Diurnal fluid expression and activity of intervertebral disc cells

The intervertebral discs are large cartilaginous structures situated between the vertebral bodies, occupying around one third of the length of the spinal column. They act as the joints of the spine and carry mechanical load arising from body weight and muscle activity. Loads change with every alteration of posture and activity and the discs thus undergo a diurnal loading pattern with high loads on the discs during the day's activity and low loads on it at night during rest. As the disc is an osmotic system, around 25% of the disc's fluid is expressed and re-imbibed during each diurnal cycle with consequent changes in the osmotic environment of the disc cells. Here, present information on the effect of osmotic changes in disc cell metabolism is reviewed; results indicate that prevailing osmolarity is a powerful regulator of disc cell activity.

Age-related accumulation of the advanced glycation endproduct pentosidine in human articular cartilage aggrecan: the use of pentosidine levels as a quantitative measure of protein turnover

During aging, non-enzymatic glycation results in the formation and accumulation of the advanced glycation endproduct pentosidine in long-lived proteins, such as articular cartilage collagen. In the present study, we investigated whether pentosidine accumulation also occurs in cartilage aggrecan. Furthermore, pentosidine levels in aggrecan subfractions of different residence time were used to explore pentosidine levels as a quantitative measure of aggrecan turnover. In order to compare protein turnover rates, protein residence time was measured as racemization of aspartic acid. As has previously been shown for collagen, pentosidine levels increase with age in cartilage aggrecan. Consistent with the faster turnover of aggrecan compared to collagen, the rate of pentosidine accumulation was threefold lower in aggrecan than in collagen. In the subfractions of aggrecan, pentosidine levels increased with protein residence time. These pentosidine levels were used to estimate the half-life of the globular hyaluronan-binding domain of aggrecan to be 19.5 years. This value is in good agreement with the half-life of 23.5 years that was estimated based on aspartic acid racemization. In aggrecan from osteoarthritic (OA) cartilage, decreased pentosidine levels were found compared with normal cartilage, which reflects increased aggrecan turnover during the OA disease process. In conclusion, we showed that pentosidine accumulates with age in aggrecan and that pentosidine levels can be used as a measure of turnover of long-lived proteins, both during normal aging and during disease.

Depth-dependent compressive properties of normal aged human femoral head articular cartilage: relationship to fixed charge density

OBJECTIVES

Determine the depth-varying confined and osmotic compression moduli of normal human articular cartilage from the femoral head, and test whether these moduli are dependent on fixed charge density.

METHODS AND RESULTS

Using an automated instrument to allow epifluorescence microscopy analysis during confined compression testing on cartilage samples, the equilibrium confined compression modulus (H(A 0)) was found to vary markedly with depth (z=0-1500 microm) from the articular surface. H(A 0) increased from 1.16+/-0.20 MPa in the superficial (0-125 microm) layer to 7.75+/-1.45 MPa in the deepest (1250-1500 microm) layer tested, and was fit by the expression, H(A 0)(z) [MPa]=1.44 exp(0.0012.z [microm]). Also, in successive slices of cartilage extending from the articular surface to the middle-deep regions, the bulk modulus (K(0)) and fixed charge density (FCD) increased, consistent with previous findings. While H(A 0), K(0), and FCD each varied with depth from the articular surface, the dependence of H(A 0) and K(0) on depth did not appear to be completely related to variations in FCD.

CONCLUSIONS

The confined compression modulus of normal aged human femoral head articular cartilage increases markedly with depth from the articular surface, a trend similar to that observed for articular cartilage from other joints in animals but with an absolute amplitude that is several-fold higher. The compressive properties were not simply related to FCD at different depths from the articular surface, suggesting that other as yet undefined factors also contribute to compressive properties.

The increased swelling and instantaneous deformation of osteoarthritic cartilage is highly correlated with collagen degradation

OBJECTIVE

To provide evidence for the hypothesis that the loss of tensile strength of osteoarthritic (OA) cartilage (resulting in swelling-the hallmark of OA) is due to an impaired collagen network and not to loss or degradation of proteoglycans.

METHODS

The amount of degraded collagen molecules, the fixed charge density (FCD) on a dry-weight basis, the degree of swelling in saline, and the instantaneous deformation (ID; a test reflecting the tensile stiffness of the collagen network) were measured in full-depth OA femoral condyle samples. In addition, levels of the crosslink hydroxylysylpyridinoline (HP), the amount of degraded collagen molecules, and the degree of swelling were determined in the 3 zones (surface, middle, and deep) of OA cartilage. We also compared the ID of normal and OA cartilage.

