The age of computational cardiology and future of long-term ablation target prediction for ventricular tachycardia

Ventricular arrhythmias, particularly ventricular tachycardia, are ubiquitously linked to 300,000 deaths annually. However, the current interventional procedure-the cardiac ablation-predict only short-term responses to treatment as the heart constantly remodels itself post-arrhythmia. To assist in the design of computational methods which focuses on long-term arrhythmia prediction, this review postulates three interdependent prospectives. The main objective is to propose computational methods for predicting long-term heart response to interventions in ventricular tachycardia Following a general discussion on the importance of devising simulations predicting long-term heart response to interventions, each of the following is discussed: (i) application of "metabolic sink theory" to elucidate the "re-entry" mechanism of ventricular tachycardia; (ii) application of "growth laws" to explain "mechanical load" translation in ventricular tachycardia; (iii) derivation of partial differential equations (PDE) to establish a pipeline to predict long-term clinical outcomes in ventricular tachycardia.

Effects of atmospheric dust particles on common medicinal plants in an industrial area of West Bengal, India

The exposure of atmospheric dust particles on four common medicinal plants (Ocimum sanctum, Andrographis paniculata, Catharanthus roseous, and Kaempferia galanga, which are available in the study area and cultivated by the local people for medicinal purposes) affects their growth, levels of essential biochemical constituents and heavy metal concentration. The plant species were grown by pot cultivation in an industrial area with high levels of coal dust to assess the capacity of heavy metals accumulation in their leaves and changes in allometry and biochemical parameters. The results showed that annual average SPM and dustfall varied between 195.88 to 645.97 μg/m3 and 17.55 to 41.16 g/m2/month, respectively. Dustfall at different polluted sites was 2.4, 2.1, 1.5, 1.4, and 2.3 times higher than at the control site. The most prevalent heavy metal in atmospheric particulate matter was Zn, followed by Pb, Ni, Cu, Co, and Cd. Plant allometry measurements such as height, stem width, root length, petiole length, and leaf area are shown to have a strong and significant (p<0.05) negative correlation with dustfall and SPM. Total chlorophyll and RWC were inversely proportional to the dust load present in all the species. Except for Andrographis paniculata, chlorophyll and leaf-extracted pH of plant species were moderately correlated with APTI, whereas no correlation was noticed for ascorbic acid. A positive correlation between SPM and heavy metals in leaves was observed. The results implied that the cultivation and collection of medicinal plants from the study area could be potentially toxic to human health.

The uptake of [Ca]calcium ions by matrix vesicles isolated from calcifying cartilage (Short Communication)

Extracellular membranous matrix vesicles, which contain various phosphatases and appear to initiate hydroxyapatite formation in growth cartilage, were isolated and incubated with (45)Ca(2+) and shown to form mineral in the presence of ATP. There is enhanced calcification in the presence of serum and under alkaline conditions.

Enzyme histochemical localisation of alkaline phosphatase activity in osteogenesis imperfecta bone and growth plate: A preliminary study

At the ultrastructural level alkaline phosphatase has been studied in calcifying cartilage but not in bone. The aim of this study was to assess if there is an osteoblast dysfunction in Osteogenesis Imperfecta (OI) with respect to alkaline phosphatase activity. Specimens from three OI type II foetal femoral bones, two OI type II growth plates, one normal foetal femoral bone and growth plate, one OI type III femoral bone specimen and one normal juvenile bone specimens were examined using modified lead nitrate method to identify alkaline phosphatase reactivity. The electron dense reaction product (indicative of the presence of alkaline phosphatase) was demonstrable on the cell membrane of the osteoblasts, as focal concentrations in the collagen osteoid and on the mineralisation front of normal bone. In normal bone the intensity of the reaction seemed to be stronger than in OI bone and appeared as a continuous black line along the osteoblast cell membranes. In OI bone the reaction product only appeared as a few electron dense beads along the osteoblast cell membrane. There appeared to be reduced and diffuse reaction product on OI osteoblasts, thus implying either a reduced level and/or altered activity of alkaline phosphatase and hence a dysfunction of osteoblasts. This confirms the findings of the previous report of the impaired activity of alkaline phosphatase in OI osteoblasts. Even in the OI growth plate, hypertrophic chondrocytes showed less intense reaction product than the chondrocytes in the normal growth plate. The normal human growth plates used in this study showed a similar pattern, but in the OI growth plate even the hypertrophic zone, where the alkaline phosphatase activity is reported to be high, showed less intense reaction product. Biochemical reports indicate that alkaline phosphatase levels are normal in cultured OI cell lines, yet ultrastructural histochemical observations reported here, show reduced enzyme localisation and this may suggest reduced amounts of protein or reduced activity at the tissue level.

