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Therapeutic Modalities

The role of synovial macrophages and macrophage-produced mediators in driving inflammatory and destructive responses in osteoarthritis.

Summary:

Here, we will review and comment on some recent work, involving both in vitro studies of human OA synovium and studies of OA pathology in animal models, which have strongly suggested that the inflamed synovium and activated syno- vial macrophages are important in promoting OA pa- thology. In particular, we will provide an overview of the role of synovial macrophages in promoting inflamma- tory and destructive responses in OA and the potential role of therapeutic strategies directed against macro- phages or macrophage-produced cytokines as remission- inducing agents in this disease.

Conclusion:

Although it remains most likely that the fundamental difference between OA and RA is found at the level of cartilage and bone rather than in the synovium, the above findings would certainly stimu- late interest from academia and industry to investigate intracellular signaling and cytokine biology in OA syno- vium, in the search for potential therapeutic targets.

Author & Journal:Bondeson, Jan, et al, Arthritis Rheum. 2010 Mar;62(3):647-57. doi: 10.1002/art.27290
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Preoperative low level laser therapy in dogs undergoing tibial plateau levelling osteotomy: A blinded, prospective, randomized clinical trial.

Summary:

To evaluate the influence of preoperative low-level laser therapy (LLLT) on therapeutic outcomes of dogs undergoing tibialplateau levelling osteotomy (TPLO).

Conclusion:

Twenty-seven dogs (27 stifles) were included and no major complications occurred. At eight weeks postoperatively, a significant difference in peak vertical force analysis was noted between the LLLT (39.6% ± 4.7%) and sham groups (28.9% ± 2.6%), (p <0.01 Time, p <0.01 L). There were no significant differences noted between groups for all other parameters. The age of dogs in the LLLT group (6.6 ± 1.6 years) was greater than that for the sham group (4.5 ± 2.0, p <0.01). Although not significant, a greater proportion of LLLT dogs (5/8) had healed at the eight-week time point than in the sham group (3/12) despite the age difference (p = 0.11) Clinicalsignificance: The results of this study demonstrate that improved peak vertical force could be related to the preoperative use of LLLT for dogs undergoing TPLO at eight weeks postoperatively. The use of LLLT may improve postoperative return to function following canine osteotomies and its use is recommended.

Author & Journal:Rogatko CP, et al, VCOT 2017:30:46-53
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Evaluation of treatment with a pulsed electromagnetic field on wound healing, clinicopathologic variables, and central nervous system activity of dogs.

Summary:

To evaluate effects of treatment with a pulsed electromagnetic field (PEMF) on healing of open and sutured wounds, clinicopathologic variables, and CNS activity of dogs.

Conclusion:

The PEMF treatment enhanced wound epithelialization in open cutaneous wounds and provided indications of early contraction without significant short-term changes in other variables.

Author & Journal:Scardino MS, et al, Am J Vet Res. 59(9):1177-1181, 1998
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Canine Hip Dysplasia: Reviewing the Evidence for Nonsurgical Management

Summary:

This systematic review of available evidence for nonsurgical management of hip dysplasia considered 14 articles and scored nonsurgical management including: activity restrictions, weight management, acupuncture, modulation of joint disease by polysulfated glycosaminoglycans, mesenchymal stem cell therapy, and extra corporeal shock wave therapy.

Conclusion:

“Weight management is an effective and important component of managing dogs with HD and associated osteoarthritis. Techniques that modulate the progression of joint disease may also be beneficial for treating dogs with HD. Further studies are needed to investigate other methods of managing HD such as hydrotherapy and physical rehabilitation.”

Author & Journal:Shaw, Kristin Kirkby et al, Veterinary Surgery, 2012
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A Pilot Clinical Study Assessing Treatment of Canine Hip Dysplasia Using Autologous Protein Solution.

Summary:

Five dogs with bilateral hip dysplasia and without osteoarthritis of other joints were enrolled in this pilot study. Objective kinetic data using a pressure sensitive mat and owner assessments using the canine brief pain inventory (CBPI) and Liverpool Osteoarthritis for Dogs (LOAD) questionnaires were obtained prior to treatment. Enrolled dogs were treated in one hip with autologous protein solution(APS) and the contralateral hip was injected with an equal volume of saline. The hip to be treated was selected using a random number generator. At exactly 28 days following treatment dogs were re-assessed using the pressure sensitive mat and the CBPI and LOAD questionnaires. No dogs were treated with any other medications or supplements throughout the study period.

