Navigation Links
New insights into inflammation in osteoarthritis
Date:10/28/2007

The most common degenerative joint disease, osteoarthritis (OA) is marked by the breakdown of articular cartilage, which is the type of cartilage that lines the ends of most limb bones. It can afflict any jointfingers, toes, wrists, ankles, elbows, shoulders, and the spine, as well as the weight-bearing knees and hips. As OA progresses, sufferers often experience inflammation around the affected joint. This inflammation has been attributed to bits of cartilage breaking off and aggravating the synovium, the thin, smooth membrane lining a joint. Yet, MRI detection of prominent synovitis in early OAwhen joint cartilage appears normalsuggests that other joint structures may be involved in triggering this inflammation. Recent studies of inflammation in spinal arthritis implicate the enthesis, which is the attachment site of ligament or tendon to bone as being a potential driving factor in joint inflammation.

Intrigued by the potential role of tendon or ligament attachment sites in synovitis, Professors Michael Benjamin of Cardiff University and Dennis McGonagle of the University of Leeds decided to investigate the extent to which different entheses could contribute to inflammation by forming a functional unit and destructive partnership with adjacent synovium. Featured in the November 2007 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), their findings shed light on a potential novel mechanism for synovial inflammation in degenerative arthritis. This is based on a structure that the authors have called the synovial-entheseal complex (SEC). Basically insertions have a different type of cartilage called fibrocartilage near the bone. Although this is different from articular cartilage that lines the ends of bones, the authors speculated that this type of cartilage could also derive nourishment from synovium. However, this close integration although desirable in health could have unfortunate consequences if the enthesis was damaged.

To validate the widespread formation and to explore further, the possible inflammatory function of SECs, researchers collected ligament and tendon attachment samples from 60 cadavers, 35 male and 25 female, with a mean age of 84 years at death. 49 different entheses19 from the arms, 26 from the legs, and 4 from the spinal columnwere preserved for examination. To exclude cartilage degeneration as a trigger for synovial inflammation, 17 of the selected entheses were not immediately adjacent to joint cartilage. Each sample was studied for evidence of inflammatory cells and soft tissue microdamage, as well as for the composition of SECs.

At 82 percent of the entheses, the formation of a SEC was found. As expected, this occurred in entheses very close to joint cartilage, where the synovium was often part of the joint itself. However, a SEC was also detected in 47 percent of the sites separated from joint cartilage. For example, the SEC found at the Achilles tendon was formed with synovium that protruded from a cavity called a bursa, located a considerable distance from the ankle joint.

Joint insertions are sites of high mechanical stressing and the authors speculated that this could lead to damage within them, including their fibrocartilage This is exactly what the authors found. Degenerative changesat least one and sometimes severalwere detected on the soft tissue side of attachment sites. Most notably, cell clustering and/or fissuring was found in 76 percent of entheses. In 85 percent of SECs, the synovial component also showed evidence of mild inflammatory change. Finally, in 73 percent of the attachments, small numbers of inflammatory cells were present in the enthesis itself. Therefore the authors suggest that joint degeneration of fibrocartilage at insertions could trigger inflammation within SECs.

As Professors Benjamin and McGonagle note, one their most striking findings was the large number of attachment sites with evidence of changes in the entheses mirroring those typically seen in joint cartilage in OAfibrocartilage cell clusters, cell hypertrophy, and fissuring among them. Such changes at certain entheses could be directly relevant to older subjects with joint symptoms due to degenerative disease, Professor McGonagle observes, and some of the symptoms could be emanating from the SEC.

Affirming the concept of a synovio-etheseal complex as widely applicable at many sites in the body, both right next to and removed from joint cartilage, this study also supports the idea that biomechanical factors related to the enthesis could play an important role in synovial inflammation in both degenerative and inflammatory arthritis.


'/>"/>

Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
Source:Eurekalert

Related medicine news :

1. New insights into herbal supplements
2. Wrinkle reduction cream has offered insights into working of nervous system
3. Study Offers Insights Into Treatment Of Rheumatoid Arthritis
4. Reindeer Provide Valuable Insights Into Sleep Disorders
5. New Insights into Antimalarial Drug Resistance
6. Insights Into Lead Pollution
7. Insights into Osteosarcoma in Cats and Dogs may Improve Palliative Care
8. Neural Basis of Anxiety: Newer Insights
9. New Insights into Chronic Inflammation and Atherosclerosis
10. Rare Womens Lung Disease May Yield Insights Into Common Diseases
11. Insights into Acute Promyelocytic Leukemia
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/18/2017)... ... ... Overseer at The House of Yahweh in Abilene, Texas, has released a new publication this ... of the Savior whom the world calls “Mother Mary”. Yisrayl says when compared to what ... historical woman. , “The world bows, kisses the feet of, cries out to and ...
(Date:8/18/2017)... ... August 18, 2017 , ... 800response, the leading ... solutions, announced today the launch of a redesigned corporate website, 800response.com . ... fully responsive design, and an enhanced search directory for businesses and advertising agencies ...
(Date:8/18/2017)... ... ... “Three Narrow Roads”: a vivid and provocative look into the narrow path toward ... Sr., is currently the pastor-teacher-visionary at Simply the WORD Church, a global prayer ministry ... program geared towards youth. , King shares, “When I take time to think about ...
(Date:8/18/2017)... (PRWEB) , ... August 18, 2017 , ... ... and marketers of high-quality anti-aging skincare solutions, recently announced the launch ... new products are an affordable, yet effective alternative to expensive plastic surgery or ...
(Date:8/18/2017)... ... ... “Steve the Snake”: an entertaining and moral-based short story about an unkind snake ... Flash Haskins Jr., a husband, father and grandfather who served as a U.S. Marine, ... short stories for children and teens. My goal is to teach kids to use ...
Breaking Medicine News(10 mins):
(Date:7/31/2017)... July 31, 2017 7D Surgical, developer of ground ... purchased the 7D Surgical System to support its strategic sales ... D.C. and Virginia.  7D Surgical has entered into ... of the premier medical facilities within those markets. ... ...
(Date:7/27/2017)... Holdings, Inc. (NYSE and SIX: ZBH) today reported financial results ... reported second quarter net sales of $1.954 billion, an ... an increase of 2.1% on a constant currency basis.  ... LDR Holding Corporation acquisition, second quarter 2017 revenues decreased ... on a constant currency basis. ...
(Date:7/26/2017)... a leading medical aesthetic clinic in Singapore ... conditions from the inside. The natural process of aging ... becomes more transparent due to the thinning of the epidermis. Over the ... sun contributes to aging skin, causing age spots and other types ... ...
Breaking Medicine Technology: