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He Z, Leong DJ, Xu L, Hardin JA, Majeska RJ, Schaffler MB, Thi MM, Yang L, Goldring MB, Cobelli NJ, Sun HB. CITED2 mediates the cross-talk between mechanical loading and IL-4 to promote chondroprotection. Ann N Y Acad Sci 2019; 1442:128-137. [PMID: 30891766 PMCID: PMC6956611 DOI: 10.1111/nyas.14021] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/04/2018] [Accepted: 01/16/2019] [Indexed: 01/28/2023]
Abstract
Osteoarthritis (OA) pathogenesis is mediated largely through the actions of proteolytic enzymes such as matrix metalloproteinase (MMP) 13. The transcriptional regulator CITED2, which suppresses the expression of MMP13 in chondrocytes, is induced by interleukin (IL)-4 in T cells and macrophages, and by moderate mechanical loading in chondrocytes. We tested the hypothesis that CITED2 mediates cross-talk between IL-4 signaling and mechanical loading-induced pathways that result in chondroprotection, at least in part, by downregulating MMP13. IL-4 induced CITED2 gene expression in human chondrocytes in a dose- and time-dependent manner through JAK/STAT signaling. Mechanical loading combined with IL-4 resulted in additive effects on inducing CITED2 expression and downregulating of MMP13 in human chondrocytes in vitro. In vivo, IL-4 gene knockout (KO) mice exhibited reduced basal levels of CITED2 expression in chondrocytes. While moderate treadmill running induced CITED2 expression and reduced MMP13 expression in wild-type mice, these effects were blunted (for CITED2) or abolished (for MMP13) in chondrocytes of IL-4 gene KO mice. Moreover, intra-articular injections of mouse recombinant IL-4 combined with regular cage activity mitigated post-traumatic OA to a greater degree compared to immobilized mice treated with IL-4 alone. These data suggest that using moderate loading to enhance IL-4 may be a potential therapeutic strategy for chondroprotection in OA.
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Affiliation(s)
- Zhiyong He
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
- Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
| | - Daniel J. Leong
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
- Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
| | - Lin Xu
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
- Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
| | - John A. Hardin
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
| | - Robert J. Majeska
- Department of Biomedical Engineering, The City College of New York, New York, New York
| | - Mitchell B. Schaffler
- Department of Biomedical Engineering, The City College of New York, New York, New York
| | - Mia M. Thi
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
- Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York
| | - Liu Yang
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington
| | - Mary B. Goldring
- Orthopaedic Soft Tissue Research Program, Hospital for Special Surgery, and Weill Cornell Medical College, New York, New York
| | - Neil J. Cobelli
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
| | - Hui B. Sun
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
- Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
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Liu L, He Z, Xu L, Lu L, Feng H, Leong DJ, Kim SJ, Hirsh DM, Majeska RJ, Goldring MB, Cobelli NJ, Sun HB. CITED2 mediates the mechanical loading-induced suppression of adipokines in the infrapatellar fat pad. Ann N Y Acad Sci 2019; 1442:153-164. [PMID: 30891782 DOI: 10.1111/nyas.14025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/23/2019] [Indexed: 12/12/2022]
Abstract
Adipokines secreted from the infrapatellar fat pad (IPFP), such as adipsin and adiponectin, have been implicated in osteoarthritis pathogenesis. CITED2, a mechanosensitive transcriptional regulator with chondroprotective activity, may modulate their expression. Cited2 haploinsufficient mice (Cited2+/- ) on a high-fat diet (HFD) exhibited increased body weight and increased IPFP area compared to wild-type (WT) mice on an HFD. While an exercise regimen of moderate treadmill running induced the expression of CITED2, as well as PGC-1α, and reduced the expression of adipsin and adiponectin in the IPFP of WT mice on an HFD, Cited2 haploinsufficiency abolished the loading-induced expression of PGC-1α and loading-induced suppression of adipsin and adiponectin. Furthermore, knocking down or knocking out CITED2 in adipose stem cells (ASCs)/preadipocytes derived from the IPFP in vitro led to the increased expression of adipsin and adiponectin and reduced PGC-1α, and abolished the loading-induced suppression of adipsin and adiponectin and loading-induced expression of PGC-1α. Overexpression of PGC-1α in these ASC/preadipocytes reversed the effects caused by CITED2 deficiency. The current data suggest that CITED2 is a critical regulator in physiologic loading-induced chondroprotection in the context of an HFD and PGC-1α is required for the inhibitory effects of CITED2 on the expression of adipokines such as adipsin and adiponectin in the IPFP.
