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Panos JA, Coenen MJ, Nagelli CV, McGlinch EB, Atasoy-Zeybek A, De Padilla CL, De la Vega RE, Evans CH. Segmental defect healing in the presence or absence of recombinant human BMP2: Novel insights from a rat model. J Orthop Res 2023; 41:1934-1944. [PMID: 36850029 PMCID: PMC10440238 DOI: 10.1002/jor.25530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/16/2023] [Accepted: 02/08/2023] [Indexed: 03/01/2023]
Abstract
This study defined and compared the course of native, impaired and growth factor-stimulated bone regeneration in a rat femoral defect model. A mid-diaphyseal defect with rigid internal fixation was surgically created in the right femur of male Fischer rats and serially analyzed over 36 weeks. Native bone regeneration was modeled using a sub-critical, 1 mm size defect, which healed uneventfully. Critical size defects of 5 mm were used to analyze impaired bone regeneration. In a third group, the 5 mm defects were filled with 11 µg of recombinant human bone morphogenetic protein 2 (rhBMP2) impregnated onto an absorbable collagen sponge, modeling its clinical use. Native bone regeneration was characterized by endochondral ossification with progressive remodeling to ultimately resemble intact femora. An endochondral response was also observed under conditions of impaired bone regeneration, but by week 8 medullary capping occurred with fibrofatty consolidation of the tissue within the defect, resembling an atrophic non-union. rhBMP2 treatment was associated with prolonged inflammatory cytokine expression and rapid intramembranous bone formation occurring with reduced expression of cartilage-associated collagens. Between weeks 4 and 36, rhBMP2-treated bones demonstrated decreased trabecular number and increased trabecular separation, which resulted in inferior mechanical properties compared with bones that healed naturally. Clinical Significance: Recombinant human bone morphogenetic protein 2 (rhBMP2) is used clinically to promote healing of long bones. Our data suggest that it drives intramembraneous ossification producing an inferior regenerate that deteriorates with time. Clinical outcomes would be improved by technologies favoring endochondral regenerative ossification.
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Affiliation(s)
- Joseph A. Panos
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
- Graduate School of Biomedical Sciences, Mayo Clinic; Rochester, Minnesota, USA
- Medical Scientist Training Program, Mayo Clinic; Rochester, Minnesota, USA
| | - Michael J. Coenen
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
| | - Christopher V. Nagelli
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
| | - Erin B. McGlinch
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
- Graduate School of Biomedical Sciences, Mayo Clinic; Rochester, Minnesota, USA
- Virology and Gene Therapy Graduate Program, Mayo Clinic; Rochester, Minnesota, USA
| | - Aysegul Atasoy-Zeybek
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
| | - Consuelo Lopez De Padilla
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
| | - Rodolfo E. De la Vega
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
- Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute; Maastricht, The Netherlands
| | - Christopher H. Evans
- Rehabilitation Medicine Research Center, Mayo Clinic; Rochester, Minnesota, USA
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic; Rochester, Minnesota, USA
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Panos JA, Coenen MJ, Nagelli CV, McGlinch EB, Atasoy-Zeybek A, De Padilla CL, Coghlan RF, Johnstone B, Ferreira E, Porter RM, De la Vega RE, Evans CH. IL-1Ra gene transfer potentiates BMP2-mediated bone healing by redirecting osteogenesis toward endochondral ossification. Mol Ther 2023; 31:420-434. [PMID: 36245128 PMCID: PMC9931547 DOI: 10.1016/j.ymthe.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/23/2022] [Revised: 09/14/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
An estimated 100,000 patients each year in the United States suffer severe disability from bone defects that fail to heal, a condition where bone-regenerative therapies could provide substantial clinical benefits. Although recombinant human bone morphogenetic protein-2 (rhBMP2) is an osteogenic growth factor that is clinically approved for this purpose, it is only effective when used at exceedingly high doses that incur substantial costs, induce severe inflammation, produce adverse side effects, and form morphologically abnormal bone. Using a validated rat femoral segmental defect model, we show that bone formed in response to clinically relevant doses of rhBMP2 is accompanied by elevated expression of interleukin-1 (IL-1). Local delivery of cDNA encoding the IL-1 receptor antagonist (IL-1Ra) achieved bridging of segmental, critical size defects in bone with a 90% lower dose of rhBMP2. Unlike use of high-dose rhBMP2, bone formation in the presence of IL-1Ra occurred via the native process of endochondral ossification, resulting in improved quality without sacrificing the mechanical properties of the regenerated bone. Our results demonstrate that local immunomodulation may permit effective use of growth factors at lower doses to recapitulate more precisely the native biology of healing, leading to higher-quality tissue regeneration.