A light and electron microscopic study of osteogenesis imperfecta bone samples, with reference to collagen chemistry and clinical phenotype

A detailed morphological study was carried out using light and electron microscopy on 36 bone specimens from patients suffering from osteogenesis imperfecta (OI) and 20 age- and site-matched control bone specimens. The findings were grouped into the clinical types of OI according to the Sillence classification. The morphological and ultrastructural alterations observed in OI bone correlate well with clinical severity. Thus, OI type I, the mildest type, showed the least abnormalities in bone ultrastructure. OI type IV closely resembled type I, with only minor abnormalities in the bone cells and osteoid. OI type III showed abnormalities in the structure and distribution of osteoid collagen fibrils, whilst OI type II, the lethal form, revealed many varied abnormalities such as thin cortical bone, sparse trabecular bone, increased numbers of osteoclasts and osteocytes, thin osteoid with thin collagen fibrils, and patchy mineralization.

A fourier transform infrared spectroscopic and solid-state NMR study of bone mineral in osteogenesis imperfecta

Fourier transform infrared spectroscopy and 31P solid-state nuclear magnetic resonance spectroscopy were used to determine if any structural or compositional differences in osteogenesis imperfecta (OI) bone mineral could be detected that might help to explain the bone fragility observed in this disease. A previous study by Cassella et al. used an electron probe X-ray microanalytical technique to compare the calcium to phosphorus (Ca/P) molar ratios in normal bone and bone from patients with OI. It was demonstrated that bone from OI patients had a lower Ca/P molar ratio. This study demonstrated that OI bone mineral had a general hydroxyapatite structure and that isomorphous substitutions in the carbanoapatite lattice could account for the low Ca/P molar ratio.

Morphometric analysis of type I collagen fibrils in the osteoid of osteogenesis imperfecta

Electron microscopy and morphometric measurements of bone osteoid collagen diameter from 42 osteogenesis imperfecta (OI) patients and 25 age- and site-matched controls were carried out. Although the mean diameter did not correlate well with the severity of the disease, it related well with the clinical types and revealed collagen fibrils of reduced diameter in the osteoid of all OI types. Thus, OI type II (the severest type) demonstrated the smallest diameter (45 nm), followed by OI type I (the mildest form) with a mean diameter of 57 nm. The diameter obtained for type III (67 nm) and type IV (64 nm) was lower than the normal control mean diameter (73 nm) but did not show a statistical difference. The thinner fibrils observed in OI bone may be unable to provide nucleating and scaffolding sites for mineral propagation and may play a role in the fragility of bone in this disease.

Abnormal mineral composition of osteogenesis imperfecta bone as determined by electron probe X-ray microanalysis on conventional and cryosections

Osteogenesis imperfecta (OI) is a genetic disorder of the connective tissue characterized by frequent bone fractures. The cause of bone fragility is still unknown even though substantial work on collagen has been done. We measured the calcium to phosphorus ratio (Ca/P) of bone mineral from 35 OI bone samples and 25 age- and site-matched control specimens, using electron probe X-ray microanalysis in the transmission electron microscope. Ultra-thin cryosections and conventionally prepared resin sections were used. Cryo-ultramicrotomy avoids any possible artifactual demineralization that may occur in conventional aqueous media. The Ca/P ratio obtained by these two methods was compared and there was no statistical difference between them. The results were differentiated according to the clinical types of OI for the first time. The Ca/P ratio of OI bone mineral was lower than normal in both resin and cryosections, and mirrored the severity of the disease. OI type II had the lowest ratio (Ca/P = 1.49) compared with normal age- and site-matched controls (Ca/P = 1.69). This abnormal mineral composition in OI type II could be a contributory factor to bone fragility in OI bone.

Association of magnesium whitlockite crystals with lipid components of the extracellular matrix in human articular cartilage

Several basic calcium phosphate mineral phases have been reported to be associated with osteoarthritis joint disease. Magnesium whitlockite crystal deposition has been reported in both osteoarthritic and normal human articular cartilage. Existing data suggest that likely prevailing conditions within cartilage would not support de novo whitlockite formation. It would appear, therefore, that additional factors must be extant at sites of crystal deposition. In this study normal articular cartilage specimens were examined for the presence and distribution of lipids relative to crystal deposition within the extracellular matrix. Specimens were examined using light and transmission electron microscopy (TEM), with standard processing protocols plus a malachite green-glutaraldehyde-osmium tetroxide (MGO) method, used to retain lipids normally removed from tissues during preparation for electron microscopy. Elemental maps of sections produced using this method were also made using X-ray microanalysis. Positive oil red O staining for lipid was clearly apparent immediately below and parallel to the articular surface of cartilage specimens using light microscopy. The extent and distribution of staining correlated well with the distribution of crystals, observed by TEM, in sections of tissue from adjacent sites of the same specimens. Using standard TEM, crystals were frequently observed scattered amongst intramatrical lipidic debris, particularly pericellularly, in areas of cell necrosis and amongst close packed tangential fibers between the articular surface and initial superficial zone chondrocytes. Cartilage specimens processed using the MGO method demonstrated electron dense features, not apparent using standard techniques, identified as lipid. Such extracellular lipid deposition varied with depth, with 100 nm globular bodies present in the superficial region, where colocalization of crystals and lipid were observed in about 10% of crystal observations. The association of lipid and crystal deposition is discussed in the context of phospholipid associated mineral formation and the potential role of such magnesium whitlockite deposition assessed.