RESULTS

In full-depth OA cartilage, a close relationship was found between swelling and ID. Swelling and ID correlated strongly with the amount of degraded collagen molecules, and were not related to FCD. OA cartilage showed the same zonal pattern in HP levels as normal cartilage (i.e., an increase with depth). No relationship was found between collagen crosslinking and swelling of the surface, middle, and deep zones. In all 3 zones, swelling was proportional to the amount of degraded collagen molecules. Compared with that of normal cartilage, the change in ID of OA cartilage was most pronounced at the surface in a direction parallel to the direction of the collagen fibrils.

CONCLUSION

The decreased stiffness of the OA collagen network (as measured by swelling and ID) is strongly related to the amount of degraded collagen molecules. The anisotropy in ID parallel and perpendicular to the direction of the fibrils revealed that the impairment of strength resides mainly in, and not between, the fibrils. Proteoglycans play only a minor role in the degeneration of the tensile stiffness of OA cartilage.

The osmotic pressure of chondroitin sulphate solutions: experimental measurements and theoretical analysis

We used equilibrium dialysis to measure the osmotic pressure of chondroitin sulphate (CS) solutions as a function of their concentration and fixed charge density (FCD) and the ionic strength and composition of the solution. Osmotic pressure varied nonlinearly with the concentration of chondroitin sulphate and in 0.15 M NaCl at FCDs typical of uncompressed cartilage (approximately 0.4 mmol/g extrafibrillar H2O) was approximately 3 atmospheres. Osmotic pressure fell by 60% as solution ionic strength increased up to about 1 M, but remained relatively constant at higher ionic strengths. The ratio of Ca2+ to Na+ in the medium was a minor determinant of osmotic pressure. The data are compared with a theoretical model of the electrostatic contribution to osmotic pressure calculated from the Poisson-Boltzmann equation using a rod-in-cell model for CS. The effective radius of the polyelectrolyte rod is taken as a free parameter. The model qualitatively reproduces the non-linear concentration dependence, but underestimates the osmotic pressure by an amount that is independent of ionic strength. This difference, presumably arising from oncotic and entropic effects, is approximately 1/3 of the total osmotic pressure at physiological polymer concentrations and ionic strength.

The effects of pH and ionic strength on intrafibrillar hydration in articular cartilage

The hydration of articular cartilage is an essential determinant of its load bearing capacity. Here we have examined the dependence of the amount of intrafibrillar water, associated with the collagen molecules in both native and PG-depleted cartilage specimens, on the pH and ionic strength of the bathing solution, in the presence and absence of an externally applied pressure. We found that high ionic strength reduces the collagen intermolecular spacing over a large pH range: this is consistent with the electrostatic nature of the interactions between the charged groups within the intrafibrillar space. We also found that as the pH is lowered from neutral to approximately 3, there is, as expected, a gradual increase in the overall positive charge of the intrafibrillar compartment. However, surprisingly, this is not accompanied by an increase in the intrafibrillar hydration; only at pH 1.8 does the amount of intrafibrillar water increase markedly. We suggest that, rather than overall intrafibrillar charge, it is specific local axial and azimuthal relationships among collagen molecules in the fibril, and more particularly, among their charged amino acid residues, that determine the intermolecular collagen spacing, and hence intrafibrillar hydration.

Mechanical properties of the collagen network in human articular cartilage as measured by osmotic stress technique

We have used an isotropic osmotic stress technique to assess the swelling pressures of human articular cartilage over a wide range of hydrations in order to determine from these measurements, for the first time, the tensile stress in the collagen network, Pc, as a function of hydration. Osmotic stress was applied by means of calibrated solutions of polyethylene glycol. Calculations of osmotic stress were based on the balance, at equilibrium, between the applied stress, the collagen stress, and the proteoglycan osmotic pressure, piPG, acting within the extrafibrillar matrix compartment. Pc vs hydration was determined for several normal human samples, both native and trypsin-treated, and for cartilage from one osteoarthritic (OA) joint. We found that for normal cartilage the collagen network does not become "limp" until the volume of cartilage has decreased by 20-25% of its initial value and that its contribution to the balance of forces in cartilage therefore must be taken into account over a much wider range of hydrations than was previously thought. For normal cartilage, the Pc vs hydration curves exhibit a steep increase with increasing hydration; trypsin treatment does not change their slope, showing that PG concentration does not influence the inherent stiffness of the collagen network. By contrast, the curves for OA specimens are considerably shallower and displaced to higher hydrations. Our findings thus highlight the role of the stiffness of the collagen network in limiting hydration in normal cartilage and ensuring a high PG concentration in the matrix, which is essential for effective load-bearing and is lost in OA.

