with the PKR inhibitor 2-aminopurine. Collectively, these results suggest a novel role for PKR in the synthesis and activation of MMPs and support our hypothesis that PKR and its activator, PACT, are implicated in the cartilage degradation that occurs in arthritic disease.

Journal Article↗

T(2) relaxation time mapping reveals age- and species-related diversity of collagen network architecture in articular cartilage.

OBJECTIVE: The magnetic resonance imaging (MRI) parameter T(2) relaxation time has been shown to be sensitive to the collagen network architecture of articular cartilage. The aim of the study was to investigate the agreement of T(2) relaxation time mapping and polarized light microscopy (PLM) for the determination of histological properties (i.e., zone and fibril organization) of articular cartilage. METHODS: T(2) relaxation time was determined at 9.4 T field strength in healthy adult human, juvenile bovine and juvenile porcine patellar cartilage, and related to collagen anisotropy and fibril angle as measured by quantitative PLM. RESULTS: Both T(2) and PLM revealed a mutually consistent but varying number of collagen-associated laminae (3, 3-5 or 3-7 laminae in human, porcine and bovine cartilage, respectively). Up to 44% of the depth-wise variation in T(2) was accounted for by the changing anisotropy of collagen fibrils, confirming that T(2) contrast of articular cartilage is strongly affected by the collagen fibril anisotropy. A good correspondence was observed between the thickness of T(2)-laminae and collagenous zones as determined from PLM anisotropy measurements (r=0.91, r=0.95 and r=0.91 for human, bovine and porcine specimens, respectively). CONCLUSIONS: According to the present results, T(2) mapping is capable of detecting histological differences in cartilage collagen architecture among species, likely to be strongly related to the differences in maturation of the tissue. This diversity in the MRI appearance of healthy articular cartilage should also be recognized when using juvenile animal tissue as a model for mature human cartilage in experimental studies.

Adult↗

The injury and repair of human articular cartilage: a morphological study of 192 cases of coxarthrosis.

The examination of articular cartilage from 192 osteoarthritic hip joints has shown a combination of cell and matrix injury on the one hand and cell and matrix regeneration on the other. The reparative cartilage tissue has three sources, bone, synovium and cartilage, which are both intrinsic and extrinsic. The observation of reparative cartilage in every case examined, and of significant amounts in more than 50% of the cases, indicates that the cartilage has considerable potential for repair. In particular, intrinsic repair which is of cartilage origin, in our opinion, has a very significant role in the articular cartilage.

Bone Regeneration↗

Sacral and iliac articular cartilage thickness and cellularity: relationship to subchondral bone end-plate thickness and cancellous bone density.

OBJECTIVES: To measure the thickness and cellularity of adult human sacral and iliac articular cartilages and the thickness and density of the subchondral bones. METHODS: The right sacroiliac joints of 15 adult patients were examined post-mortem. HOME (Highly Optimized Microscope Environment) microscopy was used to measure articular cartilage and subchondral bone end-plate thickness. Conventional morphometric techniques were employed to estimate cartilage cellularity and cancellous bone density. RESULTS: Sacral articular cartilage was thicker than iliac (1.81 vs 0.80 mm, P<0.001). Iliac cartilage cell density in all zones was higher than sacral. The overall mean was 31.19 x 10(-3) vs. 23.23 x 10(-3)/mm(3), P<0.001. Superficial zones contained more cells than middle and deep zones but there were large differences between the cell numbers of the middle and deep zones of both sacral and iliac cartilages. Iliac subchondral bone end-plates were thicker than sacral (0.36 vs 0.23 mm, P<0.001). The thickness of these plates was related inversely to that of the overlying articular cartilages. Iliac subchondral cancellous bone was twice as dense as sacral (22.07 vs. 12.05%, P<0.001), a ratio recognized anteriorly, centrally and posteriorly. CONCLUSIONS: Adult human sacral cartilage is thick and of low cell density. It rests upon a thin bone end-plate supported by porous, cancellous bone. Iliac cartilage and bone display the converse proportions. The identification of these variables may assist understanding of normal sacroiliac joint function and the interpretation of tissue changes in the spondylarthropathies.

Adult↗

Quantitative analysis of crosslinks pyridinoline and pentosidine in articular cartilage of patients with bone and joint disorders.