An ultrastructural and immunogold localization study of proteoglycans associated with the osteocytes of fetal bone in osteogenesis imperfecta

Osteogenesis imperfecta (OI) is a rare, heterogeneous, inherited connective tissue disorder frequently caused by abnormalities of type I collagen. It is characterized by bone fragility, osteopenia, and progressive skeletal deformities. Electron microscopy of three OI type II fetal bone samples revealed numerous large osteocyte lacunae. In addition, there was a perilacunar osteoid-like band of collagen surrounding the osteocytes, which was unmineralized and morphologically unusual. Furthermore, large osteocyte lacunae contained fine particles and filamentous material similar to the expected ultrastructural appearance of proteoglycans. More detailed examination was carried out using histochemical and immunogold localization of proteoglycans at light and ultrastructural levels. These tests and the use of electron probe X-ray microanalysis confirmed that the material in the osteocyte lacunae was proteoglycan. In contrast, in the age- and site-matched normal fetal bone, all the osteocyte lacunae appeared negative for proteoglycan. Proteoglycans are regarded as inhibitors of calcification. Our observation of substantial amounts of proteoglycan in abnormally enlarged osteocytic lacunae of some OI fetal bone suggests association with the abnormal bone of this particular subtype of OI type II.

Mineral changes in a transgenic mouse model for osteogenesis imperfecta

A line of transgenic mice has been investigated that expressed moderate levels of an internally deleted human gene for the pro alpha 1(I) chain of type I procollagen to determine if they would make a good model for osteogenesis imperfecta (brittle bone disease). Previous workers have reported extensive fracturing in these mice, with femurs that were shorter and bone that had decreased ash weight, mineral and collagen content. These workers demonstrated increased brittleness in the bone by biomechanical measurements. The molar calcium to phosphorus ratio in bone from patients with osteogenesis imperfecta has previously been reported to be lower than that in normal human bone. Mineral changes were observed at the ultrastructural level in these mice and were comparable with those seen in patients with osteogenesis imperfecta. Bone from both transgenic and normal littermate mice was examined to determine if any similarity with the data for human osteogenesis imperfecta could be drawn. X-ray microanalysis of bone mineral demonstrated a lower calcium to phosphorus molar ratio in transgenic mouse bone than in normal littermates. Fourier-transform infra-red spectroscopy confirmed that the mineral present was apatitic in nature despite the lower calcium to phosphorus molar ratio. Multiple fracture calluses were present on the ribs and on the long bones of the transgenic mice; this was absent in normal littermates. This mouse model may lead to a better understanding of the underlying pathology resulting in fragile bones in osteogenesis imperfecta.

A morphological and ultrastructural study of bone in osteogenesis imperfecta

A morphological and electron microscopic study of bone from patients with osteogenesis imperfecta (OI) has been performed. Bone from OI patients from various anatomical sites has been compared with that from normal, age-, site-, and sex-matched controls. The morphology of OI bone appeared variable among patients and sites of bone examined. Immature woven bone and a poor lamellar pattern were the significant morphological features and demonstrated that OI could not be characterized on the basis of a single histological pattern. At the ultrastructural level, a number of previously unreported features were evident. Abnormal collagen fibers and an altered mineral composition were found in many OI patients, however, the panoramic heterogeneity between clinical types and indeed within a single clinical type made it difficult to classify OI in this manner. The presence of intermitochondrial inclusions containing calcium and phosphorus and the presence of a stromal calcification in the bone in some OI patients suggested an abnormal mineral formation. Qualitatively, no obvious difference in the number of osteoblasts or osteoclasts was observed. The morphology and ultrastructure of OI bone were good indicators of the disease and serve a role in assessing the progress of a patient through diagnosis and treatment. This report presents new ultrastructural findings in collagen and in mineral formation in OI compared with normal human bone.

The isolation and characterization of magnesium whitlockite crystals from human articular cartilage

A number of basic calcium phosphate crystals have been demonstrated in human articular tissues. The exact relationship between crystal deposition and disease remains obscure, although there is evidence supporting a rapid degenerative arthropathy within a specific set of patients. Limited reports of 'cuboid' calcium phosphate microcrystals in articular cartilage have been made over the last 10 years. In this study the occurrence of such crystals, not apparent by light microscopy, in human articular cartilage has been confirmed by transmission electron microscopy and X-ray microanalysis of tissue prepared by aqueous and anhydrous processing techniques. A crystal isolation technique involving collagenase digestion, centrifugation and sodium hypochlorite treatment was developed enabling crystal characterization by electron and X-ray diffraction. Crystals were identified as magnesium whitlockite; the first report of this mineral in articular cartilage. The presence of this mineral phase in normal and osteoarthritic articular cartilage is discussed with consideration given to physical conditions known to favor whitlockite formation and those extant in articular cartilage.

