Development of radiographic classification criteria for hand osteoarthritis: a methodological report (Phase 2)

ObjectivesIn Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features associated with hand OA were identified in a population with hand complaints. Radiographic findings could better discriminate patients with hand OA and controls than clinical examination findings. The objective of Phase 2 was to achieve consensus on the features and their weights to be included in three radiographic criteria sets of overall hand OA, interphalangeal OA and thumb base OA.MethodsMultidisciplinary, international expert panels were convened. Patient vignettes were used to identify important features consistent with hand OA. A consensus-based decision analysis approach implemented using 1000minds software was applied to identify the most important features and their relative importance influencing the likelihood of symptoms being due to hand OA. Analyses were repeated for interphalangeal and thumb base OA. The reliability and validity of the proposed criteria sets were tested.ResultsThe experts agreed that the criteria sets should be applied in a population with pain, aching or stiffness in hand joint(s) not explained by another disease or acute injury. In this setting, five additional criteria were considered important: age, morning stiffness, radiographic osteophytes, radiographic joint space narrowing and concordance between symptoms and radiographic findings. The reliability and validity were very good.ConclusionRadiographic features were considered critical when determining whether a patient had symptoms due to hand OA. The consensus-based decision analysis approach in Phase 2 complemented the data-driven results from Phase 1, which will form the basis of the final classification criteria set

Estudio del sistema mononuclear fagocítico en un modelo de enfermedad crónica por inmunocomplejos en la rata: evidencia de una disminución de la función de los receptores Fc

Tesis doctoral original inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 18 de mayo de 198

La transparencia y gobernanza en los medios de comunicación social como garantías del derecho a la información veraz

La captura informativa es una problemática existente en todos los mercados de medios con mayor o menor intensidad. En el caso del mercado español, como en el resto de los mercados mediterráneos, este fenómeno adquiere una mayor intensidad. La digitalización está contribuyendo a agudizar esta problemática, que representa junto a la desinformación las dos principales amenazas al derecho del público a ser informado. Existen diferentes marcos jurídicoconstitucionales para regular el proceso de comunicación pública. En el caso español, existe una consagración constitucional del derecho del público a recibir información veraz, un derecho que está íntimamente conectado con el deber de veracidad o diligencia de los profesionales de la información dentro de medios de comunicación independientes. Sin embargo, el marco legislativo actual no es efectivo para garantizar ni dicho deber de diligencia ni la independencia de los medios ni el derecho del público a recibir información veraz. Ante las amenazas de la desinformación, se hace urgente renovar este marco normativo a través de nuevas herramientas..

Osteoarthritis associated with estrogen deficiency

Osteoarthritis (OA) affects all articular tissues and finally leads to joint failure. Although articular tissues have long been considered unresponsive to estrogens or their deficiency, there is now increasing evidence that estrogens influence the activity of joint tissues through complex molecular pathways that act at multiple levels. Indeed, we are only just beginning to understand the effects of estrogen deficiency on articular tissues during OA development and progression, as well as on the association between OA and osteoporosis. Estrogen replacement therapy and current selective estrogen receptor modulators have mixed effectiveness in preserving and/or restoring joint tissue in OA. Thus, a better understanding of how estrogen acts on joints and other tissues in OA will aid the development of specific and safe estrogen ligands as novel therapeutic agents targeting the OA joint as a whole organ

Synovial inflammation in an experimental model of metabolic syndrome in the rabbit

Objetivo: Analizar el efecto del síndrome metabólico (SM) sobre la inflamación sinovial en un modelo experimental en conejo. Material y métodos: Se probaron tres intervenciones dietéticas diferentes para inducir un modelo experimental de SM, en 21 conejos New Zealand hembra, de 8 meses de edad: 1) alimentación con dieta enriquecida con 1% de colesterol y 3% de aceite de cacahuete y agua ad libitum; 2) alimentación con dieta normal y agua con 30% de fructosa ad libitum; 3) alimentación con dieta enriquecida con 1% de colesterol y 3% de aceite de cacahuete y agua con 30% de fructosa ad limitum. Los animales se dejaron evolucionar durante 12 semanas y se hizo un seguimiento semanal de peso, glucosa basal, colesterol HDL, triglicéridos. Tras el sacrificio, se tomaron muestras de membrana sinovial para cuantificar el infiltrado macrofágico sinovial mediante inmunohistoquímica. Resultados: La única intervención dietética con la que conseguimos inducir alteraciones asociadas al SM en los conejos fue alimentándolos con una dieta hiperlipémica. Estos animales, además de presentar hiperglucemia y dislipemia, tenían un infiltrado macrofágico sinovial mayor que el del grupo control. Conclusión: La alimentación con dieta hiperlipémica induce alteraciones típicas del SM en el conejo, acompañadas de un aumento del infiltrado macrofágico sinovial, lo que sugiere que el macrófago podría desempeñar un papel importante en el inicio y/o la progresión de la artrosis descrita que se asocia con el SMObjetive: To analyze the effect of metabolic syndrome (MS) upon synovial inflammation in an experimental model in the rabbit. Material and methodology: Three different diets were used to induce an experimental model of MS in 21 female New Zealand rabbits (aged 8 months): 1) diet enriched with 1% cholesterol and 3% peanut oil, with water, ad libitum; 2) normal diet, with water, and 30% fructose, ad libitum; 3) diet enriched with 1% cholesterol and 3% peanut oil, with water, and 30% fructose, ad libitum. The animals were followed-up on for 12 weeks, with weekly monitoring of body weight, basal glucose, HDL-cholesterol and triglycerides. Following sacrifice, synovial membrane samples were collected to quantify the synovial macrophage infiltrate using immunohistochemical techniques. Results: The only diet to induce alterations associated with MS in the rabbits was the hyperlipidemic diet. These animals, in addition to presenting hyperglycemia and dyslipidemia, showed greater synovial macrophage infiltration than the control group. Conclusion: A hyperlipidemic diet induces alterations typical of MS in the rabbit, accompanied by an increase in synovial macrophage infiltrationEsta investigación ha sido financiada por FUNDACIÓN MAPFR

