@phdthesis{Frischholz2021,
  author    = {Frischholz, Sebastian},
  title     = {Resveratrol Counteracts IL-1β-mediated Impairment of Extracellular Matrix Deposition in 3D Articular Chondrocyte Constructs},
  doi       = {10.25972/OPUS-23745},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-237453},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Articular cartilage is an exceptional connective tissue which by a network of fibrillar collagen and glycosaminoglycan (GAG) molecules allows both low- friction articulation and distribution of loads to the subchondral bone (Armiento et al., 2018, Ulrich-Vinther et al., 2003). Because of its very limited ability to self-repair, chondral defects following traumatic injury increase the risk for secondary osteoarthritis (OA) (Muthuri et al., 2011). Still, current OA treatments such as common nonsteroidal anti-inflammatory drugs (NSAIDs) and joint replacement primarily address end-stage symptoms (Tonge et al., 2014). As low-grade inflammation plays a pivotal role in the pathogenesis of OA (Robinson et al., 2016), there is a strong demand for novel therapeutic concepts, such as integrating application of anti-inflammatory agents into cartilage cell- based therapies in order to effectively treat OA affected joints in early disease stages. The polyphenolic phytoalexin resveratrol (RSV), found in the skin of red grapes, berries, and peanuts, has been shown to have effective anti-inflammatory properties (Shen et al., 2012). However, its long-term effects on 3D chondrocyte constructs cultured in an inflammatory environment with regard to tissue quality have remained unexplored so far. Therefore, in this study, pellets made from expanded porcine articular chondrocytes were cultured for 14 days with either the pro-inflammatory cytokine interleukin-1β (IL-1β) (1 - 10 ng/ml) or RSV (50 μM) alone, or a co-treatment with both agents. Constructs treated with chondrocyte medium only served as control. Treatment with IL-1β at 10 ng/ml resulted in a significantly smaller pellet size and reduced DNA content. However, RSV counteracted the IL-1β-induced decrease and significantly enhanced diameter and DNA content. Also, in terms of GAG deposition, treatment with IL-1β at 10 ng/ml resulted in a tremendous depletion of absolute GAG content and GAG/DNA. Again, RSV co-treatment counteracted the inflammatory stimulus and led to a partial recovery of GAG content. Histological analysis utilizing safranin-O staining confirmed these findings. Marked expression of the cartilage-degrading enzyme matrix metalloproteinase 13 (MMP13) was detected in IL-1β-treated pellets, but none upon RSV co- treatment. Moreover, co-treatment of IL-1β-challenged constructs with RSV significantly increased absolute collagen content. However, under non- inflammatory conditions, RSV induced gene expression and protein accumulation of collagen type X, a marker for undesirable hypertrophy. Taken together, in the present thesis, RSV was demonstrated to elicit marked beneficial effects on the extracellular matrix composition of 3D cartilaginous constructs in long-term inflammatory culture in vitro, but also induced hypertrophy under non-inflammatory conditions. Based on these findings, further experiments examining multiple concentrations of RSV under various inflammatory conditions appear desirable concerning potential therapeutic applicability in OA.},
  subject      = {Resveratrol},
  language  = {en}
}
@article{WagenbrennerHeinzHorasetal.2020,
  author    = {Wagenbrenner, Mike and Heinz, Tizian and Horas, Konstantin and Jakuscheit, Axel and Arnholdt, J{\"o}rg and Hermann, Marietta and Rudert, Maximilian and Holzapfel, Boris M. and Steinert, Andre F. and Weißenberger, Manuel},
  title     = {The human arthritic hip joint is a source of mesenchymal stromal cells (MSCs) with extensive multipotent differentiation potential},
  series = {BMC Musculoskeletal Disorders},
  volume    = {21},
  journal   = {BMC Musculoskeletal Disorders},
  number    = {1},
  doi       = {10.1186/s12891-020-03340-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229497},
  year      = {2020},
  abstract  = {Background While multiple in vitro studies examined mesenchymal stromal cells (MSCs) derived from bone marrow or hyaline cartilage, there is little to no data about the presence of MSCs in the joint capsule or the ligamentum capitis femoris (LCF) of the hip joint. Therefore, this in vitro study examined the presence and differentiation potential of MSCs isolated from the bone marrow, arthritic hyaline cartilage, the LCF and full-thickness samples of the anterior joint capsule of the hip joint. Methods MSCs were isolated and multiplied in adherent monolayer cell cultures. Osteogenesis and adipogenesis were induced in monolayer cell cultures for 21 days using a differentiation medium containing specific growth factors, while chondrogenesis in the presence of TGF-ss1 was performed using pellet-culture for 27 days. Control cultures were maintained for comparison over the same duration of time. The differentiation process was analyzed using histological and immunohistochemical stainings as well as semiquantitative RT-PCR for measuring the mean expression levels of tissue-specific genes. Results This in vitro research showed that the isolated cells from all four