Magnesium whitlockite deposition in articular cartilage: a study of 80 specimens from 70 patients

OBJECTIVE

To examine articular cartilage from a number of joint sites, using a large sample group, for the presence of magnesium whitlockite crystal deposition.

METHODS

Articular cartilage specimens were taken from a total of 70 patients. The majority of specimens were taken from femoral heads, with smaller numbers from femoral condyle, tibial plateau, radius, ulna, and several small peripheral joints. Normal and osteoarthritic articular cartilage specimens were obtained from patients undergoing prosthesis replacement or amputation. Specimens were resin embedded and examined using transmission electron microscopy and x ray microanalysis.

RESULTS

Magnesium whitlockite crystals were identified, on the basis of morphology, size and elemental composition, in articular cartilage from all sites sampled. The distribution of crystals was similar in all samples (restricted to the superficial zone), although the density of deposition was extremely variable, with the greatest density observed in femoral head specimens. No magnesium whitlockite crystals were observed in osteophytic or epiphysial cartilage.

CONCLUSIONS

This study demonstrated the widespread extent of magnesium whitlockite deposition in human articular cartilage, albeit at much lower density than previously reported in femoral head articular cartilage. In consideration of possible roles for these crystals in articular cartilage, it is concluded that an opportunistic mode of formation, possibly influenced by mechanical stresses, would be most plausible.

An electron probe X-ray microanalytical study of bone mineral in osteogenesis imperfecta

A semiquantitative electron probe X-ray microanalytical (XRMA) technique, in conjunction with transmission electron microscopy, was used to compare the calcium to phosphorus (Ca/P) molar ratios in calcium phosphate standards of known composition, in normal bone and in bone from patients with osteogenesis imperfecta (OI). Using a modified routine processing and resin embedding schedule, the measured Ca/P molar ratio of calcium phosphates standards of known composition were found to correlate well with the Ca/P molar ratio based on their respective chemical formulae. This technique was then used to compare the Ca/P molar ratio in normal human bone and in OI bone. The Ca/P ratio values for normal bone (Ca/P = 1.631) correlated well with those for chemically prepared hydroxyapatite (Ca/P = 1.602), but in bone from OI patients, the Ca/P molar ratio was significantly lower (Ca/P = 1.488). This study has shown that there is a lower Ca/P molar ratio in OI bone compared with normal, matched bone. This suggests that the mineral deviates from the carbanoapatite usually found in bone. Isomorphous substitutions in the carbanoapatite lattice could account for this although this study has neither proved nor disproved this. The altered bone mineral is another factor that could contribute to the increased fracture rate observed in OI.

An ultrastructural, microanalytical, and spectroscopic study of bone from a transgenic mouse with a COL1.A1 pro-alpha-1 mutation

A line of transgenic mice have been investigated that expressed moderate levels of an internally deleted human gene for the pro alpha (I) chain of type I procollagen. These mice expressed the gene at approximately 50% that of the endogenous gene. The gene construct was modeled after a sporadic in-frame deletion of the human gene that produced a lethal variant of osteogenesis imperfecta by causing biosynthesis of shortened pro alpha (I) chains. Periera et al. (1993) reported extensive fracturing in these mice with femurs that were shorter in length and bone that had decreased ash weight, mineral, and collagen content. These workers demonstrated an increased brittleness in bone using biomechanical measurements. The functional consequences of these mutant genes were examined in both transgenic and in normal littermate mice to determine if a valid model at the ultrastructural and analytical level had been produced for OI. X-ray microanalysis of bone mineral demonstrated a significantly lower calcium-to-phosphorus (Ca/P) molar ratio in transgenic mouse bone than in normal littermates; this was a feature of human OI bone. Fourier transform infrared spectroscopy confirmed that the mineral present was apatitic in nature despite the lower Ca/P molar ratio. Alizarin red skeletal staining showed the presence of multiple fracture calluses on the ribs and on the long bones of some of the transgenic mice, this was not seen on normal littermates. No light microscopic differences were observed between normal and transgenic mice; however, many ultrastructural correlates with human OI were observed in the transmission electron microscope. Anomalous fibrils associated with type I collagen, and an amorphous calcified material was observed lining the cartilage, extending beyond the lamina limitans in young transgenic mice.

A morphometric analysis of osteoid collagen fibril diameter in osteogenesis imperfecta

Osteogenesis imperfecta is a genetic disorder of connective tissue characterised by frequent bone fracture following minimal trauma. Mutations of type I procollagen genes have been widely reported as the cause of OI and such mutations have been shown to introduce kinks into the collagen molecule. A study was performed to examine type I collagen fibrils at the ultrastructural level in the transmission electron microscope (TEM). Type I collagen fibrils from the bone osteoid of OI patients and age- and site-matched normal control bone were photographed in the electron microscope. A histomorphometric analysis of the diameters of collagen fibrils photographed in the TEM indicated that type I collagen in OI bone was larger in diameter compared with normal bone. This increase in diameter of type I collagen fibrils may represent an alteration in the quaternary structure of the collagen fibril as a consequence of kinked, poorly packed collagen molecules. Such alteration in the collagen fibrils may affect the formation and stability of bone mineral associated with it.

