Locomotor, ECM & Cartilage Flashcards

1
Q

What are the different parts that make up the ECM?

A

ECM – matrix of fibers – protein fibers of various types - predominantly collagen but also elastin

Groudn substance - protein fibers are embedded diffuse matrix of proteoglycans – acidic carbs linked to protein – forms hydrated mesh

Fibroblasts – role to secrete the proteins

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2
Q

What are the mechanical properties of cartilage, tendons, skin and bone?

A

Cartilage – Elasticity, low friction, resistance to compression

Tendons – strength and flexibility

Skin – Elasticity

Bone – Strength and rigidity

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3
Q

What is the molecular strucutre of collagen?

A

Collagen – major structural component of bone, tendon, skin, arteries, cartilage, etc
Makes up 25% of dry weight of the body
Class of protein – 28 types known

Collagen – consists of three chain (1000 a.a. long) – 3 helices (left-handed helical structure – 3 a.a. per rotation) that coil around to form a superhelix (twisted to the right)

Superhelix maintained by hydrogen bonds between the three different chains

Helices – gly, pro and hydroxyproline (oxidation of proline – post-translational modification)  reason for these amino acids – lack of room for large a.a. side chains

Collagen – defined by unusual triple helical structure

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4
Q

What is the amino acid composition of collagen?

A

General sequence: [Gly-X-Y]n

X is often proline
Y is often 4-hydroxyproline

Overall composition: 33% glycine
15-20% proline/hydroxyproline

Proline - imino acid – unusual bond angle between carbonyl and amino group – important for maintaining tight helical structure

Collagen is nutritionally poor as hydroxyproline is unusable - deficient in ile, phe, tyr, cys, met

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5
Q

What are the major types of collagen?

A

Every tissue has at least one major types and some minor types

Types – When it comes to the types of collagen - the helices may be identical (homotrimer) or different (heterotrimer) – note all called alpha chains but they aren’t alpha helices

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6
Q

How many collagen genes have been identified in the genome thus far?

A

There are at least 40 collagen genes, to encode all the different types of alpha-chain

Each gene has ~ 50 exons; only 20% of the gene encodes protein

Most exons encode 6 glyXY sequences (codes for 18 a.a.), so length is 6 x 3 x 3 = 54 bases

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7
Q

Provide a brief overview of the different parts of the secretory pathway in a cell?

A

Secretory protein production – all secretory proteins have a signal sequence at their N-terminus (variable length sequence – consistent property – hydrophobic – for collagen 25 aa long)

Secretion pathway

  1. Cytosol mRNA translated – first the signal sequence translated (5’ end/N-terminal) – recognized by signal recognition particle – directs it to engage with RER channel
  2. RER – Ribosome becomes bound to RER and protein becomes translated into the lumen of the RER via the channel – co-translational translocation
  3. Golgi – vesicle with protein is transported to the golgi where it move through the golgi stacks – Cis and trans golgi –buds from the trans golgi
  4. Different paths – stored in lysosome, regulated (directed) or constitutive (passive) secretion pathways
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8
Q

Outline the different steps in collagen synthesis.

A
  1. RER - co-translational translocation - pre-pro-collagen
  2. Helices form in lumen of RER + signal sequence removed
  3. Helices need to associate – starts at C-terminus starts by the formation of disulphide bonds + while this happens, we get amino acid modifications (glycosylation and hydroxylation – PTMs)
  4. Protein winds up into super helix – dependent on the hydroxyproline forming in order to form hydrogen bonds between chains – does not occur - protein is degraded and recycled
  5. Secrete via golgi apparatus
  6. End up outside the cell
  7. Once secreted the non-helical peptides are cleaved – forms tropocollagen
  8. Types of collagen that form fibrils - fibril formation and crosslinking (modification of lysine and histidine) in the extracellular space
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9
Q

Where are elastin fibres found and what structure do they have?