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Affiliation(s)
- Lidi Liu
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York.,Department of Spine Surgery, Jilin Provincial Key Laboratory of Tissue Repair, Reconstruction and Regeneration, The First Hospital of Jilin University, Jilin, China
| | - Zhiyong He
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
| | - Lin Xu
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
| | - Laijin Lu
- Department of Hand Surgery, Jilin Provincial Key Laboratory of Tissue Repair, Reconstruction and Regeneration, The First Hospital of Jilin University, Jilin, China
| | - Haotian Feng
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
| | - Daniel J Leong
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
| | - Sun J Kim
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
| | - David M Hirsh
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
| | - Robert J Majeska
- Department of Biomedical Engineering, The City College of New York, New York City, New York
| | - Mary B Goldring
- Orthopaedic Soft Tissue Research Program, Hospital for Special Surgery, and Weill Cornell Medical College, New York City, New York
| | - Neil J Cobelli
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York
| | - Hui B Sun
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York
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Leong DJ, Choudhury M, Hanstein R, Hirsh DM, Kim SJ, Majeska RJ, Schaffler MB, Hardin JA, Spray DC, Goldring MB, Cobelli NJ, Sun HB. Correction to: Green tea polyphenol treatment is chondroprotective, anti-inflammatory and palliative in a mouse posttraumatic osteoarthritis model. Arthritis Res Ther 2019; 21:1. [PMID: 30606217 PMCID: PMC6318934 DOI: 10.1186/s13075-018-1791-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 12/10/2018] [Indexed: 12/03/2022] Open
Affiliation(s)
- Daniel J Leong
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.,Department of Radiation Oncology, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Marwa Choudhury
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.,Department of Radiation Oncology, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Regina Hanstein
- Department of Neuroscience, Albert Einstein College of Medicine, 1410 Pelham Pkwy S, Bronx, NY, 10461, USA
| | - David M Hirsh
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Sun Jin Kim
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Robert J Majeska
- Department of Biomedical Engineering, The City College of New York, 160 Convent Ave, New York, NY, 10031, USA
| | - Mitchell B Schaffler
- Department of Biomedical Engineering, The City College of New York, 160 Convent Ave, New York, NY, 10031, USA
| | - John A Hardin
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - David C Spray
- Department of Neuroscience, Albert Einstein College of Medicine, 1410 Pelham Pkwy S, Bronx, NY, 10461, USA
| | - Mary B Goldring
- Tissue Engineering, Regeneration and Repair Program, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Neil J Cobelli
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - Hui B Sun
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA. .,Department of Radiation Oncology, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.
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Cobelli NJ, Leong DJ, Sun HB. Exosomes: biology, therapeutic potential, and emerging role in musculoskeletal repair and regeneration. Ann N Y Acad Sci 2017; 1410:57-67. [DOI: 10.1111/nyas.13469] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/14/2017] [Accepted: 08/21/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Neil J. Cobelli
- Department of Orthopaedic Surgery; Albert Einstein College of Medicine and Montefiore Medical Center; Bronx New York
| | - Daniel J. Leong
- Department of Orthopaedic Surgery; Albert Einstein College of Medicine and Montefiore Medical Center; Bronx New York
- Department of Radiation Oncology; Albert Einstein College of Medicine and Montefiore Medical Center; Bronx New York
| | - Hui B. Sun
- Department of Orthopaedic Surgery; Albert Einstein College of Medicine and Montefiore Medical Center; Bronx New York
- Department of Radiation Oncology; Albert Einstein College of Medicine and Montefiore Medical Center; Bronx New York
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Zhang Z, Leong DJ, Xu L, He Z, Wang A, Navati M, Kim SJ, Hirsh DM, Hardin JA, Cobelli NJ, Friedman JM, Sun HB. Curcumin slows osteoarthritis progression and relieves osteoarthritis-associated pain symptoms in a post-traumatic osteoarthritis mouse model. Arthritis Res Ther 2016; 18:128. [PMID: 27260322 PMCID: PMC4891896 DOI: 10.1186/s13075-016-1025-y] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/18/2016] [Indexed: 01/01/2023] Open
Abstract