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Affiliation(s)
- Joseph A Panos
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA; Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA; Medical Scientist Training Program, Mayo Clinic, Rochester, MN, USA
| | - Michael J Coenen
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Christopher V Nagelli
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Erin B McGlinch
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA; Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA; Virology and Gene Therapy Graduate Program, Mayo Clinic, Rochester, MN, USA
| | - Aysegul Atasoy-Zeybek
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Consuelo Lopez De Padilla
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Ryan F Coghlan
- Research Center, Shriners Hospitals for Children, Portland, OR, USA
| | - Brian Johnstone
- Research Center, Shriners Hospitals for Children, Portland, OR, USA; Department of Orthopedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Elisabeth Ferreira
- Center for Musculoskeletal Disease Research, Departments of Internal Medicine and Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ryan M Porter
- Center for Musculoskeletal Disease Research, Departments of Internal Medicine and Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Rodolfo E De la Vega
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA; Department of Cell Biology-Inspired Tissue Engineering, MERLN Institute, Maastricht, the Netherlands
| | - Christopher H Evans
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, MN, USA.
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Nagelli CV, Evans CH, De la Vega RE. Gene Delivery to Chondrocytes. Adv Exp Med Biol 2023; 1402:95-105. [PMID: 37052849 DOI: 10.1007/978-3-031-25588-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Delivering genes to chondrocytes offers new possibilities both clinically, for treating conditions that affect cartilage, and in the laboratory, for studying the biology of chondrocytes. Advances in gene therapy have created a number of different viral and non-viral vectors for this purpose. These vectors may be deployed in an ex vivo fashion, where chondrocytes are genetically modified outside the body, or by in vivo delivery where the vector is introduced directly into the body; in the case of articular and meniscal cartilage in vivo delivery is typically by intra-articular injection. Ex vivo delivery is favored in strategies for enhancing cartilage repair as these can be piggy-backed on existing cell-based technologies, such as autologous chondrocyte implantation, or used in conjunction with marrow-stimulating techniques such as microfracture. In vivo delivery to articular chondrocytes has proved more difficult, because the dense, anionic, extra-cellular matrix of cartilage limits access to the chondrocytes embedded within it. As Grodzinsky and colleagues have shown, the matrix imposes strict limits on the size and charge of particles able to diffuse through the entire depth of articular cartilage. Empirical observations suggest that the larger viral vectors, such as adenovirus (~100 nm), are unable to transduce chondrocytes in situ following intra-articular injection. However, adeno-associated virus (AAV; ~25 nm) is able to do so in horse joints. AAV is presently in clinical trials for arthritis gene therapy, and it will be interesting to see whether human chondrocytes are also transduced throughout the depth of cartilage by AAV following a single intra-articular injection. Viral vectors have been used to deliver genes to the intervertebral disk but there has been little research on gene transfer to chondrocytes in other cartilaginous tissues such as nasal, auricular or tracheal cartilage.
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Shi G, Long Z, De la Vega RE, Behfar A, Moran SL, Evans C, Zhao C. Purified exosome product enhances chondrocyte survival and regeneration by modulating inflammation and promoting chondrogenesis. Regen Med 2023; 18:55-71. [PMID: 36255073 PMCID: PMC9732920 DOI: 10.2217/rme-2022-0132] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 07/29/2022] [Accepted: 09/28/2022] [Indexed: 12/15/2022] Open
Abstract
Aim: This study was to detect the effects of purified exosome product (PEP) on C28/I2 cells and chondrocytes derived from osteoarthritis patients. Materials & methods: Cell viability and apoptosis assays were used to detect the effect of PEP on cells. qRT-PCR and cell fluorescence assays were used to investigate the potential mechanism of PEP on cell chondrogenesis. Results: PEP was internalized by cells at a fast rate and enhanced cellular proliferation and migration while attenuating apoptosis. These findings reflect the fact that PEP can increase the expression of PCNA and reduce the expression of CASP3/7/9 and BAX. Conclusion: This study suggests an innovative strategy for chondrogenesis that could be applied to osteoarthritis repair in the future.