donor tissues grew plastic-adherent and showed similar adipogenic and osteogenic differentiation capacity as proven by the histological detection of lipid droplets or deposits of extracellular calcium and collagen type I. After 27 days of chondrogenesis proteoglycans accumulated in the differentiated MSC-pellets from all donor tissues. Immunohistochemical staining revealed vast amounts of collagen type II in all differentiated MSC-pellets, except for those from the LCF. Interestingly, all differentiated MSCs still showed a clear increase in mean expression of adipogenic, osteogenic and chondrogenic marker genes. In addition, the examination of an exemplary selected donor sample revealed that cells from all four donor tissues were clearly positive for the surface markers CD44, CD73, CD90 and CD105 by flow cytometric analysis. Conclusions This study proved the presence of MSC-like cells in all four examined donor tissues of the hip joint. No significant differences were observed during osteogenic or adipogenic differentiation depending on the source of MSCs used. Further research is necessary to fully determine the tripotent differentiation potential of cells isolated from the LCF and capsule tissue of the hip joint.},
  language  = {en}
}
@article{RibitschPehamAdeetal.2018,
  author    = {Ribitsch, Iris and Peham, Christian and Ade, Nicole and Duerr, Julia and Handschuh, Stephan and Schramel, Johannes Peter and Vogl, Claus and Walles, Heike and Egerbacher, Monika and Jenner, Florian},
  title     = {Structure-Function relationships of equine menisci},
  series = {PLoS ONE},
  volume    = {13},
  journal   = {PLoS ONE},
  number    = {3},
  doi       = {10.1371/journal.pone.0194052},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-225214},
  pages     = {e0194052, 1-17},
  year      = {2018},
  abstract  = {Meniscal pathologies are among the most common injuries of the femorotibial joint in both human and equine patients. Pathological forces and ensuing injuries of the cranial horn of the equine medial meniscus are considered analogous to those observed in the human posterior medial horn. Biomechanical properties of human menisci are site-and depth-specific. However, the influence of equine meniscus topography and composition on its biomechanical properties is yet unknown. A better understanding of equine meniscus composition and biomechanics could advance not only veterinary therapies for meniscus degeneration or injuries, but also further substantiate the horse as suitable translational animal model for (human) meniscus tissue engineering. Therefore, the aim of this study was to investigate the composition and structure of the equine knee meniscus in a site-and age-specific manner and their relationship with potential site-specific biomechanical properties. The meniscus architecture was investigated histologically. Biomechanical testing included evaluation of the shore hardness (SH), stiffness and energy loss of the menisci. The SH was found to be subjected to both age and site-specific changes, with an overall higher SH of the tibial meniscus surface and increase in SH with age. Stiffness and energy loss showed neither site nor age related significant differences. The macroscopic and histologic similarities between equine and human menisci described in this study, support continued research in this field.},
  language  = {en}
}
@article{TuerpSchlenkerSchroederetal.2016,
  author    = {T{\"u}rp, Jens C. and Schlenker, Anna and Schr{\"o}der, Johannes and Essig, Marco and Schmitter, Marc},
  title     = {Disk displacement, eccentric condylar position, osteoarthrosis - misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts},
  series = {BMC Oral Health},
  volume    = {16},
  journal   = {BMC Oral Health},
  number    = {124},
  doi       = {10.1186/s12903-016-0319-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-164710},
  year      = {2016},
  abstract  = {Background Clinical decision-making and prognostic statements in individuals with manifest or suspected temporomandibular disorders (TMDs) may involve assessment of (a) the position of articular disc relative to the mandibular condyle, (b) the location of the condyle relative to the temporal joint surfaces, and (c) the depth of the glenoid fossa of the temporomandibular joints (TMJs). The aim of this study was twofold: (1) Determination of the prevalence of these variables in two representative population-based birth cohorts. (2) Reinterpretation of the clinical significance of the findings. Methods From existing magnetic resonance imaging (MRI) scans of the TMJs that had been taken in 2005 and 2006 from 72 subjects born between 1930 and 1932 and between 1950 and 1952, respectively, the condylar position at closed jaw was calculated as percentage displacement of the condyle from absolute centricity. By using the criteria introduced by Orsini et al. