This study aims to investigate the action mechanism of Shenzhuo Decoction(SZT, i.e., Ganjiang Lingzhu Decoction) in treating knee osteoarthritis(KOA). Network pharmacology was used to analyze the key targets of SZT in the treatment of KOA. At the cellular experimental level, primary chondrocytes extracted from rats were used for in vitro validation. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) staining was employed to detect chondrocyte apoptosis in the knee joint. Western blot was performed to analyze the expression of the anti-apoptotic factor(Bcl2), the apoptosis marker gene Bax, and key proteins in the phosphoinositide 3-kinase(PI3K)-protein kinase B(Akt) signaling pathway. In animal experiments, 60 7-week-old male SD rats were used to establish a KOA model and randomly divided into a control group, a KOA model group, high-, medium-, and low-dose SZT groups, and a celecoxib group, with 10 rats in each group. Micro-CT was used to observe changes in bone mineral density and osteophytes at the articular cartilage surface. Hematoxylin-eosin(HE) staining and safranin O-fast green(SFO) staining were used to observe pathological changes in cartilage tissue. Immunohistochemistry was used to detect the expression of inflammatory factor matrix metalloproteinase 13(MMP13) and cartilage marker collagen Ⅱ. Quantitative reverse transcription-polymerase chain reaction(qRT-PCR) was used to detect the expression of chondrocyte marker SRY-box transcription factor 9(SOX9) and inflammatory markers matrix metalloproteinase 9(MMP9), interleukin-6(IL-6), interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α). Cell experiments revealed that SZT effectively improved KOA, and the results of micro-CT and HE and SFO staining showed that compared with the control group, the model group had obvious formation of osteophytes on the joint surface, which became rough, with significant decreases in the trabecular bone volume fraction(BV/TV), trabecular number(Tb.N), and trabecular thickness(Tb.Th) and a significant increase in trabecular spacing(Tb.Sp). The SZT groups had few osteophytes and a smoother joint surface than the model group. Additionally, BV/TV, Tb.N, and Tb.Th were significantly increased, while Tb.Sp was gradually decreased. A SZT-component-KOA target network was constructed to locate the core targets in KOA treatment, which was further validated through in vivo and in vitro animal experiments. The immunohistochemistry results of the pathological section of rat joint tissue showed that compared with the control group, the model group had a significant increase in MMP13 and a decrease in collagen Ⅱ, while SZT could inhibit inflammation and strengthen the protection of collagen Ⅱ in articular cartilage. The qRT-PCR results showed that SZT could significantly inhibit the mRNA expression of IL-6, IL-1β, TNF-α, and MMP9 and upregulate the mRNA level of SOX9. The TUNEL detection results showed that in the lipopolysaccharide(LPS)-induced KOA model group, chondrocyte apoptosis was significantly increased, and the fluorescence intensity was significantly enhanced. SZT, however, significantly reduced the trend of chondrocyte apoptosis and decreased the fluorescence intensity. The Western blot results showed that SZT could effectively inhibit the phosphorylation level of proteins in the PI3K-Akt pathway, reduce the expression of Bax, increase the expression of Bcl2, and inhibit the degradation of SOX9. In conclusion, SZT may alleviate the degenerative damage of KOA by inhibiting the phosphorylated expression of key proteins in the PI3K-Akt signaling pathway, reducing the release of inflammatory factors, and inhibiting chondrocyte apoptosis.
Animals ; Chondrocytes/metabolism* ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Osteoarthritis, Knee/physiopathology* ; Rats, Sprague-Dawley ; Rats ; Apoptosis/drug effects* ; Signal Transduction/drug effects* ; Phosphatidylinositol 3-Kinases/metabolism* ; Proto-Oncogene Proteins c-akt/immunology* ; Humans

