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1.
Curr Opin Rheumatol ; 34(1): 68-72, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34698678

RESUMO

PURPOSE OF REVIEW: To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on patients with osteoarthritis (OA). RECENT FINDINGS: The COVID-19 pandemic negatively affected patients with OA irrespective of them contracting the infection. Patients with OA had a disruption in access to the healthcare system, which resulted in delays in joint replacement surgeries from cancellations of elective surgical procedures. On the other hand, the pandemic accelerated the drive towards telemedicine and telerehabilitation, with many nonurgent services being delivered remotely whenever possible. Cross-sectional studies showed that the majority of patients with OA were willing to accept the increased risks of contracting the COVID-19 infection and proceed with elective joint replacement surgeries. SUMMARY: The American College of Rheumatology and the European League Against Rheumatism issued guidelines for managing immune-mediated rheumatic diseases during the pandemic. However, these guidelines did not include recommendations for patients with OA.Healthcare providers, including physical therapists, should aim to schedule more frequent telemedicine follow-up appointments to maximize medical management while patients await elective joint procedures.


Assuntos
COVID-19 , Osteoartrite , Estudos Transversais , Humanos , Osteoartrite/epidemiologia , Osteoartrite/terapia , Pandemias , SARS-CoV-2 , Estados Unidos
2.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(11): 1403-1410, 2021 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-34779165

RESUMO

Based on peer-reviewed systematic reviews and randomized controlled trials published between January 2000 and June 2019 with regards to the management of glenohumeral joint osteoarthritis (GJO), the American Academy of Orthopaedic Surgeons (AAOS) established the clinical practice guidelines for the treatment of GJO. The guidelines provided practice recommendations including risk factors, non-surgical treatment, surgical treatment, prosthesis selection, and perioperative management for GJO. The recommendations were graded according to different evidence strength. This paper interprets the guidline in order to provide reference for domestic medical workers.


Assuntos
Cirurgiões Ortopédicos , Osteoartrite , Articulação do Ombro , Humanos , Osteoartrite/cirurgia , Articulação do Ombro/cirurgia , Inquéritos e Questionários , Estados Unidos
3.
BMC Musculoskelet Disord ; 22(1): 953, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34781952

RESUMO

BACKGROUND: Hand osteoarthritis is a common and disabling problem without effective therapies. Accumulating evidence suggests the role of local inflammation in causing pain and structural progression in hand osteoarthritis, and hand osteoarthritis with synovitis is a commonly encountered clinical phenotype. Methotrexate is a well-established, low-cost, and effective treatment for inflammatory arthritis with a well-described safety profile. The aim of this multicentre, randomised, double-blind, placebo-controlled trial is to determine whether methotrexate reduces pain over 6 months in patients with hand osteoarthritis and synovitis. METHODS: Ninety-six participants with hand osteoarthritis and synovitis will be recruited through the Osteoarthritis Clinical Trial Network (Melbourne, Hobart, Adelaide, and Perth), and randomly allocated in a 1:1 ratio to receive either methotrexate 20 mg or identical placebo once weekly for 6 months. The primary outcome is pain reduction (assessed by 100 mm visual analogue scale) at 6 months. The secondary outcomes include changes in physical function and quality of life assessed using Functional Index for Hand Osteoarthritis, Australian Canadian Osteoarthritis Hand Index, Health Assessment Questionnaire, Michigan Hand Outcomes Questionnaire, Short-Form-36, tender and swollen joint count, and grip strength, and structural progression assessed using progression of synovitis and bone marrow lesions from magnetic resonance imaging and radiographic progression at 6 months. Adverse events will be recorded. The primary analysis will be by intention to treat, including all participants in their randomised groups. DISCUSSION: This study will provide high-quality evidence to address whether methotrexate has an effect on reducing pain over 6 months in patients with hand osteoarthritis and synovitis, with major clinical and public health importance. While a positive trial will inform international clinical practice guidelines for the management of hand osteoarthritis, a negative trial would be highly topical and change current trends in clinical practice. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617000877381. Registered 15 June 2017, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373124.