Cell and matrix changes associated with pathological calcification of the human rotator cuff tendons

The causative mechanism of tendon calcification ('calcifying tendinitis') is unknown. In this report, pathological human tendon samples were examined to give morphological and ultrastructural detail of the calcified regions and these findings were compared with those from normal tendon. Selected specimens were cryosectioned to enable histochemical and immunohistochemical comparison of the occurrence and distribution of specific matrix molecules in diseased and normal tendon tissues. The lack of collagen type II and alkaline phosphatase in the pathological regions suggests that the calcification process is not mediated through an endochondral transition. In contrast, the pathological areas were characterised by widespread labelling for chondroitin-4-sulphate/dermatan sulphate and intense pericellular localisation of chondroitin-6-sulphate.

Calcium phosphate crystal distribution in the superficial zone of human femoral head articular cartilage

The distribution of cuboid crystals in articular cartilage was examined by image analysis of electron micrographs. The specimens were considered to be functionally normal articular cartilage from femoral heads resected either because of femoral neck fracture or tumour in the distal femur. The study was restricted to the superficial region between 0 and 50 microns depth. Crystals were present in all specimens regardless of the age of the patient. The crystal profile area density was significantly greater in superior region samples than inferior region samples and this difference was less in older specimens. A band of microcrystals 10-20 microns below the articular surface was observed in superior samples. A significant correlation between mean individual crystal profile area and age was observed. It is noted that crystals are present in regions of cartilage subject to high mechanical stress.

Production of endothelial cell stimulating angiogenesis factor (ESAF) by chondrocytes during in vitro cartilage calcification

The aim of this study was to identify the stimulus for production of the latent collagenase and angiogenic activator ESAF by growth plate chondrocytes. Stimulation correlated most closely with matrix calcification. Alkaline phosphatase was necessary for calcification (and so stimulation of ESAF production) but we could find no evidence for a direct link with ESAF production. ESAF production was also stimulated by addition of preformed mineral to non-calcified cultures but was inhibited by dexamethasone. Protein synthesis was necessary for the stimulation of ESAF production by calcification, though ESAF is not itself a protein. Based on these findings we suggest that chondrocytes, at a suitable stage of maturation in the growth plate, are stimulated to produce ESAF by the proximity of crystals in the matrix. Stimulation, which may consist of the induction of an enzyme or transport protein, leads to the release of this potent activator of collagenolysis as part of the angiogenic cascade.

Microvascular invasion of rabbit growth plate cartilage and the influence of dexamethasone

The normal morphological features of growth plate angiogenesis were examined in rabbits and compared with changes induced by dexamethasone. Penetration of growth plate cartilage was led by perivascular cells with some contribution by luminal capillary endothelial cells. There was a close relationship between the invasive perivascular cells and the luminal endothelial cells of the capillary tip. Growth plates from rabbits treated with dexamethasone underwent major changes in the pattern of capillary invasion. Most striking was the appearance of numerous narrow and tortuous channels which penetrated the cartilage, in some cases forming complete loops. These channels were filled with debris or red cells but did not contain capillaries. It is suggested that dexamethasone treatment leads to channel formation by disrupting the normal control of capillary invasion.

Growth hormone in polymethylmethacrylate cement

The in vitro release of human growth hormone (hGH) from polymethylmethacrylate bone cement was measured for up to 40 days using a specific enzyme-linked immunosorbent assay. In rabbits, hGH-loaded bone cement was inserted into one distal femur and plain cement was inserted into the contralateral distal femur as a control. The rabbits were killed at time intervals of one, two, and four months after surgery and the distal femurs embedded whole for histology. Quantitative histomorphometry indicated there was a greater percentage of osteoid present at the hGH-loaded cement surface than at the plain cement surface one month after implantation. The hGH released from bone cement may stimulate osteogenesis and new bone formation, thus improving the strength of the bone-cement interface.

Ultrastructural features of the osteoid of patients with fibrogenesis imperfecta ossium

The osteoid of a patient with Fibrogenesis Imperfecta Ossium is described. Three iliac crest biopsies were taken; firstly before treatment, secondly after calcitriol therapy and finally after successful treatment with melphalan and prednisolone. In the pretreatment biopsy the osteoid was greatly enlarged, showed complete absence of the birefringence characteristic of oriented collagen fibers, and at ultrastructural level was shown to be composed of abnormal collagen fibrils. The fibrils were often curved and were extremely variable in thickness. Calcification within the osteoid took the form of calcospherites and spread of calcification from these to collagen fibrils was greatly delayed. In the second biopsy two aspects of osteoid ultrastructure were noted; some samples resembled the first biopsy, but others had a different organization. The osteoid of these samples had two regions: an inner region containing abnormal collagen fibrils and an outer region composed of moderately electron-dense amorphous material. The osteoblasts associated with this region were clearly highly biosynthetically active. The third biopsy, after treatment with Melphalan and prednisolone, showed a reversion to more normal bone ultrastructure with uniform, oriented collagen fibrils and prompt mineralization resulting in narrow osteoid seams. Remnants of the original abnormal osteoid were present in the marrow space as calcified debris. Reasons for the success of this therapeutic regime are unclear; however, some speculation is made as to the possible roles of the cytotoxic drug and the glucocorticoid in the regression of this condition.

