[The changing position of balneo- and hydrotherapy in medicine]. / A balneo-, hidroterápia helyének változása a medicinában.

Therapy with water has been known for thousands of years. Hot water bath was always pleasant for people. During the 19th century it was applied for the treatment of several diseases and modern medicine should not miss it. Today balneotherapy may help gymnastic procedures and it is commonly used in combination with other types of physiotherapy, too.

Chondrogenic potential of mesenchymal stem cells from patients with rheumatoid arthritis and osteoarthritis: measurements in a microculture system.

BACKGROUND: Mesenchymal stem cells (MSCs) have the potential to differentiate into distinct mesenchymal tissues; including cartilage and bone, they can be an attractive cell source for cartilage tissue engineering approaches. Our objective here was to compare the in vitro chondrogenic potential of MSCs isolated from patients with rheumatoid arthritis (RA) and osteoarthritis (OA) with cells from normal donors. METHODS: Marrow samples were removed during bone surgery and adherent cell cultures were established. The cells were then passed into a newly developed microaggregate culture system in a medium containing transforming growth factor beta3, insulin, dexamethasone and/or demineralized bone matrix. In vitro chondrogenic activity was measured as metabolic sulfate incorporation and type II collagen expression in pellet cultures. RESULTS: Culture-expanded MSCs from RA and OA patients did not differ significantly from the normal population with respect to their chondrogenic potential in vitro. Capability of total protein and proteoglycan synthesis as well as collagen II mRNA expression by cell aggregates was similar for all cell preparations in the presence of the appropriate growth and differentiation factors. Chondroprotective drugs such as chondroitin sulfate and glucosamine enhanced, whereas chloroquine inhibited chondrogenesis in normal donor-derived or patient-derived MSC cultures. Galectin-1, a beta-galactoside-binding protein with marked anti-inflammatory activity, stimulated the chondrogenic differentiation of mesenchymal cells in low (<2 microg/ml) concentration. DISCUSSION: These findings show that MSCs from RA and OA patients possess similar chondrogenic potential as MSCs isolated from healthy donors, therefore these cells may serve as a potential new prospect in cartilage replacement therapy.

[Mesenchymal stem cells as potential source cartilage repair]. / A mesenchymalis ossejtek felhasználáisainak lehetoségei a porckárosodással járó mozgásszervi betegségek kezelésében.

Articular cartilage damaged by disease or trauma has a limited capacity for regeneration. The end stage of cartilage loss frequently leads to osteoarthritis resulting in a significantly decreased quality of life in millions of people. The surgical treatment of articular cartilage injury has always posed difficult problems for orthopedic surgeons and regarding long-term outcomes the currently available methods are unsatisfactory. The main lack of the applied methods is the appearance of the mechanically inadequate resident fibrocartilage instead of hyalin cartilage in the place of the cartilage defect. To find reliable methods for early repair of cartilage injuries seems of huge importance. Using techniques of tissue engineering, artificial cartilage fabricated in vitro has been applied for the repair and regeneration of damaged cartilage. Mesenchymal stem cells provide a source of cells for the repair of musculoskeletal tissue. Mesenchymal stem cells are multipotent cells that are capable of differentiating into cartilage, tendon, muscle, cartilage or hematopoiesis supporting marrow stroma. To ensure the successful durable integration and function of the engineered tissue requires suitable biomechanical and biochemical circumstances, and poses the challenge of handling in vitro culture of human cells, cell biology and molecular biology.

Synovial fluid exoglycosidases are predictors of rheumatoid arthritis and are effective in cartilage glycosaminoglycan depletion.

OBJECTIVE: To analyze enzymes involved in joint damage by simultaneous investigation of glycosidases and matrix metalloproteinases (MMPs) in patients with various joint diseases. METHODS: Activities of glycosidases (beta-D-glucuronidase, beta-D-N-acetyl-glucosaminidase, beta-D-N-acetyl-galactosaminidase, beta-D-galactosidase, and alpha-D-mannosidase) were tested at an acidic pH as well as at the original pH of the synovial fluid (SF) samples in parallel with activities of MMP-1 and MMP-9. RESULTS: Patients with rheumatoid arthritis (RA) were characterized by significantly elevated activities of beta-D-glucuronidase and beta-D-N-acetyl-glucosaminidase in SF compared with patients with osteoarthritis, seronegative spondylarthritis, or acute sports injury. To select the best predictor for distinguishing among patient groups, a stepwise logistic regression analysis was performed; the strongest association was found to be between RA and beta-D-glucuronidase/beta-D-N-acetyl-glucosaminidase activities (measured at the pH of the SF). Further, a significant correlation was observed between the activity of SF beta-D-N-acetyl-glucosaminidase and the level of rheumatoid factor. In vitro digestion of human hyaline cartilage samples revealed that the dominant glycosidases, alone or in combination with MMPs, proved to be effective in depleting glycosaminoglycans (GAGs) from cartilage. CONCLUSION: These results suggest that exoglycosidases, which are present in the SF of RA patients, may contribute to the depletion of GAGs from cartilage and thereby facilitate the invasion of synovial cells and their attachment to cartilage in RA.