Objective Based on 25 indicators including immune factors, cell count classification, and smear results of the knee joint fluid, machine learning models were established to distinguish between osteoarthritis (OA) and rheumatoid arthritis (RA). Methods 100 OA and 40 RA patients scheduled for total knee arthroplasty were enrolled respectively. Each patient's knee joint fluid was collected preoperatively. Nucleated cells were counted and classified. The expression levels of immune factors, including tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, IL-8, IL-15, matrix metalloproteinase 3 (MMP3), MMP9, MMP13, rheumatoid factor (RF), serum amyloid A (SAA), C-reactive protein (CRP), and others were measured. Smears and microscopic classification of all the immune factors were performed. Independent influencing factors for OA or RA were identified using univariate binary logistic regression, Lasso regression, and multivariate binary logistic regression. Based on the independent influencing factors, three machine learning models were constructed which are logistic regression, random forest, and support vector machine. Receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA) were used to evaluate and compare the models. Results A total of 5 indicators in the knee joint fluid were screened out to distinguish OA and RA, which were IL-1β(odds ratio(OR)=10.512, 95× confidence interval (95×CI) was 1.048-105.42, P=0.045), IL-6 (OR=1.007, 95×CI was 1.001-1.014, P=0.022), MMP9 (OR=3.202, 95×CI was 1.235-8.305, P=0.017), MMP13 (OR=1.002, 95× CI was 1-1.004, P=0.049), and RF (OR=1.091, 95×CI was 1.01-1.179, P=0.026). According to the results of ROC, calibration curve and DCA, the accuracy (0.979), sensitivity (0.98) and area under the curve (AUC, 0.996, 95×CI was 0.991-1) of the random forest model were the highest. It has good validity and feasibility, and its distinguishing ability is better than the other two models. Conclusion The machine learning model based on immune factors in the knee joint fluid holds significant value in distinguishing OA and RA. It provides an important reference for the clinical early differential diagnosis, prevention and treatment of OA and RA.
Humans ; Arthritis, Rheumatoid/metabolism* ; Machine Learning ; Male ; Female ; Middle Aged ; Aged ; Synovial Fluid/immunology* ; Osteoarthritis, Knee/metabolism* ; Knee Joint/metabolism* ; ROC Curve ; Diagnosis, Differential

This study aims to explore the mechanism of Zhuanggu Jianxi Decoction in reducing synovial tissue inflammation in human knee osteoarthritis(KOA) via the liver X receptors(LXRs)/nuclear factor(NF)-κB signaling pathway. The synovial tissue samples were collected from 5 healthy volunteers and 30 KOA synovitis patients and cultured in vitro. The samples from the heathy volunteers were set as the normal group, and those from KOA synovitis patients were randomized into synovitis, Zhuanggu Jianxi Decoction, LXRα inhibitor, and N-CoR inhibitor groups. The synovitis tissue samples of the 5 groups were treated with 10% blank serum, 10% blank serum, 10% drug-containing serum, 10% drug-containing serum+LXRα inhibitor, and 10% drug-containing serum+N-CoR inhibitor, respectively, for 7 days. After intervention, the synovial tissue samples of each group were collected and stained with hematoxylin-eosin for observation and scoring of the pathological changes. The expression intensity of the fibroblast-specific marker α-smooth musle actin(α-SMA) in the synovial tissue was observed by immunofluorescence staining. The levels of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), matrix metalloproteinase-3(MMP-3), and matrix metalloproteinase-13(MMP-13) in the supernatant of synovium homogenate were determined by ELISA. The mRNA and protein levels of LXRα, N-CoR, P50, and P65 in the synovial tissue were determined by RT-qPCR and Western blot, respectively. The results showed that compared with the normal group, the synovitis group showcased obvious synovial lining cell proliferation, inflammatory cell infiltration, synovial cell disarrangement, increased histopathological score(P<0.05), enhanced α-SMA fluorescence intensity and increased number of synovial fibroblasts(P<0.05), elevated levels of IL-1β, TNF-α, MMP-3, and MMP-13 in the synovial tissue(P<0.05), down-regulated mRNA and protein levels of LXRα and N-CoR, and up-regulated mRNA and protein levels of P50 and P65(P<0.05). Compared with the synovitis group, the Zhuanggu Jianxi Decoction group showed alleviated pathological changes, declined histopathological score of the synovial tissue(P<0.05), decreased α-SMA fluorescence intensity and number of synovial fibroblasts(P<0.05), lowered levels of IL-1β, TNF-α, MMP-3, and MMP-13(P<0.05), up-regulated mRNA and protein levels of LXRα and N-CoR, and down-regulated mRNA and protein levels of P50 and P65(P<0.05) in the synovial tissue. Compared with the Zhuanggu Jianxi Decoction group, the LXRα inhibitor group and N-CoR inhibitor group showed aggravated pathological changes, risen histopathological score of the synovial tissue(P<0.05), enhanced α-SMA fluorescence intensity and increased number of synovial fibroblasts(P<0.05), elevated levels of IL-1β, TNF-α, MMP-3, and MMP-13(P<0.05), down-regulated mRNA and protein levels of LXRα and N-CoR, and up-regulated mRNA and protein levels of P50 and P65(P<0.05). The results above indicated that Zhuanggu Jianxi Decoction could alleviate the synovial tissue inflammation in KOA patients by upregulating the mRNA and protein levels of LXRα and N-CoR in the LXRs/NF-κB pathway to downregulate the mRNA and protein levels of P50 and P65 and reduce the activity of the NF-κB pathway in the synovial tissue.
Humans ; Osteoarthritis, Knee/metabolism* ; Drugs, Chinese Herbal/administration & dosage* ; Signal Transduction/drug effects* ; Male ; Liver X Receptors/immunology* ; Middle Aged ; NF-kappa B/metabolism* ; Female ; Synovial Membrane/metabolism* ; Aged ; Adult