Background Curcumin has been shown to have chondroprotective potential in vitro. However, its effect on disease and symptom modification in osteoarthritis (OA) is largely unknown. This study aimed to determine whether curcumin could slow progression of OA and relieve OA-related pain in a mouse model of destabilization of the medial meniscus (DMM). Methods Expression of selected cartilage degradative-associated genes was evaluated in human primary chondrocytes treated with curcumin and curcumin nanoparticles and assayed by real-time PCR. The mice subjected to DMM surgery were orally administered curcumin or topically administered curcumin nanoparticles for 8 weeks. Cartilage integrity was evaluated by Safranin O staining and Osteoarthritis Research Society International (OARSI) score, and by immunohistochemical staining of cleaved aggrecan and type II collagen, and levels of matrix metalloproteinase (MMP)-13 and ADAMTS5. Synovitis and subchondral bone thickness were scored based on histologic images. OA-associated pain and symptoms were evaluated by von Frey assay, and locomotor behavior including distance traveled and rearing. Results Both curcumin and nanoparticles encapsulating curcumin suppressed mRNA expression of pro-inflammatory mediators IL-1β and TNF-α, MMPs 1, 3, and 13, and aggrecanase ADAMTS5, and upregulated the chondroprotective transcriptional regulator CITED2, in primary cultured chondrocytes in the absence or presence of IL-1β. Oral administration of curcumin significantly reduced OA disease progression, but showed no significant effect on OA pain relief. Curcumin was detected in the infrapatellar fat pad (IPFP) following topical administration of curcumin nanoparticles on the skin of the injured mouse knee. Compared to vehicle-treated controls, topical treatment led to: (1) reduced proteoglycan loss and cartilage erosion and lower OARSI scores, (2) reduced synovitis and subchondral plate thickness, (3) reduced immunochemical staining of type II collagen and aggrecan cleavage epitopes and numbers of chondrocytes positive for MMP-13 and ADAMTS5 in the articular cartilage, and (4) reduced expression of adipokines and pro-inflammatory mediators in the IPFP. In contrast to oral curcumin, topical application of curcumin nanoparticles relieved OA-related pain as indicated by reduced tactile hypersensitivity and improved locomotor behavior. Conclusion This study provides the first evidence that curcumin significantly slows OA disease progression and exerts a palliative effect in an OA mouse model. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1025-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zhuo Zhang
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, USA.,China-Japan Union Hospital of Jilin University, Bronx, NY, USA
| | - Daniel J Leong
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Lin Xu
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Zhiyong He
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Angela Wang
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mahantesh Navati
- Department of Physiology & Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sun J Kim
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David M Hirsh
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA
| | - John A Hardin
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Neil J Cobelli
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joel M Friedman
- Department of Physiology & Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Hui B Sun
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA. .,Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, USA.
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Leong DJ, Choudhury M, Hanstein R, Hirsh DM, Kim SJ, Majeska RJ, Schaffler MB, Hardin JA, Spray DC, Goldring MB, Cobelli NJ, Sun HB. Green tea polyphenol treatment is chondroprotective, anti-inflammatory and palliative in a mouse post-traumatic osteoarthritis model. Arthritis Res Ther 2014; 16:508. [PMID: 25516005 PMCID: PMC4342891 DOI: 10.1186/s13075-014-0508-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 12/09/2014] [Indexed: 12/20/2022] Open
Abstract
