Hideaki Nagase, Ph.D.
Kennedy Institute of Rheumatology-Centre for Degenerative Diseases, University of Oxford, UK
Osteoarthritis: diagnosis, treatment and challenges
Hideaki Nagase1, Ngee Han Lim1, George Bou-Gharios1, Ernst Meinjohanns2 and Morten Meldal3
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, London, W6 8LH UK
- Carlsberg Laboratory, Copenhagen, Denmark,
- Nano-Science Center, Department of Chemistry, University of Copenhagen, Denmark
Osteoarthritis (OA) is the most prevalent age-related degenerative joint disease. With the expanding ageing population, it imposes a major socio-economic burden on society. A key feature of OA is a gradual loss of articular cartilage and deformation of bone, resulting in the impairment of joint function. Currently, there is no effective disease-modifying treatment except joint replacement surgery. There are many possible causes of cartilage loss (e.g. mechanical load, injury, reactive oxygen species, aging, etc.) and etiological factors (obesity, genetics), but the degradation of cartilage is primarily caused by elevated levels of active metalloproteinases. It is therefore attractive to consider proteinase inhibitors as potential therapeutics. However, there are several hurdles to overcome, namely early diagnosis and continuous monitoring of the efficacy of inhibitor therapeutics. We are therefore aiming at developing non-invasive probes to detect cartilage degrading metalloproteinase activities.
We have designed in vivo imaging probes to detect MMP-13 (collagenase 3) activity that participates in OA by degrade cartilage collagen II and MMP-12 (macrophage elastase) activity involved in inflammatory arthritis. These activity-based probes consist of a peptide that is selectively cleaved by the target proteinase, a near-infrared fluorophore and a quencher. The probe’s signal multiplies upon proteolysis. They were first used to follow the respective enzyme activity in vivo in the mouse model of collagen-induced arthritis and we found MMP-12 activity probe (MMP12AP) activation peaked at 5 days after onset of the disease, whereas MMP13AP activation was observed at 10-15 days. The in vivo activation of these probes was inhibited by specific low molecule inhibitors. We proceeded to test both probes in the mouse model of OA induced by the surgical destabilization of medial meniscus of the knee joints. In this model, degradation of knee cartilage is first detected histologically 6 weeks after surgery with significant erosion detectable at 8 weeks. Little activation of MMP12AP was detected, which was expected, as macrophage migration is not obvious in OA. MMP13AP, on the other hand, was significantly activated in the operated knee at 6 weeks compared with the non-operated contralateral knee, but there were no significant differences between the operated and sham-operated knees. At 8 weeks, however, the signals in the operated knees were significantly higher than both the contralateral and sham-operated controls. Activation of aggrecanases and MMP-13 are observed before structural changes of cartilage. We are therefore currently improving the MMP-13 probe for earlier detection by attaching it to polymers that are retained in cartilage.
Deepthy Menon, Ph.D.
Associate Professor, Centre for Nanosciences & Molecular Medicine, Health Sciences Campus, Amrita University, Kochi, India
Nanobioengineering of implant materials for improved cellular response and activity
Deepthy Menon, Divyarani V V, Chandini C Mohan, Manitha B Nair, Krishnaprasad C & Shantikumar V Nair
Current trends in biomaterials research and development include the use of surfaces with topographical features at the nanoscale (dimensions < 100 nm), which influence biomolecular or cellular level reactions in vitro and in vivo. Progress in nanotechnology now makes it possible to precisely design and modulate the surface properties of materials used for various applications in medicine at the nanoscale. Nanoengineered surfaces, owing to their close resemblance with extracellular matrix, possess the unique capacity to directly affect protein adsorption that ultimately modulates the cellular adhesion and proliferation at the site of implantation. Taking advantage of this exceptional ability, we have nanoengineered metallic surfaces of Titanium (Ti) and its alloys (Nitinol -NiTi), as well as Stainless Steel (SS) by a simple hydrothermal method for generating non-periodic, homogeneous nanostructures. The bio- and hemocompatibility of these nanotextured metallic surfaces suggest their potential use for orthopedic, dental or vascular implants. The applicability of nanotextured Ti implants for orthopedic use was demonstrated in vivo in rat models, wherein early-stage bone formation at the tissue-implant interface without any fibrous tissue intervention was achieved. This nanoscale topography also was found to critically influence bacterial adhesion in vitro, with decreased adherence of staphylococcus aureus. The same surface nanotopography also was found to provide enhanced proliferation and functionality of vascular endothelial cells, suggesting its prospective use for developing an antithrombotic stent surface for coronary applications. Clinical SS & NiTi stents were also modified based on this strategy, which would offer a suitable solution to reduce the probability of late stent thrombosis associated with bare metallic stents. Thus, we demonstrate that nanotopography on implant surfaces has a critical influence on the fate of cells, which in turn dictates the long term success of the implant.
Acknowledgement: Authors gratefully acknowledge the financial support from Department of Biotechnology, Government of India through the Bioengineering program.