Ageing and zonal variation in post-translational modification of collagen in normal human articular cartilage. The age-related increase in non-enzymatic glycation affects biomechanical properties of cartilage

A biomechanical failure of the collagen network is postulated in many hypotheses of the development of osteoarthritis with advancing age. Here we investigate the accumulation of non-enzymatic glycation (NEG) products in healthy human articular cartilage, its relation to tissue remodelling and its role in tissue stiffening. Pentosidine levels were low up to age 20 years, and increased linearly after this age. This indicates extensive tissue remodelling at young age, and slow turnover of collagen after maturity has been reached. The slow remodelling is supported by the finding that enzymatic modifications of collagen (hydroxylysine, hydroxylysylpyridinoline, and lysylpyridinoline) were not related to age. The high remodelling is supported by levels of the crosslink lysylpyridinoline (LP) as a function of distance from the articular surface. LP was highest at the surface in mature cartilage (>20 years), whereas in young cartilage (<10 years) the opposite was seen; highest levels were close to the bone. LP levels in cartilage sections at age 14 years are high at the surface and close to the bone, but they are low in the middle region. This indicates that maturation of cartilage in the second decade of life starts in the upper half of the tissue, and occurs last in the tissue close to the bone. The effect of NEG products on instantaneous deformation of cartilage was investigated as a functional of topographical variations in pentosidine levels in vivo and in relation to in vitro induced NEG. Consistently, higher pentosidine levels were associated with a stiffer collagen network. A stiffer and more crosslinked collagen network may become more brittle and more prone to fatigue.

Aggrecan turnover in human articular cartilage: use of aspartic acid racemization as a marker of molecular age

Aggrecan is a key component of the cartilage matrix. During aging, many changes occur in its composition and structure; in particular, there is an increase in the proportion of lower molecular weight monomers and of the "free" binding region. An important question has been whether these changes represent alterations in biosynthesis or whether they are due to the accumulation with age of the partially degraded fragments of the originally synthesized large monomer. In the present work we have used an independent tool, viz., the extent of racemization of aspartic acid to study the molecular "age" of different buoyant density fractions of the aggrecan of human articular cartilage, as well as of isolated free binding region and link protein. By measuring the D/LAsp ratio of the different aggrecan species, we were able to establish directly the relative residence times of these molecules in the cartilage matrix and, in combination with compositional and structural analyses, to define their "history" and calculate some of the kinetics constants characterizing their turnover. The value of the turnover constant for the large monomer in fraction A1D1 is 0.206 per year, which corresponds to a half-life of 3.4 years, while the turnover constant for the free binding region is 0.027 per year, which corresponds to a half-life of 25 years. It is thus clear that the rate of formation and turnover of the large monomer is much more rapid than the final degradation of the free binding region fragments, which explains the accumulation of the latter in cartilage during aging.

A simplified measurement of degraded collagen in tissues: application in healthy, fibrillated and osteoarthritic cartilage

Intact triple helical collagen molecules are highly resistant to proteolytic enzymes, whereas degraded (unwound) collagen is easily digested. This fact was exploited to develop a simplified method for the quantification of the amount of degraded collagen in the collagen network of connective tissues. Essentially, the method involves extraction of proteoglycans with 4 M guanidinium chloride, selective digestion of degraded collagen by alpha-chymotrypsin, hydrolysis in 6 M HCl of the released fragments as well as the residual tissue, and then measurement of the amount of hydroxyproline in both pools. Since the digestion of degraded collagen by alpha-chymotrypsin and measurement of hydroxyproline is not restricted to a specific collagen type, this technique can be applied to a wide variety of connective tissues. The method was validated with articular cartilage. Levels of in situ degraded collagen were about four-fold higher in degenerated (fibrillated) cartilage than in its healthy counterpart derived from the same donor. More detailed investigations revealed that the collagen damage in degenerated cartilage is more extensive at the cartilage surface than in the region adjacent to bone. This was not the case in healthy cartilage; identical low values were obtained at the surface and close to the bone. An impaired collagen network has been hypothesized to be the reason for the swelling of cartilage in osteoarthritis (OA). The present paper presents the first experimental evidence to support this hypothesis: more damage to the collagen network (i.e., more degraded collagen molecules within fibrils) is linearly related to more extensive swelling of the OA tissue in hypotonic saline.

Insulin-like growth factor-I and its complexes in normal human articular cartilage: studies of partition and diffusion

Insulin-like growth factor-I (IGF-I) plays a major role in cartilage homeostasis. Our objective was to study the penetration of IGF-I, both alone and bound to serum proteins, into the different zones of normal human cartilage using radioactively labeled IGF-I. The uptake of free IGF-I was higher than that predicted on the basis of excluded volume calculations and showed concentration dependence: we attributed this to reversible binding of the hormone to the tissue. Since the extent of binding was much higher than that calculated for binding to cell receptors, we concluded that IGF-I binds to matrix components. The kinetics of desorption of IGF-I from cartilage confirmed our conclusions regarding binding. The degree of uptake of IGF-I protein complexes prepared by labeling human serum with [125I]IGF-I showed that such complexes are largely excluded from normal cartilage and that the amounts present in the tissue are too low to affect proteoglycan metabolism.

Concentration and size distribution of insulin-like growth factor-I in human normal and osteoarthritic synovial fluid and cartilage

The concentration of free insulin-like growth Factor-I (IGF-I) and its complexes was determined in human normal and osteoarthritic synovial fluids, using ultrafiltration through 20- and 100-kDa membranes, followed by a radioimmunoassay of each fraction. In addition, freshly obtained samples of normal and osteoarthritic cartilage were incubated for several days, at both 4 and 37 degrees C. The incubation media (desorbates) were analyzed the same way as the synovial fluid samples to yield the concentration of IGF-I in cartilage in situ. Our findings are (i) Free IGF-I content is extremely low in both human serum and synovial fluid and there is no significant difference between the two; (ii) The concentration of total IGF-I in normal human synovial fluid is an order of magnitude lower than that in serum due mainly to the decrease in the concentration of the large complex; (iii) Preliminary results show that the total IGF-I in osteoarthritic synovial fluids is twice as high as in normal fluids; (iv) In normal human cartilage the levels of IGF-I in all its forms are very low and are consistent with the expected exclusion of large molecules by the extracellular matrix; (v) By contrast, in osteoarthritic cartilage, the concentrations of all forms of IGF-I are high, probably due to increased permeability of the matrix and binding; (vi) The levels of IGF-I found in normal human cartilage are more than an order of magnitude lower than those which stimulate proteoglycan synthesis in human cartilage in culture, while the IGF-I levels in osteoarthritic cartilage lie in the range in which stimulation does occur.

Age-related changes in collagen packing of human articular cartilage

We have used X-ray scattering techniques to determine if the lateral packing of collagen molecules in the fibrils of human articular cartilage changes with age. Such changes would affect the available intrafibrillar volume and consequently the amount of intrafibrillar water. Measurements were made both in the presence and absence of compression on samples from donors aged 20 to 90 years. We find a weak though statistically significant tendency towards less dense collagen packing in native tissue as a function of age. However, the increase in packing density in response to pressure does not change with age, and the packing density in articular cartilage from which the proteoglycan molecules have been removed is similarly not age-dependent. The small increase in intrafibrillar water indicated by our data is insufficient to explain the reported increase in fibril diameter in samples from aged donors.

Human facet cartilage: swelling and some physicochemical characteristics as a function of age. Part 2: Age changes in some biophysical parameters of human facet joint cartilage

This study was aimed at investigating, in relating to aging, some of the biochemical and biophysical characteristics of the facet cartilage that determine the functional behavior of this tissue. In addition, facets and discs from the same segment were graded according to their macroscopic appearance. The proportion of severely degenerate discs was low in young subjects and increased with age; by contrast, the proportion of coarsely fibrillated and/or ulcerated facets was high in spines from young adults and remained constant throughout adulthood. Unlike discs, facets do not show an age-related loss of proteoglycans or a consequent decrease in the resistance to a compressive load. However, even in relatively young age groups (30-50 years) a high hydration was observed more often in facet joints than in cartilage from other joints studied. These characteristics are known to accompany damage of the collagen network and cartilage degeneration. Unlike normal femoral head cartilage, facet cartilage does not show a rise in fixed charge density with age. The cartilage from the superior processes (concave) is thicker than that from the inferior processes (convex) and has a higher fixed charge density. At the same time it has a higher water content, which indicates that damage occurs more frequently.

Human facet cartilage: swelling and some physico-chemical characteristics as a function of age. Part 1: Swelling of human facet joint cartilage

The hydration of cartilage from human facet joints was measured after the joints had been subjected to different treatments. One group of facets was opened and directly exposed to physiologic saline solution before extraction of cartilage plugs. The plugs were weighed, re-equilibrated in fluid, and weighed again. The swelling results obtained under these conditions were compared with those when similar plugs of cartilage were excised from joints that had not been exposed to solution or had been exposed to solution while still closed. It was found that swelling was least (and similar in value to hip cartilage) for joints that had been exposed open to saline solution, highest for joints that had not been exposed to solution, and intermediate for joints that had been exposed to solution while still closed. The same trends were observed whether the cartilage on the joint was intact or fibrillated, although in each group the swelling and the final hydration were higher for fibrillated than for intact tissue. It was concluded that facet cartilage, unlike human hip or knee cartilage, is underhydrated when excised from the joint. This underhydration is thought to reflect the permanent presence of stresses in vivo on some part of the facet joints, the position of the loaded site changing with time. The authors attempted to distinguish between the swelling caused by this underhydration and that from disruption of the collagen network in the case of fibrillated specimens.

