Inflammatory Response to Therapeutic Gold Bead Implantation in Canine Hip Joint Osteoarthritis

Abstract

Inflammatory changes associated with periarticular pure gold bead implants were studied in dogs involved in a clinical trial investigating motor dysfunction and chronic pain owing to hip joint dysplasia and osteoarthritis. Gold beads were percutaneously implanted via a needle into different locations surrounding the greater trochanter of the femur. Nine dogs with implants were necropsied. In all examined animals, characteristic histologic lesions were observed in the tissue surrounding the gold implants-namely, a fibrous capsule composed of concentric fibroblasts intermixed with a variable number of inflammatory cells and a paucicellular innermost layer of collagen with a few fibrocyte-like cells in empty lacunae. Lymphocytes dominated the inflammatory infiltrate, with rarely observed macrophages present in close proximity to the implant site. No giant cells were observed. Immunohistochemistry showed mixed populations of lymphocytes, both CD3 positive (T cells) and CD79a positive (B cells), which in some cases formed lymphoid follicles. Diffuse inflammatory changes were present to a minor extent in the perimysium and surrounding fascia. The inflammation observed in dogs is similar to that observed with gold implants in humans. It is possible that the clinically beneficial effect of gold beads for chronic osteoarthritis depends on sustained localized inflammation with localized release of soluble mediators. The encapsulation of the implant by a paucicellular and poorly vascularized fibrous capsule may help prevent an exaggerated inflammatory reaction by sequestering the gold bead from the surrounding tissue. Keywords B cells, dogs, gold implants, immunohistochemistry, inflammation, osteoarthritis, T cellsThe parenteral therapeutic use of gold salts (chrysotherapy) is well known in human medicine and has been used in cases of rheumatoid arthritis. 23 The mechanisms behind the anti-inflammatory effect of monovalent gold salts and its metabolites, such as Au 3þ , Au(CN) 2 -, and metallic gold, is incompletely understood.5 One proposed mechanism of action for Au þ is due to binding with thiolate and thioether ligands on proteins.5 This is thought to inhibit presentation of complexed antigen to T cells, activity of certain transcription factors, and enzymes such as protein tyrosine phosphatase in T cells, protein kinase C in neutrophils and T cells, and proteins important for B cell differentiation. Au(CN) 2 -is an effective inhibitor of the respiratory burst of neutrophils and monocytes; it also inhibits the proliferation of lymphocytes. 5A more recent therapeutic application of gold is the implantation of gold beads directly into a painful anatomic region, such as the periarticular tissue of arthritic joints. This technique is derived from acupuncture and has been used in veterinary medicine for the past decade, largely as a treatment in canine hip dysplasia.10 A recent double-blind, placebocontrolled clinical trial performed by Jaeger et al showed that the performance of dogs with hip joint osteoarthritis s...

Acupoint Injection of Autologous Stromal Vascular Fraction and Allogeneic Adipose-Derived Stem Cells to Treat Hip Dysplasia in Dogs

“…Our results show that acupuncture points represent a potential administration route for stem cells. A long-term study involving 73 dogs with hip OA showed the efficacy of gold bead implantation inserted through needles at acupuncture points as a pain-relieving treatment and improved mobility [30]. This study supports the use of acupuncture for the treatment of HD and OA.…”

Protection against osteoarthritis in experimental animals by nanogold conjugated snake venom protein toxin gold nanoparticle-Naja kaouthia cytotoxin 1

“…A cytotoxin molecule NN-32, isolated from Naja naja venom has also been reported to possess anti-arthritic property8. Gold has been reported as a therapeutic agent against arthritis in traditional medicine systems of India910. Research in the area of nanotechnology revealed that gold nanoparticles had anti-inflammatory property and could be used for the treatment of arthritis11.…”

Equine acupuncture methods and applications: A review

“…The Au(CN)2 − action is to destroy the inflammatory cells around the joint that are contributing to joint inflammation (Lie et al . ). The use of gold implants to treat canine hip dysplasia has been reported.…”

“…The negative charge is neutralised by Au3 + that binds with thiolate and thioether ligands on protein, neutralising the negative charge. The Au (CN)2 À action is to destroy the inflammatory cells around the joint that are contributing to joint inflammation (Lie et al 2011). The use of gold implants to treat canine hip dysplasia has been reported.…”