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1.
Int J Nanomedicine ; 15: 3771-3790, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32547027

RESUMO

Introduction: Rapamycin has been considered as a potential treatment for osteoarthritis (OA). Drug carriers fabricated from liposomes can prolong the effects of drugs and reduce side effects of drugs. Low-intensity pulsed ultrasound (LIPUS) has been found to possess anti-OA effects. Materials and Methods: The anti-osteoarthritic effects of liposome-encapsulated rapamycin (L-rapa) combined with LIPUS were examined by culture of normal and OA chondrocytes in alginate beads and further validated in OA prone Dunkin-Hartley guinea pigs. Results: L-rapa with LIPUS largely up-regulated aggrecan and type II collagen mRNA in human OA chondrocytes (HOACs). L-rapa with LIPUS caused significant enhancement in proteoglycan and type II collagen production in HOACs. Large decreases in both MMP-13 and IL-6 proteins were found in the HOACs exposed to L-rapa with LIPUS. Intra-articular injection of 40 µL L-rapa at both 5 µM and 50 µM twice a week combined with LIPUS thrice a week for 8 weeks significantly increased GAGs and type II collagen in the cartilage of knee. Results on OARSI score showed that intra-articular injection of 5 µM L-rapa with LIPUS displayed the greatest anti-OA effects. Immunohistochemistry revealed that L-rapa with or without LIPUS predominantly reduced MMP-13 in vivo. The values of complete blood count and serum biochemical examinations remained in the normal ranges after the injections with or without LIPUS. These data indicated that intra-articular injection of L-rapa collaborated with LIPUS is not only effective against OA but a safe OA therapy. Conclusion: Taken together, L-rapa combined with LIPUS possessed the most consistently and effectively anabolic and anti-catabolic effects in HOACs and the spontaneous OA guinea pigs. This study evidently revealed that liposome-encapsulation collaborated with LIPUS is able to reduce the effective dose and administration frequency of rapamycin and further stably reinforce its therapeutic actions against OA.


Assuntos
Osteoartrite/terapia , Sirolimo/uso terapêutico , Ondas Ultrassônicas , Animais , Peso Corporal/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/efeitos da radiação , Células Cultivadas , Condrócitos/efeitos dos fármacos , Condrócitos/patologia , Condrócitos/efeitos da radiação , Colágeno Tipo II/metabolismo , Liberação Controlada de Fármacos , Cobaias , Humanos , Injeções Intra-Articulares , Interleucina-6/metabolismo , Lipossomos/ultraestrutura , Masculino , Metaloproteinase 13 da Matriz/metabolismo , Pessoa de Meia-Idade , Osteoartrite/sangue , Osteoartrite/patologia , Proteoglicanas/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Sirolimo/administração & dosagem , Sirolimo/farmacologia
2.
Bone Joint J ; 102-B(5): 600-605, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32349588

RESUMO

AIMS: Base of thumb osteoarthritis (BTOA) is a common age-related disease which has a significant negative impact upon quality of life. Our aim was to assess current UK practice in secondary care with regard to the nature of non-surgical treatments, the surgical procedures most commonly performed, and factors influencing the surgical decision-making process. METHODS: Ten consecutive patients undergoing surgery for BTOA between March 2017 and May 2019 were prospectively identified in 15 UK centres. Demographic details, duration of symptoms, radiological grade, non-surgical management strategies, and surgery conducted were recorded. A supplementary consultant questionnaire consisting of four multiple-choice-questions (MCQ) based on hypothetical clinical scenarios was distributed. RESULTS: A total of 150 patients were identified with a mean age of 64 years (SD 9), comprising 119 females and 31 males. Median duration of symptoms prior to surgery was 24 months (Interquartile range (IQR) 12 to 40). Hand therapy was used in 67 patients (45%), splints in 80 (53%), and 121 patients (81%) received one or more intra-articular injections, of which 81 (67%) were image-guided (14 (12%) ultrasound and 67 (55%) fluoroscopic). Only 48 patients (32%) received all three non-surgical treatments. Simple trapeziectomy (79 patients) and trapeziectomy with ligament reconstruction and/or tendon interposition (69 patients) were the most commonly performed operations. One patient was treated with arthrodesis, and one with arthroplasty. The supplementary questionnaire revealed that no specific patient or disease characteristics significantly influenced the type of surgery undertaken. CONCLUSION: We found considerable variation in practice of both non-surgical and surgical management of BTOA. The proportion of patients exhausting non-surgical strategies before being offered surgery is low. Surgeons tend to favour a single type of surgery irrespective of patient or disease characteristics. Cite this article: Bone Joint J 2020;102-B(5):600-605.