Separation of rabbit epiphyseal chondrocytes in various stages of differentiation

Separation of fractions enriched in hypertrophic cells and proliferative cells has been achieved by density gradient centrifugation of cells from collagenase digests of rabbit epiphyseal cartilage. Concentrated suspensions of cells are centrifuged on a continuous Percoll density gradient. Hypertrophic cells remain in the upper part of the gradient and proliferative zone cells move to the lower regions. The resultant fractions show differences in mean cell diameter, alkaline phosphatase activity, morphology and synthetic activity in culture. Fractions rich in hypertrophic cells contain larger cells and more alkaline phosphatase activity than those enriched in proliferative cells. In culture the hypertrophic cells flatten as large irregular polygonal cells, whereas proliferative fractions form smaller spindle-shaped cells. In micromass culture hypertrophic fractions incorporate less 35S-sulphate and 14C-proline, and less tritiated thymidine than do proliferative fractions. These results suggest a general reduction in matrix and DNA synthesis with the attainment of the fully differentiated hypertrophic state, coincident with the expression of alkaline phosphatase activity and mineralisation of the cartilage matrix.

Ultrastructural localisation of alkaline phosphatase activity in osteoarthritic human articular cartilage

The distribution of alkaline phosphatase activity in human articular cartilage from normal and osteoarthritic joints has been examined by an electron microscope technique, probably for the first time. In osteoarthritic cartilage chondrocytes and matrix vesicles close to the tidemark were positive for alkaline phosphatase activity. Large numbers of matrix vesicles were found within the extracellular matrix of osteoarthritic cartilage, and there is a specific relation between phosphatase activity, matrix vesicles, and initial mineral formation in the tidemark region of articular cartilage.

Ultrastructural localisation of fibronectin in human osteoarthritic articular cartilage

A protein A-gold immunolocalisation technique has been used on sections of femoral head articular cartilage to localise fibronectin. Chondroitinase treatment enhanced gold staining, particularly when tissue samples were digested before fixation. The greatest accumulations of fibronectin were seen in the surface zone of osteoarthritic cartilage. Disease free cartilage contained very little fibronectin in this region. Cells which appeared to produce fibronectin were rare in normal specimens but common in the superficial region of osteoarthritic cartilage. These chrondrocytes appeared to release fibronectin as part of an amorphous material which accumulated in the pericellular region. This is the first ultrastructural demonstration of fibronectin synthesis by articular cartilage chondrocytes.

Epiphyseal growth plate cartilage and chondrocytes in mineralising cultures produce a low molecular mass angiogenic procollagenase activator

We have investigated one aspect of the biochemical control of angiogenesis in the mammalian growth plate. This is the first report of an angiogenic compound from normal growing skeletal tissue. The active agent was indistinguishable from ESAF (endothelial cell-stimulating angiogenic factor), previously identified from tumour, retina and synovial fluid. 1. Using a procollagenase activation assay, ESAF was detected in low molecular weight extracts of growth plate cartilage from two species (foetal calf and young rabbit). ESAF content declined with increasing age of the foetal calf growth plate cartilage. 2. Rabbit growth plate chondrocytes in high density culture also produced ESAF 24-48 h after calcification of the culture. Inhibition of alkaline phosphatase in these cultures reduced the stimulation of ESAF production. These findings suggest that ESAF production occurs as a stage in chondrocyte differentiation which is linked with the onset of matrix calcification. A model is proposed for the control of angiogenesis in the growth plate.

An immunohistochemical study of fibronectin in human osteoarthritic and disease free articular cartilage

Fibronectin is a minor component of cartilage connective tissue matrix, which is reported to accumulate in increased amounts in osteoarthritis. The presence of raised levels of fibronectin in human osteoarthritic cartilage by immunoperoxidase localisation is confirmed. Residual femoral head articular cartilage from 17 patients with osteoarthritis contained variable but substantial amounts of fibronectin. This was localised mainly in a band within the matrix of the surface zone. No significant deposits of fibronectin were found in this or any other area of the normal specimens. Intracellular fibronectin was identified in some cells of the surface zone, indicating that it was, in part, synthesised locally. The presence and distribution of locally produced fibronectin in osteoarthritic cartilage suggest that its synthesis is a response by chondrocytes to changes in the cartilage matrix.