Assuntos
Osteoartrite , Sinovite , Austrália , Canadá , Método Duplo-Cego , Humanos , Metotrexato/uso terapêutico , Estudos Multicêntricos como Assunto , Osteoartrite/diagnóstico por imagem , Osteoartrite/tratamento farmacológico , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Sinovite/diagnóstico por imagem , Sinovite/tratamento farmacológico , Resultado do Tratamento
4.
Comput Math Methods Med ; 2021: 5499450, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34754325

RESUMO

Background: As a chronic disease, osteoarthritis has caused great trouble to the health of middle-aged and elderly people. Studies have shown that glucosamine (GlcN) can be used to abate the progression and improve this disease. Based on this point of view, we try to verify the connection between GlcN and osteoarthritis and find more effective biomarkers. Methods: We downloaded the GSE72575 data set from the GEO database, and used the R language to perform DEG analysis on the gene expression profile of the samples. Next, the GO function and the KEGG signaling pathways were analyzed through the DAVID database, and then, the KEGG pathways enriched in the gene set were analyzed based on GSEA. Then, the PPI network of DEGs was constructed based on the STRING online database, and finally, the hub genes were selected by Cytoscape. Results: Three GlcN-treated MH7A cell treatment groups and 3 control groups in the GSE72575 data set were studied. Through analysis, there were 52 DEGs in these samples. Then, through GO, KEGG, and GSEA, regulation of endoplasmic reticulum stress-induced intrinsic apoptotic signaling pathway, FoxO signaling pathway, JAK-STAT signaling pathway, PI3K-Akt signaling pathway, TGF-beta signaling pathway, and ECM receptor interaction were involved in the regulatory mechanisms of the osteoarthritis pathogenesis. After that, the hub genes IL6 and DDIT3 were identified through PPI network construction and analysis. And it was found that IL6 was lowly expressed in the group with GlcN-treated MH7A cells, while DDIT3 was highly expressed. Conclusion: The above results provide a basis for GlcN to participate in the treatment of osteoarthritis and a possibility for finding effective therapeutic targets.


Assuntos
Glucosamina/genética , Glucosamina/uso terapêutico , Osteoartrite/tratamento farmacológico , Osteoartrite/genética , Linhagem Celular , Biologia Computacional , Bases de Dados Genéticas , Progressão da Doença , Ontologia Genética , Marcadores Genéticos , Humanos , Osteoartrite/metabolismo , Mapas de Interação de Proteínas/genética , Transdução de Sinais/genética , Transcriptoma
5.
Zhongguo Gu Shang ; 34(10): 985-90, 2021 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-34726030

RESUMO

Osteoarthritis(OA) is one of the most common joint diseases. As Chinese society enters the age of aging, the incidence of OA has been soar year by year, and research on its pathogenesis has been continuously valued by researchers. Studies have found that inflammatory cytokines, mainly interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α), were responsible for the construction of OA inflammatory networks. It was also found that the overexpression of proteases, mainly matrix metalloproteinases(MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), was the direct cause of OA cartilage deficiency. What's more, signaling pathways such as stromal cell derived factor-1 (SDF-1) and Wnt, chondrocytic senescence and the senescence-associated secretory phenotype (SASP), chondrocyte apoptosis and autophagy, and estrogen all play significant roles in OA pathogenesis. This paper extensively reviews the research literature relevant to the pathogenesis of OA in recent years, and systematically expounds the pathogenesis of OA from two aspects:molecular level and cell level. At the end of the paper, we discussed and predicted some potential directions in the future clinical diagnosis and treatment of OA.


Assuntos
Cartilagem Articular , Osteoartrite , Cartilagem , Condrócitos , Humanos , Interleucina-1beta , Osteoartrite/genética , Transdução de Sinais , Fator de Necrose Tumoral alfa
6.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(6): 923-928, 2021 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-34841755

RESUMO

Chondrocytes have a limited supply of glucose and oxygen for metabolism since articular cartilages are relatively avascular. We herein reviewed the characteristics of chondrocyte glucose metabolism and the new research progress in chondrocyte glucose metabolism in the osteoarthritis process. Current research has shown that chondrocytes obtain glucose from synovial fluids and subchondral bones, take in glucose via specific glucose transporters, and metabolize glucose mainly through glycolysis and mitochondrial respiration to produce adenosine triphosphate (ATP). Glucose metabolism in chondrocytes is distinctive because it relies much more on glycolysis rather than mitochondrial respiration for ATP production, and shows Warburg effect and Crabtree effect. In osteoarthritic chondrocytes, the glucose metabolism disorder is presented as further suppression of mitochondrial respiration, over-active or impaired glycolysis, and decreased total production of ATP. However, the significance of the glucose supply for chondrocytes from synovial fluids and subchondral bones remains undefined. There are still disputes in the understanding of the changes in glycolytic pathways in osteoarthritic chondrocytes. Therefore, future research is needed to explore the characteristics of glucose metabolism in normal and osteoarthritic chondrocytes in order to develop new diagnostic and therapeutic strategies for osteoarthritis.


