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Annals of the Rheumatic Diseases Aug 2023'Invasive pannus' is a pathological hallmark of rheumatoid arthritis (RA). This study aimed to investigate secretome profile of synovial fibroblasts of patients with RA...
OBJECTIVES
'Invasive pannus' is a pathological hallmark of rheumatoid arthritis (RA). This study aimed to investigate secretome profile of synovial fibroblasts of patients with RA (RA-FLSs), a major cell type comprising the invasive pannus.
METHODS
Secreted proteins from RA-FLSs were first identified using liquid chromatography-tandem mass spectrometry analysis. Ultrasonography was performed for affected joints to define synovitis severity at the time of arthrocentesis. Expression levels of myosin heavy chain 9 (MYH9) in RA-FLSs and synovial tissues were determined by ELISA, western blot analysis and immunostaining. A humanised synovitis model was induced in immuno-deficient mice.
RESULTS
We first identified 843 proteins secreted from RA-FLSs; 48.5% of the secretome was associated with pannus-driven pathologies. Parallel reaction monitoring analysis of the secretome facilitated discovery of 16 key proteins related to 'invasive pannus', including MYH9, in the synovial fluids, which represented synovial pathology based on ultrasonography and inflammatory activity in the joints. Particularly, MYH9, a key protein in actin-based cell motility, showed a strong correlation with fibroblastic activity in the transcriptome profile of RA synovia. Moreover, MYH9 expression was elevated in cultured RA-FLSs and RA synovium, and its secretion was induced by interleukin-1β, tumour necrosis factor α, toll-like receptor ligation and endoplasmic reticulum stimuli. Functional experiments demonstrated that MYH9 promoted migration and invasion of RA-FLSs in vitro and in a humanised synovitis model, which was substantially inhibited by blebbistatin, a specific MYH9 inhibitor.
CONCLUSIONS
This study provides a comprehensive resource of the RA-FLS-derived secretome and suggests that MYH9 represents a promising target for retarding abnormal migration and invasion of RA-FLSs.
Topics: Animals; Mice; Synoviocytes; Secretome; Synovial Membrane; Arthritis, Rheumatoid; Cell Movement; Synovitis; Fibroblasts; Cells, Cultured; Cell Proliferation
PubMed: 37188496
DOI: 10.1136/ard-2022-223625 -
Cureus Sep 2023Septic arthritis of the knee is the most common form of septic arthritis in children and can lead to irreversible damage to the joint. is the primary pathogen... (Review)
Review
Septic arthritis of the knee is the most common form of septic arthritis in children and can lead to irreversible damage to the joint. is the primary pathogen associated with septic arthritis, although other causative pathogens may be isolate in children with specific risk factors. The diagnosis of knee septic arthritis is based on comprehensive evaluation, including the patient's medical history, physical examination, blood tests, and arthrocentesis. Empirical treatment typically involves anti-staphylococcal penicillin or a first-generation cephalosporin, although modifications may be made based on local resistance patterns and clinical culture data. Surgical debridement, either through open surgery or arthroscopy, involving extensive debridement of the joint, is effective in eliminating the infection. In most cases, additional surgical intervention is not necessary.
PubMed: 37868524
DOI: 10.7759/cureus.45659 -
Journal of Maxillofacial and Oral... Dec 2022The aim of this clinical study was to evaluate the level of Interleukine-6 (IL-6), pre and post arthrocentesis to validate it as a biomarker in the Internal Derangement...
PURPOSE
The aim of this clinical study was to evaluate the level of Interleukine-6 (IL-6), pre and post arthrocentesis to validate it as a biomarker in the Internal Derangement (ID) of TMJ.