Osteoarthritis (Osteoarthritis, OA) is a common clinical degenerative joint disease with increased incidence rate in recent years. Animal experiment is one of the important ways to explore pathogenesis and treatment of OA, while induced animal model is the most important part in animal experiment. Intra-articular injection of drugs is a classical method for establishing animal model of OA. Choose of animal should follows the principle of correlation, appropriateness and practicability, injections should perform in accordance with experimental purposes and subject, detections means and evaluation methods also should corresponding to experimental reality. The gold standard of OA animal model and intra-articular injections has not build, need further study.
Animals ; Cytokines ; analysis ; Disease Models, Animal ; Injections, Intra-Articular ; Mice ; Osteoarthritis ; diagnosis ; etiology ; immunology ; Rabbits ; Rats

Rheumatoid arthritis (RA) and osteoarthritis (OA), two common types of arthritis, affect the joints mainly by targeting the synovium and cartilage. Increasing evidence indicates that a significant network connects synovitis and cartilage destruction during the progression of arthritis. We recently demonstrated that hypoxia-inducible factor (HIF)-2alpha causes RA and OA by regulating the expression of catabolic factors in fibroblast-like synoviocytes (FLS) or chondrocytes. To address the reciprocal influences of HIF-2alpha on FLS and chondrocytes, we applied an in vitro co-culture system using a transwell apparatus. When co-cultured with HIF-2alpha-overexpressing chondrocytes, FLS exhibited increased expression of matrix metalloproteinases and inflammatory mediators, similar to the effects induced by tumor-necrosis factor (TNF)-alpha treatment of FLS. Moreover, chondrocytes co-cultured with HIF-2alpha-overexpressing FLS exhibited upregulation of Mmp3 and Mmp13, which is similar to the effects induced by interleukin (IL)-6 treatment of chondrocytes. We confirmed these differential HIF-2alpha-induced effects via distinct secretory mediators using Il6-knockout cells and a TNF-alpha-blocking antibody. The FLS-co-culture-induced gene expression changes in chondrocytes were significantly abrogated by IL-6 deficiency, whereas TNF-alpha neutralization blocked the alterations in gene expression associated with co-culture of FLS with chondrocytes. Our results further suggested that the observed changes might reflect the HIF-2alpha-induced upregulation of specific receptors for TNF-alpha (in FLS) and IL-6 (in chondrocytes). This study broadens our understanding of the possible regulatory mechanisms underlying the crosstalk between the synovium and cartilage in the presence of HIF-2alpha, and may suggest potential new anti-arthritis therapies.
Animals ; Arthritis/genetics/*immunology/pathology ; Arthritis, Rheumatoid/genetics/immunology/pathology ; Basic Helix-Loop-Helix Transcription Factors/genetics/*immunology ; Cells, Cultured ; Chondrocytes/immunology/metabolism/*pathology ; Coculture Techniques ; Fibroblasts/immunology/metabolism/*pathology ; Gene Expression Regulation ; Interleukin-6/genetics/*immunology ; Male ; Mice ; Mice, Inbred C57BL ; Osteoarthritis/genetics/immunology/pathology ; Synovial Membrane/immunology/metabolism/*pathology ; Tumor Necrosis Factor-alpha/genetics/*immunology ; Up-Regulation

INTRODUCTIONOsteoarthritis (OA) is a progressive degenerative disorder of the articular cartilage. Available diagnostic radiography has been poorly associated with the progress and severity of this clinical disease. As osteogenic protein-1 (OP-1) has been identified as a bone morphogenetic protein with a major role in cartilage repair, we aimed to evaluate its potential role in the diagnosis of OA.