Nucleoside triphosphate pyrophosphatase of rabbit matrix vesicles, a mechanism for the generation of inorganic pyrophosphate in epiphyseal cartilage

Inorganic pyrophosphate (PPi) may be important in the regulation of mineralisation but its origin in epiphyseal cartilage is ill-defined. Nucleoside triphosphate pyrophosphatase is one potential source, as this enzyme catalyses the formation of PPi from nucleoside triphosphates. This enzyme has been identified in matrix vesicles derived from rabbit epiphyseal cartilage and a method developed to measure the activity using ATP as substrate in intact matrix vesicles under relatively physiological conditions. The enzyme had a high affinity for ATP (Km less than 10 microM) and was also active towards GTP, CTP and UTP. Disruption of the matrix vesicle membrane by sonication failed to alter the activity. Treatment of sonicated matrix vesicles with Triton X-100 increased the activity which may indicate a direct effect of the detergent on the enzyme. Activity towards ATP was inhibited substantially by ADP and AMP and by another potential substrate beta,gamma-methyleneadenosine 5'-triphosphate. Dichloromethylene bisphosphonate, an analogue of the product PPi, inhibited the activity to a lesser extent. Two other potential substrates, NADP+ and thymidine 5'-monophosphate p-nitrophenyl ester were only weakly inhibitory as was 1-hydroxyethylidene 1,1-bisphosphonate. These results imply that nucleoside triphosphates are the substrates in vivo and the inhibitory effects of ADP and AMP suggest mechanisms whereby this activity could be regulated.

Mineralization in in vitro cultures of rabbit marrow stromal cells

Localized regions of mineralization were found in confluent cultures of rabbit marrow fibroblastic cells. The mineralized tissue developed within clusters of giant fat cells in the spaces between the cells. Investigations with light and electron microscopy demonstrated that in these sites there was some differentiation of the fibroblastic cells in an osteogenic direction, shown by changes to more polygonal shapes, and the synthesis of well-banded collagen similar to that found in bone tissue. Differentiation may be due, in part, to increased cell density in a confined space. Growth of the mineralized tissue was observed in the living cultures with a fluorescence microscope. Electron probe microanalysis confirmed that the mineral formed was hydroxyapatite. Initiating sites of mineralization included membranous vesicular bodies, lipid, and products of cellular degeneration. Once initiated, mineralization appeared to spread rapidly into adjacent collagenous and other structures, suggesting the appearance of a mixture of skeletal-type and dystrophic mineralization.

Distribution of alkaline phosphatase activity in experimentally produced callus in rats

Experimentally produced fractures in long bones studied by light and electron microscopic histochemistry were found to heal by a process of enchondral calcification. There was intense proliferation in the cells of the cambium layer of the periosteum, with differentiation to chondroblasts and osteoblasts, suggesting that this layer was the primary tissue responsible for development of the callus. Cytoplasmic processes of the hypertrophic chondrocytes appeared to bud and produce matrix vesicles. Alkaline phosphatase activity was detected along the plasma membrane of the hypertrophic chondrocytes and around the matrix vesicles, before any signs of mineral deposition. Calcification took place by deposition of hydroxyapatite crystals in and around these matrix vesicles which frequently showed alkaline phosphatase activity. It is suggested that there is a close functional association between alkaline phosphatase activity and calcification in the process of fracture healing, which is another type of enchondral calcification mediated by matrix vesicles.

Biochemical and histological changes in osteoarthritic synovial membrane

In order to investigate the relationship between the synovial inflammatory response and lysosomal enzyme activity in osteoarthritis, synovial specimens obtained from 19 osteoarthritic patients and control specimens from 10 normal joints were analysed for cathepsin D and acid phosphatase enzyme levels. In estimating enzyme activities methods previously developed for quantitative enzyme determination in cartilage were modified and applied to synovial tissues for the first time. In addition, samples of osteoarthritic synovium were histologically graded according to their degree of inflammation. It was found that in osteoarthritic synovium cathepsin D and acid phosphatase, which is a general marker for lysosomal enzyme activity, were significantly increased compared with normal control synovium. No significant relationship was found between the degree of synovial tissue inflammation and lysosomal enzyme activity.

Delayed aggregation of proteoglycans in adult human articular cartilage

The biosynthesis and macromolecular organization of proteoglycans was studied in explants of adult human articular cartilage. In a series of pulse-chase experiments, labelling with (35S)sulphate, it was shown that the proteoglycan monomer is synthesized as a precursor that has a low affinity for hyaluronic acid. These findings suggest a possible mechanism by which the rate of incorporation of proteoglycans into the extracellular matrix may be controlled.