Physicochemical properties of the aging and diabetic sand rat intervertebral disc

Hydration, fixed charge density, (FCD) and hydration under various osmotic pressures were compared in young, old, and young diabetic sand rats. This rat is a desert animal that may develop diabetes when fed a regular diet; it is also known to have radiographic and histologic evidence of intervertebral disc (IVD) disease. Forty-five rats and 180 IVD were used in this study; they were divided into three equal groups: young healthy, old healthy, and young diabetics. IVD, cancellous bone, and muscle were sampled from distal lumbar spines. The young diabetic rats (YD) were considerably heavier than the age-matched controls, had higher insulin and glucose levels, and all YD had cataracts. The discs of the young diabetic animals demonstrated decreased hydration, FCD and ability to resist compression under osmotic pressures as compared with the young and healthy discs and were more similar to the discs from old rats. The IVD is the most affected musculoskeletal connective tissue in sand rats with aging and diabetes. The aged and diabetic discs in the sand rat demonstrated changes similar to human changes with regard to lower hydration, FCD, and ability to resist osmotic pressure. Therefore, the sand rat may be a suitable animal model for studying the pathogenesis of disc degeneration.

Racemization of aspartic acid in human articular cartilage

The rate of racemization of aspartic acid was measured in young and aged human femoral head cartilage. Normal femoral heads were obtained at postmortem, osteoarthritic specimens at operations for total hip replacement. In order to distinguish between the aspartic acid racemization in collagen from that in proteoglycan (PG), in addition to native tissue, we tested cartilage specimens from which PG had been enzymatically removed. Preliminary results indicate that there is only a very slow collagen turnover in normal adult cartilage. The same is true of residual cartilage from osteoarthritic femoral heads, indicating no rapid repair except where osteophytes are formed. Native, PG-containing cartilage, whether normal or osteoarthritic was found to have unexpectedly high racemization rates.

The effect of osmotic and mechanical pressures on water partitioning in articular cartilage

X-ray diffraction measurements on native and proteoglycan-free articular cartilage have been made in order to test the dependence of the lateral packing of the collagen molecules on the osmotic pressure gradient, either naturally occurring or externally applied, between the intra- and extrafibrillar compartments. From the information on collagen packing we have been able to calculate, albeit with several assumptions, the amount of intrafibrillar water as a function of pressure. In parallel with the above measurements, we have quantitated, using serum albumin partitioning, the intrafibrillar water in proteoglycan-free cartilage, as a function of mechanically applied pressure. The results of both sets of experiments lead to the conclusion that the molecular packing density, and hence the intrafibrillar water content, are a function of the osmotic pressure difference between the extrafibrillar and intrafibrillar spaces or the equivalent mechanically applied pressure. The determination of intrafibrillar water has enabled us to calculate, from measured values of fixed charge density, the internal osmotic pressure of cartilage specimens, both in compressed and uncompressed states.

Influence of cyclic loading on the nutrition of articular cartilage

Articular cartilage is avascular. Nutrients are transported to the cells mainly by diffusion from the synovial fluid. Nutrient transport is also sometimes thought to be assisted by movement of fluid in and out of cartilage in response to cyclic loading of the tissue ('pumping'). The influence of pumping on transport of solutes through cartilage was measured by subjecting plugs of human femoral head cartilage immersed in medium containing radioactive solutes to a simulated walking cycle of 2.8 MPa at 1 Hz. The rate of absorption or desorption of tracers from the cycled plugs was compared with that of unloaded control plugs. For small solutes (urea, NaI) fluid transport did not affect the rate of solute transport significantly. Most major nutrients, such as glucose and oxygen, are small solutes and thus nutrition should not be affected by pumping. The rate of desorption of a large solute (serum albumin), however, was increased by 30-100% in plugs subjected to cyclic loading.

Some biochemical and biophysical parameters for the study of the pathogenesis of osteoarthritis: a comparison between the processes of ageing and degeneration in human hip cartilage

We have investigated the changes in some of the biochemical and biophysical properties of human femoral head cartilage on the one hand during ageing and on the other hand in osteoarthritis. Topographical variations were also investigated. The parameters studied were those relevant to cartilage function, viz., proteoglycan concentration (as expressed by the concentration of negatively charged groups), the rate of glycosaminoglycan synthesis, water content, osmotic pressure and fluid loss during compression. During ageing the fixed charge density was found to increase at all sites of the femoral head provided fibrillation was absent: osmotic pressure increased accordingly whilst loss of fluid under the effect of externally applied compression diminished. In cartilage from osteoarthritic joints the opposite changes were found. The rate of GAG synthesis varied considerably with site on the femoral head. It decreased somewhat with age on the superior surface, but increased on the inferior surface. When the same sites were compared, the rate of GAG synthesis in cartilage from osteoarthritic heads was either the same as or lower than in cartilage form normal heads in the same group.