Introduction Epigallocatechin 3-gallate (EGCG), a polyphenol present in green tea, was shown to exert chondroprotective effects in vitro. In this study, we used a posttraumatic osteoarthritis (OA) mouse model to test whether EGCG could slow the progression of OA and relieve OA-associated pain. Methods C57BL/6 mice were subjected to surgical destabilization of the medial meniscus (DMM) or sham surgery. EGCG (25 mg/kg) or vehicle control was administered daily for 4 or 8 weeks by intraperitoneal injection starting on the day of surgery. OA severity was evaluated using Safranin O staining and Osteoarthritis Research Society International (OARSI) scores, as well as by immunohistochemical analysis to detect cleaved aggrecan and type II collagen and expression of proteolytic enzymes matrix metalloproteinase 13 (MMP-13) and A disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS5). Real-time PCR was performed to characterize the expression of genes critical for articular cartilage homeostasis. During the course of the experiments, tactile sensitivity testing (von Frey test) and open-field assays were used to evaluate pain behaviors associated with OA, and expression of pain expression markers and inflammatory cytokines in the dorsal root ganglion (DRG) was determined by real-time PCR. Results Four and eight weeks after DMM surgery, the cartilage in EGCG-treated mice exhibited less Safranin O loss and cartilage erosion, as well as lower OARSI scores compared to vehicle-treated controls, which was associated with reduced staining for aggrecan and type II collagen cleavage epitopes, and reduced staining for MMP-13 and ADAMTS5 in the articular cartilage. Articular cartilage in the EGCG-treated mice also exhibited reduced levels of Mmp1, Mmp3, Mmp8, Mmp13,Adamts5, interleukin 1 beta (Il1b) and tumor necrosis factor alpha (Tnfa) mRNA and elevated gene expression of the MMP regulator Cbp/p300 interacting transactivator 2 (Cited2). Compared to vehicle controls, mice treated with EGCG exhibited reduced OA-associated pain, as indicated by higher locomotor behavior (that is, distance traveled). Moreover, expression of the chemokine receptor Ccr2 and proinflammatory cytokines Il1b and Tnfa in the DRG were significantly reduced to levels similar to those of sham-operated animals. Conclusions This study provides the first evidence in an OA animal model that EGCG significantly slows OA disease progression and exerts a palliative effect. Electronic supplementary material The online version of this article (doi:10.1186/s13075-014-0508-y) contains supplementary material, which is available to authorized users.
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Leong DJ, Choudhury M, Hirsh DM, Hardin JA, Cobelli NJ, Sun HB. Nutraceuticals: potential for chondroprotection and molecular targeting of osteoarthritis. Int J Mol Sci 2013; 14:23063-85. [PMID: 24284399 PMCID: PMC3856106 DOI: 10.3390/ijms141123063] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/30/2013] [Accepted: 11/01/2013] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. There is no cure for OA, and no effective treatments which arrest or slow its progression. Current pharmacologic treatments such as analgesics may improve pain relief but do not alter OA disease progression. Prolonged consumption of these drugs can result in severe adverse effects. Given the nature of OA, life-long treatment will likely be required to arrest or slow its progression. Consequently, there is an urgent need for OA disease-modifying therapies which also improve symptoms and are safe for clinical use over long periods of time. Nutraceuticals-food or food products that provide medical or health benefits, including the prevention and/or treatment of a disease-offer not only favorable safety profiles, but may exert disease- and symptom-modification effects in OA. Forty-seven percent of OA patients use alternative medications, including nutraceuticals. This review will overview the efficacy and mechanism of action of commonly used nutraceuticals, discuss recent experimental and clinical data on the effects of select nutraceuticals, such as phytoflavonoids, polyphenols, and bioflavonoids on OA, and highlight their known molecular actions and limitations of their current use. We will conclude with a proposed novel nutraceutical-based molecular targeting strategy for chondroprotection and OA treatment.
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Affiliation(s)
- Daniel J. Leong
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA; E-Mails: (D.J.L.); (M.C.); (D.M.H.); (J.A.H.); (N.J.C.)
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Golding 101, Bronx, NY 10461, USA
| | - Marwa Choudhury
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA; E-Mails: (D.J.L.); (M.C.); (D.M.H.); (J.A.H.); (N.J.C.)
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Golding 101, Bronx, NY 10461, USA
| | - David M. Hirsh
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA; E-Mails: (D.J.L.); (M.C.); (D.M.H.); (J.A.H.); (N.J.C.)
| | - John A. Hardin
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA; E-Mails: (D.J.L.); (M.C.); (D.M.H.); (J.A.H.); (N.J.C.)
| | - Neil J. Cobelli
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA; E-Mails: (D.J.L.); (M.C.); (D.M.H.); (J.A.H.); (N.J.C.)
| | - Hui B. Sun
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA; E-Mails: (D.J.L.); (M.C.); (D.M.H.); (J.A.H.); (N.J.C.)