Assuntos
Articulação da Mão , Osteoartrite/terapia , Padrões de Prática Médica/estatística & dados numéricos , Polegar , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Reino Unido
3.
FP Essent ; 491: 17-21, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32315144

RESUMO

Glenohumeral joint osteoarthritis (OA) and adhesive capsulitis are two common causes of shoulder pain. The glenohumeral joint is the third most common large joint affected by OA. Studies have shown that 16% to 20% of adults older than 65 years have radiographic signs of glenohumeral joint OA. Management of shoulder OA starts with conservative therapies, including oral drugs, injections, and physical therapy. Joint replacement can be considered if conservative measures are not effective. Adhesive capsulitis, also known as frozen shoulder, is estimated to affect 2% to 5% of the population and is seen most often in patients between ages 40 and 65 years. The exact causal mechanism of adhesive capsulitis is unknown but risk factors include diabetes and thyroid disease. Adhesive capsulitis is thought to follow a set of clinical stages. It ultimately is self-limited, although some patients experience residual effects. Management starts with conservative therapies, including oral drugs, injections, and physical therapy. Surgical management can be considered if conservative measures are not effective.


Assuntos
Bursite , Osteoartrite , Articulação do Ombro , Adulto , Idoso , Bursite/terapia , Humanos , Pessoa de Meia-Idade , Osteoartrite/terapia , Amplitude de Movimento Articular , Ombro , Dor de Ombro
4.
Med Clin North Am ; 104(2): 293-311, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32035570

RESUMO

Osteoarthritis (OA) is a worldwide endemic and debilitating disease. Previously thought to simply be damaged from "wear and tear," OA is now understood to be a complex interaction of local and systemic factors. This article reviews the pathology, symptoms, diagnosis, and various conservative, surgical, and novel treatments of OA.


Assuntos
Osteoartrite , Administração dos Cuidados ao Paciente/métodos , Humanos , Osteoartrite/diagnóstico , Osteoartrite/fisiopatologia , Osteoartrite/terapia
5.
Am J Nurs ; 120(3): 58-60, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32079801

RESUMO

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times.In this month's article, from the May 1925 issue, nurse Ellen G. Dawson from Evanston Hospital in Illinois presents three case studies as evidence for a new use for immobilizing traction: the treatment of osteoarthritis. The protocol includes the use of traction for days or weeks, hot fomentations (poultices) applied to the skin over the painful joint, and a body cast (for back pain) or leg cast (for knee pain) worn for an extended period afterward. If the joint pain was severe, a lotion made from tinctures of opium and arnica, witch hazel, and lead water was also applied. The author notes, "We could cite case after case, with varying lengths of time, where the results have been equally gratifying."Today, nurses are involved in more formal arthritis research. In this issue, So-Hyun Park and Shiela M. Strauss examine the impact of arthritis on recommended physical activity in their original research article, "Arthritis-Related Functional Limitations and Inadequate Physical Activity Among Female Adult Cancer Survivors."


Assuntos
Temperatura Alta/uso terapêutico , Osteoartrite/terapia , Tração/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Occup Environ Med ; 77(3): 168-171, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31959639