A
  • Elastin fibers important in lungs, skin and arteries
  • Fibers are elastic
  • Elastin core surrounded by microfibrils formed from fibrillin
  • Elastin - Unusual amino acid composition – small aa – but do not form triple helices – instead helices are cross-linked to-eachother
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10
Q

How are elastin fibres cross-linked - molecular view?

A

One example - Desmosines

Lysine is oxidized – allows for cross-linking to occur.

Used to generate highly cross-linked structure that is highly elastic

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11
Q

Why is elastin important to understand for emphysema?

A
  1. During inflammation neutrophils release proteinases which break down elastin
  2. Level of proteinase degradation is controlled by a1-antitrypsin, which is able to bind very tightly to proteinases forming an inactive complex – inhibition
  3. But the process of proteinase inactivation can be inhibited by…
    - Mutations in a1-antitrypsin (synthesis and secretion) – increasing predisposition to emphysema
    - And inhibition can also occur via oxidization of anti-trypsin by oxidants such as peroxynitrite - which are released from smoking
  4. Both cases – there is elevated levels of proteinase activity which leads to elastin break down and subsequent emphysema
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12
Q

What is the basic structure and characteristics of glycosaminglycans?

A

Glycosaminglycans - negatively charged polysaccharide units - consist of repeating disaccharide units

Characteristics - polysaccharides, acidic, negatively charged and poly-dispersed (variable MW)

Consists of a unronic sugar and amino sugar

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13
Q

Outline the general structure of proteoglycans and what are it’s properties?

A

Proteoglycan structure - sugar chains (glycosaminoglycans) attached to a core protein

Sugars attach at consensus sequences

These proteoglycans can then attach to a core protein forming even larger structures.

Examples in cartilage - Aggrecans – can associate non-covalently with hyaluronic acid

Properties - Large structure, high acidic (covered in carboxyl and sulphate groups), negatively charged, heavily hydrated + associates with many cations - acts like a sponge for water

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14
Q

What implication/impact does the negative charge of proteoglycans have?

A

Negative charge - attracts +ively charged ions

Charged ions draws in water

Faciliates/allow for the property of compressability - movement of water - water drawn in (acting like a cushion) and pushed out

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15
Q

What is mucopolysaccharidoses?

A

Mucopolysaccharidoses are set of rare genetic conditions where we get accumulation of partially degraded glycosaminoglycan in lysosomes and not in the ECM

This causes skeletal deformities and mental retardation.

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16
Q

What is the chemical composition of bone?

A

Chemical composition

20% protein (mostly collagen type I) - organic matrix

70% Minerals (inorganic salts – basic form of calcium phosphate - hydroxyapatite) - Other ions like fluoride and magnesium are also present

10% Water

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17
Q

What are the stages of bone deposition?

A
  1. Formation of the collagen matrix
  2. Deposition of CaHPO4 at the ends of collagen fibrils
  3. Conversion of calcium phosphate to hydroxyapatite

3Ca3(PO4)2.Ca(OH)2 – forms crystalline matrix

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18
Q

What are the causes of poor mineralisation?

A
  1. Vitamin D deficiency (affects intestinal absorption of Ca2+)
  2. Chronic metabolic acidaemia (affects hydroxyapatite formation)
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19
Q

Name some nutritional and genetic conditions associated with ECM?

A

Nutritional – associated with vitamin C (Scurvy) and D (e.g. rickets)

Hereditary conditions –most effecting collagen but not all

  1. Osteogenesis imperfecta type I (decreased) and II (abnormal) - brittle bone disease
  2. Alport syndrome – rare condition that effects type 4 collagen – mainly effects the kidney
  3. Elhers Danlos syndrome - heterogenous collection of diseases – classification runs to 14 types – effecting collagen synthesis, processing and assembly

Most common type – hypermobile EDS – cause unknown – hypereleastic joints + risk of dislocations

Most dangerous type – decreased amount of type III collagen

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20
Q

What goes wrong in collagen synthesis when vitamin C is deficient - mechanism?

