Proteomics makes progress in cartilage and arthritis research

Understanding biology at the systems level is a powerful method for discovery of previously unrecognized molecular pathways and mechanisms in human disease. The application of proteomics to arthritis research has lagged behind many other clinical targets, partly due to the unique biochemical properties of cartilage and associated biological fluids such as synovial fluid. In recent years, however, proteomic-based studies in cartilage and arthritis research have risen sharply and have started to make a significant impact on our understanding of joint disease, including the discovery of new and promising biomarkers of cartilage degeneration, a hallmark of arthritis. In this review we will make the case for the ongoing proteomic analysis of cartilage and other tissues affected by joint disease, overview some of the core proteomic techniques and discuss how the challenge of cartilage proteomics has been met through technical innovation. The major outcomes and information obtained from recent proteomic analysis of synovial fluid, cartilage and chondrocytes will also be described. In addition, we present some novel insights into post-translational regulation of cartilage proteins, through proteomic identification of proteolytic fragments in mouse cartilage extracts and explant culture media. We conclude with our prediction of how emerging proteomic technologies that have yet to be applied in arthritis research are likely to contribute further important information.     

Low intensity ultrasound as a supporter of cartilage regeneration and its engineering

Ultrasound (US) is being used widely in clinic for diagnostic and therapeutic purposes, but clinical utilization of low intensity ultrasound (LIUS) has been very limited. However, therapeutic potential of LIUS has been reported in animal models of musculoskeletal system disorders, and its application is being expanded in various fields. This review will focus on the application of LIUS on the cartilage tissue engineering and repair of cartilage disorder such as osteoarthritis (OA). We will introduce our experimental results showing the LIUS effects on the chondrocyte viability, proliferation and matrix protein synthesisin vitro, and its application in the cartilage tissue engineering using mesenchymal stem cells (MSCs)in vivo. Also the current status on the issues will be discussed by comparing our results with those of other laboratories. In conclusion, we suggest that LIUS is an efficient and clinically applicable method for cartilage tissue engineering and cartilage repair.     

A surface roughness comparison of cartilage in different types of synovial joints

The naturally occurring structure of articular cartilage has proven to be an effective means for the facilitation of motion and load support in equine and other animal joints. For this reason, cartilage has been extensively studied for many years. Although the roughness of cartilage has been determined from atomic force microscopy (AFM) and other methods in multiple studies, a comparison of roughness to joint function has not be completed. It is hypothesized that various joint types with different motions and regimes of lubrication have altered demands on the articular surface that may affect cartilage surface properties. Micro- and nanoscale stylus profilometry was performed on the carpal cartilage harvested from 16 equine forelimbs. Eighty cartilage surface samples taken from three different functioning joint types (radiocarpal, midcarpal, and carpometacarpal) were measured by a Veeco Dektak 150 Stylus Surface Profilometer. The average surface roughness measurements were statistically different for each joint. This indicates that the structure of cartilage is adapted to, or worn by, its operating environment. Knowledge of cartilage micro- and nanoscale roughness will assist the future development and design of treatments for intra- articular substances or surfaces to preserve joint integrity and reduce limitations or loss of joint performance.     

透明质酸在间充质干细胞向软骨细胞分化中的应用

随着组织工程学的发展,利用间充质干细胞(mesenchymal stem cells,MSCs)定向分化为软骨细胞,用于治疗骨性关节炎、关节创伤等因素造成的软骨缺损的研究方兴未艾。透明质酸(hyaluronic acid,HA) 是一种酸性多糖类生物大分子,亦是软骨基质的主要成分之一。由于其优良的生物相容性、可降解等特性,HA已成为优良的天然生物材料,其作为支架材料应用于软骨缺损修复已有一段历史。近年来又发现,HA除作为载体支架材料外,还可作为调节因子应用于MSCs向软骨细胞分化。以下将对近年来利用HA应用于MSCs向软骨细胞分化的研究进行总结,旨在为以MSCs为基础的组织工程化软骨的临床应用奠定基础。     