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Golding 101, Bronx, NY 10461, USA
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Abstract
Osteoarthritis (OA) is characterized by the breakdown of articular cartilage that is mediated in part by increased production of matrix metalloproteinases (MMPs) and aggrecanases (ADAMTS), enzymes that degrade components of the cartilage extracellular matrix. Efforts to design synthetic inhibitors of MMPs/ADAMTS have only led to limited clinical success. In addition to pharmacologic therapies, physiologic joint loading is widely recommended as a nonpharmacologic approach to improve joint function in osteoarthritis. Clinical trials report that moderate levels of exercise exert beneficial effects, such as improvements in pain and physical function. Experimental studies demonstrate that mechanical loading mitigates joint destruction through the downregulation of MMPs/ADAMTS. However, the molecular mechanisms underlying these effects of physiologic loading on arthritic joints are not well understood. We review here the recent progress on mechanotransduction in articular joints, highlighting the mediators and pathways in the maintenance of cartilage integrity, especially in the prevention of cartilage degradation in OA.
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Affiliation(s)
- Daniel J. Leong
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
- Department of Radation Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
- Oncophysics Research Institute, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - John A. Hardin
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Neil J. Cobelli
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Hui B. Sun
- Department of Orthopaedic Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
- Department of Radation Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
- Oncophysics Research Institute, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
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Abstract
Seventeen, supracondylar femur fractures in 15 severely osteoporotic patients (average age, 81.9 years) were treated with a 95 degree supracondylar plate and dynamic compression screw supplemented with intramedullary methyl methacrylate and massive cancellous bone graft harvested from the distal femoral metaphysis. Interfragmentary compression and rigid fracture fixation was obtained in all cases with the use of the A-O compression device. Patients were allowed early protected weight bearing without external immobilization. At follow-up observation (average, 2.1 years), bony union was noted in all cases, and knee flexion averaged 100.4 degrees. There were no malunions or cases of implant failure. Complications included two early postoperative deaths and three femur fractures above the plate. This technique was effective in rapidly restoring patient mobility while avoiding the complications of implant failure.
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Affiliation(s)
- S Struhl
- Albert Einstein College of Medicine, Bronx, New York 10469
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10
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McAllister CM, Zillmer D, Cobelli NJ. Clostridium perfringens and Staphylococcus epidermidis polymicrobial septic arthritis. A case report. Clin Orthop Relat Res 1989:245-7. [PMID: 2538275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Septic arthritis caused by Clostridium perfringens is extremely rare. Previously there has been only one report of Clostridium perfringens in combination with an aerobe causing septic arthritis. This report presents a 23-year-old man with a mixed aerobic/anaerobic septic arthritis treated with intravenous antibiotics and repeated surgical drainage. It is the only report to date of a polymicrobial septic arthritis involving both Staphylococcus epidermidis and Clostridium perfringens. This report and a review of the literature demonstrate the existence of polymicrobial septic arthritis and illustrate its fulminant nature.
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Affiliation(s)
- C M McAllister
- Department of Orthopaedic Surgery, Montefiore Hospital, Bronx, New York 10467
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Steinfield PH, Cobelli NJ, Sadler AH, Szporn MN. Open tibial fractures treated by anterior half-pin frame fixation. Clin Orthop Relat Res 1988:208-14. [PMID: 3342569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Forty-two open tibial fractures were treated with anterior half-pin frame fixation, weight bearing as tolerated, and early reconstruction of the soft tissue envelope. Thirty fractures were followed to completion of therapy. The infection rate was 7.1%, nonunion rate, 3.0%, and pin tract infection rate, 0.5%. Problems of malunion (23.3%) and of secondary fractures around lag screws (17.6%) may be reduced by early cancellous bone grafting and limited use of minimal internal fixation.
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Affiliation(s)
- P H Steinfield
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York
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12
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Cobelli NJ, Sadler AH. Ender rod versus compression screw fixation of hip fractures. Clin Orthop Relat Res 1985:123-9. [PMID: 4064396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Eighty-seven matched pairs of patients with extracapsular hip fractures were treated with either Ender rod or compression screw and plate fixation. The data obtained both perioperatively and from one to 39 months postoperatively showed no significant differences with respect to infection rate, mortality, length of stay, or ultimate functional status. In the Ender rod group, 66.7% of the patients experienced technical problems, compared with 10.3% of patients in the compression screw group. The Ender technique offered few practical advantages and an unacceptably high level of problems, even when patients with only stable fractures were considered.
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