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Inflammatory Environment and Cartilage Repair

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Joint Function Preservation
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Abstract

Articular cartilage has become the focus of early reparative treatments and the object of joint preservation just in the last decades.

Osteoarthritis represents one of the most debilitating diseases with important physical, psychological, and socioeconomic severe burdens. Recently OA has been identified as an inflammation-associated multifactorial disorder, characterized by a chronic, comparatively low-grade inflammation. The body reacts to the initial damage by the activation of several molecular, immune and mechanical pathways, transducing joint trauma, chronic injury, or overuse damage into inflammatory processes. These inflammatory processes determine the modifications of cartilage metabolism that lead to osteochondral unit breakdown and degeneration. These new understandings of OA pathophysiology have opened the way to the development of new, specific molecular drugs and various orthobiologic components that may intervene not just on symptoms, but be able to establish new treatment paradigms that may modify the disease development and progression.

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References

  1. Benedek TG. A history of the understanding of cartilage. Osteoarthr Cartil. 2006;14(3):203–9.

    Article  CAS  Google Scholar 

  2. Galen on the usefulness of various parts of the body. Cornell University Press, Ithaca, NY, 1968 Trans. by M.T. May, (a) Book 16, ii (1:683); (b) Book 12, ii (1:552).

    Google Scholar 

  3. Avicenna the canon of medicine. AM Kelley, New York 1970; Trans. by O.C. Gruner, Chap. 16, p. 94.

    Google Scholar 

  4. A. Vesalius. On the fabric of the human body, cartilage, its nature, function and differentiation. San Francisco, CA: Norman Publishing, 1998. Trans. by Richardson WF and Carman JB, Chap. 2, vol. 1, pp. 8–11, 39–40.

    Google Scholar 

  5. Hunter W. Of the structure and diseases of articulating cartilages. Philos Trans R Soc Lond. 1743;42:514–21.

    Google Scholar 

  6. Morgagni JB. The seats and causes of diseases investigated by anatomy. London: Millar and Cadell; 1769. p. 3.

    Google Scholar 

  7. Comroe BI. Arthritis and allied conditions. 3rd ed. Philadelphia: Lea & Febiger; 1944. p. 93.

    Google Scholar 

  8. Mankin HJ, Lipiello L. The turnover of adult rabbit articular cartilage. J Bone Joint Surg. 1969;51A:1591–600.

    Article  Google Scholar 

  9. Strawich E, Nimni ME. Properties of a collagen molecule containing three identical components extracted from bovine articular cartilage. Biochemistry. 1971;10:3905–11.

    Article  PubMed  CAS  Google Scholar 

  10. Rhodes RK, Miller EJ. Physicochemical characterization and molecular organization of the collagen a and B chains. Biochemistry. 1978;17:3442–8.

    Article  PubMed  CAS  Google Scholar 

  11. Litwic A, Edwards MH, Dennison EM, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull. 2013;105:185–99.

    Article  PubMed  Google Scholar 

  12. Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum. 2008;58(1):15–25.

    Article  PubMed  Google Scholar 

  13. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States Part II. Arthritis Rheum. 2008;58:26–35.

    Article  PubMed  PubMed Central  Google Scholar 

  14. National Collaborating Centre for Chronic Conditions. Osteoarthritis: national clinical guideline for care and management in adults. London: Royal College of Physicians; 2008.

    Google Scholar 

  15. Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, Simmons A, Williams G. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998;57(11):649–55.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Sharma L, Cooke TD, Guermazi A, Roemer FW, Nevitt MC. Valgus malalignment is a risk factor for lateral knee osteoarthritis incidence and progression: findings from the multicenter osteoarthritis study and the osteoarthritis initiative. Arthithis Rheum. 2014;65(2):355–62.

    Google Scholar 

  17. Grotle M, Hagen KB, Natvig B, et al. Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord. 2008;9:132.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. Martel-Pelletier J, Barr AJ, Cicuttini FM, Conaghan PG, Cooper C, Goldring MB, et al. Osteoarthritis. Nat. Rev. Dis. 2016;2:16072.

    Google Scholar 

  20. Solomon DH, Husni ME, Libby PA, Yeomans ND, Lincoff AM, Lüscher TF, et al. The risk of major NSAID toxicity with celecoxib, ibuprofen, or naproxen: a secondary analysis of the PRECISION trial. Am J Med. 2017;130(12):1415–22.

