Rats with Bad Knees Teach Researchers about Potential Treatment for Osteoarthritis

Rats with Bad Knees Teach Researchers about Potential Treatment for Osteoarthritis

By Staff.

A new report published in Nature Communications shows that having adenosine, which is a biochemical, plays a role in making and sustaining cartilage.  This finding may reveal potential treatments for most common joint diseases.

The molecule adenosine is derived from adenosine triphosphate (ATP), which plays a role in inflammation and diminishes with age.  The result is less natural adenosine in the body to make and sustain cartilage.  Until now, scientists had not linked diminished adenosine levels to osteoarthritis, the commonplace, “wear-and-tear” form of arthritis.

Researchers used rats with damage to the anterior cruciate ligament (ACL), which is known to lead to osteoarthritis in humans.  They found that maintaining high levels of adenosine in the rats, prevented them from developing disease. If their findings translate to trials in humans, the researchers from NYU Langone Medical Center say adenosine replacement therapy could potentially delay the onset of osteoarthritis and the need for joint replacements.

“We found that if adenosine levels decrease, or if the capacity to respond to adenosine diminishes, cartilage starts to degenerate,” says study senior investigator Bruce Cronstein, MD, the Dr. Paul R. Esserman Professor of Medicine at NYU Langone. “Our study suggests that diminished ATP and adenosine production are likely contributing factors to the development of osteoarthritis in aging individuals,” says Cronstein, who also serves as the director of the Clinical and Translational Science Institute (CTSI), and chief of the Division of Translational Medicine at NYU Langone.

The study suggests that greater risk for osteoarthritis may be driven not by lower adenosine levels alone.  Instead, they believe lower levels of the protein on the surface of chondrocytes designed to receive and pass on adenosine’s signal, are in play.

Adenosine helps to sustain such cells by fitting into a protein called the A2A adenosine receptor on their surfaces, like a key into a lock.  And, the researchers found that the mice lacking the A2A adenosine receptor did not walk as easily or as well as mice with the A2A receptor.  Radiologic examination of the knees of mice without the A2A receptor confirmed that they had osteoarthritis.

When they administered adenosine packaged in lipid bubbles into rats’ ACL injuries, Cronstein and team found that the excess adenosine prevented the development of osteoarthritis in the animals.

“Because joints may have to be replaced again and again, if we can put off the need for joint replacement until later in life, odds are that patients will only have to have this done once,” says Cronstein.

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Authored by: Staff

There are 2 comments for this article
  1. Jean Price at 11:04 am

    Ibin…it’s especially sad to me when young people have the burden of pain and yet can’t receive appropriate care for it now! The current denial of effective medications is ONE of our national shames now, I believe. And I’m so sorry your son has been affected by not only his injury and failed surgery…but also the ridiculous path our pain care has taken in the last several years. As a former nurse, I remember back when we were so excited, due to the development and the resurgence of hospice care across the country, that pain care in general was being looked at much more closely…and as a result, pain care was improving dramatically!

    Medical science had begun to realize one size didn’t fit all people…for dosages or frequency of pain medication…and waiting that last fifteen minutes for four hours to be up before we gave a person their pain medication was not only unnecessary…it was NOT at all helpful in the long run, either! Because the more their pain increased, the harder it would be to get on top of! Plus pain creates inflammation which causes more pain…so healing can be delayed and other areas of the body can be affected negatively! We even began to realize that addiction was a non issue…whenever opioids were taken by the patient TO TREAT their PHYSICAL PAIN…and to improve their comfort and functioning! PAIN even became the 5th VITAL SIGN to be assessed…something so overlooked previously! So if a mediation wasn’t helping someone, the patient was encouraged to tell us this…and more or a different medication would be tried…instead of just ignoring this and letting them suffer…or judging them weak or a drug seeker!

    There was unfortunately still the mindset of a few who would harshly judge the person who came into the ER for a “shot” for a headache…when they looked to be in no acute distress. And there was still the overworked nurse who felt like certain patients just watched the clock for their pain medicine…instead of calling for it when their pain started up again! Most of the time…this was really more about the nurses feeling like they didn’t have adequate time to take care of what they deemed ” more seriously ill” patients…to be giving out pain meds “all the time”! And it had much less to do which a true assessment of the patient’s pain or their needs…and nothing to do with any “evils” of opioids themselves!

    Yet, over all I would say pain care was viewed much more appropriately and humanely! And so we’re people with pain! I remember reading an article about this back in 1994, praising better pain care! They also talked about something called “pseudo addiction” which was a term coined to describe people with long term pain who DID NOT EVEN USE ENOUGH PAIN MEDICINE! Mostly because they were conscientious, AND they wanted to still function, without any side effect of drowsiness or difficulty being alert! Doctors would coach their patients to not let their pain increase, because that would invariably cause more inflammation and MORE pain! So patients were told to be sure to take their medication AS NEEDED, and as ordered! And of course this help! Oh my….How TIMES HAVE CHANGED!