The distributions and diffusivities of small ions in chondroitin sulphate, hyaluronate and some proteoglycan solutions

The distributions and diffusivities of Na+, Ca2+ and Cl- in chondroitin sulphate (CS), hyaluronate (HA) and proteoglycan solutions were measured using equilibrium dialysis and a capillary tube method. Measurements were made for a range of glycosaminoglycan (GAG) concentrations up to those normally found in dense connective tissue (10% CS, 2.5% HA), ionic strengths up to normal physiological concentrations (0.15 M) and for different combinations of monovalent and divalent cations. The partition coefficients, Ki, of the positive ions increased with increasing matrix concentration and with decreasing ionic strength but with one exception the selectivity coefficient KCaNa = square root of KCa/KNa was close to unity, indicating nearly ideal Donnan distributions. The ionic diffusivities decreased very much like those of small neutral solutes with increasing matrix concentration and with one exception were relatively independent of ionic strength, The exception in both cases was low matrix concentrations and low ionic strengths for which the diffusivity of Ca2+ was an order of magnitude lower and selectivity coefficients were approximately 2. We conclude that at physiological ionic strengths and GAG concentrations the distributions of small ions are determined by simple electrostatic interactions, without binding or condensation, and the diffusivities are not affected by the electrostatic field.

The theoretical distributions and diffusivities of small ions in chondroitin sulphate and hyaluronate

The electrostatic interactions between polyionic glycosaminoglycans and small mobile ions are investigated using the Poisson-Boltzmann equation and a rod-in-cell model of the polyelectrolyte. Calculations are made for the range of polyelectrolyte concentrations and buffer compositions for which measurements of ion distributions and diffusivities are reported in a companion paper (Maroudas et al., Biophys. Chem. 32 (1988) 257). We conclude that the distribution of mobile ions is largely determined by the 'far-field' potential and is adequately described by the Poisson-Boltzmann theory and also by more approximate theories such as ideal Donnan or 'condensation' theory. The measured variations in cation diffusivities, particularly the increase in diffusivity with increasing matrix concentration at low ionic strengths, are predicted qualitatively using an approximate diffusion theory together with the calculated potential fields. However, the same theory applied to anion diffusion gives qualitatively wrong results.

Effects of low-amplitude pulsed magnetic fields on cellular ion transport

Pulsed magnetic fields (PMFs) are widely used to treat difficult fractures of bone and other disorders of connective tissue. It is not clear how they interact with tissue metabolism, although it has been proposed that induced currents or electric fields impinging on cell membranes may modify their ion transport function. This hypothesis was tested by treating in vitro models for ion transport processes with short-term exposure to PMFs. No change occurred in active transport of potassium or calcium in human red cells or in calcium transport through an epithelial membrane. We considered less direct action on red cell membranes, that their permeability might be modified after PMF treatment, and also that PMFs might alter the extracellular ionic activity within connective tissue by interacting with its Donnan potential. Each of these studies proved negative, and we conclude that the PMF waveforms used here do not exert a general short-term effect on cellular ion transport.

"Free" and "exchangeable" or "trapped" and "non-exchangeable" water in cartilage

We repeated some of our own previous experiments, as well as some of Torzilli's recent experiments (11) on which he bases his conclusions relating to a nonexchangeable "trapped water" in cartilage. We are unable to confirm Torzilli's findings. We observed partition coefficients for 3H.HO very close to unity. That both the extrafibrillar and most of the intrafibrillar water is freely exchangeable and behaves as available water towards small solutes has been independently shown (3) for other collagenous tissues. All the different permutations of partition experiments have yielded results that are fully consistent with our original picture of the very major fraction of cartilage water being free.

The "instantaneous" deformation of cartilage: effects of collagen fiber orientation and osmotic stress

The present study was undertaken with two objectives in view. The first was to distinguish between the "instantaneous" deformation and creep of articular cartilage when subjected to a step loading in unconfined compression. This was done by observing changes in the specimen's diameter rather than its thickness. The second objective was to investigate experimentally the anisotropic behaviour of cartilage in a compressive loading mode, corresponding to the physiological situation. An apparatus was thus developed and constructed which enabled us to follow the "instantaneous" changes of the surface area of the sample as the latter was being loaded in unconfined compression. Specimens of human articular cartilage from normal femoral heads and condyles were tested. Full thickness specimens were tested with and without the underlying bone, as well as partial thickness specimens, characterizing the different zones of cartilage. Solutions of different ionic strength were used to vary the osmotic stress and specimens covering a considerable range of proteoglycan concentrations were selected. The effects of hydration and proteoglycan removal on the "instantaneous" deformation were also studied. The "instantaneous" deformation was found to be of a strongly anisotropic nature in all zones. The deformation was always smaller along the Indian-ink prick pattern than at 90 degrees to it, and this effect was most pronounced in the superficial zone of cartilage. The results reveal an analogy with the tensile properties of cartilage and indicate that the collagen network is mainly responsible for controlling the "instantaneous" deformation. The proteoglycans play an indirect role by modulating the stiffness of the collagen network through their osmotic pressure.