    Article  PubMed  CAS  Google Scholar 

  21. Lee T, Lu N, Felson DT, Choi HK, Dalal DS, Zhang Y, et al. Use of non-steroidal anti-inflammatory drugs correlates with the risk of venous thromboembolism in knee osteoarthritis patients: a UK population-based case-control study. Rheumatology. 2016;55(6):1099–105.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wang Y, Chen X, Cao W, Shi Y. Plasticity of mesenchymal stem cells in immunomodulation: pathological and therapeutic implications. Nat Immunol. 2014;15:1099–16.

    Article  CAS  Google Scholar 

  23. Ren G, et al. Mesenchymal stem cell-mediated immunosuppression occurs via concerted action of chemokines and nitric oxide. Cell Stem Cell. 2008;2:141–50.

    Article  PubMed  CAS  Google Scholar 

  24. Su J, et al. Phylogenetic distinction of iNOS and IDO function in mesenchymal stem cell-mediated immunosuppression in mammalian species. Cell Death Differ. 2014;21:388–96.

    Article  PubMed  CAS  Google Scholar 

  25. Shi Y, Wang Y, Li Q, et al. Immunoregulatory mechanisms of mesenchymal stem and stromal cells in inflammatory diseases. Nat Rev Nephrol. 2018;14(8):493–507.

    Article  PubMed  CAS  Google Scholar 

  26. Kong L, Zheng LZ, Qin L, Ho KKW. Role of mesenchymal stem cells in osteoarthritis treatment. J Orthop Transl. 2017;9:89–103.

    Google Scholar 

  27. Barry FM. Murphy Mesenchymal stem cells in joint disease and repair. Nat Rev Rheumatol. 2013;910:584–94.

    Article  CAS  Google Scholar 

  28. Centeno CJ, Busse D, Kisiday J, Keohan K, Freeman K, Karli D. Increased knee cartilage volume in degenerative joint disease using percutaneously implanted, autologous mesenchymal stem cells. Pain Physician. 2008;113:343–53.

    Google Scholar 

  29. Emadedin M, Ghorbani Liastani M, Fazeli R, Mohseni F, Moghadasali R, Mardpour S, Hosseini SE, Niknejadi M, Moeininia F, Aghahossein Fanni A, Baghban Eslaminejhad R, Vosough Dizaji A, Labibzadeh N, Mirazimi Bafghi A, Baharvand H, Aghdami N. Long-term follow-up of intra-articular injection of autologous mesenchymal stem cells in patients with knee, ankle, or hip osteoarthritis. Arch Iran Med. 2015;18(6):336–44.

    PubMed  Google Scholar 

  30. Emadedin M, Labibzadeh N, Liastani MG, Karimi A, Jaroughi N, Bolurieh T, Hosseini SE, Baharvand H, Aghdami N. Intra-articular implantation of autologous bone marrow-derived mesenchymal stromal cells to treat knee osteoarthritis: a randomized, triple-blind, placebo-controlled phase 1/2 clinical trial. Cytotherapy. 2018;20(10):1238–46.

    Article  PubMed  Google Scholar 

  31. Jo CH, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, et al. Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof- of-concept clinical trial. Stem Cells. 2014;325:1254–66.

    Article  Google Scholar 

  32. Hong Z, Chen J, Zhang S, Zhao C, Bi M, Chen X, Bi Q. Intra-articular injection of autologous adipose-derived stromal vascular fractions for knee osteoarthritis: a double-blind randomized self-controlled trial. Int Orthop. 2019;43:1123–34.

    Article  PubMed  Google Scholar 

  33. Lee WS, Hwan JK, Kim K-IL, Kim GB, Jin W. Intra-articular injection of autologous adipose tissue-derived mesenchymal stem cells for the treatment of knee osteoarthritis: a phase IIb, randomized, placebo-controlled clinical trial. Stem Cells Transl Med. 2019;00:1–8.

    Google Scholar 

  34. Andriacchi T, Mundermann A, Smith R, Alexander E, Dyrby C, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng. 2004;32:447–57.

    Article  PubMed  Google Scholar 

  35. Chen C, Tambe DT, Deng L, Yang L. Biomechanical properties and mechanobiology of the articular chondrocyte. Am J Physiol Cell Physiol. 2013;305:C1202–8.

    Article  PubMed  CAS  Google Scholar 

  36. Kraus VB, Blanco FJ, Englund M, Karsdal MA, Lohmander LS. Call for standardized definitions of osteoarthritis and risk stratification for clinical trials and clinical use. Osteoarthr Cartil. 2015;23(8):1233–41.