Tissue engineering of functional articular cartilage: the current status

Osteoarthritis is a degenerative joint disease characterized by pain and disability. It involves all ages and 70% of people aged >65 have some degree of osteoarthritis. Natural cartilage repair is limited because chondrocyte density and metabolism are low and cartilage has no blood supply. The results of joint-preserving treatment protocols such as debridement, mosaicplasty, perichondrium transplantation and autologous chondrocyte implantation vary largely and the average long-term result is unsatisfactory. One reason for limited clinical success is that most treatments require new cartilage to be formed at the site of a defect. However, the mechanical conditions at such sites are unfavorable for repair of the original damaged cartilage. Therefore, it is unlikely that healthy cartilage would form at these locations. The most promising method to circumvent this problem is to engineer mechanically stable cartilage ex vivo and to implant that into the damaged tissue area. This review outlines the issues related to the composition and functionality of tissue-engineered cartilage. In particular, the focus will be on the parameters cell source, signaling molecules, scaffolds and mechanical stimulation. In addition, the current status of tissue engineering of cartilage will be discussed, with the focus on extracellular matrix content, structure and its functionality.     

Cartilage stress-relaxation proceeds slower at higher compressive strains

Articular cartilage is the connective tissue which covers bone surfaces and deforms during in vivo activity. Previous research has investigated flow-dependent cartilage viscoelasticity, but relatively few studies have investigated flow-independent mechanisms. This study investigated polymer dynamics as an explanation for the molecular basis of flow-independent cartilage viscoelasticity. Polymer dynamics predicts that stress-relaxation will proceed more slowly at higher volumetric concentrations of polymer. Stress-relaxation tests were performed on cartilage samples after precompression to different strain levels. Precompression increases the volumetric concentration of cartilage biopolymers, and polymer dynamics predicts an increase in relaxation time constant. Stress-relaxation was slower for greater precompression. There was a significant correlation between the stress-relaxation time constant and cartilage volumetric concentration. Estimates of the flow-dependent timescale suggest that flow-dependent relaxation occurs on a longer timescale than presently observed. These results are consistent with polymer dynamics as a mechanism of cartilage viscoelasticity.     

Etude Histologique et Microradiographique du Cartilage Hémal de la Vertebre de la Carpe, Cyprinus carpio L. (Pisces, Teleostei, Cyprinidae)

The abdominal vertebrae of the adult carp retain a bulk of cartilage at the basement of the haemapophyses. This cartilage has two opposite directions of differentiation. There is an enchondral ossification of the hypertrophic calcified cartilage in its distal area whereas its proximal area is calcifying without previous hypertrophy. The calcification of this proximal area (hyaline calcified cartilage) is permanent and shows typical rings and waves of Liesegang. The calcification of the cartilage of the hemapophyses is of a globular type. The hyaline calcified cartilage is not a metaplastic bone. Other studies, specially with electron microscope, will allow us to understand the innermost process of the different stages of calcification in the cartilage of the carp.     

富血小板血浆注射治疗在膝骨关节炎中的应用进展

富血小板血浆(platelet-rich plasma，PRP)由于富含多种活性生长因子，能够刺激软骨细胞增殖，促进软骨前体细胞增殖、迁移、向软骨细胞分化，促进胶原蛋白合成以及抑制软骨的炎性反应和退变，提供有利于组织修复的内环境，延缓病情进展。近年来PRP注射治疗已成为治疗与骨关节炎(osteoarthritis，OA)相关疾病的新型选择，并且疗效显著。为了进一步提高其效用，PRP注射治疗不仅在关节腔内进行，还可在软骨下骨内进行注射。软骨下骨的病变会加速软骨损耗，故有必要将软骨下骨也当作OA众多发病机制和病理过程的关键因素之一。根据PRP的生物特效以及PRP注射治疗在膝骨关节炎(knee osteoarthritis，KOA)中应用的研究进展进行了综述，同时对软骨下骨内PRP注射治疗KOA的研究进行了展望，以期为KOA的治疗提供更加有效的方法。     

Mini-review: Mechanical factors affecting cartilage regeneration in vitro

In the last 5 to 10 years, tissue engineering has revolutionized the way in which medical researchers and clinicians are thinking of and, in some cases, actually treating diseases involving tissue damage and destruction. One such disease, osteoarthritis, results from progressive degeneration of articular cartilage, which has a limited ability to repair itself. With tissue engineering, scientists are now able to regenerate cartilage in vitro from isolated mature chondrocytes. While the regeneration process is still not fully understood, enough has been learned that physicians are already implanting cultured chondrocytes into humans and other animals in the hopes of effecting joint repair. One aspect which has not been fully explored is the effect of mechanical stress on developing and implanted cartilage, especially over the long term. This article will review in brief what is now known about the mechanical factors affecting cartilage regeneration in vitro and what still remains to be determined for optimum tissue engineering of cartilage constructs. (c) 1996 John Wiley & Sons, Inc.     

