Basic calcium phosphate deposition in the joint: a potential therapeutic target in osteoarthritis

PURPOSE OF REVIEW: Basic calcium phosphate crystals are responsible for a number of clinical syndromes. The study of basic calcium phosphate crystal deposition diseases has been hindered by a lack of readily available, accurate, diagnostic tests. Recent data have provided further understanding of the mechanisms by which basic calcium phosphate crystals induce inflammation and degeneration within the joint, as well as their potential role in other conditions such as cancer and atherosclerosis. RECENT FINDINGS: New information on the effects of basic calcium phosphate crystals on matrix metalloproteinases and mitogenesis further supports a role for basic calcium phosphate crystals in the pathogenesis of osteoarthritis. Phosphocitrate remains the most promising of the potential therapeutic agents, which could antagonize the effects of basic calcium phosphate crystals, although other therapies have also been examined. SUMMARY: Further work is needed to clarify the exact role basic calcium phosphate crystals play in the development of osteoarthritis.     

Polymorphism in signal transduction is a major route through which osteoarthritis susceptibility is acting

PURPOSE OF REVIEW: In the last year there has been considerable success in the identification of genes harbouring susceptibility for primary osteoarthritis. This report brings the reader up-to-date by focusing on three of the more compelling finds. RECENT FINDINGS: A UK group reported an association of the FRZB gene with hip osteoarthritis in females. FRZB codes for secreted frizzled-related protein 3, an antagonist of Wnt signalling. The Wnt signal transduction pathway is critical for normal development and is also active in adult tissues. Secreted frizzled-related protein 3 helps to maintain articular cartilage and the associated alleles at FRZB reduce the activity of this important protein. A Japanese group has reported an association of the asporin gene ASPN with knee and hip osteoarthritis and an association of the calmodulin 1 gene CALM1 with hip osteoarthritis. Asporin is a cartilage extracellular protein that regulates the activity of transforming growth factor-beta. Calmodulin is an intracellular protein that interacts with a number of proteins involved in signal transduction. The associated alleles at ASPN and CALM1 reduce the ability of chondrocytes to express the genes encoding aggrecan and type II collagen. Since these are essential structural components of articular cartilage, the ASPN and CALM1 associations are predicted to adversely affect the maintenance of cartilage. SUMMARY: The FRZB, ASPN and CALM1 results are compelling and highlight that polymorphism in signal transduction pathways is a major component of osteoarthritis susceptibility. This is an exciting observation since signal transduction pathways are malleable and therefore potentially amenable to intervention and modification.     

Signaling transduction mechanisms mediating biological actions of the vascular endothelial growth factor family

The central role of vascular endothelial growth factor (VEGF) in angiogenesis in health and disease makes it attractive both as a therapeutic target for anti-angiogenic drugs and as a pro-angiogenic cytokine for the treatment of ischaemic heart disease. While VEGF binds to two receptor protein tyrosine kinases, VEGFR1 (Flt-1) and VEGFR2 (KDR), most biological functions of VEGF are mediated via VEGFR2, and the role of VEGFR1 is currently unknown. Neuropilin-1, a non-tyrosine kinase transmembrane molecule, may function as a co-receptor for VEGFR2. Considerable progress has recently been made towards delineating the signal transduction pathways distal to activation of VEGFR2. Activation of the mitogen-activated protein kinase, protein kinase C and Akt pathways are all strongly implicated in mediating diverse cellular biological functions of VEGF, including cell survival, proliferation, the generation of nitric oxide and prostacyclin and angiogenesis. Upregulation of metalloproteinases, activation of focal adhesion kinase and interactions between VEGF receptors and integrins are strongly implicated in VEGF-induced endothelial cell migration. Recent findings suggest important roles for the vasodilators nitric oxide and prostacyclin, in linking post-receptor signaling networks to downstream biological effects and in mediating some in vivo endothelial functions of VEGF.     

Signaling properties of a covalent modification cycle are altered by a downstream target

We used a model system of purified components to explore the effects of a downstream target on the signaling properties of a covalent modification cycle, an example of retroactivity. In the experimental system used, a bifunctional enzyme catalyzed the modification and demodification of its substrate protein, with both activities regulated by a small molecule stimulus. Here we examined how a downstream target for one or both forms of the substrate of the covalent modification cycle affected the steady-state output of the system, the sensitivity of the response to the stimulus, and the concentration of the stimulus required to provide the half-maximal response (S₅₀). When both the modified and unmodified forms of the substrate protein were sequestered by the downstream target, the sensitivity of the response was dramatically decreased, but the S₅₀ was only modestly affected. Conversely, when the downstream target only sequestered the unmodified form of the substrate protein, significant effects were observed on both system sensitivity and S₅₀. Behaviors of the experimental systems were well approximated both by simple models allowing analytical solutions and by a detailed model based on the known interactions and enzymatic activities. Modeling and experimentation indicated that retroactivity may result in subsensitive responses, even if the covalent modification cycle displays significant ultrasensitivity in the absence of retroactivity. Thus, we provide examples of how a downstream target can alter the signaling properties of an upstream signal transduction covalent modification cycle.     

