Cartilage Arthritis Flashcards

1
Q

Which articular joints does arthritis occur in hyaline cartilage breakdown

A

Hip and knee joints

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2
Q

What is osteoarthritis

A

Loss of cartilage ecm and has a chondrogenic phenotype

Induced by mechanical stresses eg injury or without cause

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3
Q

What are oa symptoms

A

Loss of joint movement , joint deformity and inflammation pain

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4
Q

How can bone be seen in wrong areas in joint for oa

A

Ossification deformities

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5
Q

Which 3 ways can you detect oa

A

Genetic test

Examine mmp activity

Examine levels of sox9 which allows chondrocyte production

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6
Q

How would integrin usually cause homeostasis

A

Recognise fragments and cause fak signalling causing change in gene exp

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7
Q

What mimics mechanical stress to induce oa in mice

A

Destabilisation of the medial meniscus in joints (dmm)

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8
Q

Which 2 enzymes were found to reduce ecm in dmm oa mice causing oa

A

Adamts5 (reduced aggrecan stain)

Mmp 13 collagenase

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9
Q

What was found to be more important , mm13 or adamts5

A

Mm 13 showing how important collagen is in the ecm of cartilage

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10
Q

What would happen if you mutated the site where mmp13 and adamts5 cuts

A

The ecm would be restored showing low oa levels in dmm mice

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11
Q

How much of oa is inheritable

A

50%

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12
Q

Oa is polygenic what does this mean

A

Many genes involved

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13
Q

Mmp13 is seen in everyone but not everyone develops oa. Explain

A

Oa is multi factorial eg dependant also on environment

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14
Q

Give the 4 most important genes causing oa

A

Gdf5

Runx2

Pthlh

Smad3

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15
Q

What does gdf5 do

A

It’s in the tgf family which cause ecm synthesis via chondrocyte release of col II and aggrecan , and reduces mmp

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16
Q

What does runx2 do

A

A tf which induces mmp13 collagen breakdown and ossification

17
Q

What does pthlh do

A

Encode for pthrp involved in maintains chondrocytes

18
Q

What does smad3 do

A

Ic signalling protein involved in the tgfb response

19
Q

What are the 3 ways of therapy for oa since there’s no cure

A

NSAIDs to reduce inflammation Made by ecm breakdown

Surgery to replace joints

Genetic screening eg of sox9,smad3,gdf5

20
Q

What is ra classified as

A

Inflammatory autoimmune disease

21
Q

How is ra same as oa

A

Chondrogenic phenotype and ecm loss

22
Q

What MHC II is responsible for ra (more present in ra patients)

A

Hla - dr4

Particular gene hla drb1

23
Q

Are the symptoms the same as oa

A

Yes Eg loss of joint movement and inflammation

24
Q

What is rheumatoid factor rf

A

Auto igm antibody which binds igg via fc portion in RA

25
Is rf present in people without ra
Yes in 15%
26
What is acpa
Anti citrullinated peptide ab Auto antibody in ra recognising citrullinated peptides presented on the dr mhcII
27
How many ra patients have acpa
60%
28
What environmental fsctor can increase ptm citrullination of peptides and therefore increase ra
Smoking
29
Where does inflammation occur in ra
Synovium
30
What are synoviocytes
Cells in synovium whcih produce matrix
31
How does inflammation in ra start
Unknown trigger causes leukocytes to go to synovium
32
What happens after trigger
Auto reactive T cells eg to citrullinated peltides on MHC hla dr Get activated and then can also release cytokines, activate auto B cells to produce arthritogenic antibodies
33
What type of cytokines can auto T cells in synovium release
Tnf a, il 17 if th17 and also il 1
34
What do tnf a and Il 1 do
Cause ecm breakdown by inducing synovium fibroblasts to release mmps
35
What does il 17 do
Causes rank ligand release which stimulates osteoclasts for the breakdown of bone
36
What type of auto antigens are recognised by auto T cells in ra
Collagen or aggrecan CIA or PGIA (Presented on hla dr / mhcII)
37
What drug blocks tnf a
Infliximab
38
How does rituximab work for ra
Depletes B cells via targeting cd20 and kills them
39
What can be screened to identify ra
Acpa