MATERIAL AND METHODS
This study included 30 patients (20 females and 10 males) of Temporo-Mandibular Dysfunction (TMD) with Disc displacement without reduction (DDwoR) Wilkes stage III, who were refractory to conservative management. Arthrocentesis was performed as a therapeutic modality. Synovial fluid aspirates were obtained prior to arthrocentesis and post arthrocentesis with 300 ml of Ringer Lactate solution into the superior joint compartment for the assessment of level of IL-6. The clinical parameters used for correlating the level of IL-6 were degree of pain (VAS I), chewing ability (VAS II), Maximal Mouth Opening (MMO) in both pre and post op phase with the follow-up period of 01 day, 01 week, 01 month, 03 month and 06 month and the results were compared. ELISA was performed to analyze the levels of IL-6 in the aspirates. The clinical parameters and the level of IL-6 were recorded and analyzed statistically.
RESULTS
The study showed ID of TMJ (Wilkes stage III) s are more prevalent in females especially in the fourth decades of life with the mean age of 38.4 years. The post operative assessment in terms of pain, maximum mouth opening, lateral movements of the mandible and the levels of IL-6 were found to be statistically significant with a value <0.01.
CONCLUSION
This study validates the role of IL-6 as a definitive biomarker for the pathogenesis of ID of TMJ Wilkes stage III and arthrocentesis proved to be a minimally invasive therapeutic modality for its management.
PubMed: 36896078
DOI: 10.1007/s12663-021-01533-0 -
Stomatologija 2021The article presents a systematic overview of single- and double-puncture techniques of arthrocentesis methods published in the Scopus database during 2016-2020,... (Review)
Review
OBJECTIVE
The article presents a systematic overview of single- and double-puncture techniques of arthrocentesis methods published in the Scopus database during 2016-2020, highlighting the advantages and shortcomings of different methods.
MATERIALS AND METHODS
A search was conducted in the Scopus database using the terms "TMJ OR temporomandibular OR mandibular OR jaw AND arthrocentesis". Arthrocentesis techniques were described and categorized mostly as single- or double-needle ones.
RESULTS
The literature reviewed in the article represents studies of arthrocentesis treatment in 2675 patients involving 2740 joints. Arthrocentesis techniques can mainly be divided into single- and double-needle techniques. Single-needle techniques are subcategorized into type 1 and type 2, of which the first is a single-needle cannula technique where inflow and outflow pass through the same lumen, while the second uses a Y-shaped device, which has two ports and two lumens. Double needle techniques use two needles - one for the inflow and the other for the outflow. The literature found in the Scopus database during the period investigated presents 28% of single-puncture (type 1 - 10%, type 2 - 15%, single puncture with distention of the upper joint compartment - 3%), 69% of double-puncture, 1% of ancillary second-puncture methods and 1% employing a CBCT-based tragus-supported guide with 3 needles.
CONCLUSION
All of the arthrocentesis techniques described in the literature are effective as treatment modalities, none appears to be superior to others. The selection of the method to be used depends on the surgeon´s choice and experience.
Topics: Arthrocentesis; Humans; Needles; Punctures; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 35635520
DOI: No ID Found -
Reumatologia Clinica 2020One of the missions of the Spanish Society of Rheumatology is to provide the necessary tools for excellence in health care. Currently, there is no reference point to...
INTRODUCTION
One of the missions of the Spanish Society of Rheumatology is to provide the necessary tools for excellence in health care. Currently, there is no reference point to quantify medical actions in this specialty, and this is imperative.
MATERIAL AND METHOD
A list of actions was drawn up and a hierarchical classification system was established by developing a complexity index, calculated based on the completion time and difficulty level of each action.
RESULTS
The results of the Delphi method tended to the consensus opinion within a group (mean σ2 - σ1=0.75-1.43=-0.68, mean IQR2 - IQR1=0.8-1.9=-1.1). The values of the complexity index ranged between 48 and 465 points. Among consultation actions, those reaching the highest scores were the first inpatient visit (366) and visits to the patient's home (369). Among diagnostic techniques, biopsies were prominent, those with the highest score were: bone biopsy (465), sural nerve biopsy (416) and synovial biopsy (380). Ultrasound scan scored 204, capillaroscopy 113 and densitometry 112. Among therapeutic techniques, infiltration/ arthrocentesis/articular injection in children reached the highest difficulty (388). The score for ultrasound-guided articular injection was 163. The score for clinical report on disability was 323 and expert report 370.