    I also so clearly remember in 1990, when my neurologist said the timing of my low back surgery “just depended on how SOON I wanted to be OUT OF PAIN!”! Well, here I am some 27+ years later…having had multiple surgeries to correct a severe complication FROM SURGERY…(well, at least correct it as much as they even could!!)…and I’m STILL “WAITING” to be out of the pain he talked about so many years ago!

    Surgery is not a quick fix or a guarantee—ever! That’s not to say SOME people don’t improve…because they CAN and they DO! MANY times! MANY people! Yet, I knew going into surgery there would be risks…there always are! And the primary one TO ME is definitely WORSE pain and worse damage…AND decreased ability to function! However, there are times we have no other helpful options left to us,…to prevent more nerve damage and further disabilities!

    Several years later, I was very resistant to a further back surgery…when my physical therapist told me no matter what else I did…or how hard I worked…it wouldn’t help me! My hip muscles weren’t working AT ALL, so I was walking (limping!) by using my abdominal muscles entirely—to push and pull my leg out and back! And this was causing no end of other problems and other pains! I had to reevaluate my decision then…based on continuing to lose strength and continuing to hurt from all the other things I was trying. An extensive surgery was my only possibility of help…and the surgeon told me then he wouldn’t be able to “take away” nearly all of my pain! If I expected this, he said we could just part as friends…and I shouldn’t have the surgery! He also told me if I was still using strong pain medication for the rest of my life…he would consider we were 100% successful…and we had prevented increasing damage.

    So, there are times we DO take the risks, often gladly…and I think not really expecting WE will be the one with complications! And there are also times when the choice to do nothing isn’t acceptable either…times when this would practically guarantee more damage and more immobility and continued pain! That’s also a bleak future! I’m sure your son was faced with all of this, and made a wise decision…yet unfortunately he had a very poor outcome…like I did, too.

    Outcomes are always uncontrollable…even if our decisions are good and our doctors are expertly skilled! So the older…(maybe even wiser!)…I become, the more encouraged I am about non-surgical treatments…like this article tells about…and like the use of stem cells and PRP injections to help repair or even prevent further damage in joints and vertebrae and tendons, etc. We each are so very unique and individual with our conditions and injuries… and so are our health needs, medically and surgically. Yet it seems prudent to use the less risky treatments and procedures FIRST now…if they have even some chance of helping us. And seek second opinions when we can! Different areas of the country definitely tend to have different practices and routines of care for the same problems…so researching about all of this can help us too.

    With more scientific research on prevention and also preventing disease progression…along with new treatments…I hope others will have the opportunity for a better life in the future. For now…many of us are faced with living with “unfixable” problems…and the best we might hope for is appropriate, effective and less invasive care, including controlling our pain! That’s why all of this CDC deceit and their manufactured hype about the “sins of opioids” is so devastating! It’s been somehow adopted as the only truth, and has filtered over to all areas of health care…to our providers and systems…through legislature and government intervention! Our physiciansseem to either be embracing all this heartily… or just afraid to not follow the trend! Since they would then risk being imprisoned and prosecuted if they treated pain appropriately and effectively with the amounts of opioid medications needed!!

    So, our main life lines are being cut…sometimes they are our only lifelines! Yet we are totally innocent of any wrong doing! Pain HAS surely become a horrible punishment…and we seem to have many powerful “abusers” who are making this happen across our whole country…even to those with acute or post surgical pain! So sad!

  2. Ibin Aiken at 6:12 am

    The discovery of ATP may in fact help those with cartilage damage and failure to replenish itself….in the future. My 27 year old son hurt his knee, quite accidentally and the orthopedic doctor, whom I knew, advised me that the damage incurred was in fact “repairable” with ONE surgery. After two surgeries one week apart, reoccurring infections, and the ultimately release from his care cost my son four more years of treatment and an artificial knee replacement……at TWO other care facilities in mid North Carolina. It started at 27 years old and he was 31 plus when finally release from orthopedic care. This is not an exceptional case but, becoming MORE the “normal”. he suffers and I do mean suffers daily /nightly with consistent severe pain. As usual, according to the CDC “misguided-line?, he was reduced in very helpful opioid therapy dosage. He teches high school biology and chemistry. At this date he is VERY unsure of being able to continue teaching and supporting his family. He is now 37 years old. I realize that the “cause” to amend or abolish the mis-guide-line is not furthered by sharing his narrative but, it is confirmation of the asinine method the CDC is attempting to curb opioid abuse and their commune-istic approach.