Assuntos
Cartilagem Articular , Osteoartrite , Condrócitos , Glucose/metabolismo , Glicólise , Humanos , Osteoartrite/metabolismo
7.
PLoS One ; 16(11): e0259679, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34739521

RESUMO

BACKGROUND: Osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability among Americans. Physical therapy (PT) is recommended per the 2019 ACR /Arthritis Foundation Guideline for Treatment of OA of the Hand, Hip, and Knee. During COVID-19, access to healthcare has been altered in a variety of clinical settings, with the pandemic creating delays in healthcare, with an unknown impact on access to PT care for OA. OBJECTIVES: We sought to determine whether referrals to PT for OA were reduced in 2020 during the COVID-19 pandemic compared to 2019. METHODS: A retrospective analysis was done of 3586 PT referrals placed by the University of California, Davis for 206 OA ICD-10 codes from January to November 2019 and from January to November 2020. The numbers of PT referrals per month of each year were compared using both descriptive statistics and Poisson Regression analysis. RESULTS: A total of 1972 PT referrals for OA were placed from January to November 2019. Only 1614 referrals for OA were placed from January to November 2020, representing a significant decrease (p = 0.001). Month-by-month analysis of 2020 compared to 2019 revealed statistically significant drops in PT referrals for OA in April (p = 0.001), May (p = 0.001), and August (p = 0.001). CONCLUSIONS: These findings reveal a significant reduction in the number of referrals for PT for OA placed in 2020 during the first year of the COVID-19 pandemic. These reductions were particularly evident in the months following state-mandated actions and closures. Factors associated with this outcome may include decreased access to primary care providers, perceptions of PT availability by health care providers, decreased mobility limiting access to both clinic and PT appointments, and/or willingness to engage in PT by patients during the pandemic.


Assuntos
COVID-19/epidemiologia , Osteoartrite do Quadril/terapia , Osteoartrite do Joelho/terapia , Osteoartrite/epidemiologia , Modalidades de Fisioterapia , Encaminhamento e Consulta , Terapia por Exercício , Humanos , Inflamação , Osteoartrite do Quadril/epidemiologia , Osteoartrite do Joelho/epidemiologia , Pandemias , Distribuição de Poisson , Estudos Retrospectivos , SARS-CoV-2 , Sociedades Médicas , Estados Unidos
8.
Scand J Immunol ; 94(4): e13092, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34780075

RESUMO

The cholinergic anti-inflammatory pathway (CAP) is a classic neuroimmune pathway, consisting of the vagus nerve, acetylcholine (ACh)-the pivotal neurotransmitter of the vagus nerve-and its receptors. This pathway can activate and regulate the activities of immune cells, inhibit cell proliferation and differentiation, as well as suppress cytokine release, thereby playing an anti-inflammatory role, and widely involved in the occurrence and development of various diseases; recent studies have demonstrated that the CAP may be a new target for the treatment of autoimmune rheumatic diseases. In this review, we will summarize the latest progress with the view of figuring out the role of the cholinergic pathway and how it interacts with inflammatory reactions in several autoimmune rheumatic diseases, and many advances are results from a wide range of experiments performed in vitro and in vivo.


Assuntos
Doenças Autoimunes/etiologia , Doenças Reumáticas/etiologia , Acetilcolina/imunologia , Animais , Artrite Reumatoide/etiologia , Artrite Reumatoide/imunologia , Doenças Autoimunes/imunologia , Humanos , Inflamação/imunologia , Lúpus Eritematoso Sistêmico/etiologia , Lúpus Eritematoso Sistêmico/imunologia , Neuroimunomodulação , Osteoartrite/etiologia , Osteoartrite/imunologia , Receptores Colinérgicos/imunologia , Doenças Reumáticas/imunologia , Escleroderma Sistêmico/etiologia , Escleroderma Sistêmico/imunologia , Síndrome de Sjogren/etiologia , Síndrome de Sjogren/imunologia , Espondiloartropatias/etiologia , Espondiloartropatias/imunologia , Nervo Vago/imunologia
9.
J Hand Surg Asian Pac Vol ; 26(4): 625-634, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34789091