RESUMO

OBJECTIVE: It is postulated that increased load from pinch and grasp in occupational tasks increases the risk of thumb carpometacarpal (CMC1) osteoarthritis (OA). We sought to characterise the relationship between doctor-diagnosed CMC1 OA and occupation in a large working population. METHODS: We performed a matched case-control study using a Swedish healthcare register. We identified residents aged 30-65 years in 2013 with physician-diagnosed CMC1 OA from 1998 to 2013. We matched four controls per person with CMC1 OA by age, sex, education and postcode. Swedish Standard Classification of Occupations was used to assign occupation. Occupation was categorised as light, light-moderate, moderate and heavy labour. We used conditional logistic regression to estimate ORs with 95% CIs. RESULTS: We identified 3462 patients with CMC1 OA and matched 13 211 controls. The mean age of the CMC1 OA group was 63 (SD 7) years, with 81% women. The ORs for CMC1 OA in men were 1.31 (95% CI 0.96 to 1.79) for light-moderate, 1.76 (95% CI 1.29 to 2.40) for moderate and 2.00 (95% CI 1.59 to 2.51) for heavy compared with light work. Women had ORs for CMC1 OA of 1.46 (95% CI 1.32 to 1.61) for light-moderate, 1.27 (95% CI 1.10 to 1.46) for moderate and 1.31 (95% CI 1.07 to 1.59) for heavy compared with light work. CONCLUSIONS: The association between increased manual load in occupation and risk of CMC1 OA is more pronounced in men than in women, likely due to higher workload in the heavy labour category.


Assuntos
Articulações Carpometacarpais/patologia , Doenças Profissionais/epidemiologia , Osteoartrite/diagnóstico , Osteoartrite/epidemiologia , Polegar/fisiopatologia , Carga de Trabalho , Idoso , Estudos de Casos e Controles , Feminino , Força da Mão , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Osteoartrite/terapia , Papel do Médico , Sistema de Registros , Fatores de Risco , Suécia/epidemiologia
7.
Arthritis Rheumatol ; 72(2): 220-233, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31908163

RESUMO

OBJECTIVE: To develop an evidence-based guideline for the comprehensive management of osteoarthritis (OA) as a collaboration between the American College of Rheumatology (ACR) and the Arthritis Foundation, updating the 2012 ACR recommendations for the management of hand, hip, and knee OA. METHODS: We identified clinically relevant population, intervention, comparator, outcomes questions and critical outcomes in OA. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available educational, behavioral, psychosocial, physical, mind-body, and pharmacologic therapies for OA. Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of the evidence. A Voting Panel, including rheumatologists, an internist, physical and occupational therapists, and patients, achieved consensus on the recommendations. RESULTS: Based on the available evidence, either strong or conditional recommendations were made for or against the approaches evaluated. Strong recommendations were made for exercise, weight loss in patients with knee and/or hip OA who are overweight or obese, self-efficacy and self-management programs, tai chi, cane use, hand orthoses for first carpometacarpal (CMC) joint OA, tibiofemoral bracing for tibiofemoral knee OA, topical nonsteroidal antiinflammatory drugs (NSAIDs) for knee OA, oral NSAIDs, and intraarticular glucocorticoid injections for knee OA. Conditional recommendations were made for balance exercises, yoga, cognitive behavioral therapy, kinesiotaping for first CMC OA, orthoses for hand joints other than the first CMC joint, patellofemoral bracing for patellofemoral knee OA, acupuncture, thermal modalities, radiofrequency ablation for knee OA, topical NSAIDs, intraarticular steroid injections and chondroitin sulfate for hand OA, topical capsaicin for knee OA, acetaminophen, duloxetine, and tramadol. CONCLUSION: This guideline provides direction for clinicians and patients making treatment decisions for the management of OA. Clinicians and patients should engage in shared decision-making that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.


Assuntos
Articulação da Mão , Osteoartrite do Quadril/terapia , Osteoartrite do Joelho/terapia , Osteoartrite/terapia , Humanos
9.
Am J Emerg Med ; 38(1): 127-131, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31337598

RESUMO

BACKGROUND: There is an increasing focus in the emergency department (ED) on addressing the needs of persons with cognitive impairment, most of whom have multiple chronic conditions. We investigated which common comorbidities among multimorbid persons with cognitive impairment conferred increased risk for ED treat and release utilization. METHODS: We examined the association of 16 chronic conditions on use of ED treat and release visit utilization among 1006 adults with cognitive impairment and ≥ 2 comorbidities using the nationally-representative National Health and Aging Trends Study merged with Fee-For-Service Medicare claims data, 2011-2015. RESULTS: At baseline, 28.5% had ≥6 conditions and 35.4% were ≥ 85 years old. After controlling for sex, age, race, education, urban-living, number of disabled activities of daily living, and sampling strata, we found significantly increased adjusted risk ratios (aRR) of ED treat and release visits for persons with depression (aRR 1.38 95% CI 1.15-1.65) representing 78/100 person-years, and osteoarthritis or rheumatoid arthritis (aRR 1.32 95% CI 1.12-1.57) representing 71/100 person-years. At baseline 93.9% had ≥1 informal caregiver and 69.7% had a caregiver that helped with medications or attended physician visits. CONCLUSION: These results show that multimorbid cognitively impaired older adults with depression or osteoarthritis or rheumatoid arthritis are at higher risk of ED treat and release visits. Future ED research with multimorbid cognitively impaired persons may explore behavioral aspects of depression and/or pain and flairs associated with osteoarthritis or rheumatoid arthritis, as well as the role of informal caregivers in the care of these conditions.