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Affiliation(s)
- Guidong Shi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55901, USA
- Department of Orthopaedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Zeling Long
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55901, USA
| | - Rodolfo E De la Vega
- Musculoskeletal Gene Therapy Research Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN 55901, USA
- Department cBITE, MERLN Institute, Maastricht University, Maastricht, 6221, The Netherlands
| | - Atta Behfar
- Department of Cardiovascular Diseases, Van Cleve Cardiac Regenerative Medicine Program, Center for Regenerative Medicine, Mayo Clinic, Rochester, MN 55901, USA
| | - Steven L Moran
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55901, USA
| | - Christopher Evans
- Musculoskeletal Gene Therapy Research Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN 55901, USA
| | - Chunfeng Zhao
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55901, USA
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De la Vega RE, Atasoy-Zeybek A, Panos JA, VAN Griensven M, Evans CH, Balmayor ER. Gene therapy for bone healing: lessons learned and new approaches. Transl Res 2021; 236:1-16. [PMID: 33964474 PMCID: PMC8976879 DOI: 10.1016/j.trsl.2021.04.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/11/2022]
Abstract
Although gene therapy has its conceptual origins in the treatment of Mendelian disorders, it has potential applications in regenerative medicine, including bone healing. Research into the use of gene therapy for bone healing began in the 1990s. Prior to this period, the highly osteogenic proteins bone morphogenetic protein (BMP)-2 and -7 were cloned, produced in their recombinant forms and approved for clinical use. Despite their promising osteogenic properties, the clinical usefulness of recombinant BMPs is hindered by delivery problems that necessitate their application in vastly supraphysiological amounts. This generates adverse side effects, some of them severe, and raises costs; moreover, the clinical efficacy of the recombinant proteins is modest. Gene delivery offers a potential strategy for overcoming these limitations. Our research has focused on delivering a cDNA encoding human BMP-2, because the recombinant protein is Food and Drug Administration approved and there is a large body of data on its effects in people with broken bones. However, there is also a sizeable literature describing experimental results obtained with other transgenes that may directly or indirectly promote bone formation. Data from experiments in small animal models confirm that intralesional delivery of BMP-2 cDNA is able to heal defects efficiently and safely while generating transient, local BMP-2 concentrations 2-3 log orders less than those needed by recombinant BMP-2. The next challenge is to translate this information into a clinically expedient technology for bone healing. Our present research focuses on the use of genetically modified, allografted cells and chemically modified messenger RNA.
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Affiliation(s)
- Rodolfo E De la Vega
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota; cBITE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, Netherlands
| | - Aysegul Atasoy-Zeybek
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Joseph A Panos
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Martijn VAN Griensven
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota; cBITE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, Netherlands
| | - Christopher H Evans
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota.
| | - Elizabeth R Balmayor
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, Minnesota; Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota; IBE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, Netherlands
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López De Padilla CM, Coenen MJ, Tovar A, De la Vega RE, Evans CH, Müller SA. Picrosirius Red Staining: Revisiting Its Application to the Qualitative and Quantitative Assessment of Collagen Type I and Type III in Tendon. J Histochem Cytochem 2021; 69:633-643. [PMID: 34549650 DOI: 10.1369/00221554211046777] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Collagen has a major role in the structural organization of tendons. Picrosirius red (PSR) staining viewed under polarized light microscopy is the standard method to evaluate the organization of collagen fibers in tissues. It is also used to distinguish between type I and type III collagen in tissue sections. However, accurate analysis and interpretation of PSR images are challenging because of technical factors and historical misconceptions. The aim of this study was to clarify whether collagen types I and III can be distinguished by PSR staining in rat Achilles tendons, using double immunohistochemistry as the positive control. Our findings showed that PSR staining viewed with polarized light microscopy was suitable for qualitative and quantitative assessment of total collagen but was not able to distinguish collagen types. We found it critical to use a polarizing microscope equipped with a rotating stage; tendon section orientation at 45° with respect to crossed polarizers was optimal for the qualitative and quantitative assessment of collagen organization. Immunohistochemistry was superior to PSR staining for detection of collagen type III. We also compared formalin and Bouin solution as fixatives. Both produced similar birefringence, but formalin-fixed tendons provided higher quality histological detail with both hematoxylin-eosin and immunostaining.
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Affiliation(s)
| | - Michael J Coenen
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Alejandro Tovar
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Rodolfo E De la Vega
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota.,Department cBITE, MERLN Institute, Maastricht University, The Netherlands
| | - Christopher H Evans
- Musculoskeletal Gene Therapy Research Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Sebastian A Müller
- Department of Orthopedic Surgery, Kantonsspital Baselland, University of Basel, Basel, Switzerland (Research Collaborator [limited tenure], Mayo Clinic, Rochester, Minnesota)
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De la Vega RE, Scheu M, Brown LA, Evans CH, Ferreira E, Porter RM. Specific, Sensitive, and Stable Reporting of Human Mesenchymal Stromal Cell Chondrogenesis. Tissue Eng Part C Methods 2020; 25:176-190. [PMID: 30727864 DOI: 10.1089/ten.tec.2018.0295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
IMPACT STATEMENT The promoter characterized in this study has been made accessible as a resource for the skeletal tissue engineering and regenerative medicine community. When combined with suitable reporter vectors, the resulting tools can be used for noninvasive and/or high-throughput screening of test conditions for stimulating chondrogenesis by candidate stem/progenitor cells. As demonstrated in this study, they can also be used with small animal imaging platforms to monitor the chondrogenic activity of implanted progenitors within orthotopic models of bone and cartilage repair.