METHODSThis was an experimental study conducted at the Department of Biochemistry, Sikkim Manipal Institute of Medical Sciences, India. Polyclonal antibodies (i.e. anti-OP-1[f]) were raised against OP-1 in mice, and subsequently used in a sandwich enzyme-linked immunosorbent assay (ELISA) to detect the presence of OP-1 in the synovial fluids of 75 osteoarthritic patients. For the purpose of correlation, the radiographic assessments of the knees of the 75 patients were graded using the Kellgren-Lawrence scoring system.

RESULTThe polyclonal antibody (i.e. anti-OP-1[f]) raised against OP-1 was able to detect the presence of OP-1 in the synovial fluids of all the osteoarthritic patients via sandwich ELISA. The level of the OP-1 was found to be much higher than the reference range and correlated positively with the severity of OA (r = 0.24; p = 0.04).

CONCLUSIONOur study shows that the polyclonal antibody, anti OP-1(f), could be used for the immunodiagnosis of osteoarthritis via sandwich ELISA.

Adult ; Aged ; Aged, 80 and over ; Animals ; Antibodies ; chemistry ; Bone Morphogenetic Protein 7 ; chemistry ; immunology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Knee ; physiopathology ; Mice ; Middle Aged ; Osteoarthritis ; diagnosis ; immunology ; Synovial Fluid ; chemistry

BACKGROUND: Interleukin-17 (IL-17)-producing T helper (Th) 17 cells are considered as a new subset of cells critical to the development of rheumatoid arthritis (RA). We aimed to investigate the distribution of Th1 and Th17 cells and their association with disease activity, and determine the Th17-related cytokine levels in the peripheral blood of RA patients. METHODS: Peripheral blood mononuclear cells from 55 RA and 20 osteoarthritis (OA) patients were stimulated with mitogen, and the distributions of CD4+Interferon (INF)+IL-17- (Th1 cells) and CD4+INF-IL-17+ (Th17 cells) were examined by flow cytometry. Serum levels of IL-6, IL-17, IL-21, IL-23, and tumor necrosis factor (TNF)-alpha were measured by ELISA. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were recorded. The 28-joint disease activity score (DAS28) was also assessed. RESULTS: The median percentage of Th17 cells was higher in RA patients than in OA patients (P=0.04), and in active than in inactive RA (P=0.03), whereas that of Th1 cells was similar in both groups. Similarly, the levels of IL-17, IL-21, and IL-23 were detected in a significantly higher proportion of RA patients than OA patients and the frequencies of detectable IL-6, IL-17, and IL-21 were higher in active RA than in inactive RA group. The percentage of Th17 cells positively correlated with the DAS28, ESR, and CRP levels. CONCLUSIONS: These observations suggest that Th17 cells and Th17-related cytokines play an important role in RA pathogenesis and that the level of Th17 cells in peripheral blood is associated with disease activity in RA.
Adult ; Aged ; Arthritis, Rheumatoid/blood/metabolism/*pathology ; Blood Sedimentation ; C-Reactive Protein/analysis ; Cytokines/blood ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis/blood/metabolism/pathology ; Severity of Illness Index ; Th1 Cells/cytology/immunology/metabolism ; Th17 Cells/*cytology/immunology/metabolism

OBJECTIVETo explore the effects of Pilose antler polypeptide on apoptosis of chondrocyte and related cytokines in experimental knee osteoarthritis.

METHODSTotally 64 New Zealand White rabbits of 6 months old were randomly divided into 2 groups:normal group(n=8)and model group (n=56). Model group was surgically induced into knee osteoarthritis model by method of Hulth. After successful modeling,the rabbits of model group were further divided into 2 groups: Pilose antler polypeptide-treatment group (n=24) and control group (n=24). Pilose antler polypeptide-treatment group received 0.5 ml intraarticular injection of Pilose antler polypeptide dilution liquid once per 2 days for 30 days while control group received 0.5 ml intra-articular injection of physiological saline. On days 7, 15 and 30 after intervention, articular cartilage samples and synovial fluid were collected respectively. The morphological changes of articular cartilage under optical microscope and the structural change of chondrocyte were observed by transmission electron microscopy. The levels of interleukin-1beta and tumor necrosis factor-alpha in synovial fluid was detected by Enzyme-linked Immunosorbent Assay.