Assuntos
Doença Crônica/psicologia , Doença Crônica/terapia , Disfunção Cognitiva , Serviço Hospitalar de Emergência/estatística & dados numéricos , Multimorbidade , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/psicologia , Artrite Reumatoide/terapia , Utilização de Instalações e Serviços , Feminino , Humanos , Estudos Longitudinais , Masculino , Medicare , Osteoartrite/psicologia , Osteoartrite/terapia , Estados Unidos
10.
PLoS One ; 14(12): e0214107, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31794570

RESUMO

Osteoarthritis (OA) is characterized by cartilage degradation and chronic joint inflammation. Mesenchymal stem cells (MSCs) have shown promising results in OA, but their mechanism of action is not fully understood. We hypothesize that MSCs polarize macrophages, which are strongly associated with joint inflammation to more homeostatic sub-types. We tracked ferumoxytol (Feraheme™, iron oxide nanoparticle)-labeled murine MSCs (Fe-MSCs) in murine OA joints, and quantified changes to joint inflammation and fibrosis. 10-week-old C57BL/6 male mice (n = 5/group) were induced to undergo osteoarthritis by destabilization of medical meniscus (DMM) or sham surgery. 3 weeks post-surgery, mice were injected intra-articularly with either fluorescent dye-(DiR) labeled or DiR-Fe-MSC or saline to yield 4 groups (n = 5 per group for each timepoint [1, 2 and 4weeks]). 4 weeks after injection, mice were imaged by MRI, and scored for i) OARSI (Osteoarthritis Research Society International) to determine cartilage damage; ii) immunohistochemical changes in iNOS, CD206, F4/80 and Prussian Blue/Sca-1 to detect pro-inflammatory, homeostatic and total macrophages and ferumoxytol -labeled MSCs respectively, and iii) Masson's Trichrome to detect changes in fibrosis. Ferumoxytol-labeled MSCs persisted at greater levels in DMM vs. SHAM-knee joints. We observed no difference in OARSI scores between MSC and vehicle groups. Sca-1 and Prussian Blue co-staining confirmed the ferumoxytol label resides in MSCs, although some ferumoxytol label was detected in proximity to MSCs in macrophages, likely due to phagocytosis of apoptotic MSCs, increasing functionality of these macrophages through MSC efferocytosis. MRI hypertintensity scores related to fluid edema decreased in MSC-treated vs. control animals. For the first time, we show that MSC-treated mice had increased ratios of %CD206+: %F4/80+ (homeostatic macrophages) (p<0.05), and decreased ratios of %iNOS+: %F4/80+ macrophages (p<0.01), supporting our hypothesis that MSCs may modulate synovial inflammation.


Assuntos
Células-Tronco Mesenquimais/fisiologia , Nanopartículas Metálicas/uso terapêutico , Osteoartrite/terapia , Animais , Anti-Inflamatórios/farmacologia , Cartilagem Articular , Modelos Animais de Doenças , Compostos Férricos , Humanos , Inflamação/tratamento farmacológico , Injeções Intra-Articulares , Ferro/metabolismo , Ferro/uso terapêutico , Articulação do Joelho , Masculino , Transplante de Células-Tronco Mesenquimais/métodos , Camundongos , Camundongos Endogâmicos C57BL , Nanopartículas
12.
Biomed Res Int ; 2019: 7695768, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781642

RESUMO

Osteoarthritis (OA) is a joint degenerative disease, which is prominent in the middle-aged and elderly population, often leading to repeated pain in the joints of patients and seriously affecting the life quality of patients. At present, the treatment of OA mainly depends on the surgery and drug treatment. Nevertheless, these treatments still face many problems, such as surgical safety, complications, and drug side effects. Exosomes can be secreted and released by multiple cell types and have lipid bilayer membranes and contain abundant biological molecules, including proteins, lipids, and nucleic acids. Moreover, exosomes play a critical role in local and distal intercellular and intracellular communication. In recent years, several studies have found that exosomes can regulate the progression of OA and have a potential efficacy for OA treatment. Thus, in this article, we summarize and review the relevant research of exosomes in OA and emphasize the importance of exosomes in the development of OA.


Assuntos
Exossomos , Osteoartrite/terapia , Humanos
13.
Int J Rheum Dis ; 22(11): 2045-2051, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31722448

RESUMO

BACKGROUND: No data exist on patient participation in the selection of core domains for clinical trials of hand osteoarthritis (HOA). We aim to explore HOA patients' perspectives in the relative importance of domains. METHODS: Seven domains affecting patients' lives were derived from a prior qualitative study. We recruited consecutive patients with symptomatic HOA to rate on 11-point numeric rating scales for each domain, from 0 representing "not important at all" to 10 representing "most important", with consideration in two scenarios: (a) how important the domains are in affecting their current lives; and (b) how important the domains are when there are treatments for HOA (eg exercise or drugs). RESULTS: Forty-five patients (91% female; mean age ± standard deviation 64.3 ± 7.5 years) with mild HOA symptoms were included. Of these, 31%-42% rated current impact of HOA in various domains as highly important. Seven domains with rated scores of ≥7/10 in importance were endorsed for clinical trials in the following order: pain and HOA symptoms (endorsed by 77.8% of patients), physical function (66.7%), ability to participate in social roles (64.4%), ability to participate in social activities (62.2%), work productivity (62.2%), emotional health (60%), and appearance of fingers (55.6%). CONCLUSION: The preliminary important domains as endorsed by patients with HOA for inclusion into clinical trials were explored. Apart from pain and physical function, further research is needed to refine other domains of impact, such as participation, emotional health and aesthetic concerns, as core domain sets for HOA.


Assuntos
Ensaios Clínicos como Assunto/métodos , Articulação da Mão/fisiopatologia , Conhecimentos, Atitudes e Prática em Saúde , Osteoartrite/terapia , Participação do Paciente , Projetos de Pesquisa , Idoso , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Emoções , Emprego , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Osteoartrite/diagnóstico , Osteoartrite/fisiopatologia , Qualidade de Vida , Comportamento Social , Resultado do Tratamento
14.
Wiad Lek ; 72(9 cz 1): 1671-1675, 2019.
Artigo em Polonês | MEDLINE | ID: mdl-31586981

RESUMO

Osteoarthritis is the disease connected with aging which is characterised by progressive degeneration of all elements building the joint but also influencing the muscles constituting motor unit with the affected joint. The effective and unified therapy has not been yet introduced despite the broad multi-site studies concentrating on metabolic pathways responsible for the development of the disease. The reason of which is probably its multifactorial aetiology. The treatment methods are based on decreasing of cartilage destruction activity, retardation of proinflammatory factors activity and fighting with pain. Physiotherapy, movement rehabilitation, painkillers, anti-inflammatory drugs, glucosamine sulphates and hyaluronic acids are used as therapeutic strategies. The methods recently introduced are platelet rich plasma concentrates and stem cells injected directly into the affected joint. The aim of this review article was the presentation of differential therapeutic options offered to patients in different stages of osteoarthritis.


Assuntos
Envelhecimento , Cartilagem/patologia , Osteoartrite/terapia , Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Glucosamina/uso terapêutico , Humanos , Ácido Hialurônico/uso terapêutico
15.
Clin Exp Rheumatol ; 37 Suppl 120(5): 48-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621566