    Article  CAS  Google Scholar 

  37. Haseeb A, Haqqui TM. Immunopathogenesis of osteoarthritis. Clin Immunol. 2013;146(3):185–96.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  38. Brandt KD, Dieppe P, Radin E. Etiopathogenesis of osteoarthritis. Med Clin North Am. 2009;93:1–24.

    Article  PubMed  Google Scholar 

  39. Lane Smith R, Trindade MC, Ikenoue T, et al. Effects of shear stress on articular chondrocyte metabolism. Biorheology. 2000;37:95–107.

    PubMed  CAS  Google Scholar 

  40. Jasin HE. Immune mediated cartilage destruction. Scand J Rheumatol Suppl. 1988;76:111–6.

    Article  PubMed  CAS  Google Scholar 

  41. Ayral X, Pickering EH, Woodworth TG, et al. Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis - results of a 1 year longitudinal arthroscopic study in 422 patients. Osteoarthr Cartil. 2005;13:361–7.

    Article  CAS  Google Scholar 

  42. Hill CL, Hunter DJ, Niu J, et al. Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis. Ann Rheum Dis. 2007;66:1599–603.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Revell PA, Mayston V, Lalor P, Mapp P. The synovial membrane in osteoarthritis: a histological study including the characterisation of the cellular infiltrate present in inflammatory osteoarthritis using monoclonal antibodies. Ann Rheum Dis. 1988;47:300–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  44. Sakkas LI, Scanzello C, Johanson N, et al. T cells and T-cell cytokine transcripts in the synovial membrane in patients with osteoarthritis. Clin Diagn Lab Immunol. 1998;5:430–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  45. Nakamura H, Yoshino S, Kato T, et al. T-cell mediated inflammatory pathway in osteoarthritis. Osteoarthr Cartil. 1999;7:401–2.

    Article  CAS  Google Scholar 

  46. Wang Q, Rozelle AL, Lepus CM, et al. Identification of a central role for complement in osteoarthritis. Nat Med. 2011;17:1674–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  47. Robinson WH, Lepus CM, Wang Q, Raghu H, Mao R, Lindstrom TM, Sokolove J. Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis. Nat Rev Rheumatol. 2016;12(10):580–92.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  48. Orlowsky EW, Kraus VB. The role of innate immunity in osteoarthritis: when our first line of defense goes on the offensive. J Rheumatol. 2015;42:363–71.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  49. Happonen K, Saxne T, Aspberg A, Morgelin M, Heinegard D, Blom A. Regulation of complement by cartilage oligomeric matrix protein allows for a novel molecular diagnostic principle in rheumatoid arthritis. Arthritis Rheum. 2010;62:3574–83.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  50. Sjoberg A, Manderson G, Morgelin M, Day A, Heinegard D, Blom A. Short leucine-rich glycoproteins of the extracellular matrix display diverse patterns of complement interaction and activation. Mol Immunol. 2009;46:830–9.

    Article  PubMed  CAS  Google Scholar 

  51. Gabay C. Interleukin-6 and chronic inflammation. Arthritis Res Ther. 2006;8(Suppl. 2):S3.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  52. Goldring M, Fukuo K, Birkhead J, Dudek E, Sandell L. Transcriptional suppression by interleukin-1 and interferon-gamma of type II collagen gene expression in human chondrocytes. J Cell Biochem. 1994;54:85–99.

    Article  PubMed  CAS  Google Scholar 

  53. Scanzello CR, Goldring SR. The role of synovitis in osteoarthritis pathogenesis. Bone. 2012;51:249–57.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  54. Miller RJ, Banisadr G, Bhattacharyya BJ. CXCR4 signaling in the regulation of stem cell migration and development. J Neuroimmunol. 2008;198:31–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  55. van Lent PL, et al. Crucial role of synovial lining macrophages in the promotion of transforming growth factor β-mediated osteophyte formation. Arthritis Rheum. 2004;50:103–11.

    Article  PubMed  CAS  Google Scholar 

  56. Haywood L, McWilliams DF, Pearson CI, Gill SE, Ganesan A, Wilson D, et al. Inflammation and angiogenesis in osteoarthritis. Arthritis Rheum. 2003;48:2173–7.

    Article  PubMed  CAS  Google Scholar 

  57. Conde J, Scotece M, Gomez R, Lopez V, Gomez-Reino J, Gualillo O. Adipokines and osteoarthritis: novel molecules involved in the pathogenesis and progression of disease. Arthritis. 2011;2011:203901.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Francin PJ, et al. Association between adiponectin and cartilage degradation in human osteoarthritis. Osteoarthr Cartil. 2014;22:519–26.