Development of avascularity during cartilage differentiation in the embryonic limb

The differentiation of cartilage and muscle in limb-bud mesenchyme has been interpreted by some investigators in terms of a vascular pre-pattern model. It has been argued that a pre-pattern of the early limb vasculature compartmentalises the mesenchyme into specific microenvironmental areas in which, depending on the oxygen tension and nutrient supply, cartilage or muscle will differentiate. However, recent analyses of the development and differentiation of blood vessels in limbs have shown that regional variations in vascularization develop co-incidentally with the earliest indication of cartilage formation or mesenchymal condensation. The simple model described in the present study suggests that the mechanical compression/tension forces generated by the condensing mesenchyme are sufficient to constrict and eventually close off the thin-walled undifferentiated vessels caught in the condensation foci, thus leading to the avascularity of cartilage rudiments. This view suggests that the vasculature has no major function in governing the pattern of cartilage differentiation.     

Chondrogenesis and developments in our understanding

Conditions affecting cartilage through damage or age-related degeneration pose significant challenges to individual patients and their healthcare systems. The disease burden will rise in the future as life expectancy increases. This has resulted in vigorous efforts to develop novel therapies to meet current and future needs. Due to the limited regenerative capacity of cartilage, in vitro tissue engineering techniques have emerged as the favoured technique by which to develop replacements. Tissue engineering is mainly concerned with developing cartilage replacements in the form of chondrocyte suspensions and three-dimensional scaffolds seeded with chondrocytes. One major limiting factor in the development of clinically useful cartilage constructs is our understanding of the process by which cartilage is formed, chondrogenesis. For example, techniques of culturing chondrocytes in vitro have been used for decades, resulting in chondrocyte-like cells which produce an extracellular matrix of similar composition to native cartilage, but with inferior physical properties. It has now been realised that one aspect of chondrogenesis which had been ignored was the physical context in which cartilage exists in vivo. This has resulted in the development of bioreactor systems which aim to introduce various physical stresses to engineered cartilage in a controlled environment. This has resulted in some improvements in the quality of tissue engineered cartilage. This is but one example of how the knowledge of chondrogenesis has been translated into research practice. This paper aims to review what is currently known about the process of chondrogenesis and discusses how this knowledge can be applied to tissue engineering.     

In situ split costal cartilage graft harvesting through a small incision using a gouge

A costal cartilage graft is one of the most useful materials in reconstructive plastic surgery. In this article, a technique of in situ split costal cartilage graft harvesting through a small incision (2 to 3 cm) using a gouge is described. The technique used has many advantages: it is a simple technique, is easy to learn, and can be performed quickly through a small incision. By avoiding complete costal cartilage graft harvesting, the associated potential complications such as pleural perforation, chest wall deformities, long-lasting postoperative pain, and incisional scar length are reduced. This technique will be useful in selected cases for which a complete block of costal cartilage graft is not needed.     

Wnt signaling in cartilage development and degeneration

The Wnt signaling network, which is composed of Wnt ligands, receptors, antagonists, and intracellular signaling molecules, has emerged as a powerful regulator of cell fate, proliferation, and function in multicellular organisms. Over the past two decades, the critical role of Wnt signaling in embryonic cartilage and bone development has been well established, and much has been learnt regarding the role of Wnt signaling in chondrogenesis and cartilage development. However, relatively little is known about the role of Wnt signaling in adult articular cartilage and degenerative cartilage tissue. This review will briefly summarize recent advances in Wnt regulation of chondrogenesis and hypertrophic maturation of chondrocytes, and review data concerning the role of Wnt signaling in the maintenance and degeneration of articular chondrocytes and cartilage.     

Human articular chondrocytes express three facilitative glucose transporter isoforms: GLUT1, GLUT3 and GLUT9

Glucose is an important metabolite and a structural precursor for articular cartilage and its transport has significant consequences for cartilage development and functional integrity. In this study the expression of facilitative glucose transporters (GLUTs) in human chondrocytes was investigated. Results showed that at least three GLUT isoforms (GLUT1, GLUT3 and GLUT9) are expressed by normal chondrocytes. Given the central role of glucose in chondrocyte physiology and metabolism, its regular provision via GLUTs will influence the metabolic activity and survival of chondrocytes in cartilage matrices.     