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Affiliation(s)
- Rodolfo E De la Vega
- 1 Department of Orthopaedic Surgery, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,2 Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Maximiliano Scheu
- 1 Department of Orthopaedic Surgery, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,2 Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts.,3 Department of Orthopaedic Surgery, Clínica Alemana de Santiago, Universidad del Desarrollo, Vitacura, Chile
| | - Lennart A Brown
- 1 Department of Orthopaedic Surgery, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,2 Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Christopher H Evans
- 1 Department of Orthopaedic Surgery, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,2 Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Elisabeth Ferreira
- 1 Department of Orthopaedic Surgery, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,2 Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
| | - Ryan M Porter
- 1 Department of Orthopaedic Surgery, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,2 Department of Orthopaedic Surgery, Harvard Medical School, Boston, Massachusetts
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Bajpayee AG, De la Vega RE, Scheu M, Varady NH, Yannatos IA, Brown LA, Krishnan Y, Fitzsimons TJ, Bhattacharya P, Frank EH, Grodzinsky AJ, Porter RM. Sustained intra-cartilage delivery of low dose dexamethasone using a cationic carrier for treatment of post traumatic osteoarthritis. Eur Cell Mater 2017; 34:341-364. [PMID: 29205258 PMCID: PMC5744663 DOI: 10.22203/ecm.v034a21] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Disease-modifying osteoarthritis drugs (DMOADs) should reach their intra-tissue target sites at optimal doses for clinical efficacy. The dense, negatively charged matrix of cartilage poses a major hindrance to the transport of potential therapeutics. In this work, electrostatic interactions were utilised to overcome this challenge and enable higher uptake, full-thickness penetration and enhanced retention of dexamethasone (Dex) inside rabbit cartilage. This was accomplished by using the positively charged glycoprotein avidin as nanocarrier, conjugated to Dex by releasable linkers. Therapeutic effects of a single intra-articular injection of low dose avidin-Dex (0.5 mg Dex) were evaluated in rabbits 3 weeks after anterior cruciate ligament transection (ACLT). Immunostaining confirmed that avidin penetrated the full cartilage thickness and was retained for at least 3 weeks. Avidin-Dex suppressed injury-induced joint swelling and catabolic gene expression to a greater extent than free Dex. It also significantly improved the histological score of cell infiltration and morphogenesis within the periarticular synovium. Micro-computed tomography confirmed the reduced incidence and volume of osteophytes following avidin-Dex treatment. However, neither treatment restored the loss of cartilage stiffness following ACLT, suggesting the need for a combinational therapy with a pro-anabolic factor for enhancing matrix biosynthesis. The avidin dose used caused significant glycosaminoglycan (GAG) loss, suggesting the use of higher Dex : avidin ratios in future formulations, such that the delivered avidin dose could be much less than that shown to affect GAGs. This charge-based delivery system converted cartilage into a drug depot that could also be employed for delivery to nearby synovium, menisci and ligaments, enabling clinical translation of a variety of DMOADs.
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Affiliation(s)
- Ambika G. Bajpayee
- Departments of Bioengineering and Mechanical Engineering, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA,Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Rodolfo E. De la Vega
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA,Current affiliation: Rehabilitation Medicine Research Centre, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Maximiliano Scheu
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA,Department of Orthopaedic Surgery, Clínica Alemana de Santiago, Avenida Vitacura 5951, Vitacura, Chile
| | - Nathan H. Varady
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Isabel A. Yannatos
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Lennart A. Brown
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Yamini Krishnan
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Tomas J. Fitzsimons
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Paulomi Bhattacharya
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Eliot H. Frank
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Alan J. Grodzinsky
- Centre for Biomedical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA,Departments of Biological, Mechanical and Electrical Engineering, MIT, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Ryan M. Porter
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Centre (BIDMC), Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA,Address for correspondence: Ryan M. Porter, University of Arkansas for Medical Sciences, Division of Endocrinology and Metabolism, 4301 W. Markham Street, Mail Slot #587, Little Rock, AR 72205, Telephone : +1 5015266990,
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