Synovial Oxygenation at Photoacoustic Imaging to Assess Rheumatoid                     Arthritis Disease Activity

Yang, Meng; Zhao, Chenyang; Wang, Ming; Wang, Qian; Zhang, Rui; Bai, Wei; Liu, Jian; Zhang, Shangzhu; Xu, Dong; Liu, Sirui; Li, Xuelan; Zhang, Qi; Yang, Fang; Zhu, Lei; He, Xueling; Tian, Xinping; Zeng, Xiaofeng; Li, Jianchu; Jiang, Yuxin

doi:10.1148/radiol.212257

Cited by 11 publications

(13 citation statements)

References 36 publications

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“…This can be connected to chronical in ammation which happens in recurrence of GA. With the development of in ammation, blood ow is slowed down with congestion and stagnation and the local oxygen saturation decreases 39 . A lasting low-grade in ammation leads to local hypoxia which has been demonstrated in other arthritis, such as posttraumatic OA animal 23 , RA animal 40 and RA patient 21 . This also supports the chronic in ammation progress in GA with the stimulus persists, which in this case is the accumulation of MSU crystal 1,4 .…”

Section: Discussionmentioning

confidence: 85%

“…Then, chronic in ammation may ensue with the signal triggering the acute in ammatory response persisting, which is the MSU crystal in GA 18 . Hypoxia has been observed in rheumatoid arthritis (RA) 20,21 and osteoarthritis (OA) 22,23 with no report concerning GA so far. However, the state of in ammation is crucial for treatment choice especially for highly dynamic and diverse process.…”

Section: Introductionmentioning

confidence: 99%

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Morphological and Physiological Monitoring of Gouty Arthritis Response to Low-Level Light Therapy

Gu,

Tan,

Zhang

et al. 2024

Preprint

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Gouty arthritis (GA), induced by deposition of monosodium urate (MSU) crystals in joints, presents as intermittent episodes of acute inflammation along with chronic inflammation which can lead to irreversible erosive joint damage. Though widespread with a major negative impact on patients, there is no nonradiative and noninvasive method to monitor the inflammation quantitatively. By taking advantages of dual-wavelength optical-resolution photoacoustic microscopy (PAM), we monitored morphological and physiological features of vasculature in GA joint of rats in vivo. We showed that a hyperoxia period was followed by a hypoxia state in GA joints for the first time. Aiming at symptom control and recurrence prevention, we designed a ring-shape low-level light therapy (LLLT) device to treat the GA rats daily. We find that LLLT was able to reduce swelling, alleviate pain and accelerate dissolution of MSU crystals, which shortened the recovering time to half. Specifically, we observed that LLLT modulated the oxygen saturation level in joints with a less hyperoxia state at the beginning of GA and healed it to a normal level without experiencing hypoxia. Our result provided a non-invasive monitoring method and a drug-free treatment choice for GA, which revealed important aspects of the disease development and treatment mechanism.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Morphological and Physiological Monitoring of Gouty Arthritis Response to Low-Level Light Therapy

Gu,

Tan,

Zhang

et al. 2024

Preprint

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“…The role of the macrophage phenotype in the synovium and dorsal root ganglion, and glial cells in the CNS is still being elucidated, but given the data is suggested to be a key player in the onset and maintenance of arthritis-associated pain [44]. Photoacoustic imaging, based on the use of laser-generated United States, is currently being studied to detect the oxygenation status of tissue in patients with RA [45]. Studies have found photoacoustic imaging-detected hypoxia has been associated with higher disease activity in participants with RA [45], and this may be another methodology to detect true synovitis.…”

Section: Future Directionsmentioning

confidence: 99%

“…Photoacoustic imaging, based on the use of laser-generated United States, is currently being studied to detect the oxygenation status of tissue in patients with RA [45]. Studies have found photoacoustic imaging-detected hypoxia has been associated with higher disease activity in participants with RA [45], and this may be another methodology to detect true synovitis. The use of different brain metrics based on MRI is also being studied as a potential biomarker of fatigue in RA [46].…”

Section: Future Directionsmentioning

confidence: 99%

Fibromyalgia and centralized pain in the rheumatoid arthritis patient

Minhas

Murphy

Clauw

2023

Current Opinion in Rheumatology

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Purpose of reviewIndividuals with rheumatoid arthritis (RA) have traditionally been characterized as having nociceptive pain, leading to the assumption that effective immunosuppression should be enough to provide effective pain management. However, despite therapeutic advancements providing excellent control of inflammation, patients continue to have significant pain and fatigue. The presence of concurrent fibromyalgia, driven by augmented central nervous system processing and largely unresponsive to peripheral therapies, may contribute to this pain persistence. This review provides updates on fibromyalgia and RA as relevant for the clinician. Recent findingsPatients with RA have high levels of concomitant fibromyalgia and nociplastic pain. The presence of fibromyalgia can lead to higher scores on disease measures, erroneously indicating that worse disease is presently leading to the increased use of immunosuppressives and opioids. Disease scores that provide a comparison between patient-reported and provider-reported and clinical factors may be helpful to indicate centralized pain. IL-6 and Janus kinase inhibitors, in addition to targeting peripheral inflammation, may provide pain relief by acting on peripheral and central pain pathways. SummaryCentral pain mechanisms that may be contributing to pain in RA are common and should be distinguished from pain directly arising from peripheral inflammation.

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“…In addition, recent studies have addressed the use of exogenous PA contrast agents combined with drugs as the imaging or therapeutic medium for RA [29] , [46] , [47] . Currently, PAI is not only limited to animal models, and relevant imaging devices and techniques are already available in the clinic [48] , [49] , [50] . One study examined seven small joints in humans using a PA/US imaging system to measure relative oxygen saturation values in inflamed joints and showed that the sub-PA score was highly positively correlated with the standard clinical score for RA.…”

Section: Introductionmentioning

confidence: 99%

Photoacoustic/ultrasonic dual-mode imaging for monitoring angiogenesis and synovial erosion in rheumatoid arthritis

et al. 2023

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Synovial Oxygenation at Photoacoustic Imaging to Assess Rheumatoid Arthritis Disease Activity

Cited by 11 publications

References 36 publications

Morphological and Physiological Monitoring of Gouty Arthritis Response to Low-Level Light Therapy

Morphological and Physiological Monitoring of Gouty Arthritis Response to Low-Level Light Therapy

Fibromyalgia and centralized pain in the rheumatoid arthritis patient

Photoacoustic/ultrasonic dual-mode imaging for monitoring angiogenesis and synovial erosion in rheumatoid arthritis

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