The adipokine lipocalin-2 in the context of the osteoarthritic osteochondral junction

Corrigendum: The adipokine lipocalin-2 in the context of the osteoarthritic osteochondral junction. Scientific Reports, 6, 30666. https://doi.org/10.1038/srep30666Obesity and osteoarthritis (OA) form a vicious circle in which obesity contributes to cartilage destruction in OA, and OA-associated sedentary behaviour promotes weight gain. Lipocalin-2 (LCN2), a novel adipokine with catabolic activities in OA joints, contributes to the obesity and OA pathologies and is associated with other OA risk factors. LCN2 is highly induced in osteoblasts in the absence of mechanical loading, but its role in osteoblast metabolism is unclear. Therefore, because osteochondral junctions play a major role in OA development, we investigated the expression and role of LCN2 in osteoblasts and chondrocytes in the OA osteochondral junction environment. Our results showed that LCN2 expression in human osteoblasts and chondrocytes decreased throughout osteoblast differentiation and was induced by catabolic and inflammatory factors; however, TGF-beta 1 and IGF-1 reversed this induction. LCN2 reduced osteoblast viability in the presence of iron and enhanced the activity of MMP-9 released by osteoblasts. Moreover, pre-stimulated human osteoblasts induced LCN2 expression in human chondrocytes, but the inverse was not observed. Thus, LCN2 is an important catabolic adipokine in osteoblast and chondrocyte metabolism that is regulated by differentiation, inflammation and catabolic and anabolic stimuli, and LCN2 expression in chondrocytes is regulated in a paracrine manner after osteoblast stimulation.The authors acknowledge Mr. Oliver Shaw for performing the English revision and the support of Dr. Esbrit's. The authors' research is supported by research grants from Fondo de Investigación Sanitaria funded by the Instituto de Salud Carlos III (PI12/00144, PI13/00570, CP15/00007, PI14/00016 and PIE13/00024). R.G. is funded by the Instituto de Salud Carlos III through a Miguel Servet programme. A.V. is the recipient of a fellowship from the Fundación Conchita Rábago. A.G.M. was funded by the Universidad Carlos III de Madrid (Spain). R.L. and O.G. were funded by the Instituto de Salud Carlos III. O.G. is a member of the RETICS Programme, RD12/0009/0008 Instituto de Salud Carlos III (ISCIII). The research is supported by research grant from FEDE

Disorganization of chondrocyte columns in the growth plate does not aggravate experimental osteoarthritis in mice

Osteoarthritis (OA) is a multifactorial joint disease mainly affecting articular cartilage (AC) with a relevant biomechanical component. During endochondral ossification growth plate (GP) chondrocytes arrange in columns. GPs do not ossify in skeletally mature rodents. In neonatal mice, an altered joint loading induces GP chondrocyte disorganization. We aimed to study whether experimental OA involves GP disorganization in adult mice and to assess if it may have additional detrimental effects on AC damage. Knee OA was induced by destabilization of the medial meniscus (DMM) in wild-type (WT) adult mice, and in Tamoxifen-inducible Ellis-van-Creveld syndrome protein (Evc) knockouts (Evc ), used as a model of GP disorganization due to Hedgehog signalling disruption. Chondrocyte column arrangement was assessed in the tibial GP and expressed as Column Index (CI). Both DMM-operated WT mice and non-operated-Evc showed a decreased CI, indicating GP chondrocyte column disarrangement, although in the latter, it was not associated to AC damage. The most severe GP chondrocyte disorganization occurred in DMM-Evc mice, in comparison to the other groups. However, this altered GP structure in DMM-Evc mice did not exacerbate AC damage. Further studies are needed to confirm the lack of interference of GP alterations on the analysis of AC employing OA mice. cKO cKO cKO cKOThis work was financially supported by grants from the Instituto de Salud Carlos III [PI15/00340, PI16/00065, PI18/00261] to RL and GH-B, and Fondo Europeo de Desarrollo Regional (FEDER) by grants SAF-2013–43365-R and SAF2016-75434-R to VL R-P. AL and PG were funded by Fundación Conchita Rábago