Extrafibrillar proteoglycans osmotically regulate the molecular packing of collagen in cartilage

The molecular packing density of collagen and hence the intrafibrillar water content appears to be regulated in cartilage by the osmotic pressure gradient existing between the extrafibrillar and the intrafibrillar compartments.

Effects of mechanical and osmotic pressure on the rate of glycosaminoglycan synthesis in the human adult femoral head cartilage: an in vitro study

We studied the effects of mechanical and osmotic compression on sulphate incorporation into glycosaminoglycans of human femoral head cartilage. We found that both mechanical and osmotic compression produce the same lowering of sulphate uptake relative to uncompressed controls. It appears that this effect is not associated with changes in solute transport or changes in solute concentration in the matrix, but is due, in part at least, to an increased osmotic pressure acting on the chondrocytes. A second mechanism of action might be involved directly through the increased proteoglycan concentration in the pericellular environment, resulting from a reduction in the water content. We also found that glycosaminoglycan synthesis returned to its control level when the conditions prevailing in the matrix, in the absence of pressure or added solute, were restored.

Studies of hydration and swelling pressure in normal and osteoarthritic cartilage

An experimental study was carried out which involved comparing cartilage from normal and osteoarthritic joints with respect to (a) swelling pressure and (b) variation of hydration with applied pressure. The main conclusion was that whilst osteoarthritic cartilage is undoubtedly less able to resist water loss under a given applied pressure than normal cartilage, this is not due to a change in the "quality" of the proteoglycans, resulting in a change in the osmotic pressure of the latter, but simply to a decreased fixed charge density. The latter decrease is either caused by an increase in the water content - and this we attribute to a weakened collagen network - and/or to a loss of part of the proteoglycans from the tissue.

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.

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.

Nutrition of the intervertebral disc: effect of fluid flow on solute transport

Adult dogs were injected intravenously with 35S-sulphate, and moderately exercised for one to six hours to measure isotope concentrations and profiles throughout the intervertebral discs. The isotope profiles were also observed in control animals that had been under anesthesia between injections and death. In both sets of animals, the profiles were in agreement with those expected for isotope transport by diffusion. This agreement indicates that fluid "pumping" during movement has an insignificant effect on transport of nutrients into the disc. Small solutes, e.g., O2, glucose, and sulphate, are transported into the disc chiefly by diffusion. However, calculations show that because of their low diffusivities, "pumping" may increase the rate of transport of large solutes into the disc, as it does in articular cartilage.

Swelling of the intervertebral disc in vitro

Slices of the intervertebral disc swell rapidly in aqueous solutions. Following swelling, a large proportion of the proteoglycans leach out. These changes can introduce artifacts into in vitro experimental work. Swelling results from the large Gibbs-Donnan osmotic pressure of the proteoglycans which the collagen network of the disc is unable to oppose alone. Swelling can be prevented by applying pressure to disc slices either mechanically or with iso-osmotic solutions.

Nutrition of the intervertebral disc: solute transport and metabolism

The metabolism of the canine nucleus pulposus was investigated at different oxygen tensions. It was found that even at high oxygen tensions the metabolism is mainly anaerobic, only approximately 1.5% of the glucose being converted to carbon dioxide. The concentration dependence of oxygen consumption is limited to very low oxygen tensions. Values of oxygen consumption and lactic acid production were used to calculate the concentration profiles of these substances within the nucleus pulposus, using a diffusion theory. The predicted concentration profiles were compared with the experimental measurements of concentration at various positions in the disc. The good agreement in these values found in the nucleus confirms that the main mechanism of metabolite transport is diffusion, and the main route of nutrient supply into the nucleus is via the endplate.

Further studies on the composition of human femoral head cartilage

This report continues our previous studies on the composition and swelling of articular cartilage. When the protein part of the proteoglycan moiety has been taken into consideration, there is no longer a large fraction of the tissue which is not accounted for. In fact, the collagen, proteoglycans, and free electrolyte represent over 92% of the dry weight of adult femoral head cartilage, the remainder consisting most probably of other glycoproteins. Once the composition of cartilage had been well defined, it was possible to calculate the overall wet volume of tissue per unit weight of collagen for both normal and osteoarthritic cartilage. This is an important parameter, as it constitutes a direct measure of the extensibility of the collagen network. By determining the fixed charge density profile close to the articular surface, we have also been able to estimate the swelling pressure due to the proteoglycans in this region of the tissue, and to show that there is a gentle grading of osmotic stresses.

