No abstract

Collagen molecules in articular cartilage have an exceptionally long lifetime, which makes them susceptible to the accumulation of advanced glycation end products (AGEs). In fact, in comparison to other collagen-rich tissues, articular cartilage contains relatively high amounts of the AGE pentosidine. To test the hypothesis that this higher AGE accumulation is primarily the result of the slow turnover of cartilage collagen, AGE levels in cartilage and skin collagen were compared with the degree of racemization of aspartic acid (% D-Asp, a measure of the residence time of a protein). AGE (N ⑀ -(carboxymethyl)lysine, N ⑀ -(carboxyethyl)lysine, and pentosidine) and % D-Asp concentrations increased linearly with age in both cartilage and skin collagen (p < 0.0001). The rate of increase in AGEs was greater in cartilage collagen than in skin collagen (p < 0.0001). % D-Asp was also higher in cartilage collagen than in skin collagen (p < 0.0001), indicating that cartilage collagen has a longer residence time in the tissue, and thus a slower turnover, than skin collagen. In both types of collagen, AGE concentrations increased linearly with % D-Asp (p < 0.0005). Interestingly, the slopes of the curves of AGEs versus % D-Asp, i.e. the rates of accumulation of AGEs corrected for turnover, were identical for cartilage and skin collagen. The present study thus provides the first experimental evidence that protein turnover is a major determinant in AGE accumulation in different collagen types. From the age-related increases in % D-Asp the half-life of cartilage collagen was calculated to be 117 years and that of skin collagen 15 years, thereby providing the first reasonable estimates of the half-lives of these collagens.Nonenzymatic glycation is a post-translational modification of proteins in vivo, which is initiated by the spontaneous reaction of sugars with lysine residues in proteins and eventually results in the formation of advanced glycation end products (AGEs), 1 such as N ⑀ -(carboxymethyl)lysine (CML), N ⑀ -(carboxyethyl)lysine (CEL), and pentosidine (1-3). Because AGEs are irreversible chemical modifications of protein, they accumulate with age in long lived proteins such as lens crystallins and tissue collagens (1, 3-9). Because collagen molecules in articular cartilage have an exceptionally long lifetime (Ͼ100 years) (10, 11), they are highly susceptible to the accumulation of AGEs. Indeed, in comparison to other collagen-rich tissues (such as skin), articular cartilage contains relatively high amounts of pentosidine (3, 12). Although differences in AGE levels between different proteins have been attributed to differences in protein turnover rates (3,(12)(13)(14), no quantitative evidence to support this assumption is available.To compare protein turnover rates, information on the residence time of a protein in tissue can be obtained from the racemization of aspartic acid. Amino acids are incorporated into peptides and proteins as the L-enantiomers. During aging, racemization slowly converts the L-form into a race...

Objective. In mice, CD4؉CD25؉ regulatory T cells play a pivotal role in preventing autoimmunity. Regulatory T cells are also present and functional in healthy humans. We investigated the presence, phenotype, and function of CD4؉CD25؉ regulatory T cells in peripheral blood (PB) and synovial fluid (SF) from patients with rheumatoid arthritis (RA).Methods. The presence and phenotype of CD4؉CD25؉ regulatory T cells were determined by flow cytometry. Anergy and suppressive activity were assessed by culturing CD4؉CD25؊ and CD4؉CD25؉ T cells with anti-CD3 monoclonal antibodies and antigen-presenting cells, followed by proliferation and cytokine detection.Results. The percentage of CD4؉CD25؉ T cells in RA SF was significantly increased compared with that in RA PB, and both of these percentages were higher than that in PB from controls. The cells in RA PB were similar in phenotype and function to CD4؉CD25؉ regulatory T cells from controls. In SF, however, ϳ40-50% of CD4؉CD25؉ T cells expressed an activated phenotype, i.e., CD69؉, class II MHC؉, OX-40؉, with high levels of CTLA-4 and glucocorticoid-induced tumor necrosis factor receptor. These synovial CD4؉CD25؉ T cells displayed an increased suppressive capacity compared with blood CD4؉CD25؉ T cells. However, this enhanced suppressive activity was counterbalanced, because activated responder T cells from SF were less susceptible to CD4؉CD25؉ T cell-mediated suppression than were responder cells from PB.Conclusion. We demonstrate that CD4؉CD25؉ regulatory T cells are present and functional in patients with RA, with higher numbers of regulatory T cells with increased suppressive activity found in SF compared with PB. These findings suggest a negative feedback system that is active at the site of inflammation. The balance between activated responder and regulatory T cells appears to influence the extent of immunoregulation in RA.

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.

Summary. The pathogenetic mechanism of haemophilic arthropathy is multifactorial and includes degenerative cartilage-mediated and inflammatory synovium-mediated components. Intra-articular blood first has a direct effect on cartilage, as a result of the iron-catalysed formation of destructive oxygen metabolites (resulting in chondrocyte apoptosis), and subsequently affects the synovium, in addition to haemosiderin-induced synovial triggering. Both processes occur in parallel, and while they influence each other they probably do not depend on each other. This concept resembles degenerative joint damage as found in osteoarthritis as well as inflammatory processes in rheumatoid arthritis. These processes finally result in a fibrotic and destroyed joint.