A

Oxidation/hydroxylation of proline requires ascorbic acid as a co-factor – required to maintain enzyme in active state

This keeps iron in prolyl hydroxylase in it’s ferrous form (Fe2+) instead of the ferric form (3+) - ascorbic acid acts as a reducing agent

Prolyl hydroxylase - responsible for catalysis

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21
Q

What are some typical symptoms associated with scurvy?

A
  1. Poor wound healing
  2. Hair and tooth loss
  3. Capillary weakness
  4. Stunted growth
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22
Q

What roles does vitamin D play in terms of calcium metabolism, how is it generated and what happens when it is not present?

A
  1. Promotes Calcium uptake in the gut
  2. Promotes mineral deposition in the skeleton
  3. Inhibits calcium and phosphate excretion

Vitamin D – not taken up in diet – UV dependent reaction – Cholesterol is the precursor for vitamin D – followed by hydroxylation in the liver and kidney before forming active form

In the absence of vitamin D – poor bone mineralization – rickets

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23
Q

Why is collagen sensitive to alterations?

A

Collagen sensitive to alterations because…

  1. Multiple gly-x-y repeats which are intolerant of point mutations
  2. Complex (50 genes) – possibility of splicing errors
  3. Many types of post-translational modifications
  4. Triple helical structure – mutations are often dominant
24
Q

If we have a heterozygous individuals with a mutation in alpha1 chain of collagen - what proportion of collagen will carry 0, 1 or 2 copies of the alpha1 point mutation?

A

Example using type 1 collagen

Heterozygous mutation in genes encoding a1 chain–

  1. 50% of type 1 collagen chains will carry mutated alpha 1 strand - 50% of chains produced will carry this mutation
  2. 25% of type 1 collagen chains will 2 strands with mutations
  3. 25% of type 1 collagen chains wil be completely normal

Total of 75% of collagen will be effected

25
Q

Does the position of mutations matter in terms of their impact of collagen triple helix formation?

A

Effect of mutations on the triple helical structure

Yes, mutations do exhibit polarity

Tendency for severe mutations to be located at the C-terminus - Why? Assembly starts at the C-terminal end – will effect winding up of helix from the start –> mutations here are less permissable

26
Q

What are the clinical presentations/symptoms of osteogenesis imperfecta?

A

Type 1 - decreased type 1 collagen - Blue sclerae (colouration of the eye whites), early fractures, bone deformities

Type 2 - abnormal type 1 collagen - Crumpled bones, fractures in utero, perinatal death

27
Q

What are some symptoms associated with EDS?

A

Ehlers-Danlos syndrome
1. Joint hyperflexibility
2. Skin hyperelasticity
3. Cutaneous fragility

Type III - Skin lesions, hypermobility and facial abnormalities (most common)

Type IV - Arterial, intestinal or uterine rupture, easy bruising (most dangerous)

28
Q

What is Marfan’s syndrome?

A

Marfan syndrome: relatively common (1 per 5000) - autosomal dominant condition caused by mutations (~1300 known) in the FBN-1 gene, which affect the amount, structure, stability or secretion of fibrillin-1

Microfibrils bind the growth factor TGF-beta; hence in Marfan’s syndrome we see increased levels of free TGF-beta causing developmental abnormalities

Symptoms include….
1. Increased linear bone growth (arachnodactyly)
2. Craniofacial abnormalities
3. Joint hypermobility
4. Lens dislocation
5. Aortic dissection/rupture
6. Obstructive lung disease
7. Pneumothorax

29
Q

What is fibrillin-1?

A

Fibrillin-1 is a 350-kDa Ca2+-binding glycoprotein

It is a major structural component of 10-nm microfibrils, which form a template for the elastin matrix

30
Q

What will we be focusing in the locomoter module?