Signaling pathway of insulin-like growth factor- Ⅱ as a target of molecular therapy for hepatoblastoma

AIM: To address the possibility that insulin-like growth factor (IGF)-II is a growth factor and its signaling pathway so as to develop a molecular therapy for hepatoblastoma. METHODS: Huh-6 and HepG2, human hepatoblastoma cell lines, were used. IGF-II was added to the medium deprived of serum. Western blot analysis was performed to clarify the expression of IGF-I receptor (IGF-IR). Inhibitors of IGF-IR (piclopodophyllin, PPP), phosphatidyl-inositol (PI) 3-kinase (LY294002 and Wortmannin), or mitogen-activated protein (MAP) kinase (PD98059) were added to unveil the signaling pathway of IGF-II. Cells were analyzed morphologically with hematoxylin-eosin staining to reveal the mechanism of suppression of cell proliferation. RESULTS: IGF-II stimulated cells proliferated to 2.7 (269%+/-76%) (mean+/-SD) (Huh-6) and 2.1 (211%+/-85%) times (HepG2). IGF-IR was expressed in Huh-6 and HepG2. PPP suppressed the cell number to 44%+/-11% (Huh-6) and 39%+/-5% (HepG2). LY294002 and Wortmannin suppressed the cell number to 30%+/-5% (Huh-6), 44%+/-0.4% (HepG2), 49%+/-1.0% (Huh-6) and 46%+/-1.1% (HepG2), respectively. PD98059 suppressed the cell number to 33%+/-11% for HepG2 but not for Huh-6. When cell proliferation was prohibited, many Huh-6 and HepG2 cells were dead with pyknotic or fragmented nuclei, suggesting apoptosis. CONCLUSION: IGF-II was shown to be a growth factor of hepatoblastoma via IGF-I receptor and PI3 kinase which were good candidates for target of molecular therapy.     

Distinct functional motifs within the IL-17 receptor regulate signal transduction and target gene expression

IL-17 is the founding member of a novel family of proinflammatory cytokines that defines a new class of CD4+ effector T cells, termed "Th17." Mounting evidence suggests that IL-17 and Th17 cells cause pathology in autoimmunity, but little is known about mechanisms of IL-17RA signaling. IL-17 through its receptor (IL-17RA) activates genes typical of innate immune cytokines, such as TNFalpha and IL-1beta, despite minimal sequence similarity in their respective receptors. A previous bioinformatics study predicted a subdomain in IL-17-family receptors with homology to a Toll/IL-1R (TIR) domain, termed the "SEFIR domain." However, the SEFIR domain lacks motifs critical for bona fide TIR domains, and its functionality was never verified. Here, we used a reconstitution system in IL-17RA-null fibroblasts to map functional domains within IL-17RA. We demonstrate that the SEFIR domain mediates IL-17RA signaling independently of classic TIR adaptors, such as MyD88 and TRIF. Moreover, we identified a previously undescribed"TIR-like loop" (TILL) required for activation of NF-kappaB, MAPK, and up-regulation of C/EBPbeta and C/EBPdelta. Mutagenesis of the TILL domain revealed a site analogous to the LPS(d) mutation in TLR4, which renders mice insensitive to LPS. However, a putative salt bridge typically found in TIR domains appears to be dispensable. We further identified a C-terminal domain required for activation of C/EBPbeta and induction of a subset IL-17 target genes. This structure-function analysis of a IL-17 superfamily receptor reveals important differences in IL-17RA compared with IL-1/TLR receptors.     

High prevalence of patellofemoral osteoarthritis in China: a multi-center population-based osteoarthritis study

Clinical Rheumatology - To describe the prevalence and risk factors of patellofemoral osteoarthritis (PFOA) among Chinese residents. A multi-center population-based osteoarthritis study was...     