RESUMO

Osteoarthritis (OA) is the most common age-related chronic and disabling joint disease. Long considered to be a "wear and tear" disease, OA is now seen as a low-grade inflammation disease that affects all tissues of the joint, involving cartilage degradation, bone remodelling, osteophytes, and synovitis. The process, called inflammaging, is characterised by the association of low-grade inflammation, profound changes in intra-cellular mechanisms, and the decreased efficiency of the immune system with ageing. The activation of innate immunity plays a critical role in the development and progression of OA. Innate immunity, including inflammasome activation, is triggered by small endogenous molecules called alarmins or damage-associated molecular patterns (DAMPs). These molecules are released in the extracellular media after cell stress or damage, bind to pathogen-recognition receptors (PRRs), such as Toll-like receptors (TLRs) and the receptor for advanced glycation end products (RAGE), and activate the secretion of pro-inflammatory factors, leading to joint inflammation. Moreover, such sterile inflammation triggers cell senescence, characterised by a senescence-associated secretory phenotype (SASP). Understanding the substantial age-related changes of joint tissues that influence the pathogenesis of OA is critical to improving the quality of life of elderly people in the context of increased life expectancy. This review will focus on age-related sterile inflammation in OA and highlight the various innovative and promising therapies targeting the mechanisms of aging.


Assuntos
Osteoartrite , Qualidade de Vida , Idoso , Envelhecimento , Humanos , Inflamação/imunologia , Osteoartrite/imunologia , Osteoartrite/patologia , Osteoartrite/terapia , Receptor para Produtos Finais de Glicação Avançada/metabolismo , Receptores Toll-Like/metabolismo
17.
Phys Med Rehabil Clin N Am ; 30(4): 775-786, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31563169

RESUMO

Chronic musculoskeletal pain and disability dramatically reduce quality and quantity of life worldwide, disproportionately so in low- and middle-income countries. Complementary therapies not typically learned in conventional medical training have much to offer but are under-utilized. Prolotherapy is an injection-based complementary therapy supported by high-quality evidence for osteoarthritis, tendinopathy, and low back pain. Prolotherapy addresses causes of pain and disability at the tissue level, is straightforward to learn, and relies on common, inexpensive material, and requires no refrigeration. Not-for-profit organizations are delivering prolotherapy to underserved patients in low- and middle-income countries through service-learning projects.


Assuntos
Países em Desenvolvimento , Dor Musculoesquelética/terapia , Proloterapia/métodos , Humanos , Intercâmbio Educacional Internacional , Dor Lombar/terapia , Osteoartrite/terapia , Tendinopatia/terapia
18.
Life Sci ; 236: 116861, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31513815

RESUMO

Osteoarthritis is a prevalent worldwide joint disease, which demonstrates a remarkable adverse effect on the patients' life modality. Medicinal agents, exclusively nonsteroidal anti-inflammatory drugs (NSAIDs), have been routinely applied in the clinic. But, their effects are restricted to pain control with insignificant effects on cartilage renovation, which would finally lead to cartilage destruction. In the field of regenerative medicine, many researchers have tried to use stem cells to repair tissues and other human organs. However, in recent years, with the discovery of extracellular microvesicles, especially exosomes, researchers have been able to offer more exciting alternatives on the subject. Exosomes and microvesicles are derived from different types of bone cells such as mesenchymal stem cells, osteoblasts, and osteoclasts. They are also recognized to play substantial roles in bone remodeling processes including osteogenesis, osteoclastogenesis, and angiogenesis. Specifically, exosomes derived from a mesenchymal stem cell have shown a great potential for the desired purpose. Exosomal products include miRNA, DNA, proteins, and other factors. At present, if it is possible to extract exosomes from various stem cells effectively and load certain products or drugs into them, they can be used in diseases, such as rheumatoid arthritis, osteoarthritis, bone fractures, and other diseases. Of course, to achieve proper clinical use, advances have to be made to establish a promising regenerative ability for microvesicles for treatment purposes in the orthopedic disorders. In this review, we describe the exosomes biogenesis and bone cell derived exosomes in the regenerate process of bone and cartilage remodeling.