A

Introduction to fundamental biomedical and clinical aspects of the bones, cartilage and joints of the musculoskeletal system

Look at the basic science of connective tissue all the way to how disorders of the connective tissue manifest at the clinical level

31
Q

What are the main joint and bone disorders associated with young, middle aged and elderly people?

A
  1. Young – growth disorders
  2. Middle aged – injury/trauma
  3. Old age – osteoarthritis (OA); rheumatoid arthritis (RA); OP (osteoporosis)
32
Q

Generally speaking, are we able to cure many disorders of the joints and bones?

A

Many of the disorders of the bones and joints cannot be ‘cured’ – only their
symptoms treated so long-term drug use is common.

For example use of NSAIDs – non-steroidal anti-inflammatories (reduce inflammation, pain) – e.g. VIOXX (Merck) fewer GI problems, but could cause heart attacks, strokes.

Futhermore, there is evidence that long-term NSAIDs and corticosteroid treatment leads to accelerated bone loss, reduced fracture healing and compromised treatment of osteoporosis using bisphosphonates.

33
Q

What is the difference between multimorbidity and co-morbidity?

A

Comorbidity is the presence of one or more additional conditions often co-occurring with a primary condition.

Multimorbidities are co-occurring diseases (i.e. not additional conditions related to a primary one) e.g. a person could have diabetes and heart disease and high blood pressure. Increasingly common.

Musculoskeletal conditions are very common in multimorbidity – often living with additional chronic conditions - e.g. mental health conditions - often associated with earlier death

34
Q

What are Harris growth arrest lines?

A

Growth arrest lines, also known as Harris lines, are lines of increased bone density that represent the position of the growth plate - causes malnutrition, disease or trauma

35
Q

Why is repair of connective tissue from so poor/non-existent?

A
  • Poor vascular supply
  • Limited supply of nutrients
  • Very low synthesis rates of some tissue
    components
  • Loss of cell-matrix interactions – leads to irreversible loss of phenotype
  • Integration of repair tissue very poor
  • Mechanical properties of repair tissue
    inferior/weak
36
Q

What are the different groups/categories of connective tissue?

A
37
Q

What are the three main componenets of connective tissue?

A
  1. Cells

Resident cells- Chondrocytes in cartilage, fibroblasts in most CTs, tenocytes (fibroblast-like cells) in tendon – cell type depends on mechanical role of the CT – cells control the mechanical stability of tissues by synthesis/degradation of the ECM.

Cells are very sensitive to their physico-chemical environment linked to the ECM by integrins – role in mechanical signalling (i.e. mechanotransduction)

Immigrant cells - i.e. macrophages, lymphocytes, neutrophils (defence), mast cells

  1. Extracellular matrix (ECM) - collagens & proteoglycans

Collagens - fibrillar proteins resist tensile stresses – like ‘rope’

Proteoglycans (also called ‘ground substance’ – unstructured material) composed of negatively-charged glycosaminoglycans (GAGs) which attract cations and SWELL - like partially
inflated ‘balloons’ and resist compressive forces

  1. Interstitial fluid

Complex composition – influenced by the negatively charged GAGs.

38
Q

What are chondrocytes?

A

Cells responsible for cartilage formation - synthesis and breakdown of ECM

Can synthesise the full range of ECM proteins (collagens/ proteoglycans, degradative enzymes and inhibitors of enzymes).

Normally synthesise cartilage-specific ECM components

Cell metabolism highly sensitive to the physico-chemical environment.

Specialised matrix surrounds cells (lacuna or chondron)

No cell division in healthy tissue – life-span years/decades?

39
Q

What are fibroblasts?

A

A fibroblast is a type of cell that contributes to the formation of connective tissue

Fibroblasts and fibrocytes are two states of the same cells, the former being the activated state, the latter the less active state.

Involved in the synthesis of fibrous matrix proteins, particularly collagens (mainly type I collagen) - forming rope-like network.

Cell metabolism is highly sensitive to the physico-chemical environment.