Nutrition of the intervertebral disk. An in vivo study of solute transport

The main mechanism for solute transport within the intervertebral disk is passive diffusion. The 2 routes for the exchange of solutes with the blood vessels outside the disk are via the periphery of the annulus, and through the end-plates. While the periphery of the annulus is completely permeable, the bone--disk interface is only partially so. In the region of the nucleus the effective area through which solute transport is taking place constitutes some 85% of the actual bone/disk interface; in the region of the inner annulus it is reduced to only 35% while the bone--disk interface at the outer annulus is almost completely impermeable. These figures, calculated from tracer diffusion experiments correlate very well with the qualitative observations of blood vessel contact. Apart from its dependence on the permeability of the endplate, solute diffusion is also determined by the nature of the solute. For example, a negatively charged solute such as the sulphate ion is considerably excluded from the nucleus, which limits its rate of penetration via the endplates. The sulphate uptake by the disk cells to produce glycosaminoglycans is low and comparable to that in articular cartilage.

Chemical composition and swelling of normal and osteoarthrotic femoral head cartilage. II. Swelling

Studies of the equilibrium, partition, and diffusion of tritiated water were carried out on normal and osteoarthrotic cartilage as well as on cartilage from which proteoglycans had been extracted chemically. All the water was found to be freely exchangeable in both normal and degenerate specimens. The diffusiviity of the water was equal to about 40% of the value in free solution, with an activation energy equal to that in free solution. It was concluded that the swelling of degenerate tissue is not due to any changes in the state of the water, but to a failure of the damaged collagen network to oppose the swelling pressure of the proteoglycans. Swelling similar to that observed in fibrillated cartilage was also found in initially normal specimens treated with collagenase.

Chemical composition and swelling of normal and osteoarthrotic femoral head cartilage. I. Chemical composition

Radiochemical and biochemical methods were used to characterize post-mortem and osteoarthrotic femoral head cartilage. Fixed charge density measurements were correlated with glycosaminoglycan content as estimated by uronic acid and hexosamine analyses. In post-mortem cartilage water content decreased from a maximum at the surface to a minimum in the deep zones. In the osteoarthrotic specimens water content was greatest in the middle zones. Glycosaminoglycan content increased with depth and in the osteoarthrotic specimens was reduced throughout the depth of the cartilage. With increasing degeneration there was an increase in water content and decrease in glycosaminoglycan content. The difference in the water content profile in osteoarthrotic cartilage was explained in terms of damage to the collagen network. In osteoarthrosis the latter is no longer capable of restraining the swelling pressure produced by the glycosaminoglycans and swelling is greatest in the midzones, where glycosaminoglycan content is highest.

Transport of solutes through cartilage: permeability to large molecules

A review of the transport of solutes through articular cartilage is given, with special reference to the effect of variations in matrix composition. Some physiological implications of our findings are discussed. Also, results of an experimental study of the permeability of articular cartilage to large globular proteins are presented. Because of the very low partition coefficients of large solutes between cartilage and an external solution new experimental techniques had to be devised, particularly for the study of diffusion. The partition coefficients of solutes were found to decrease very steeply with increase in size, up to serum albumin. There was, however, no further decrease for IGG. The diffusion coefficient of serum albumin in cartilage was relatively high (one quarter of the value in aqueous solution). These two facts taken together suggest that there may be a very small fraction of relatively large pores in cartilage through which the transport of large molecules is taking place. The permeability of cartilage to large molecules is extremely sensitive to variations in the glycosaminoglycan content: for a threefold increase in the latter there is a hundredfold decrease in the partition coefficient. For cartilage of fixed charge density around 0-19 m-equiv/g, there is no penetration at all of globular proteins of size equal to or larger than serum albumin.

The distribution of serum albumin in human normal and degenerate articular cartilage

A method for studying the distribution of a high molecular weight solute (serum albumin) between physiological saline and human articular cartilage is described. Samples of normal and fibrillated articular cartilage from both femoral condyles and femoral heads have been studied. Limited studies have also been performed where the glycosaminoglycan content of normal cartilage has been reduced by chemical or enzymic methods. With naturally occurring cartilage a wide range of partition coefficients (0.3 to less than 0.002) was obtained. The partition coefficients are very dependent upon proteoglycan concentration, with the partition coefficient decreasing with increasing fixed charge density. An attempt is made to interpret the observed partitioning in terms of the steric exclusion by the proteoglycans.