Effect of Pulsed Low-Intensity Ultrasonography on Symptom Relief and Tibiofemoral Articular Cartilage Thickness Among Veterans Affairs Enrollees With Knee Osteoarthritis

Sawitzke, Allen D.; Jackson, Christopher; Carlson, Kimberly; Bizien, Marcel; Leiner, Mathew; Reda, Domenic J.; Sindowski, Tom; Hanrahan, Christopher J.; Spencer, Richard G.; Kwoh, C. Kent; Lee, Susan J.; Hose, Kalli; Robin, Lisa; Cain, Donna W.; Taylor, Meredith D.; Bangerter, Neal K.; Finco, Martha F.; Clegg, Daniel O.

doi:10.1001/jamanetworkopen.2022.0632

Cited by 3 publications

(6 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of LIPUS in OA treatment has been reported as an effective manner in protecting cartilage from degeneration via reducing the expression of MMP3, MMP13, and TGF-b1 (275). LIPUS has been considered an effective strategy for patients with OA, which was verified by a recent randomized clinical trial (276).…”

Section: Low-intensity Pulsed Ultrasoundmentioning

confidence: 84%

Nrf2-mediated anti-inflammatory polarization of macrophages as therapeutic targets for osteoarthritis

Wang

2022

Front. Immunol.

View full text Add to dashboard Cite

Macrophages are the most abundant immune cells within the synovial joints, and also the main innate immune effector cells triggering the initial inflammatory responses in the pathological process of osteoarthritis (OA). The transition of synovial macrophages between pro-inflammatory and anti-inflammatory phenotypes can play a key role in building the intra-articular microenvironment. The pro-inflammatory cascade induced by TNF-α, IL-1β, and IL-6 is closely related to M1 macrophages, resulting in the production of pro-chondrolytic mediators. However, IL-10, IL1RA, CCL-18, IGF, and TGF are closely related to M2 macrophages, leading to the protection of cartilage and the promoted regeneration. The inhibition of NF-κB signaling pathway is central in OA treatment via controlling inflammatory responses in macrophages, while the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway appears not to attract widespread attention in the field. Nrf2 is a transcription factor encoding a large number of antioxidant enzymes. The activation of Nrf2 can have antioxidant and anti-inflammatory effects, which can also have complex crosstalk with NF-κB signaling pathway. The activation of Nrf2 can inhibit the M1 polarization and promote the M2 polarization through potential signaling transductions including TGF-β/SMAD, TLR/NF-κB, and JAK/STAT signaling pathways, with the regulation or cooperation of Notch, NLRP3, PI3K/Akt, and MAPK signaling. And the expression of heme oxygenase-1 (HO-1) and the negative regulation of Nrf2 for NF-κB can be the main mechanisms for promotion. Furthermore, the candidates of OA treatment by activating Nrf2 to promote M2 phenotype macrophages in OA are also reviewed in this work, such as itaconate and fumarate derivatives, curcumin, quercetin, melatonin, mesenchymal stem cells, and low-intensity pulsed ultrasound.

show abstract

Section: Low-intensity Pulsed Ultrasoundmentioning

confidence: 84%

Nrf2-mediated anti-inflammatory polarization of macrophages as therapeutic targets for osteoarthritis

Wang

2022

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…We included 21 studies published in English, and the characteristics of the included studies were shown in Table 1 [ [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] ]. These 21 studies reported a total of 1315 participants aged 40–72 years.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the included studies had small sample sizes, with only 3 studies having more than 40 participants per treatment group [ 40 , 41 , 48 ]. 10 studies were from Turkey [ 32 , 33 , 41 , 43 , 44 , 46 , [49] , [50] , [51] , [52] ]; 3 studies from China [ [38] , [39] , [40] ], and the rest from Egypt [ 35 ], Canada [ 44 ], Iran [ 37 ], Japan [ 42 ], and Brazil [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

“…16 trials described the low risk of allocation concealment [ 32 , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , 44 , 47 , 49 , 50 , 52 ]. Three trials [ 33 , 34 , 48 ] had a high risk of bias when it came to incomplete outcome assessment. For other biases, such as commercial support, only 12 studies [ 34 , 35 , 37 , [40] , [41] , [42] , [43] , [44] , 46 , 47 , 49 , 50 ] declared that they did not receive any conflict of interest and 12 trials did not receive any support from commercial organizations funded by commercial organizations [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among the included studies, in addition to Draper 2018 [ 34 ] (3 MHz); Jia 2016 [ 40 ] (0.6 MHz); Kitano 2023 [ 42 ] (3 MHz) and Sawitzke 2022 [ 48 ] (1.5 MHz) four studies, all studies used 1 MHz US with intensities ranging from 0.03 W/cm 2 to 2.5 W/cm 2 . In the different studies, the duration of US treatment varied, as did the duration of the session of treatments.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations