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- Arokoski, Jari, et al.
(författare)
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Nivelrikon etiopatogeneesi [Etiopathogenesis of osteoarthritis].
- 2001
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Ingår i: Duodecim. - : Duodecim. - 0012-7183 .- 2242-3281. ; 117:16, s. 1617-1626
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Tidskriftsartikel (refereegranskat)abstract
- Nivelrikon patofysiologia tunnetaan huonosti. Nykykäsityksen mukaan artroosissa ei olekyse nivelruston passiivisesta kulumisesta vaan biokemiallisesta tapahtumasarjasta, jossasoluväliaineen tuhoutuminen saa ylivallan rustoa korjaavista prosesseista. Nivelrikon alkuvaiheessarustosoluissa eli kondrosyyteissä aktivoituvat sekä ruston aineosien synteesitoimintaettä rustoa hajottavien entsyymien ilmentyminen ja niitä koodaavien geenientoiminta. Nivelrikko on koko nivelen sairaus, joka aiheuttaa muutoksia niin nivelrustossa,luussa kuin pehmytosissakin. Vallitsevan käsityksen mukaan nivelrikko käynnistyynivelruston pinnallisesta vyöhykkeestä. On myös esitetty, että nivelalueen altistuminenliialliselle kuormitukselle aiheuttaisi ensin rustonalaisen luun paksunemisen ja jäykkenemisen,mikä puolestaan altistaisi nivelruston suuremmille kuormittaville voimille. Riskitekijöistätärkeimpiä ovat ikääntyminen, liikapaino, niveleen kohdistuvat vammat ja ruumiillisentyön aiheuttama liikarasitus. Perinnöllisten tekijöiden osuus on myös merkittävä.Ruston kollageenien rakennevirheiden tiedetään altistavan nivelrikolle.
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- Arokoski, Jari, et al.
(författare)
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Nivelrikon lääkehoito [Medical treatment of osteoarthritis]
- 2008
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Ingår i: Duodecim. - 0012-7183. ; 124, s. 1899--1907
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Forskningsöversikt (refereegranskat)abstract
- teho ei riitä, siirrytään tulehduskipulääkkeisiin niiden haitat huomioiden. Ellei parasetamolilla ja tulehduskipulääkkeillä saada riittävää tehoa nivelrikkokipuun tai niitä ei haittavaikutusten vuoksi ole mahdollista käyttää, kipua voidaan hoitaa opioideilla. Niveleen annettu glukokortikoidi- tai hyaluronaattihoito näyttää lievittävän nivelkipua. Glukosamiini saattaa helpottaa nivelrikon oireita, mutta luotettava tieteellinen näyttö sen tehosta puuttuu edelleen. Kehitteillä on nykyisiin vaikutusmekanismeihin tukeutuvia oireita lievittäviä lääkeaineita, mutta merkittävämpi ja haastavampi pitkän aikavälin tavoite on kehittää rustovaurioita hidastavia lääkkeitä. Potentiaalisia tautiprosessiin vaikuttavia lääkeaineita ovat mm. rustomatriksia hajottavien entsyymien estäjät, typpioksidisynteesin estäjät, sytokiinimodulaattorit ja PPAR-agonistit.
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3. |
- Haapala, Jussi, et al.
(författare)
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Coordinated regulation of hyaluronan and aggrecan content in the articular cartilage of immobilized and exercised dogs.
- 1996
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Ingår i: Journal of Rheumatology. - : Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 23:9, s. 1586-1593
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the influence of joint loading and immobilization on articular cartilage hyaluronan concentration and histological distribution in the knee joints of young dogs subjected to 11 weeks' immobilization by splinting, and 15 weeks' running exercise at a rate of 40 km/day.METHODS: The amount of hyaluronan in articular cartilage was determined by a competitive binding assay using a biotinylated hyaluronan binding complex (HABC) of aggrecan and link protein. Histologic sections were stained for the localization of hyaluronan with the HABC probe. Extracted proteoglycans were characterized by sodium dodecyl sulfate agarose gel electrophoresis.RESULTS: Immobilization significantly reduced the concentration of hyaluronan in all sites studied (tibial and femoral condyles, patellar surface of femur). The proportion of hyaluronan to total uronic acid (mainly from aggrecan) remained unchanged because of a concurrent decrease in aggrecan. The ratio of hyaluronan and aggrecan remained constant also in runners. The staining pattern of free hyaluronan in the tissue sections and the electrophoretic mobility of the extracted proteoglycans were not affected by the different loading regimes.CONCLUSION: Reduced joint loading due to splint immobilization significantly decreases both hyaluronan and aggrecan in the articular cartilage. The remarkably parallel changes in aggrecan and hyaluronan content suggest that joint loading exerts a coordinated influence on their metabolism.