RESUMO

Background: Proximal Row Carpectomy (PRC) is a widespread, safe and effective salvage surgical procedure for wrist arthritis. Some authors believe that PRC results in low grip strength (GS), due to the loss of carpal height, supporting the idea to discourage PRC in high-demanding patients. Resurfacing Capitate Prosthesis Implant (RCPI) allows extending the indication for PRC also in case of deformity and/or arthritis of the head of capitate, with possible implications of clinical outcomes, including GS. Methods: Retrospective multicentre study on a population of active workers, affected by secondary post traumatic wrist arthritis, who underwent PRC (27 patients) or PRC + RCPI (20 patients), Primary outcome was to assess GS between PRC and PRC + RCPI. Secondary outcome was to assess CHR and to search for any possible contributors to GS. Active range of motion (AROM), hand function (DASH, Work-DASH, VAS, PRWHE), pain, time to return to work, job maintenance, major complications and general satisfaction were also assessed. Results: PRC + RCPI results in more GS maintenance compared with PRC alone, with higher values of CHR. CHR values were associated with GS with a good correlation. According to linear regression model analysis within PRC + RCPI group (GS-CHR), it is esteemed that the increase in parameter CHR is associated with an increase in parameter GS. Looking at a multiple linear regression model analysis built on the whole sample (GS% increase - (group × CHR) + GS% pre-operative). It is estimated that the increase of one unit of the GS coefficient is associated with an increase in GS% increase. Furthermore, higher pre-operative GS values positively influence post-operative GS. No differences were revealed between the two treatments in terms of the remaining secondary outcomes. Conclusions: PRC alone and PRC + RCPI are both effective salvage procedures for wrist arthritis. RCPI provides a better GS preservation, in part due to the carpal height preservation.


Assuntos
Osteoartrite , Punho , Carbono , Humanos , Estudos Retrospectivos
10.
J Hand Surg Asian Pac Vol ; 26(4): 728-733, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34789097

RESUMO

Thumb carpometacarpal joint osteoarthritis is a common condition that is treated nonsurgically. When conservative treatments fail, surgery is considered. Recently, suture button suspensionplasty has attracted attention and yielded good clinical results. We have developed a novel suture button suspensionplasty procedure called "cross-coupling suture button suspensionplasty" (CC-SBS) using a pair of suture button devices after a complete trapeziectomy. This retrospective study aimed to report the short-term clinical results of patients who underwent CC-SBS at our institution. We evaluated 10 hands of 10 patients (9 women and 1 man; average age, 67 years) who were refractory to conservative treatment and underwent CC-SBS at our institution between 2015 and 2017. We evaluated the preoperative Eaton stage and postoperative trapezial space height immediately after surgery and at the final visit; measured the trapezial space height, range of motion of the palmar and radial abduction of the carpometacarpal joint at the final visit; measured the preoperative and postoperative pinch strength; and recorded postoperative complications. The mean trapezial space height was 6.5 mm, and the mean radial and palmar abductions were 47° and 45°, respectively, at the final visit. The average pinch strength improved to 3.8 kg at the final visit compared to that pre-operation. In one case, a second metacarpal fracture occurred 2 weeks post-surgery, but no other complications were reported. Conclusion: CC-SBS showed short-term clinical outcomes similar to those of ligament reconstruction and tendon interposition and demonstrated faster overall recovery. Our procedure does not need a donor tendon for suspension and is technically simple and less invasive than ligament reconstruction tendon interposition. Thus, stronger initial fixation is obtained by using two suture button devices, and rehabilitation can be started from an early stage. We believe that this procedure is a good surgical option for carpometacarpal joint osteoarthritis.


Assuntos
Articulações Carpometacarpais , Osteoartrite , Idoso , Articulações Carpometacarpais/diagnóstico por imagem , Articulações Carpometacarpais/cirurgia , Feminino , Humanos , Masculino , Osteoartrite/diagnóstico por imagem , Osteoartrite/cirurgia , Estudos Retrospectivos , Suturas , Polegar/cirurgia
11.
J Hand Surg Asian Pac Vol ; 26(4): 684-696, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34789103

