Ageing and osteoarthritis: A different perspective

Purpose of review: Across the world, osteoarthritis is the most commonly occurring musculoskeletal disease of the elderly, affecting more than 25% of the population older than 60 years of age. By far the single greatest risk factor for the development of osteoarthritis is age, but a mechanism to explain this relation has not yet been identified. If such a mechanism is identified, this potentially also provides a novel target for osteoarthritis therapy. The identification of new therapeutic targets is of utmost importance, because a disease-modifying treatment for osteoarthritis is not available and, because of the graying of the population, the number of patients with osteoarthritis will continue to increase, which will pose an enormous social and economic burden on society. Recent findings: Advanced glycation end products accumulate in human articular cartilage with increasing age, and affect biomechanical, biochemical, and cellular characteristics of the tissue. As an illustration, accumulation of advanced glycation end products increase cartilage stiffness and brittleness while decreasing the synthesis and degradation of cartilage matrix constituents. Articular cartilage becomes more prone to damage, and thus osteoarthritis, at elevated concentrations of advanced glycation end products. Summary: The reviewed literature demonstrates that the age-related accumulation of advanced glycation end products in articular cartilage may provide a molecular mechanism capable of (at least in part) explaining the age-related increase in the incidence of osteoarthritis. This conclusion paves the way for new strategies to prevent or treat osteoarthritis via inhibition and/or reversal of this process. © 2003 Lippincott Williams & Wilkins. Chemicals/CAS: Glycosylation End Products, Advance

Ageing and zonal variation in post-translational modification of collagen in normal human articular cartilage: The age-related increase in Non-Enzymatic Glycation affects biomechanical properties of cartilage

A biomechanical failure of the collagen network is postulated in many hypotheses of the development of osteoarthritis with advancing age. Here we investigate the accumulation of non-enzymatic glycation (NEG) products in healthy human articular cartilage, its relation to tissue remodelling and its role in tissue stiffening. Pentosidine levels were low up to age 20 years, and increased linearly after this age. This indicates extensive tissue remodelling at young age, and slow turnover of collagen after maturity has been reached. The slow remodelling is supported by the finding that enzymatic modifications of collagen (hydroxylysine, hydroxylysylpyridinoline, and lysylpyridinoline) were not related to age. The high remodelling is supported by levels of the crosslink lysylpyridinoline (LP) as a function of distance from the articular surface. LP was highest at the surface in mature cartilage (> 20 years), whereas in young cartilage (< 10 years) the opposite was seen; highest levels were close to the bone. LP levels in cartilage sections at age 14 years are high at the surface and close to the bone, but they are low in the middle region. This indicates that maturation of cartilage in the second decade of life starts in the upper half of the tissue, and occurs last in the tissue close to the bone. The effect of NEG products on instantaneous deformation of cartilage was investigated as a functional of topographical variations in pentosidine levels in vivo and in relation to in vitro induced NEG. Consistently, higher pentosidine levels were associated with a stiffer collagen network. A stiffer and more crosslinked collagen network may become more brittle and more prone to fatigue

Functional adaptation of equine articular cartilage: The formation of regional biochemical characteristics up to age one year

Biochemical heterogeneity of cartilage within a joint is well known in mature individuals. It has recently been reported that heterogeneity for proteoglycan content and chondrocyte metabolism in sheep develops postnatally under the influence of loading. No data exist on the collagen network in general or on the specific situation in the horse. The objective of this study was to investigate the alterations in equine articular cartilage biochemistry that occur from birth up to age one year, testing the hypothesis that the molecular composition of equine cartilage matrix is uniform at birth and biochemical heterogeneity is formed postnatally. Water content, DNA content, glycosaminoglycan content (GAG) and biochemical characteristics of the collagen network (collagen content, hydroxylysine content and hydroxylysylpyridinoline [HP] crosslinks) were measured in immature articular cartilage of neonatal (n = 16), 5-month-old foals (n = 16) and yearlings (n = 16) at 2 predefined differently loaded sites within the metacarpophalangeal joint. Statistical differences between sites were analysed by ANOVA (P<0.01), and age correlation was tested by Pearson's product moment correlation analysis (P<0.01). In neonatal cartilage no significant site differences were found for any of the measured biochemical parameters. This revealed that the horse has a biochemically uniform joint (i.e. the cartilage) at birth. In the 5-month-old foals and yearlings, significant site differences, comparable to those in the mature horse, were found for DNA, GAG, collagen content and hydroxylysine content. This indicates that functional adaptation of articular cartilage to weight bearing for these biochemical parameters takes place during the first months postpartum. Water content and HP crosslinks showed no difference between the 2 sites from neonatal horses, 5-month-old animals and yearlings. At both sites water, DNA and GAG decreased during maturation while collagen content, hydroxylysine content and HP crosslinks increased. We propose that a foal is born with a uniform biochemical composition of cartilage in which the functional adaptation to weight bearing takes place early in life. This adaptation results in biochemical and therefore biomechanical heterogeneity and is thought to be essential to resist the different loading conditions to which articular cartilage is subjected during later life. As collagen turnover is extremely low at mature age, an undisturbed functional adaptation of the collagen network of articular cartilage at a young age may be of significant importance for future strength and resistance to injury