CONCLUSIONS
A nomenclature of 54 actions in Rheumatology was compiled. Biopsies (bone, sural nerve, synovial), inpatient visits, visits to the patient's home, infiltrations in children, and the preparation of the expert report were identified as the most complex actions. Musculoskeletal ultrasound is twice as complex as subsequent visits, capillaroscopy or bone densitometry.
Topics: Arthrocentesis; Biopsy; Bone and Bones; Delphi Technique; Densitometry; House Calls; Humans; Injections, Intra-Articular; Inpatients; Microscopic Angioscopy; Rheumatology; Sural Nerve; Synovial Membrane; Time Factors; Ultrasonography
PubMed: 30745278
DOI: 10.1016/j.reuma.2018.11.010 -
Journal of Clinical Medicine May 2024This overview was conducted following the Preferred Reporting Items for Overviews of Reviews guidelines and aimed to collect and compare the results of systematic... (Review)
Review
This overview was conducted following the Preferred Reporting Items for Overviews of Reviews guidelines and aimed to collect and compare the results of systematic reviews on temporomandibular joint injection treatment. Systematic reviews of randomized clinical trials on temporomandibular disorders treated with lavage or intra-articular administrations were qualified for syntheses. The final searches were conducted on 27 February 2024, without time frame restrictions. Of the 232 identified records, 42 systematic reviews were selected. The most evidence-based conclusions call into question the clinical differences between many therapeutic approaches, including the following: (1) injectable selection for the treatment of pain and hypomobility; (2) the method of performing arthrocentesis; (3) the use of imaging when rinsing the TMJ cavity; (4) the supplementation of the extracapsular administration of unprocessed blood with intracapsular deposition in the treatment of TMJ hypermobility. Systematic reviews based solely on randomized clinical trials proved the following differences: (1) in painful temporomandibular hypomobility, a better therapeutic effect is observed with arthrocentesis followed by I-PRF administration compared to lavage alone; (2) in painful temporomandibular hypomobility, inferior- or double-compartment injection leads to better results than superior-compartment injection; (3) in temporomandibular joint recurrent dislocation, hypertonic dextrose administration is superior to placebo, although (4) unprocessed blood has a better effect than hypertonic dextrose. PROSPERO registration number: CRD42024496142.
PubMed: 38792396
DOI: 10.3390/jcm13102855 -
Journal of Personalized Medicine Jul 2023Septic arthritis (SA) in children is an acute inflammatory disease of the joints. If not treated promptly, it could become a surgical emergency. The incidence of the... (Review)
Review
BACKGROUND
Septic arthritis (SA) in children is an acute inflammatory disease of the joints. If not treated promptly, it could become a surgical emergency. The incidence of the disease in children in Europe is approximately 2-7 per 100,000 children. The aim of this systematic review was to investigate which of these treatments-arthrocentesis, arthrotomy, and arthroscopy-provides better results in children and when to use them.
METHODS
Three independent authors conducted a systematic review of PubMed, ScienceDirect, and MEDLINE databases to assess studies with any level of evidence that reported the surgical outcome of SA. Two senior investigators evaluated and approved each stage's findings.
RESULTS
A total of 488 articles were found. After screening, we chose 24 articles that were suitable for full-text reading based on the inclusion and exclusion criteria. The results of our analysis showed that there are no numerically significant differences reported in the literature on clinical and radiographic outcomes by surgical technique.
CONCLUSIONS
We developed an algorithm that could be used if septic arthritis is suspected. Based on our results, the surgical technique to be used will depend on the operator who will perform it.
PubMed: 37511710
DOI: 10.3390/jpm13071097