The composition of normal and osteoarthritic articular cartilage from human knee joints. With special reference to unicompartmental replacement and osteotomy of the knee

The articular cartilage from nineteen osteoarthritic and fourteen normal control adult human knee joints was analyzed for changes in water content, proteoglycan composition and structure, glycosaminoglycan synthesis rates, and cell content. We found no significant differences between visually intact cartilage from osteoarthritic knee joints and cartilage from control joints for any of the parameters studied. In osteoarthritic specimens in which the cartilage surface was not intact the biochemical changes depended on the degree of fibrillation. Surface-fibrillated specimens had a higher water content in the surface layers but no change in the content or synthesis rate of glycosaminoglycan. Deeply fibrillated cartilage, however, had an increased water content through its full depth, and there was a decrease in both the rate of synthesis and the content of glycosaminoglycans.

CLINICAL RELEVANCE

The results of this study suggest that degenerative changes in osteoarthritic knees are focal in origin and that corrective osteotomy or unicompartmental joint replacement might be rational procedures for knees in which the cartilage in all of one compartment is visually intact.

Differences in the rates of aggregation of proteoglycans from human articular cartilage and chondrosarcoma

Pieces of adult human articular cartilage and chondrosarcoma were incubated in the presence of [35S]sulphate. After continuous or pulse-change incorporation of radioactivity, proteoglycans were extracted with 4.0 M-guanidinium chloride, purified by equilibrium density-gradient centrifugation and fractionated by gel chromatography. A comparison of the results suggests that the formation of stable aggregates occurs at a lower rate in articular cartilage than in chondrosarcoma.

Structure of proteoglycans from different layers of human articular cartilage

Full-depth plugs of adult human articular cartilage were cut into serial slices from the articular surface and analysed for their glycosaminoglycan content. The amount of chondroitin sulphate was highest in the mid-zone, whereas keratan sulphate increased progressively through the depth. Proteoglycans were isolated from each layer by extraction with 4M-guanidinium chloride followed by centrifugation in 0.4M-guanidinium chloride/CsCl at a starting density of 1.5 g/ml. The efficiency with which proteoglycans were extracted depended on slice thickness, and extraction was complete only when cartilage from each zone was sectioned at 20 microns or less. When thick sections (250 microns) were extracted, hyaluronic acid was retained in the tissue. Most of the proteoglycans, extracted from each layer under optimum conditions, could interact with hyaluronic acid to form aggregates, although the extent of aggregation was less in the deeper layers. Two pools of proteoglycan were identified in all layers by gel chromatography (Kav. 0.33 and 0.58). The smaller of these was rich in keratan sulphate and protein, and gradually increased in proportion through the cartilage depth. Chondroitin sulphate chain size was constant in all regions. The changes in composition and structure observed were consistent with the current model for hyaline-cartilage proteoglycans and were similar to those observed with increasing age in human articular cartilage.

Formation of calcium phosphate crystals in normal and osteoarthritic cartilage

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Age-related changes in the composition and structure of human articular-cartilage proteoglycans

1. Analysis of the purified proteoglycans extracted from normal human articular cartilage with 4M-guanidinium chloride showed that there was an age-related increase in their content of protein and keratan sulphate. 2. The hydrodynamic size of the dissociated proteoglycans also decreased with advancing age, but there was little change in the proportion that could aggregate. 3. Results suggested that some extracts of aged-human cartilage had an increased content of hyaluronic acid compared with specimens from younger patients. 4. Dissociated proteoglycans, from cartilage of all age groups, bind to hyaluronic acid and form aggregates in direct proportion to the hyaluronic acid concentration. 5. Electrophoretic heterogeneity of the dissociated proteoglycans was demonstrated on polyacrylamide/agarose gels. The number of proteoglycan species observed was also dependent on the age of the patient.

Studies on cathepsin B in human articular cartilage

The thiol proteinase cathepsin B (EC 3.4.22.1), previously called cathepsin B1, was assayed in human articular cartilage by its hydrolysis of the synthetic substrate alpha-N-benzoyl-DL-arginine 2-naphthylamide. The enzyme was activated by cysteine and EDTA and completely inhibited by iodoacetamide and HgCl2. It was also partially inhibited by whole human serum. Human osteoarthrotic cartilage had increased activity when compared with normal cartilage. Cathepsin B activity of normal cartilage was age-related, being high in juveniles and declining to low values in adult and elderly individuals. Cathepsin D and cathepsin B both exhibited a zonal variation through the cartilage depth; the surface cells appeared to contain more activity than those close to the subchondral bone.

Isolation of proteoglycans from human articular cartilage

Proteoglycans were extracted from normal human articular cartilage of various ages with 4M-guanidinium chloride and were purified and characterized by using preformed linear CsCl density gradients. With advancing age, there was a decrease in high-density proteoglycans of low protein/uronic acid weight ratio and an increase in the proportion of lower-density proteoglycans, richer in keratan sulphate and protein. Proteoglycans of each age were also shown to disaggregate in 4M-guanidinium chloride and at low pH and to reaggregate in the presence of hyaluronic acid and/or low-density fractions. Osteoarthrotic-cartilage extracts had an increased content of higher-density proteoglycans compared with normal cartilage of the same age, and results also suggested that these were not mechanical or enzymic degradation products, but were possibly proteoglycans of an immature nature.