    Article  Google Scholar 

  59. Clockaerts S, Bastiaansen-Jenniskens Y, Runhaar J, Van Osch G, Van Offel J, Verhaar J, et al. The infrapatellar fat pad should be considered as an active osteoarthritic joint tissue: a narrative review. Osteoarthr Cartil. 2010;18:876–82.

    Article  CAS  Google Scholar 

  60. Hui W, Litherland G, Elias M, Kitson G, Cawston T, Rowan A, et al. Leptin produced by joint white adipose tissue induces cartilage degradation via upregulation and activation of matrix metalloproteinases. Ann Rheum Dis. 2012;71:455–62.

    Article  PubMed  CAS  Google Scholar 

  61. Ushiyama T, Chano T, Inoue K, Matsusue Y. Cytokine production in the infrapatellar fat pad: another source of cytokines in knee synovial fluids. Ann Rheum Dis. 2003;62:108–12.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  62. Bohnsack M, Meier F, Walter G, Hurschler C, Schmolke S, Wirth C, et al. Distribution of substance-P nerves inside the infrapatellar fat pad and the adjacent synovial tissue: a neurohistological approach to anterior knee pain syndrome. Arch Orthop Trauma Surg. 2005;125:592–7.

    Article  PubMed  Google Scholar 

  63. Martel-Pelletier J, Pelletier JP, Fahmi H. Cyclooxygenase-2 and prostaglandins in articular tissues. Semin Arthritis Rheum. 2003;33:155–67.

    Article  PubMed  CAS  Google Scholar 

  64. Casale TB, Abbas MK, Carolan EJ. Degree of neutrophil chemotaxis is dependent upon the chemoattractant and barrier. Am J Respir Cell Mol Biol. 1992;7:112–7.

    Article  PubMed  CAS  Google Scholar 

  65. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum. 2012;64:1697–707.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Roemer FW, Guermazi A, Felson DT, Niu J, Nevitt MC, Crema MD, et al. Presence of MRI- detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: the MOST study. Ann Rheum Dis. 2011;70:1804–9.

    Article  PubMed  Google Scholar 

  67. Scanzello C, McKeon B, Swaim B, DiCarlo E, Asomugha E, Kanda V, et al. Synovial inflammation in patients undergoing arthroscopic meniscectomy: molecular characterization and relationship to symptoms. Arthritis Rheum. 2011;63:391–400.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Berembaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthr Cartil. 2013;21(1):16–21.

    Article  Google Scholar 

  69. Sellam J, Berenbaum F. The role of synovitis in pathophysiology and clinical symptoms of osteoarthritis. Nat Rev Rheumatol. 2010;6:625–35.

    Article  PubMed  CAS  Google Scholar 

  70. Lories R, Luyten F. The bone-cartilage unit in osteoarthritis. Nat Rev Rheumatol. 2011;7:43–9.

    Article  PubMed  CAS  Google Scholar 

  71. Luyten FP, Denti M, Filardo G, Kon E, Engebretsen L. Definition and classification of early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2012;20(3):401–6.

    Article  PubMed  Google Scholar 

  72. Schiphof D, Oei EHG, Hofman A, et al. Sensitivity and associations with pain and body weight of an MRI definition of knee osteoarthritis compared with radiographic Kellgren and Lawrence criteria: a population-based study in middle-aged females. Osteoarthr Cartil. 2014;22:440–6.

    Article  CAS  Google Scholar 

  73. Zhu Z, Laslett LL, Jin X, et al. Association between MRI-detected osteophytes and changes in knee structures and pain in older adults: a cohort study. Osteoarthr Cartil. 2017;25:1084–92.

    Article  CAS  Google Scholar 

  74. Nagai K, Nakamura T. Fu FH the diagnosis of early osteoarthritis of the knee using magnetic resonance imaging. AOJ. 2018;3:110.

    Google Scholar 

  75. Felson D, Kim Y. The futility of current approaches to chondroprotection. Arthritis Rheum. 2007;56:1378–83.

    Article  PubMed  Google Scholar 

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Sciarretta, F.V. (2022). Inflammatory Environment and Cartilage Repair. In: Gobbi, A., Lane, J.G., Longo, U.G., Dallo, I. (eds) Joint Function Preservation. Springer, Cham. https://doi.org/10.1007/978-3-030-82958-2_22

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