OBJECTIVE: To determine the content of two crosslinks, pyridinoline (a mature crosslink) and pentosidine (a senescent crosslink), in human articular cartilage, and to examine the effect of bone and joint disorders on the content of those crosslinks in articular cartilage. METHODS: After pretreatment with SP-Sephadex C-25, high-performance liquid chromatography was conducted on a hydrolysate of human articular cartilage from 53 patients with one of the following diseases: osteoarthritis (OA), rheumatoid arthritis (RA), osteoporosis, femoral head necrosis, and renal osteodystrophy (ROD). RESULTS: Pyridinoline levels were either unchanged with age or were slightly decreased in elderly patients. Pentosidine levels increased with age in the entire patient population. There was no significant difference in the pyridinoline content among the study groups, but there was a significant difference in pentosidine content (P < 0.001). ROD patients had the highest mean level of pentosidine (407 mumoles/mole of hydroxyproline), and RA patients had a higher mean level than age-matched OA patients (214 versus 103 mumoles/mole of hydroxyproline). CONCLUSION: Bone and joint disorders do not affect the pyridinoline content in articular cartilage, but they do not affect the pentosidine content.

Adult↗

Immune deposits in articular cartilage of patients with rheumatoid arthritis have a granular pattern not seen in osteoarthritis.

Frozen sections of articular cartilage, obtained from patients with rheumatoid arthritis (RA) or osteoarthritis (OA) undergoing joint replacement, were stained with fluoresceinated specific antisera to IgG, IgM, IgA, C1q, C4, and C3. Specimens positive for IgG were examined for IgG subclasses using mouse monoclonal antibodies. IgG was present in 22 of 34 cartilage specimens obtained from patients with RA, and in 14 of these 22 patients, a granular pattern was present. IgM, IgA, C1q, and C3 when present showed a similar granular pattern. In articular cartilage of patients with RA, all IgG subclasses tended to be present. The remaining eight specimens positive for IgG from patients with RA had staining patterns also seen in patients with OA. IgG staining was present in 31 of 117 cartilage specimens obtained from patients with OA and none had the granular pattern seen in RA. Intermittent linear staining at the surface was the most common pattern seen in cartilage from patients with OA. The different patterns of immune deposits in articular cartilage in RA and OA suggest that antibodies with different specificities are present or that different mechanisms of immune deposit formation exist in these disorders.

Antibodies, Monoclonal↗

Surface extraction and thickness measurement of the articular cartilage from MR images using directional gradient vector flow snakes.

The accuracy of the surface extraction of magnetic resonance images of highly congruent joints with thin articular cartilage layers has a significant effect on the percentage errors and reproducibility of quantitative measurements (e.g., thickness and volume) of the articular cartilage. Traditional techniques such as gradient-based edge detection are not suitable for the extraction of these surfaces. This paper studies the extraction of articular cartilage surfaces using snakes, and a gradient vector flow (GVF)-based external force is proposed for this application. In order to make the GVF snake more stable and converge to the correct surfaces, directional gradient is used to produce the gradient vector flow. Experimental results show that the directional GVF snake is more robust than the traditional GVF snake for this application. Based on the newly developed snake model, an articular cartilage surface extraction algorithm is developed. Thickness is computed based on the surfaces extracted using the proposed algorithm. In order to make the thickness measurement more reproducible, a new thickness computation approach, which is called T-norm, is introduced. Experimental results show that the thickness measurement obtained by the new thickness computation approach has better reproducibility than that obtained by the existing thickness computation approaches.

Algorithms↗

Comparison of the equilibrium response of articular cartilage in unconfined compression, confined compression and indentation.

At mechanical equilibrium, articular cartilage is usually characterized as an isotropic elastic material with no interstitial fluid flow. In this study, the equilibrium properties (Young's modulus, aggregate modulus and Poisson's ratio) of bovine humeral, patellar and femoral cartilage specimens (n=26) were investigated using unconfined compression, confined compression, and indentation tests. Optical measurements of the Poisson's ratio of cartilage were also carried out. Mean values of the Young's modulus (assessed from the unconfined compression test) were 0.80+/-0.33, 0.57+/-0.17 and 0.31+/-0.18MPa and of the Poisson's ratio (assessed from the optical test) 0.15+/-0.06, 0.16+/-0.05 and 0.21+/-0.05 for humeral, patellar, and femoral cartilages, respectively. The indentation tests showed 30-79% (p<0.01) higher Young's modulus values than the unconfined compression tests. In indentation, values of the Young's modulus were independent of the indenter diameter only in the humeral cartilage. The mean values of the Poisson's ratio, obtained indirectly using the mathematical relation between the Young's modulus and the aggregate modulus in isotropic material, were 0.16+/-0.06, 0.21+/-0.05, and 0.26+/-0.08 for humeral, patellar, and femoral cartilages, respectively. We conclude that the values of the elastic parameters of the cartilage are dependent on the measurement technique in use. Based on the similar values of Poisson's ratios, as determined directly or indirectly, the equilibrium response of articular cartilage under unconfined and confined compression is satisfactorily described by the isotropic elastic model. However, values of the isotropic Young's modulus obtained from the in situ indentation tests are higher than those obtained from the in vitro unconfined or confined compression tests and may depend on the indenter size in use.