RESUMO

Background: Unconstrained pyrocarbon and metal-on-polyethylene (MoP) proximal interphalangeal (PIP) joint arthroplasty is an increasingly popular alternative to silicone implants and arthrodesis. This systematic review appraises their outcomes. Methods: 30 studies comprising 1,324 joints (813 pyrocarbon, 511 MoP) were included. Mean patient age was 59 years (38 to 78) and mean follow-up period was 54 months (1.2 to 380). Results: There were mean improvements of 4.5 points (2 to 6.9) in pain Visual Analogue Score, 10.5° (-26 to 58) in range of motion (ROM), 3.1 kg (-4 to 7) in grip strength, 0.6 kg (-1.5 to 2) in pinch strength, and 18 points (-3 to 29) in the Disabilities of the Arm, Shoulder and Hand score, with no significant differences between implant types. ROM gains, in particular, deteriorated over time. Clinical complications were frequent (23%), and significantly more common with pyrocarbon, as were radiographic complications. However, most were mild-moderate and did not necessarily correlate with negative outcomes or dissatisfaction. Overall reoperation rate was 21%, and revision rate 11%, both more frequent with pyrocarbon. Most revisions were within 24 months, beyond which survival was maintained up to ten years. Conclusions: Unconstrained PIP joint arthroplasty is effective at improving pain scores, active ROM, grip/pinch strength, and patient reported outcome measures, particularly in patients with osteoarthritis. Results are generally maintained at least to the medium term, although gains diminish in the longer term. Complication and early revision rates are high, particularly with pyrocarbon implants. The majority of patients express positive attitudes to arthroplasty, with significant improvements in patient-reported outcome measures for both pyrocarbon and MoP implants. Patients with post-traumatic and inflammatory arthropathy are generally less satisfied. There is currently insufficient data to recommend one implant type over another, although the early-to-medium term results of MoP implants are promising. Prospective surveillance via small joint registries is recommended.


Assuntos
Artroplastia de Substituição de Dedo , Prótese Articular , Osteoartrite , Artroplastia , Articulações dos Dedos/cirurgia , Humanos , Pessoa de Meia-Idade , Osteoartrite/cirurgia , Estudos Prospectivos , Resultado do Tratamento
12.
Acta Orthop Belg ; 87(3): 533-539, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34808729

RESUMO

The aim of the study was to determine if the use of tendon allografts in combination with distal scaphoid resection for the treatment of isolated STT arthrosis is a save procedure. We reviewed the postoperative complications, re-operations, clinical and radiological results of this treatment modality. A retrospective cohort study was conducted. Investigated parameters include wrist mobility (wrist extension and -flexion), strength (grip- and pinch strength), patient-reported outcome scores : Visual Analogue Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand score (Q-DASH) and Patient Rated Wrist/Hand Evaluation score (PRWHE) and radiographic measurements : scapholunate (SL) angle, radiolunate (RL) angle and capitolunate (CL) angle. Ten wrists were included in nine patients. No revision surgery was performed. Two patients had transient neuropraxia of the radial nerve. Postoperative flexion-extension arc was 112°. Grip-strength was significantly increased after surgery (20 to 28kg). The average VAS score the past week was 1.75 (range 0-6.7), the average maximum VAS score was 3.0 (range 0-10). The mean PRWHE score was 16.6 (range 0- 69). The mean Q-DASH score was 17.95 (range 0-51). The current study indicates that distal scaphoid resection for isolated STT arthritis is a save procedure with minimal complications. It significantly improves grip strength. Mobility of the wrist was similar to contralateral wrist after surgery. Pain postoperatively was very limited (low VAS scores) and good functional scores (Q-DASH and PRWHE) were noted. Our findings support the prior findings that excisional arthroplasty might worsen carpal instability.


Assuntos
Osteoartrite , Osso Escafoide , Aloenxertos , Avaliação da Deficiência , Seguimentos , Força da Mão , Humanos , Osteoartrite/cirurgia , Amplitude de Movimento Articular , Estudos Retrospectivos , Osso Escafoide/diagnóstico por imagem , Osso Escafoide/cirurgia , Tendões , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/cirurgia
13.
BioDrugs ; 35(6): 611-641, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34807432

RESUMO

Musculoskeletal pain such as osteoarthritis (OA) and low back pain (LBP) are very common and contribute to enormous burden and societal costs, despite dramatic therapeutic advances over recent decades. Novel approaches and targeted therapies are required to satisfy the urgent unmet medical need of musculoskeletal pain relief in both conditions. Nerve growth factor (NGF) inhibitors have utilized novel mechanisms different from conventional drugs, which have a variety of gastrointestinal, cardiac, or renal adverse effects. Several phase 2/3 studies have been accomplished for these drugs, such as tanezumab, fasinumab, and tyrosine receptor kinase A (TrkA) inhibitors. We searched the literature using the PubMed database and clinical trials using ClinicalTrials.gov to identify original papers, meta-analyses as well as ongoing clinical trials assessing the efficacy and safety profile of these drugs. In this narrative review, we briefly overview the disease burden of musculoskeletal pain, the role of NGF signaling and its receptors in the genesis of pain, and the mechanisms of action of inhibitors of NGF signaling and downstream pathways, and then discuss the efficacy and safety of each investigational drug in OA and LBP. Finally, we briefly review two serious adverse effects of NGF inhibitors, namely rapidly progressive OA and sympathetic system effects, and conclude with possible barriers and potential research directions to overcome these.