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:489-97, 1998), a textbook-like disc position at closed jaw was distinguished from an anterior location. TMJ morphology of the temporal joint surfaces was assessed at open jaw by measuring the depth of the glenoid fossa, using the method proposed by Muto et al. (J Oral Maxillofac Surg 52:1269-72, 1994). Frequency distributions were recorded for the condylar and disc positions at closed jaw. Student's t-test with independent samples was used as test of significance to detect differences of condylar positions between the age cohorts (1930 vs. 1950) and the sexes. The significance levels were set at 5\%. First, the results from the measurement of the age cohorts were compared without differentiation of sexes, i.e., age cohort 1930-1932 versus age cohort 1950-1952. Subsequently, the age cohorts were compared by sex, i.e., men in cohort 1930-1932 versus men in cohort 1950-1952, and women in cohort 1930-1932 women men in cohort 1950-1952. Results In both cohorts, condylar position was characterized by great variability. About 50\% of the condyles were located centrically, while the other half was either in an anterior or in a posterior position. In both female cohorts, a posterior position predominated, whereas a centric position prevailed among men. Around 75\% of the discs were positioned textbook-like, while the remaining forth was located anteriorly. Age had no statistically significant influence on condylar or on disc position. Conversely, comparison between the age groups revealed a statistically significant decrease of the depth of the glenoid fossa in both older cohorts. This age-dependent changes may be interpreted as flattening of the temporal joint surfaces. Conclusions We call for a re-interpretation of imaging findings because they may insinuate pathology which usually is not present. Instead, anterior or posterior positions of the mandibular condyle as well as an anterior location of the articular disc should be construed as a variation of normalcy. Likewise, flattening of articular surfaces of the TMJs may be considered as normal adaptive responses to increased loading, rather than pathological degenerative changes.},
  language  = {en}
}
@phdthesis{Muelek2015,
  author    = {M{\"u}lek, Melanie},
  title     = {Distribution and metabolism of constituents and metabolites of a standardized maritime pine bark extract (Pycnogenol®) in human serum, blood cells and synovial fluid of patients with severe osteoarthritis},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-128085},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Dietary polyphenols have been related to beneficial effects on humans' health. Pycnogenol®, a dietary polyphenol-rich food supplement complies with the monograph "Maritime pine extract" in the United States Pharmacopeia (USP) and has demonstrated effects in different diseases. Several human trials concerning knee osteoarthritis have shown significant improvement of the symptoms like reducing the pain and the stiffness of the joint(s) upon intake of Pycnogenol®. After oral intake of multiple doses of Pycnogenol® previously low concentrations in the nanomolar range of monomeric extract constituents have been found in human plasma as well as a bioactive metabolite, δ-(3,4-dihydroxy-phenyl)-γ-valerolactone (M1), which is formed by the human intestinal flora from the procyanidins' catechin units. It is not clear yet which compound(s) of the complex extract is (are) mainly responsible for the described clinical effects of Pycnogenol®. To gain deeper insights into the in vivo fate of the pine bark extract the distribution of its constitutents and metabolites was closer investigated in the present thesis. Initial in vitro experiments suggested a facilitated cellular uptake of M1 into human erythrocytes, possibly via GLUT-1 transporter. For elucidating further the in vitro and in vivo metabolism of M1 in human blood cells, a metabolomic approach was performed using UPLC-ESI-qTOF-MSE analysis, which revealed a comprehensive and rapid metabolism of M1 to a variety of biotransformation products in human blood cells. Predominant metabolites were found to be conjugates of glutathione (GSH) isomers, namely M1-S-GSH and M1-N-GSH. Further sulfur-containing biotransformation products of M1 were conjugates with oxidized glutathione (M1-GSSG) and cysteine (M1-CYS) and the sulfated derivative of M1 (M1-sulfated). Other in vitro biotransformation products constituted the open-chained ester form of M1 (M1-COOH), hydroxybenzoic acid and the methylated (M1-methylated), acetylated (M1-acetylated), hydroxylated (M1-hydroxylated) and ethylated (M1-ethylated) derivatives of M1. Indeed, six of these in vitro metabolites, respectively M1-COOH, M1-sulfated, hydroxybenzoic acid, M1-S-GSH, M1-methylated and M1-acetylated, were also identified in vivo in blood cells of human volunteers after ingestion of Pycnogenol®. Related reference material was synthesized for reliable confirmation of the metabolites M1-GSH, M1-GSSG, M1-CYS and M1-COOH. In the course of a randomized controlled clinical trial patients suffering from severe osteoarthritis ingested multiple doses of 200 mg/day Pycnogenol® for three weeks before they were scheduled for an elective knee replacement surgery. Various biological specimen, respectively blood cells, synovial fluid and serum samples, were to be analyzed to investigate the distribution and disposition of possibly bioactive constituents and metabolites. Therefore, highly sensitive methods were developed using liquid chromatography tandem mass spectrometry (LC-MS/MS)- technology because of the expected low concentrations of the analytes in the related matrices. Initially, for each matrix