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4. |
- Haapala, Jussi, et al.
(författare)
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Remobilization does not fully restore immobilization induced articular cartilage atrophy.
- 1999
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Ingår i: Clinical Orthopaedics and Related Research. - : Lippincott Williams & Wilkins. - 0009-921X .- 1528-1132. ; :362, s. 218-229
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Tidskriftsartikel (refereegranskat)abstract
- The recovery of articular cartilage from immobilization induced atrophy was studied. The right hind limbs of 29-week-old beagle dogs were immobilized for 11 weeks and then remobilized for 50 weeks. Cartilage from the immobilized knee was compared with tissue from age matched control animals. After the immobilization period, uncalcified articular cartilage glycosaminoglycan concentration was reduced by 20% to 23%, the reduction being largest (44%) in the superficial zone. The collagen fibril network showed no significant changes, but the amount of collagen crosslinks was reduced (13.5%) during immobilization. After remobilization, glycosaminoglycan concentration was restored at most sites, except for in the upper parts of uncalcified cartilage in the medial femoral and tibial condyles (9% to 17% less glycosaminoglycans than in controls). The incorporation of 35SO4 was not changed, and remobilization also did not alter the birefringence of collagen fibrils. Remobilization restored the proportion of collagen crosslinks to the control level. The changes induced by joint unloading were reversible at most sites investigated, but full restoration of articular cartilage glycosaminoglycan concentration was not obtained in all sites, even after remobilization for 50 weeks. This suggests that lengthy immobilization of a joint can cause long lasting articular cartilage proteoglycan alterations at the same time as collagen organization remains largely unchanged. Because proteoglycans exert strong influence on the biomechanical properties of cartilage, lengthy immobilization may jeopardize the well being of articular cartilage.
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7. |
- Hyttinen, Mika, et al.
(författare)
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Age matters : collagen birefringence of superficial articular cartilage is increased in young guinea-pigs but decreased in older animals after identical physiological type of joint loading.
- 2001
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Ingår i: Osteoarthritis and Cartilage. - : Saunders Elsevier. - 1063-4584 .- 1522-9653. ; 9:8, s. 694-701
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare responses of the collagen network and glycosaminoglycans (GAGs) of articular cartilage to physiological type of joint loading in young growing and adult mature guinea-pigs.DESIGN: 10- and 44-week-old guinea-pigs were accustomed to treadmill running for 3 weeks. Thereafter the animals ran 2500 m/day, 5 days a week, for 15 weeks. Articular cartilage specimens from knee joints were collected at 28 and 62 weeks. Osteoarthritis (OA) prevalence and severity was evaluated by aid of light microscopy. The degree of collagen fibril network organization and content was analyzed with quantitative polarized light microscopy. The local concentration of GAGs was determined from cartilage sections with digital densitometry after safranin-O staining.RESULTS: In the young guinea-pigs, running increased up to 24% the optical retardation of polarized light by collagen in the superficial articular cartilage of femur, indicating either a higher degree of fibril assembly and organization or increased amount of collagen, or both. In contrast, in the adult mature animals the optical retardation decreased almost 50% after joint loading (P< 0.01-0.001). Running did not increase cartilage fibrillation. Significant changes in GAG content of cartilage were not found either in the young or adult mature runners.CONCLUSIONS: Increased birefringence of the superficial articular cartilage after joint loading in young guinea-pigs can be interpreted to be a sign of improved and decreased birefringence in older animals a sign of worsened property of the collagen network. It can be suggested therefore that joint loading strengthened the collagen network in the young runners. It can be hypothesized further that with time the inferior property of the collagen network predisposes the older runners to earlier OA than in controls.
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8. |
- Julkunen, Petro, et al.
(författare)
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Biomechanical, biochemical and structural correlations in immature and mature rabbit articular cartilage.