Assuntos
Cartilagem Articular/citologia , Exossomos/transplante , Osteoartrite/terapia , Osteogênese , Células-Tronco/citologia , Humanos , Osteoartrite/complicações , Osteoartrite/patologia , Medicina Regenerativa
19.
Biomed Res Int ; 2019: 4732654, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428637

RESUMO

Introduction: High levels of total cholesterol, triglycerides, and, connected with them, lipoprotein fractions may result in atherosclerosis. There are various forms of therapy used to prevent cardiovascular diseases, such as balneophysiotherapy, the effectiveness of which is confirmed by numerous scientific publications. Objective: The objective of this study was to assess the impact of balneophysiotherapeutic procedures on the systemic metabolism of lipids in patients suffering from osteoarthritis of the motor organ. Material and Methods: The study was conducted in the Health Resort Swieradów-Zdrój. Observation included patients undergoing radon water therapy. Before therapy and after 21 days of treatment, lipid profile was assessed with the use of standard colorimetric assay. Study group consisted of n=34 patients with degenerative joints and disc disease. The mean age of patients was 56.5l. The control group consisted of 17 people selected among the employees of the spa also suffering from osteoarthritis. The mean age was 54.2 years. Results: The results of the study are based on a single, 21-day health resort stay period in April/May. A statistically significant increase in HDL cholesterol levels was observed in female patients having undergone health resort treatment (P<0.01). Statistically significant drops in LDL cholesterol and TG levels were observed in the control group (P<0.01). An increase in HDL levels was observed in the male and female control subjects, with P<0.05. Conclusions: (1) After the end of therapy, there were no changes in lipid metabolism in men, while in the group of women an increase in HDL level was observed. (2) In the control group, statistically significant changes in the field of lipid metabolism may be related to lifestyle changes as a result of educational activities conducted prior to the research. (3) Due to the divergent results, it is advisable to conduct randomized studies in a larger population. This trial is registered with NCT03274128.


Assuntos
Balneologia , Degeneração do Disco Intervertebral , Lipídeos/sangue , Osteoartrite , Caracteres Sexuais , Idoso , Feminino , Humanos , Degeneração do Disco Intervertebral/sangue , Degeneração do Disco Intervertebral/fisiopatologia , Degeneração do Disco Intervertebral/terapia , Masculino , Pessoa de Meia-Idade , Osteoartrite/sangue , Osteoartrite/fisiopatologia , Osteoartrite/terapia
20.
Cells ; 8(8)2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434236

RESUMO

Osteoarthritis (OA) is a degenerative condition that involves the production of inflammatory cytokines (e.g., interleukin-1ß (IL-1ß), tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6)) that stimulate degradative enzymes, matrix metalloproteinases (MMPs) and aggrecanases (ADAMTS) resulting in articular cartilage breakdown. The presence of interleukin-1ß (IL-1ß) is one reason for poor clinical outcomes in current cell-based tissue engineering strategies for treating focal early osteoarthritic defects. Mesenchymal stem cells (MSCs) are a potential cell source for articular cartilage regeneration, although IL-1ß has been shown to inhibit in vitro chondrogenesis. In vivo, articular chondrocytes reside under a low oxygen environment between 2-5% oxygen (physioxia) and have been shown to enhance in vitro MSC chondrogenic matrix content with reduced hypertrophic marker expression under these conditions. The present investigation sought to understand the effect of physioxia on IL-1ß inhibited MSC chondrogenesis. MSCs expanded under physioxic (2% oxygen) and hyperoxic (20%) conditions, then chondrogenically differentiated as pellets in the presence of TGF-ß1 and either 0.1 or 0.5 ng/mL IL-1ß. Results showed that there were donor variations in response to physioxic culture based on intrinsic GAG content under hyperoxia. In physioxia responsive donors, MSC chondrogenesis significantly increased GAG and collagen II content, whilst hypertrophic markers were reduced compared with hyperoxia. In the presence of IL-1ß, these donors showed a significant increase in cartilage matrix gene expression and GAG content relative to hyperoxic conditions. In contrast, a set of MSC donors were unresponsive to physioxia and showed no significant increase in matrix production independent of IL-1ß presence. Thus, physioxia has a beneficial effect on MSC cartilage matrix production in responsive donors with or without IL-1ß application. The mechanisms controlling the MSC chondrogenic response in both physioxia responsive and unresponsive donors are to be elucidated in future investigations.


Assuntos
Cartilagem Articular/citologia , Condrogênese/fisiologia , Ílio/citologia , Interleucina-1beta/metabolismo , Células-Tronco Mesenquimais/citologia , Oxigênio/metabolismo , Adulto , Células Cultivadas , Humanos , Masculino , Osteoartrite/terapia , Engenharia Tecidual/métodos , Fator de Crescimento Transformador beta1/metabolismo , Adulto Jovem
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