Assuntos
Dor Musculoesquelética , Osteoartrite , Humanos , Dor Musculoesquelética/tratamento farmacológico , Fator de Crescimento Neural , Osteoartrite/tratamento farmacológico
14.
Med Hypotheses ; 157: 110713, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34710749

RESUMO

Osteoarthritis is still a disease burden for pharmaceutical scientists and strategy makers. It is associated with the chronic inflammation of joints especially weight-bearing joints like knee, hip, backbone, and phalanges. NSAIDs that are used for the management of inflammation associated with osteoarthritis have high side effects related to gastric upset, gastric ulcer, and long term treatment associated with liver and kidney damage. Nanotechnology has gained a huge scope for the management of arthritis as it can reach out to the deep inside the cell and alter cellular physiology as desired. The present study hypothesizes the use of polyion complex nanoparticles of hyaluronic acid linked Pentosan polysulfate sodium, a disease-modifying agent for the treatment of osteoarthritis administered through transdermal route. The hypothesis involves the use of drug repurposing as the drug was initially approved for interstitial cystitis, a condition of the urinary bladder associated with pain and swelling. Being very low oral bioavailability and gastric irritation profile, the transdermal route would be beneficial. To overcome the problem associated with the oral route, there is a need for the targeted approach that will particularly reach at inflammatory sites. Thereby transdermal delivery of hyaluronic acid linked Pentosan polysulfate sodium through polyion complex nanoparticle therapy will be a novel therapeutic approach to combat osteoarthritis.


Assuntos
Cistite Intersticial , Nanopartículas , Osteoartrite , Reposicionamento de Medicamentos , Humanos , Ácido Hialurônico , Osteoartrite/tratamento farmacológico , Poliéster Sulfúrico de Pentosana
15.
Molecules ; 26(20)2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34684706

RESUMO

The remarkable lubrication properties of normal articular cartilage play an essential role in daily life, providing almost frictionless movements of joints. Alterations of cartilage surface or degradation of biomacromolecules within synovial fluid increase the wear and tear of the cartilage and hence determining the onset of the most common joint disease, osteoarthritis (OA). The irreversible and progressive degradation of articular cartilage is the hallmark of OA. Considering the absence of effective options to treat OA, the mechanosensitivity of chondrocytes has captured attention. As the only embedded cells in cartilage, the metabolism of chondrocytes is essential in maintaining homeostasis of cartilage, which triggers motivations to understand what is behind the low friction of cartilage and develop biolubrication-based strategies to postpone or even possibly heal OA. This review firstly focuses on the mechanism of cartilage lubrication, particularly on boundary lubrication. Then the mechanotransduction (especially shear stress) of chondrocytes is discussed. The following summarizes the recent development of cartilage-inspired biolubricants to highlight the correlation between cartilage lubrication and OA. One might expect that the restoration of cartilage lubrication at the early stage of OA could potentially promote the regeneration of cartilage and reverse its pathology to cure OA.


Assuntos
Cartilagem/fisiologia , Osteoartrite/fisiopatologia , Líquido Sinovial/metabolismo , Animais , Fenômenos Biofísicos/fisiologia , Cartilagem/metabolismo , Cartilagem Articular/metabolismo , Condrócitos/metabolismo , Fricção , Humanos , Ácido Hialurônico/metabolismo , Mecanotransdução Celular , Estresse Mecânico
16.
BMC Public Health ; 21(1): 1821, 2021 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627194