Conclusion:

Assessment of the total pressure index (TPI) collected using the pressure sensitive mat showed that the hips treated with APS improved significantly more than hips treated with saline (p = 0.0005) and that the hips treated with APS bore significantly more weight than the hips treated with saline at day 28 (p < 0.05). Statistically significant improvement was noted by owners in “pain” and “function” as assessed by the CBPI as well “mobility at exercise” using the LOAD questionnaire. This pilot study provided proof of principle that APS is beneficial in treating pain and lameness in dogs affected by coxofemoral osteoarthritis.

Author & Journal:Frank, S.P., Front Vet Sci. 2019 Aug 9;6:243. doi: 10.3389/fvets.2019.00243. eCollection 2019
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Photobiomodulation directly benefits primary neurons functionally inactivated by toxins: role of cytochrome c oxidase.

Summary:

Far red and near infrared (NIR) light promotes wound healing, but the mechanism is poorly understood. Our previous studies using 670 nm light-emitting diode (LED) arrays suggest that cytochrome c oxidase, a photoacceptor in the NIR range, plays an important role in therapeutic photobiomodulation. If this is true, then an irreversible inhibitor of cytochrome c oxidase, potassium cyanide (KCN), should compete with LED and reduce its beneficial effects. This hypothesis was tested on primary cultured neurons. LED treatment partially restored enzyme activity blocked by 10-100 microm KCN. It significantly reduced neuronal cell death induced by 300 microm KCN from 83.6 to 43.5%. However, at 1-100 mm KCN, the protective effects of LED decreased, and neuronal deaths increased. LED significantly restored neuronal ATP content only at 10 microm KCN but not at higher concentrations of KCN tested. Pretreatment with LED enhanced efficacy of LED during exposure to 10 or 100 microm KCN but did not restore enzyme activity to control levels. In contrast, LED was able to completely reverse the detrimental effect of tetrodotoxin, which only indirectly down-regulated enzyme levels. Among the wavelengths tested (670, 728, 770, 830, and 880 nm), the most effective ones (830 nm, 670 nm) paralleled the NIR absorption spectrum of oxidized cytochrome c oxidase, whereas the least effective wavelength, 728 nm, did not.

Conclusion:

The results are consistent with our hypothesis that the mechanism of photobiomodulation involves the up-regulation of cytochrome c oxidase, leading to increased energy metabolism in neurons functionally inactivated by toxins.

Author & Journal:Wong-Riley MT, et al, J Biol Chem 2005;280: 4761-4771
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Effect of Targeted Pulsed Electromagnetic Field Therapy on Canine Postoperative Hemilaminectomy: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial.

Summary:

Intervertebral disc disease is one of the leading causes of paralysis in dogs. Pulsed electromagnetic field (PEMF) therapy has been advocated for improving wound healing and pain reduction; however, robust clinical trials are lacking. The present prospective, double-blind, placebo-controlled trial evaluated targeted PEMF therapy administered to 53 client-owned dogs who underwent hemilaminectomyfor naturally occurring disk extrusion intervertebral disc disease.

Conclusion:

No untoward effects were recorded in either treatment group. More frequent evaluation of outcome measures with larger patient numbers, as well as histologic samples, may be useful in future studies. Dogs receiving PEMF therapy following postoperative hemilaminectomy demonstrated improved wound scores at 6 wk and reduced mean number of owner-administered pain medications compared with the control group therapy.

Author & Journal:Alvarez LX, et al, J Am Anim Hosp Assoc 2019; 55:83-91
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Low-level laser irradiation induces in vitro proliferation of mesenchymal stem cells

Summary:

To evaluate the effect of low-level laser irradiation on the proliferation and possible nuclear morphological changes of mouse mesenchymal stem cells.

Conclusion:

Low-level laser irradiation stimulated the proliferation of mouse mesenchymal stem cells without causing nuclear alterations. The biostimulation of mesenchymal stem cells using laser therapy might be an important tool for regenerative therapy and tissue engineering.

Author & Journal:Augusto Galvão Barboza,Carlos, et al, eintstein, 2014
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The thermal effects of therapeutic lasers with 810 and 904 nm wavelengths on human skin.

Summary:

To investigate the effect of therapeutic infrared class 3B laser irradiation on skin temperature in healthy participants of differing skin color, age, and gender.

Conclusion:

The thermal effects of LLLT at doses recommended by WALT-guidelines for musculoskeletal and inflammatory conditions are negligible (<1.5°C) in light, medium, and dark skin. However, higher LLLT doses delivered with a strong 3B laser (200 mW) are capable of increasing skin temperature significantly and these photothermal effects may exceed the thermal pain threshold for humans with dark skin color.

Author & Journal:Joensen J, et al, Photomed Laser Surg 2011:29(3):145-153
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