Patellofemoral joint osteoarthritis: an important subgroup of knee osteoarthritis

Knee osteoarthritis (OA) is a prevalent disease afflicting elderly people. As the knee joint is tri-compartmental, numerous radiographic patterns of disease are possible. The patellofemoral joint (PFJ) is one of the most commonly affected compartments. Although PFJ OA is frequently observed, this particular disease sub-group has gone largely unrecognised. Recent research suggests that not only is the PFJ an important source of symptoms in knee OA, but also that afflicted individuals demonstrate disease features distinct from those observed in tibiofemoral joint OA. This has implications for the assessment and treatment of patients with PFJ OA. This review summarises the evidence suggesting why PFJ OA should be considered a distinct clinical entity and how it may best be managed using conservative, non-pharmacological treatment approaches that are targeted to the PFJ. Interventions such as patella taping, patella bracing and physiotherapy have the potential to alleviate joint stress and symptoms for people with this condition.     

Signaling pathway of insulin-like growth factor-Ⅱ as a target of molecular therapy for hepatoblastoma

AIM: To address the possibility that insulin-like growth factor (IGF)-Ⅱ is a growth factor and its signaling pathway so as to develop a molecular therapy for hepatoblastoma.METHODS: Huh-6 and HepG2, human hepatoblastoma cell lines, were used. IGF-Ⅱ was added to the medium deprived of serum. Western blot analysis was performed to clarify the expression of IGF-Ⅰ receptor (IGF-IR). Inhibitors of IGF-IR (piclopodophyllin, PPP),phosphatidyl-inositol (PI) 3-kinase (LY294002 and Wortmannin), or mitogen-activated protein (MAP) kinase (PD98059) were added to unveil the signaling pathway of IGF-Ⅱ. Cells were analyzed morphologically with hematoxylin-eosin staining to reveal the mechanism of suppression of cell proliferation.RESULTS: IGF-Ⅱ stimulated cells proliferated to 2.7(269% ± 76%) (mean ± SD) (Huh-6) and 2.1 (211%± 85%) times (HepG2). IGF-IR was expressed in Huh-6 and HepG2. PPP suppressed the cell number to 44% ±11% (Huh-6) and 39% ± 5% (HepG2). LY294002 and Wortmannin suppressed the cell number to 30% ± 5%(Huh-6), 44% ± 0.4% (HepG2), 49% ± 1.0% (Huh-6)and 46% ± 1.1% (HepG2), respectively. PD98059 suppressed the cell number to 33% ± 11% for HepG2 but not for Huh-6. When cell proliferation was prohibited,many Huh-6 and HepG2 cells were dead with pyknotic or fragmented nuclei, suggesting apoptosis.CONCLUSION:IGF- Ⅱ was shown to be a growth factor of hepatoblastoma via IGF-I receptor and PI3 kinase which were good candidates for target of molecular therapy.     

Signaling pathway of insulin-like growth factor-Ⅱ as a target of molecular therapy for hepatoblastoma

AIM: To address the possibility that insulin-like growth factor (IGF)-Ⅱ is a growth factor and its signaling pathway so as to develop a molecular therapy for hepatoblastoma.METHODS: Huh-6 and HepG2, human hepatoblastoma cell lines, were used. IGF-Ⅱ was added to the medium deprived of serum. Western blot analysis was performed to clarify the expression of IGF-Ⅰ receptor (IGF-IR). Inhibitors of IGF-IR (piclopodophyllin, PPP),phosphatidyl-inositol (PI) 3-kinase (LY294002 and Wortmannin), or mitogen-activated protein (MAP) kinase (PD98059) were added to unveil the signaling pathway of IGF-Ⅱ. Cells were analyzed morphologically with hematoxylin-eosin staining to reveal the mechanism of suppression of cell proliferation.RESULTS: IGF-Ⅱ stimulated cells proliferated to 2.7(269% ± 76%) (mean ± SD) (Huh-6) and 2.1 (211%± 85%) times (HepG2). IGF-IR was expressed in Huh-6 and HepG2. PPP suppressed the cell number to 44% ±11% (Huh-6) and 39% ± 5% (HepG2). LY294002 and Wortmannin suppressed the cell number to 30% ± 5%(Huh-6), 44% ± 0.4% (HepG2), 49% ± 1.0% (Huh-6)and 46% ± 1.1% (HepG2), respectively. PD98059 suppressed the cell number to 33% ± 11% for HepG2 but not for Huh-6. When cell proliferation was prohibited,many Huh-6 and HepG2 cells were dead with pyknotic or fragmented nuclei, suggesting apoptosis.CONCLUSION:IGF- Ⅱ was shown to be a growth factor of hepatoblastoma via IGF-I receptor and PI3 kinase which were good candidates for target of molecular therapy.     