RESUMO

BACKGROUND: Objectively measured differences in physical activity (PA) and sleep have been documented among people with osteoarthritis (OA) and rheumatoid arthritis (RA) compared to non-arthritic controls. However, it is not clear whether OA and RA subgroups also differ on these indexes or the extent to which distinct arthritis subgroups versus controls can be accurately identified on the basis of objective PA and sleep indexes compared to self-report responses on questionnaires. This study addressed these gaps. METHODS: This case-control study comprised Chinese adults with OA (N = 40) or RA (N = 40) diagnoses based on physician assessments as well as a control group of adults without chronic pain (N = 40). All participants wore a Sensewear Armband (SWA) for consecutive 7 days and completed the International Physical Activity Questionnaire Short Form-Chinese as well as Pittsburgh Sleep Diary to obtain objective and subjective PA and sleep data, respectively. RESULTS: There were no differences between the three groups on any self-report indexes of PA or sleep. Conversely, OA and RA subgroups displayed significantly lower PA levels and more sleep problems than controls did on a majority of SWA indexes, though arthritis subgroups were not differentiated from one another on these measures. Logistic regression analyses indicated four non-multicollinear SWA indexes (i.e., steps, active energy expenditure, vigorous activity, time awake after sleep onset) correctly identified the subgroup membership of 75.0-82.5% of participants with RA or OA while classification accuracy results were attenuated for controls. CONCLUSIONS: Where possible, objective measures should be used to assess PA and sleep of adults with OA and RA while particular self-report PA questionnaires should be used sparingly.


Assuntos
Artrite Reumatoide , Osteoartrite , Adulto , Estudos de Casos e Controles , China/epidemiologia , Exercício Físico , Humanos , Osteoartrite/epidemiologia , Autorrelato , Sono
17.
JAMA ; 326(16): 1595-1605, 2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34698782

RESUMO

Importance: Approximately 3.4% of adults have ankle (tibiotalar) osteoarthritis and, among younger patients, ankle osteoarthritis is more common than knee and hip osteoarthritis. Few effective nonsurgical interventions exist, but platelet-rich plasma (PRP) injections are widely used, with some evidence of efficacy in knee osteoarthritis. Objective: To determine the effect of PRP injections on symptoms and function in patients with ankle osteoarthritis. Design, Setting, and Participants: A multicenter, block-randomized, double-blinded, placebo-controlled clinical trial performed at 6 sites in the Netherlands that included 100 patients with pain greater than 40 on a visual analog scale (range, 0-100) and tibiotalar joint space narrowing. Enrollment began on August 24, 2018, and follow-up was completed on December 3, 2020. Interventions: Patients were randomly assigned (1:1) to receive 2 ultrasonography-guided intra-articular injections of either PRP (n = 48) or placebo (saline; n = 52). Main Outcomes and Measures: The primary outcome was the validated American Orthopaedic Foot and Ankle Society score (range, 0-100; higher scores indicate less pain and better function; minimal clinically important difference, 12 points) over 26 weeks. Results: Among 100 randomized patients (mean age, 56 years; 45 [45%] women), no patients were lost to follow-up for the primary outcome. Compared with baseline values, the mean American Orthopaedic Foot and Ankle Society score improved by 10 points in the PRP group (from 63 to 73 points [95% CI, 6-14]; P < .001) and 11 points in the placebo group (from 64 to 75 points [95% CI, 7-15]; P < .001). The adjusted between-group difference over 26 weeks was -1 ([95% CI, -6 to 3]; P = .56). One serious adverse event was reported in the placebo group, which was unrelated to the intervention; there were 13 other adverse events in the PRP group and 8 in the placebo group. Conclusions and Relevance: Among patients with ankle osteoarthritis, intra-articular PRP injections, compared with placebo injections, did not significantly improve ankle symptoms and function over 26 weeks. The results of this study do not support the use of PRP injections for ankle osteoarthritis. Trial Registration: Netherlands Trial Register: NTR7261.


Assuntos
Articulação do Tornozelo , Osteoartrite/terapia , Placebos/administração & dosagem , Plasma Rico em Plaquetas , Método Duplo-Cego , Feminino , Humanos , Injeções Intra-Articulares/métodos , Masculino , Pessoa de Meia-Idade , Países Baixos , Medição da Dor , Resultado do Tratamento , Ultrassonografia de Intervenção
18.
Int J Pharm ; 609: 121211, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34687817