- 2009
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Ingår i: Osteoarthritis and Cartilage. - : Saunders Elsevier. - 1063-4584 .- 1522-9653. ; 17:12, s. 1628-1638
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The structure and composition of articular cartilage change during development and growth. These changes lead to alterations in the mechanical properties of cartilage. In the present study, biomechanical, biochemical and structural relationships of articular cartilage during growth and maturation of rabbits are investigated.DESIGN: Articular cartilage specimens from the tibial medial plateaus and femoral medial condyles of female New Zealand white rabbits were collected from seven age-groups; 0 days (n=29), 11 days (n=30), 4 weeks (n=30), 6 weeks (n=30), 3 months (n=24), 6 months (n=24) and 18 months (n=19). The samples underwent mechanical testing under creep indentation. From the mechanical response, instantaneous and equilibrium moduli were determined. Biochemical analyses of tissue collagen, hydroxylysylpyridinoline (HP) and pentosidine (PEN) cross-links in full thickness cartilage samples were conducted. Proteoglycans were investigated depth-wise from the tissue sections by measuring the optical density of Safranin-O-stained samples. Furthermore, depth-wise collagen architecture of articular cartilage was analyzed with polarized light microscopy. Finite element analyses of the samples from different age-groups were conducted to reveal tensile and compressive properties of the fibril network and the matrix of articular cartilage, respectively.RESULTS: Tissue thickness decreased from approximately 3 to approximately 0.5mm until the age of 3 months, while the instantaneous modulus increased with age prior to peak at 4-6 weeks. A lower equilibrium modulus was observed before 3-month-age, after which the equilibrium modulus continued to increase. Collagen fibril orientation angle and parallelism index were inversely related to the instantaneous modulus, tensile fibril modulus and tissue thickness. Collagen content and cross-linking were positively related to the equilibrium compressive properties of the tissue.CONCLUSIONS: During maturation, significant modulation of tissue structure, composition and mechanical properties takes place. Importantly, the present study provides insight into the mechanical, chemical and structural interactions that lead to functional properties of mature articular cartilage.
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9. |
- Király, Kari, et al.
(författare)
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Safranin O reduces loss of glycosaminoglycans from bovine articular cartilage during histological specimen preparation.
- 1996
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Ingår i: The Histochemical Journal. - : Chapman & Hill. - 0018-2214 .- 1573-6865. ; 28:2, s. 99-107
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Tidskriftsartikel (refereegranskat)abstract
- The ability of Safranin O, added to fixation and decalcification solutions, to prevent the escape of glycosaminoglycans (GAGs) from small cartilage tissue blocks during histological processing of cartilage has been studied. GAGs in the fixatives and decalcifying solutions used and those remaining in the 1 mm3 cubes of cartilage were assayed biochemically. The quantity of GAGs remaining in the cartilage cubes were determined from Safranin O-stained sections using videomicroscopy or microspectrophotometry. A quantity (10.6%) of GAGs were lost during a conventional 4% buffered formaldehyde fixation (48 h) and a subsequent decalcification in 10% EDTA (12 days) at 4 degrees C. Roughly one-quarter of the total GAG loss occurred during the 48 h fixation, and three-quarters during the 12 days of decalcification. Inclusion of 4% formaldehyde in the decalcification fluid decreased the loss of GAGs to 6.2%. The presence of 0.5% Safranin O in the fixative reduced this loss to 3.4%. When 0.5% Safranin O was included in the fixative and 4% formaldehyde in the decalcification solution, Safranin O staining of the histological sections increased on average by 13.5%. After fixation in the presence of 0.5% Safranin O, there was no difference in the staining intensities when decalcification was carried out in the presence of either Safranin O or formaldehyde, or both. It took 24 h for Safranin O to penetrate into the deep zone of articular cartilage, warranting a fixation period of at least this long. In conclusion, the addition of Safranin O to the fixative and either Safranin O or formaldehyde in the following decalcification fluid, markedly reduces the loss of GAGs from small articular cartilage explants during histological processing. However, for immunohistochemical studies, Safranin O cannot be included in the processing solutions, because it may interfere.
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10. |
- Kiviranta, Ilkka, et al.
(författare)
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Effects of mechanical loading and immobilization on the articular cartilage
- 1997
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Ingår i: Bailliere's Clinical Orthopaedics. - 1074-8814. ; 2:1, s. 109-122
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Forskningsöversikt (refereegranskat)abstract
- Articular cartilage provides nearly frictionless surfaces for joint movemants and reduces contact pressures, protecting the underlying suchondral bone from excess stress. The unique properties of articular cartilage are based on the interaction of the main components of the extracellular matrix: proteoglycans (PGs), collagen and interstitial fluid. Animal experiments and in vitro studies demonstrate that one of the most important regulators of the extracellular matrix metabolism is mechanical loading acting on the joints. Unloading and immobilization leads to PG depletion and softening of articular cartilage, increasing the risk of permanent cartilage degeneration. Moderate running exercise and increased weight bearing increases cartilage thickness, PG concentration and improves biomechanical properties of articular cartilage. With further increase in training intensity this positive influence of exercise disappears and cartilage shows changes analogous to immobilization of the joint, i.e. PG depletion and softening of the tissue. In humans most epidemiological studies have failed to prove the connection between running training and cartilage degeneration, but there is evidence that sports activities exposing joints to impact loading might increase the risk of osteoarthrosis.
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