Department of Traumatic Orthopedics, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China.
Hubei Key Laboratory of Embryonic Stem Cell Research, Department of Anatomy, School of Basic Medical Sciences, Hubei University of Medicine, No. 30 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, China.
J Orthop Surg Res. 2022 Aug 31;17(1):400. doi: 10.1186/s13018-022-03294-z.
Osteoarthritis (OA) presents cartilage damage in addition to chronic inflammation. However, self-recovery of damaged cartilage in an inflammatory environment is not possible. Mesenchymal stem cells (MSCs) in the bone marrow are a source of regenerative repair of damaged cartilage. To date, whether intra-luminal administration of the bone marrow can delay the progression of OA is still unknown. This study, therefore, aimed to explore the role of intra-bone marrow injection of Magnesium isoglycyrrhizinate (MgIG) in delaying the OA progression and to investigate the underlying mechanism.
Rabbit OA models were established using the anterior cruciate ligament transection method while a catheter was implanted into the bone marrow cavity. 1 week after surgery, MgIG treatment was started once a week for 4 weeks. The cartilage degradation was analyzed using hematoxylin-eosin staining, Masson's trichrome staining and Alcian blue staining. Additionally, the pro-inflammatory factors and cartilage regeneration genes involved in the cartilage degeneration and the underlying mechanisms in OA were detected using enzyme-linked immunosorbent assay, quantitative real-time PCR (qRT-PCR) and Western blotting.
The results of histological staining revealed that intra-bone marrow injection of MgIG reduced degeneration and erosion of articular cartilage, substantially reducing the Osteoarthritis Research Society International scores. Furthermore, the productions of inflammatory cytokines in the bone marrow cavity and articular cavity such as interleukin-1β(IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) were inhibited upon the treatment of MgIG. At the same time, the expression of alkaline phosphate, tartrate-resistant acid phosphatase-5b (TRAP-5b) and C-telopeptides of type II collagen (CTX-II) in the blood also decreased and was positively correlated. On the contrary, cartilage-related genes in the bone marrow cavity such as type II collagen (Col II), Aggrecan (AGN), and SRY-box 9 (SOX9) were up-regulated, while matrix metalloproteinase-3 (MMP-3) was down-regulated. Mechanistically, MgIG was found to exert an anti-inflammatory effect and impart protection to the cartilage by inhibiting the NF-κB pathway.
Intra-bone marrow injection of MgIG might inhibit the activation of the NF-κB pathway in the progression of OA to exert an anti-inflammatory effect in the bone marrow cavity and articular cavity, thereby promoting cartilage regeneration of MSCs in the bone marrow, making it a potential new therapeutic intervention for the treatment of OA.
骨关节炎(OA)除了慢性炎症外,还表现为软骨损伤。然而,在炎症环境中受损软骨的自我恢复是不可能的。骨髓间充质干细胞(MSCs)是受损软骨再生修复的来源。迄今为止,骨髓腔内注射是否能延缓 OA 的进展尚不清楚。因此,本研究旨在探讨骨髓腔内注射镁甘氨酸(MgIG)在延缓 OA 进展中的作用,并探讨其潜在机制。
采用前交叉韧带切断法建立兔 OA 模型,同时将导管植入骨髓腔。术后 1 周,每周开始 MgIG 治疗 1 次,共 4 周。采用苏木精-伊红染色、Masson 三色染色和阿尔辛蓝染色分析软骨降解。此外,通过酶联免疫吸附试验、实时定量 PCR(qRT-PCR)和 Western blot检测软骨退变中涉及的促炎因子和软骨再生基因,以及 OA 中的潜在机制。
组织学染色结果显示,骨髓腔内注射 MgIG 可减少关节软骨的退变和侵蚀,显著降低骨关节炎研究协会国际评分。此外,MgIG 治疗可抑制骨髓腔和关节腔内白细胞介素 1β(IL-1β)、白细胞介素 6(IL-6)和肿瘤坏死因子-α(TNF-α)等炎症因子的产生。同时,血液中碱性磷酸酶、抗酒石酸酸性磷酸酶 5b(TRAP-5b)和 II 型胶原 C 端肽(CTX-II)的表达也降低,呈正相关。相反,骨髓腔中软骨相关基因如 II 型胶原(Col II)、聚集蛋白(AGN)和性别决定区 Y 框 9(SOX9)上调,基质金属蛋白酶 3(MMP-3)下调。机制上,MgIG 通过抑制 NF-κB 通路发挥抗炎作用,保护软骨。
骨髓腔内注射 MgIG 可能通过抑制 NF-κB 通路在 OA 进展中发挥抗炎作用,在骨髓腔和关节腔中发挥作用,从而促进骨髓间充质干细胞的软骨再生,为 OA 的治疗提供一种新的潜在治疗干预措施。