Animals↗

Immunolocalization of stromelysin, tumor necrosis factor (TNF) alpha, and TNF receptors in atrophied canine articular cartilage treated with hyaluronic acid and transforming growth factor beta.

OBJECTIVE: To evaluate the ability of hyaluronic acid (HA), with and without transforming growth factor beta (1GF-beta), to stabilize the catabolic processes associated with atrophy of articular cartilage. ANIMALS: 20 adult, skeletally normal, hound-type dogs. PROCEDURE: Dogs (20 to 30 kg) were randomly assigned to 1 of 5 groups. One group served as untreated controls. Bivalve casts were placed on the left hind limbs of the remaining 16 dogs to limit weightbearing and motion of the limb for 92 days. One group served as the cast control. Beginning on day 56, 3 groups received aseptic intra-articular injections in the left stifles of either 5 mg of HA or 5 mg of HA containing either 20 or 50 micrograms of TGF-beta. Intraarticular injections were repeated at 4-day intervals until the end of the study. Or day 92, stifles were harvested at necroscropy. Medial femoral condyle were histologically processed, and the articular cartilage was stained for the presence of proteoglycans, stromelysin, tumor necrosis facto (TNF) alpha, and TNF receptors (p55 and p75). RESULTS: Decreased metachromasia was evident in the cartilage matrix of all cast groups, with the smallest decrease in the HA-treated group. Stromelysin was immunolocalized in articular cartilage of the cast (left) limbs of cast control and both HA/TGF-beta-treated groups. TNF-alpha was localized in articular cartilage of all cast (left) and right limbs, except those of the HA-treated group. Receptors for TNF were observed in both limbs of untreated control and cast control groups and cast limbs of HA/TGF-3-treated groups. The receptors were not localized in the right limbs of the HA with or without TGF-beta-treated groups. TGF-beta did not decrease stromelysin or TNF-alpha or receptors at the doses used. CONCLUSIONS: HA may mediate a chondrostabilizing influence on articular cartilage by down-regulating TNF-alpha importantly. HA appeared to exert its inhibitory influence on TNF-alpha, as well as stromelysin and TNF receptors, on a systemic basis. CLINICAL RELEVANCE: Results provide insight into the mode of action of HA as a therapeutic agent for arthritis and its stabilizing influence on cartilage metabolism.

Animals↗

Effects of insulin-like growth factor-II on the mitogenic and metabolic activities of equine articular cartilage with and without interleukin 1-beta.

OBJECTIVE: To investigate the effects of insulin-like growth factor-II (IGF-II) on DNA and glycosaminoglycan (GAG) synthesis and the expression of matrix-related genes in equine articular cartilage explants and chondrocytes, respectively, with and without interleukin 1-beta (IL1-beta). SAMPLE POPULATION: Articular cartilage from 12 adult horses. PROCEDURE: Articular cartilage was incubated in standard media with and without equine IL1-beta (10 ng/mL) containing various concentrations of IGF-II for 72 hours. Synthesis of DNA and GAG was determined by incorporation of thymidine labeled with radioactive hydrogen (3H) and sulfate labeled with radioactive sulfur (35S), respectively. Total GAG content of the explants and spent media was determined by use of the 1,9-dimethylmethylene blue assay. Northern blots of RNA from cultured equine articular cartilage chondrocytes were hybridized with cDNA of major matrix molecules. RESULTS: Insulin-like growth factor-II stimulated DNA and GAG synthesis at concentrations of 25 and 50 ng/mL, respectively. In cartilage explants conditioned with IL1-beta, IGF-II stimulated DNA and GAG synthesis at concentrations of 500 and 50 ng/mL, respectively. Insulin-like growth factor-II had no effect on total GAG content as determined by the 1,9-dimethylmethylene blue assay. No specific effects on steady-state levels of messenger RNAs were observed. CONCLUSIONS AND CLINICAL RELEVANCE: Insulin-like growth factor-II stimulated DNA and GAG synthesis in equine adult cartilage and may have potential application in vivo.

Analysis of Variance↗

Unconfined compression of articular cartilage: nonlinear behavior and comparison with a fibril-reinforced biphasic model.

