Injectable Peptide Therapy: A Primer for Orthopaedic and Sports Medicine Physicians.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: One or more of the authors has declared the following potential conflict of interest or source of funding: J.N.L. has received speaking fees from Stryker and hospitality payments from Innocoll Biotherapeutics. G.R.H. has received consulting fees from Arthrex. S.C.G. has received speaking fees from Arthrex; has received consulting fees from Biomet, Zimmer, and Exactech; has received royalties from Zimmer; and holds stock or stock options in Kelvi. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. 3. Ann Rheum Dis. 2025 Jun;84(6):1033-1044. doi: 10.1016/j.ard.2025.03.001. Epub 2025 Apr 4. Injury and obesity differentially and synergistically induce dysregulation of synovial immune cells in osteoarthritis. Harasymowicz NS(1), Harissa Z(2), Rashidi N(3), Lenz K(4), Tang R(4), Guilak F(5). Author information: (1)Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA; Shriners Hospitals for Children, St. Louis, MO, USA; Center of Regenerative Medicine, Washington University, St. Louis, MO, USA; Department of Orthopaedic Surgery Operations University of Utah, Salt Lake City, UT, USA; Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA. (2)Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA; Shriners Hospitals for Children, St. Louis, MO, USA; Center of Regenerative Medicine, Washington University, St. Louis, MO, USA; Department of Biomedical Engineering, Washington University in Saint Louis, St. Louis, MO, USA. (3)Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA; Shriners Hospitals for Children, St. Louis, MO, USA; Center of Regenerative Medicine, Washington University, St. Louis, MO, USA; Department of Mechanical Engineering & Materials Science, Washington University, St. Louis, MO, USA. (4)Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA; Shriners Hospitals for Children, St. Louis, MO, USA; Center of Regenerative Medicine, Washington University, St. Louis, MO, USA. (5)Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA; Shriners Hospitals for Children, St. Louis, MO, USA; Center of Regenerative Medicine, Washington University, St. Louis, MO, USA. Electronic address: guilak@wustl.edu. OBJECTIVES: The heterogeneity and phenotype of immune cells orchestrate many physiologic and pathologic processes. Recent evidence suggests that immune cells play critical roles in the progression of osteoarthritis (OA). We hypothesised that injury and obesity, two major risk factors for OA, affect the immunophenotype of the synovium, the primary reservoir of immune cells in the joint. METHODS: Using single-cell transcriptomics, immunoprofiling, transgenic mouse models, and genetic fate mapping methods, we characterised the presence and fate of multiple populations of immune cells found in the knee joint capsule. RESULTS: We found that joint injury and obesity differentially and synergistically alter the architectural, cellular, and molecular profiles of the synovial capsule. We observed fewer patrolling monocytes in obese animals and found a significantly higher influx of proinflammatory monocyte-derived macrophages in the first 3 days after joint injury in obese compared with that in control animals. We also showed a significant loss of barrier-forming synovial lining macrophages 3 days after destabilisation of medial meniscus surgery, with a significant restoration of their numbers in normal weight but not in obese mice in advanced stages of OA. Finally, we characterised the presence and changes of other immune cell subtypes, including T, B, and mast cells and neutrophils, as well as local synovial fluid cytokines associated with injury and obesity. CONCLUSIONS: Our data revealed that injury and obesity independently and synergistically contribute to the dysregulation of the synovial immune landscape, providing new insight into their role in the pathogenesis of OA. Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved. DOI: 10.1016/j.ard.2025.03.001