different sample preparation techniques (protein precipitation, liquid-liquid extraction, solid phase extraction and useful combinations thereof) were compared to achieve maximum detection sensitivity of the analytes that were of highest interest, namely M1, ferulic acid and taxifolin. By comparing 32 various sample clean-up procedures in human serum, the highest recovery of the metabolite M1 was achieved using a liquid-liquid extraction with ethyl acetate and tert-butyl methyl ether at a serum pH-value of 3.2. A similar extraction method was also chosen for analyte detection in human synovial fluid after comparing 31 different sample preparation techniques. Whole blood or blood cells are difficult to handle because of their high viscosity and strong coloration. The QuEChERS (quick, easy, cheap, effective, rugged and safe) approach which was originally developed for the food safety and thus for the determination of pesticide residues in fruits and vegetables yielded the highest total recovery rate of M1 in human blood cells when assessing 18 different sample clean-up techniques. By applying the QuEChERS method for the first time for the simultaneous and highly sensitive quantification of selected polyphenols in human blood cells it was demonstrated that this fast and inexpensive technique can be applied in clinical fields for cleaning-up highly complex and thus challenging biological matrices. All developed methods for the different biological specimen were optimized to achieve maximum sensitivity of the target analytes. The determined lower limits of quantification (LLOQs) were sufficient for the quantification of the study samples. The LLOQs ranged from 113 pg/mL for taxifolin to 48 ng/mL for caffeic acid in blood cells and from 80 pg/mL for taxifolin to 3 ng/mL for caffeic acid in synovial fluid. In human serum the LLOQs even ranged down to 35 pg/mL for taxifolin and up to 8 ng/mL for caffeic acid. All analytical methods were subjected to a full validation according to current EMA and FDA guidelines and fulfilled those criteria, showing excellent performance and reliability of the developed and optimized methods. Serum, blood cells and synovial fluid samples of the osteoarthritis patients were all processed with an enzymatic incubation with ß-glucuronidase/sulfatase to hydrolyse conjugates (phase-II-metabolism) prior the actual sample preparation. Additionally, serum samples of the osteoarthritis patients were prepared without enzymatic hydrolysis to determine the individual degree of conjugation with sulfate and glucuronic acid of the analytes. All determined concentrations in the patients' samples were in the lower ng/mL range. Notably, highest total concentrations of the polyphenols were not detected in serum, in which the degree of analyte conjugation with sulfate and glucuronic acid ranged from 54.29 ± 26.77\% for catechin to 98.34 ± 4.40\% for M1. The flavonoids catechin and taxifolin mainly partitioned into blood cells, whereas the metabolite M1, ferulic and caffeic acid primarily resided in the synovial fluid. The concentration of M1 in the blood cells was low, however, this could be explained by the previously observed extensive and rapid intracellular metabolism in vitro. This was now supported by the in vivo evidence in samples of patients who received Pycnogenol® in which the open-chained ester form of M1 (M1-COOH) as well as the glutathione conjugate of M1 (M1-GSH) were identified, indicating that M1 does not accumulate in its original form in vivo. Possibly, a variety of bioactive metabolites exist which might play an important role for the clinical effects of Pycnogenol®. Although the study participants were requested to avoid polyphenol-rich food and beverages within the last two days before the blood samplings this was obviously difficult for most of the patients. Hence, no statistically significantly difference was observed in the mean polyphenol concentrations in serum, blood cells and synovial fluid between the intervention and the control group. Nevertheless, it was possible to identify marker compounds for Pycnogenol® intake under real life conditions with occasional or regular consumption of polyphenol-rich foods and beverages. Thereby, ferulic acid was found in serum samples exclusively after intake of Pycnogenol®, confirming that ferulic acid is a suitable marker of consumption of French maritime pine bark extract. Taxifolin was present in serum and synovial fluid exclusively in the intervention group indicating a role as further marker of Pycnogenol® intake. Taxifolin, ferulic acid and caffeic acid were detected in both serum and synovial fluid only in the intervention group. Moreover, the metabolite M1, taxifolin and ferulic acid were only detected simultaneously in all matrices (serum, blood cells and synovial fluid) after ingestion of Pycnogenol®. Thus, deeper insights into the distribution of bioactive constituents and metabolites of Pycnogenol® into serum, blood cells and synovial fluid after oral administration to patients with severe osteoarthritis were gained. The present study provides the first evidence that polyphenols indeed distribute into the synovial fluid of patients with osteoarthritis where they might contribute to clinical effects.},
  subject      = {Pycnogenol},
  language  = {en}
}