Imaging: new techniques used in osteoarthritis

Nowadays, one of the critical challenges for imaging techniques is the development of more sensitive methods to assess osteoarthritis. This review is focused on the main methods used to evaluate anatomical damage in osteoarthritis patients. Conventional radiography is the more accessible and well known method, but can not evaluate non-calcified tissues. Magnetic resonance imaging allows visualization of articular and extraarticular soft tissues, including the morphologic and biochemical characteristics of cartilage, but it is an expensive and less accessible method. Increasing interest has been shown in ultrasonography as a suitable, non expensive and accurate method which can evaluate articular (including cartilage) and extraarticular structures, with the disadvantage of a limited acoustic window and impossibility to evaluate joint space width.     

Hyaluronan-binding receptors: possible involvement in osteoarthritis

Abstract

Our objectives were to compare the expression of the hyaluronan receptors CD44 and RHAMM in knee synovial tissue of patients with and without advanced osteoarthritis (OA). Both receptors were detected immunohistochemically; the staining appeared more intense in the tissues from the patients with advanced OA. Expression of CD44 and RHAMM were each significantly increased (p < 0.05) in synovial tissue from patients with OA, as determined by means of Western-blot analysis. The findings suggested that changes in levels of the HA-binding proteins might be implicated in the development or progression of OA.     

Structural factors associated with malalignment in knee osteoarthritis: the Boston osteoarthritis knee study

OBJECTIVE: Osteoarthritis (OA) is a multifactorial condition. The progression of knee OA is determined in part by mechanical effects on local structures. One of the mechanical influences on cartilage loss is limb alignment. We explored the structural factors associated with malalignment in subjects with symptomatic OA. METHODS: We conducted a cross-sectional assessment using The Boston Osteoarthritis of the Knee Study, a natural history study of symptomatic knee OA. Baseline assessments included knee magnetic resonance imaging (MRI) and information on weight and height. Long-limb radiographs to assess mechanical alignment were obtained at 15 months. Subarticular bone attrition, meniscal degeneration, anterior and posterior cruciate ligament integrity, medial and lateral collateral ligament integrity, marginal osteophytes, and cartilage morphology were assessed on MRI using a semiquantitative, multi-feature scoring method (Whole-Organ MRI Score) for whole-organ evaluation of the knee that is applicable to conventional MRI techniques. We also quantified the following meniscal position measures on coronal MRI images in both medial and lateral compartments: subluxation, meniscal height, and meniscal covering of the tibial plateau. Using the long-limb radiographs, mechanical alignment was measured in degrees on a continuous scale. The purpose of this cross-sectional analysis was to determine the individual and relative contribution of various structural factors to alignment of the lower extremity. We assessed the cross-sectional association between various structural factors and alignment of the lower extremity using a linear regression model. RESULTS: The 162 subjects with all measures acquired had a mean age of 67.0 years (SD 9.2), body mass index 31.4 (SD 5.6); 30% were female and 77% of knees had a Kellgren-Lawrence grade > or = 2. The main univariate determinants of varus alignment in decreasing order of influence were medial bone attrition, medial meniscal degeneration, medial meniscal subluxation, and medial tibiofemoral cartilage loss. Multivariable analysis revealed that medial bone attrition and medial tibiofemoral cartilage loss explained more of the variance in varus malalignment than other variables. The main univariate determinants of valgus malalignment in decreasing order of influence were lateral tibiofemoral cartilage loss, lateral osteophyte score, and lateral meniscal degeneration. CONCLUSION: Cartilage loss has been thought to be the major determinant of alignment. We found that other factors including meniscal degeneration and position, bone attrition, osteophytes, and ligament damage contribute to the variance of malalignment. Further longitudinal analysis is required to determine cause and effect relationships. This should assist researchers in determining strategies to ameliorate the potent effects of this mechanical disturbance.     

Hyaluronan-binding receptors: possible involvement in osteoarthritis

Our objectives were to compare the expression of the hyaluronan receptors CD44 and RHAMM in knee synovial tissue of patients with and without advanced osteoarthritis (OA). Both receptors were detected immunohistochemically; the staining appeared more intense in the tissues from the patients with advanced OA. Expression of CD44 and RHAMM were each significantly increased (p < 0.05) in synovial tissue from patients with OA, as determined by means of Western-blot analysis. The findings suggested that changes in levels of the HA-binding proteins might be implicated in the development or progression of OA.