A mathematical modelling study of epiphyseal cartilage calcification

Recent studies in this laboratory have suggested that proteoglycan may function as a Ca ion-exchanger in the calcification of epiphyseal growth plate cartilage. Specifically, it has been proposed that phosphate liberated from hypertrophic chondrocytes may displace calcium ions bound to the anionic groups of proteoglycans, thereby raising the Ca x PO4 activity product above the threshold for precipitation of hydroxyapatite. In order to determine whether this mechanism is quantitatively feasible, a mathematical model of the interaction between Ca, Na, proteoglycan and phosphate has now been developed. This model is based on a general binding theory, and utilizes previously-determined values for the binding constants of the Ca-proteoglycan interaction, inhibition constants for the effect of Na and phosphate on this interaction, and literature values for the concentrations of proteoglycan, Na and Ca in epiphyseal cartilage. Using this approach, it was predicted that the free Ca concentration in epiphyseal cartilage in the absence of phosphate will be 1.55 mM. At 0.7 mM phosphate, the approximate concentration in non-calcified cartilage matrix, the free Ca concentration will be 2.40 mM, corresponding to a Ca x PO4 product of 1.68 (mM)2. In order to achieve a Ca x PO4 product sufficient for spontaneous precipitation of hydroxyapatite [approximately 4.3 (mM)2], a phosphate concentration of approximately 1.40 mM is required. Therefore, calcification of epiphyseal cartilage matrix by the mechanism described above will require an approximate doubling of the phosphate concentration in the pre-calcifying zones, indicating that the release of a fraction of the intracellular phosphate could trigger the calcification process.     

FORMATION,STRUCTURE AND FUNCTION OF CARTILAGE

Improved investigative techniques including electron microscopy, isotope tracings and improved histochemistry have greatly increased knowledge of the function of cartilage as a body tissue. Highly complex and delicate enzyme systems contained in the cartilage cell are involved in cartilage matrix formation and in the processes of calcification and cartilage repair. Heat, various drugs, freezing, and changes in the chemical environment damage or destroy these enzyme systems and interfere with the growth and function of cartilage. Hyaline cartilage to be transplanted must be handled with great care to preserve the cellular enzyme systems—otherwise the graft will be resorbed and clinical failure will result.     

Clinical translation of stem cells: insight for cartilage therapies

Abstract

The limited regenerative capacity of articular cartilage and deficiencies of current treatments have motivated the investigation of new repair technologies. In vitro cartilage generation using primary cell sources is limited by cell availability and expansion potential. Pluripotent stem cells possess the capacity for chondrocytic differentiation and extended expansion, providing a potential future solution to cell-based cartilage regeneration. However, despite successes in producing cartilage using adult and embryonic stem cells, the translation of these technologies to the clinic has been severely limited. This review discusses recent advances in stem cell-based cartilage tissue engineering and the major current limitations to clinical translation of these products. Concerns regarding appropriate animal models and studies, stem cell manufacturing, and relevant regulatory processes and guidelines will be addressed. Understanding the significant hurdles limiting the clinical use of stem cell-based cartilage may guide future developments in the fields of tissue engineering and regenerative medicine.     

Effects of inserting a pressensor film into articular joints on the actual contact mechanics.

Fuji film has been widely used in studies aimed at obtaining the contact mechanics of articular joints. Once sealed for practical use in biological joints, Fuji Pressensor film has a total effective thickness of 0.30 mm, which is comparable to the cartilage thickness in the joints of many small animals. The average effective elastic modulus of Fuji film is approximately 100 MPa in compression, which is larger by a factor of 100-300 compared to that of normal articular cartilage. Therefore, inserting a Pressensor film into an articular joint will change the contact mechanics of the joint. The measurement precision of the Pressensor film has been determined systematically; however, the changes in contact mechanics associated with inserting the film into joints have not been investigated. This study was aimed at quantifying the changes in the contact mechanics associated with inserting sealed Fuji Pressensor film into joints. Spherical and cylindrical articular joint contact mechanics with and without Pressensor film and for varying degrees of surface congruency were analyzed and compared by using finite element models. The Pressensor film was taken as linearly elastic and the cartilage was assumed to be biphasic, composed of a linear elastic solid phase and an inviscid fluid phase. The present analyses showed that measurements of the joint contact pressures with Fuji Pressensor film will change the maximum true contact pressures by 10-26 percent depending on the loading, geometry of the joints, and the mechanical properties of cartilage. Considering this effect plus the measurement precision of the film (approximately 10 percent), the measured joint contact pressures in a joint may contain errors as large as 14-28 percent.