RESULTSAlong with the extending of time, articular cartilage degenerated gradually and chondrocytes apoptosis increased significantly. On days 7,15 and 30 after intervention, the chondrocyte apoptosis index of the Pilose antler polypeptide-treatment group were (20.30 +/- 1.23), (28.60 +/- 2.37), (37.10 +/- 1.82) and those of control group were (31.50 +/- 2.44), (34.40 +/- 1.77), (42.30 +/- 2.33). There were significant differences between them (P<0.05). At the same time, the chondrocyte apoptosis index of the Pilose antler polypeptide-treatment group were lower than those of control group,which had a statistical significance (P<0.05). On days 7,15 and 30 after intervention, the levels of interleukin-1beta in synovia fluid of Pilose antler polypeptide-treatment group were (15.81 +/- 1.26), (12.59 +/- 1.42), (9.57 +/- 0.92) microg/L and the level of tumor necrosis factor-alpha were (48.47 +/- 2.64), (43.46 +/- 1.33), (40.96 +/- 1.05) microg/L, with statistical differences(P<0.05). The levels of interleukin-1beta in synovia fluid of control group were (18.92 +/- 1.83), (20.25 +/- 2.76), (22.13 +/- 2.24) microg/L and the levels of tumor necrosis factor-alpha were (57.92 +/- 2.12), (60.25 +/- 1.48), (63.35 +/- 2.15) microg/L. At the same period,the levels of interleukin-1beta and tumor necrosis factor-alpha were lower than those of the control group,which had a statistical significance (P<0.05).

CONCLUSIONPilose antler polypeptide can inhibit chondrocytes apoptosis, decrease the levels of interleukin-1beta and tumor necrosis factor-alpha and delay the degeneration of articular cartilage to some extent.

Animals ; Antlers ; chemistry ; Apoptosis ; drug effects ; Chondrocytes ; drug effects ; pathology ; Female ; Interleukin-1beta ; analysis ; Male ; Osteoarthritis, Knee ; drug therapy ; immunology ; pathology ; Peptides ; pharmacology ; Rabbits ; Tumor Necrosis Factor-alpha ; analysis

OBJECTIVETo explore the effects and mechanism of invigorating kidney and activating blood, invigorating kidney and expelling wind on hemorheology, IL-1β and TNF-α of SD rats with knee osteoarthritis, then definite the evolution of muscle certified turning into heumatism and compare the effect of Chinese herbal.

METHODSOne hundred and eighty SD rats with 3-month-old (each weight was 185 to 215 g) received intra-articular injection of papain solution for establishing knee OA models. All rats were randomly divided into activating blood group, preventing group, expelling wind group, invigorating kidney group, invigorating kidney and activating blood group and model group. Laboratory indexes were obtained at the 30th, 60th, 90th days after gastric perfusion, which including state of mind, activity, fur, weight, joint swelling, largely image, hemorheology, inflammation and HE pathological appearance.

RESULTSAfter operation, rats appeared blood stasis and swelling and difficulty crawling. There was significant difference of hemorheology in invigorating kidney and activating blood group the content of IL-1β and TNF-α was obviously lower than model group (P < 0.05 ). While the content of IL-1β and TNF-α on the early stage was obviously higher than late stage (P < 0.05).

CONCLUSIONKnee osteoarthritis mainly show synovial inflammation at the early stage, inflammation at early stage is more severe than late; invigorating kidney and activating blood decoction can inhibit the knee cartilage injury, improve blood circulation and prevent local inflammatory reaction. Activating blood decoction and invigorating kidney and activating blood Decoction have certain curative effect in early time, but the effects of invigorating kidney and activating blood Decoction is more effective than other on the late stage.

Animals ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Injections, Intra-Articular ; Interleukin-1beta ; immunology ; Kidney ; drug effects ; physiopathology ; Male ; Osteoarthritis, Knee ; drug therapy ; immunology ; physiopathology ; prevention & control ; Rats ; Tumor Necrosis Factors ; immunology

Osteoarthritis is a common joint disease, which seriously affects the patient's health and quality of life. It results in substantial social and economic costs. Etiology and pathogenesis of OA is still not completely clear, but people paid more attention on Cytokines, especially IL-1, which is considered as core factor in the development of OA. In recent years, many clinical trials considered IL-1 as a target treatment for OA. It provided a new treatment method. This article is to overview the mechanism of IL-1 in OA cartilage damage.
Animals ; Disease Progression ; Humans ; Interleukin-1 ; genetics ; immunology ; Osteoarthritis ; genetics ; immunology ; pathology