Mechanical behavior of articular cartilage was characterized in unconfined compression to delineate regimes of linear and nonlinear behavior, to investigate the ability of a fibril-reinforced biphasic model to describe measurements, and to test the prediction of biphasic and poroelastic models that tissue dimensions alter tissue stiffness through a specific scaling law for time and frequency. Disks of full-thickness adult articular cartilage from bovine humeral heads were subjected to successive applications of small-amplitude ramp compressions cumulating to a 10 percent compression offset where a series of sinusoidal and ramp compression and ramp release displacements were superposed. We found all equilibrium behavior (up to 10 percent axial compression offset) to be linear, while most nonequilibrium behavior was nonlinear, with the exception of small-amplitude ramp compressions applied from the same compression offset. Observed nonlinear behavior included compression-offset-dependent stiffening of the transient response to ramp compression, nonlinear maintenance of compressive stress during release from a prescribed offset, and a nonlinear reduction in dynamic stiffness with increasing amplitudes of sinusoidal compression. The fibril-reinforced biphasic model was able to describe stress relaxation response to ramp compression, including the high ratio of peak to equilibrium load. However, compression offset-dependent stiffening appeared to suggest strain-dependent parameters involving strain-dependent fibril network stiffness and strain-dependent hydraulic permeability. Finally, testing of disks of different diameters and rescaling of the frequency according to the rule prescribed by current biphasic and poroelastic models (rescaling with respect to the sample's radius squared) reasonably confirmed the validity of that scaling rule. The overall results of this study support several aspects of current theoretical models of articular cartilage mechanical behavior, motivate further experimental characterization, and suggest the inclusion of specific nonlinear behaviors to models.

Animals↗

Articular cartilage proteoglycans in osteoarthritic STR/Ort mice.

Compared to controls, the lateral and medial tibial articular cartilage chondroitin sulfate (CS) content in male STR/Ort mice was elevated between 8 and 19 weeks of age, fell at 24-26 weeks and increased again thereafter. The CS cartilage content of CBA mice remained relatively unchanged. Cartilage CS content was measured in female CBA and STR/Ort mice and in male and female Balb C mice, all at 18 weeks of age. In every case the content was much lower than that found in male STR/Ort mice. CS unsaturated disaccharides were analysed by capillary electrophoresis after digestion of the glycosaminoglycans with chondroitinase ABC. Chondroitin-4-sulfate (C4S) was the predominant isomer at all ages in both strains. The C4S:C6S isomer ratio in CBA mice was much higher in the lateral than the medial cartilage. This difference was much less marked in STR/Ort knee joints: these mice have relatively more C6S than CBA mice. Proteoglycans, extracted from STR/Ort and CBA male mouse cartilage, were characterized by large pore gel electrophoresis and Western blotting. All cartilages contained two slow mobility bands identified as aggrecan by the reactivity with the mab 1C6. Both bands contained C4S and C6S chains. A third band of faster mobility contained only C4S and was 1C6 negative. It was present in both strains. Thus the STR/Ort cartilage contained a normal spectrum of murine articular cartilage proteoglycans.

Animals↗

High susceptibility of human articular cartilage glycosaminoglycan synthesis to changes in inorganic sulfate availability.

The effect of sulfate concentration in the medium on glycosaminoglycan synthesis in articular cartilage of five different species was examined in relation to the physiological serum sulfate concentration in these species. Only the rate of sulfated glycosaminoglycan synthesis in human articular cartilage was sensitive to small deviations from the physiological sulfate concentration. A reduction in the sulfate concentration from 0.3 mM (physiological) to 0.2 mM resulted in a 33% reduction in glycosaminoglycan synthesis. In addition, we studied the effect of arthritic and "osteoarthritic" alterations in murine cartilage on the dependence of glycosaminoglycan synthesis on low sulfate concentrations. Arthritic and "osteoarthritic" cartilage had a similar dependence on the sulfate concentration in the medium as normal cartilage. Glycosaminoglycan synthesis in human articular cartilage appears to be very sensitive to the potential sulfate-depleting effects of drugs used in the treatment of rheumatoid arthritis and osteoarthritis.

Aged↗

The role of type X collagen in facilitating and regulating endochondral ossification of articular cartilage.

UNLABELLED: AUTHOR: Shen G Objective -This review was compiled to explore the role of type X collagen in growth, development and remodeling of articular cartilage by elucidating the linkage between the synthesis of this protein and the phenotypic changes in chondrogenesis and the onset of endochondral ossification. DESIGN: The current studies closely dedicated to elucidating the role of type X collagen incorporating into chondrogenesis and endochondral ossification of articular cartilage were assessed and analyzed to allow for obtaining the mainstream consensus on the bio-molecular mechanism with which type X collagen functions in articular cartilage. RESULTS: There are spatial and temporal correlations between synthesis of type X collagen and occurrence of endochondral ossification. The expression of type X collagen is confined within hypertrophic condrocytes and precedes the embark of endochondral bone formation. Type X collagen facilitates endochondral ossification by regulating matrix mineralization and compartmentalizing matrix components. CONCLUSION: Type X collagen is a reliable marker for new bone formation in articular cartilage. The future clinical application of this collagen in inducing or mediating endochondral ossification is perceived, e.g. the fracture healing of synovial joints and adaptive remodeling of madibular condyle.

Animals↗