RESUMO

Osteoarthritis (OA) is a chronic disease that seriously impairs people's physical function and quality of life. Triptolide (TP), as a promising anti-inflammatory drug for the treatment of OA, has limited clinical application due to its severe systemic toxicity, poor solubility and rapid elimination in the body. To extend its application prospect for OA treatment. We have developed a liposome-loaded dissolving microneedle (DMN) system, which can effectively deliver poorly water-soluble TP and improve OA symptoms. To incorporate TP into DMNs, triptolide liposome (TP-Lipo) with entrapment efficiency of 90.25% was prepared by ethanol injection. Subsequently, TP-Lipo was concentrated by ultrafiltration tube and mixed with hyaluronic acid solution to prepare DMNs, TP-Lipo-loaded DMNs (TP-Lipo@DMNs) showed sufficient mechanical and insertion properties to penetrate about 200 µm of rat skin. The drug distribution in vivo showed that TP-Lipo@DMNs had a slow-release effect compared with intra-articular injection. In vivo pharmacodynamic research showed that TP-Lipo@DMNs significantly reduced knee joint swelling and the level of inflammatory cytokines (TNF-α, IL-1ß, IL-6). Micro-CT and histological evaluation showed that TP-Lipo@DMNs effectively reduced cartilage destruction and alleviated OA symptoms. These results support that TP@Lipo@DMNs may be a promising option for OA treatment.


Assuntos
Lipossomos , Osteoartrite , Administração Cutânea , Animais , Diterpenos , Sistemas de Liberação de Medicamentos , Compostos de Epóxi , Osteoartrite/tratamento farmacológico , Fenantrenos , Qualidade de Vida , Ratos
19.
J Oral Rehabil ; 48(12): 1380-1394, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34599524

RESUMO

STUDY OBJECTIVES: To assess the general subjective sleep quality in individuals with and without TMD, and its distribution among the TMD diagnostic groups. METHODS: A systematic review search was performed in Pubmed/MEDLINE, Embase, LILACS, Web of Science, SciELO, CINAHL and Cochrane Central as well as in the grey literature. Observational studies published since 1992 which used either the DC/TMD or RDC/TMD for TMD diagnosis and either the PSQI, SAQ or ESS questionnaires for sleep assessment were included. Articles selected for meta-analysis underwent quality, heterogeneity and publication bias evaluation. RESULTS: A total of 1071 articles were found by online search, and 10 articles were added manually. For full-text reading, 138 papers were selected. Thirty-six articles were included in the final review, and 19 in the meta-analysis (PSQI only). Subjective sleep quality was shown to be associated with all RDC/TMD or DC/TMD Axis I diagnostic groups: muscle disorders, arthralgia/osteoarthritis/osteoarthrosis and disk displacements; with the highest association in the first two groups, and the lowest in the last one. A 4.45 times increased odds ratio of TMD prevalence was found for individuals who presented poor subjective sleep quality. CONCLUSION: Subjective sleep quality should be considered in the management of TMD.


Assuntos
Osteoartrite , Transtornos da Articulação Temporomandibular , Artralgia , Humanos , Sono , Inquéritos e Questionários
20.
Biomater Sci ; 9(22): 7603-7616, 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34671794

RESUMO

Osteoarthritis (OA), a chronic and degenerative joint disease, remains a challenge in treatment due to the lack of disease-modifying therapies. As a promising therapeutic agent, adipose-derived stem cells (ADSCs) have an effective anti-inflammatory and chondroprotective paracrine effect that can be enhanced by genetic modification. Unfortunately, direct cell delivery without matrix support often results in poor viability of therapeutic cells. Herein, a hydrogel implant approach that enabled intra-articular delivery of gene-engineered ADSCs was developed for improved therapeutic outcomes in a surgically induced rat OA model. An injectable extracellular matrix (ECM)-mimicking hydrogel was prepared as the carrier for cell delivery, providing a favorable microenvironment for ADSC spreading and proliferation. The ECM-mimicking hydrogel could reduce cell death during and post injection. Additionally, ADSCs were genetically modified to overexpress transforming growth factor-ß1 (TGF-ß1), one of the paracrine factors that exert an anti-inflammatory and pro-anabolic effect. The gene-engineered ADSCs overexpressing TGF-ß1 (T-ADSCs) had an enhanced paracrine effect on OA-like chondrocytes, which effectively decreased the expression of tumor necrosis factor-alpha and increased the expression of collagen II and aggrecan. In a surgically induced rat OA model, intra-articular injection of the T-ADSC-loaded hydrogel markedly reduced cartilage degeneration, joint inflammation, and the loss of the subchondral bone. Taken together, this study provides a potential biomaterial strategy for enhanced OA treatment by delivering the gene-engineered ADSCs within an ECM-mimicking hydrogel.


Assuntos
Hidrogéis , Osteoartrite , Adipócitos , Tecido Adiposo , Animais , Osteoartrite/terapia , Ratos , Células-Tronco
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