Effect of mesenchymal stem cells combined with chondroitin sulfate in an in vitro model of osteoarthritis.

Osteoarthritis (OA) is a degenerative joint disease affecting the whole joint structure. The specific molecules responsible for the inflammatory processes involved in the development of OA have been the focus of many studies. Adipose tissue-derived mesenchymal stem cells (ASCs) constitute a promising cell-based therapy which could be used as an alternative to or in combination with drug therapies. Chondroitin sulfate (CS) plays a protective role in the joint by decreasing concentrations of pro-inflammatory cytokines and therefore has an important part in moderating chondrocyte metabolism. The aim of this study is to use an in vitro model of OA to evaluate the combined effectiveness of CS and ASCs as a treatment. We give a detailed discussion of the roles of cytokines and other key molecules involved in OA. In addition, we report the effects of treating inflamed chondrocytes with ASCs and CS on the expression of specific cartilage genes. Findings show that both treatments reduced expression of all genes associated with the pro-inflammatory cytokines we analyzed. However, we saw no increase in the expression of the specific genes encoding for cartilage matrix proteins, such as collagen type II and aggrecan. This study shows the effectiveness of combining ASCs and CS in the treatment of OA.

Evaluation of Dram Score as a Predictor of Poor Postoperative Outcome in Spine Surgery.

The Distress Risk Assessment Method (DRAM) was presented by Main, Wood and Hillis in 1992 as a simple means of assessing the risk of failure due to psychosocial factors in spine surgery. To our knowledge, it has not been used in our setting. The aim of this study was to analyse the usefulness of the Spanish translation of this instrument to predict poor outcomes. METHODS: A prospective blind study was conducted including 65 patients undergoing spine surgery. We created two groups of patients based on DRAM score: not distressed (NDRAM) or distressed (DDRAM). A visual analogue scale for pain and the 12-Item Short Form Health Survey (SF-12) were used at baseline, 6 weeks and 6 months. RESULTS: 24 patients were classified as DDRAM and 38 as NDRAM, with 3 patients not completing the questionnaires. The analysis found no significant differences in the demographic or clinical variables at baseline. At 6 weeks and 6 months, the NDRAM group showed improvements in low back pain (p < 0.001; p = 0.005), leg pain (p < 0.001; p = 0.017), physical health (p = 0.031; p = 0.003) and mental health (p = 0.137; p = 0.049). In contrast, in the DDRAM group, though leg pain score improved (p < 0.001; p = 0.002), there was no improvement at 6 weeks or 6 months in low back pain (p = 0.108; p = 0.287), physical health (p = 0.620; p = 0.263) or mental health (p = 0.185; p = 0.329). CONCLUSIONS: In our setting, the DRAM is a useful screening tool, and it has allowed the creation of a program between psychiatry and spine surgery.

Biología y mecanobiología del disco intervertebral / Biology and mechanobiology of the intervertebral disc

El disco intervertebral (DIV) se caracteriza por su escasa celularidad y por constituir la estructura avascular más grande del cuerpo humano. Las escasas células del disco tienen que adaptarse a un metabolismo anaerobio con baja tensión de O2 y pH ácido. Además de sobrevivir a un microambiente adverso, están expuestas a un elevado estrés mecánico. La adaptación biológica de las células a las condiciones de acidosis e hiperosmolaridad está regulada por mecanoproteínas responsables de convertir una señal mecánica en respuesta celular, modificando su expresión génica. La mecanobiología nos ayuda a entender mejor la biopatología del DIV y su potencial reparación biológica

The intervertebral disc (IVD) is noted for its low cell content, and being the largest avascular structure of human body. The low amount of cells in the disc have to adapt to an anaerobic metabolism with low oxygen pressure and acidic pH. Apart from surviving in an adverse microenvironment, they are exposed to a high level of mechanical stress. The biological adaptation of cells to acidosis and hyperosmolarity conditions are regulated by mechanoproteins, which are responsible for converting a mechanical signal into a cellular response, thus modifying its gene expression. Mechanobiology helps us to better understand the pathophysiology of IVD and its potential biological repair

[Biology and mechanobiology of the intervertebral disc]. / Biología y mecanobiología del disco intervertebral.

The intervertebral disc (IVD) is noted for its low cell content, and being the largest avascular structure of human body. The low amount of cells in the disc have to adapt to an anaerobic metabolism with low oxygen pressure and acidic pH. Apart from surviving in an adverse microenvironment, they are exposed to a high level of mechanical stress. The biological adaptation of cells to acidosis and hyperosmolarity conditions are regulated by mechanoproteins, which are responsible for converting a mechanical signal into a cellular response, thus modifying its gene expression. Mechanobiology helps us to better understand the pathophysiology of IVD and its potential biological repair.