Critical role in wound healing.

The lifespan of fibroblasts is months

40
Q

What are the three types of cartilage?

A
  1. HYALINE (articular) CARTILAGE
  2. FIBROCARTILAGE
  3. ELASTIC CARTILAGE
41
Q

What is hyaline cartilage? What are its properties/characteristics?

A

Hyaline cartilage - otherwise known as articular cartilage - present on surfaces of moveable joints

Glassy/shiny appearance & low friction surface

  • Withstands compressive and tensile forces – load-bearing but NOT elastic
  • Pliable - spreads loads over ends of bones – no focal points of pressure
  • working with synovial fluid, provides a low friction surface for articulating joints.

Mainly made up of type II colagen and some type IX (9) collagen

Connects to the underlying bone at the osteochondrial junction

Cells - Chondrocytes - surrounded by lacuna

42
Q

What are chondrocytes? What do they do?

A

Cells found in cartilage that are exclusively responsible for synthesis / breakdown of ECM components

Elliptical/spheroidal morphology - surrounded by specialized matrix - lacuna

Normally synthesise cartilage-specific ECM components (collagen type II, large proteoglycan - aggrecan for basketweave matrix)

Also Synthesise wide range of ECM degradative enzymes (and their inhibitors).

Chondrocytes are phenotypically unstable – can differentiate into fibroblasts - role for the cytoskeleton in cell signalling – expend a significant amount of energy to maintain cell identity

Arrangement in human cartilage - random/clustered

43
Q

What is fibrocartilage? What are its properties and characteristics?

A

Type of connective tissue - Fibrocartilage

Found at intervertebral disc, meniscus, etc.

Role - Support, prevents bone-bone contact, spread load, limits movement

Can withstand tensile and compressive forces.

Collagen fibres thick & normally have clear parallel orientation and structure.

Cells - arranged often in rows, mainly fibroblasts but some chondrocytes.

44
Q

What are the resident cells of fibrocartilage?

A

Fibroblasts

Mainly produce type I collagen – not a basket structured matrix but rather a rope-like matrix

Produce small proteoglycans rather than large

45
Q

Where is elastic cartilage found? What are its properties?

A

Elastic Cartilage - auricle of ear, epiglottis, etc.

Histologically very similar to hyaline

BUT - Contains elastin - highly & reversibly deformable.

Ideal for a flexible skeleton

Fibroblasts synthesise elastin, collagens, small PGs, and degradative enzymes (and their inhibitors)

46
Q

What role deos synovial fluid play? What are its properties?

A

Primary role of lubricating joints

Viscous when joint immobile but ‘Warming-up’ exercises increases production/secretion, reduces viscosity - Smart lubrication.

Ultrafiltrate of plasma - with hyaluronic acid – lubricant.

Produced by synoviocytes of synovial membrane

Primary source of nutrition & removal of waste for cartilage cells.

47
Q

Is connective tissue responsive to changes in environmental conditions?

A

Appear simple and homogeneous - but at the cellular level it is complex and heterogeneous.

CTs not inert but living and responsive to mechanical environment.

Load-bearing cartilage thicker & stronger than
non-load-bearing

In immobilised joints (long-term bed rest?), cartilage thins & lost - usually reversible when performing appropriate mechanical loading (passive movement without loading is insufficient)

48
Q

What are the role of tendons and ligaments?

A

Tendons transmit load from muscle to bone

Ligaments transmit load/give stability from bone to bone (joins bones together)

Structures are adaptive - Cells adapt to prevailing mechanical forces by modifying ECM synthesis.

For example - depending on the location of the tendon and the different compressive forces we can see varying levels of proteoglycans and collagen

49
Q

What is Wolff’s Law?

A

Wolff’s Law - form follows function - meaning that the form/structure is dependent on the function it needs to carry out

e.g. Cartilage thickness proportional to prevailing load – thicker where load is greater, thinner where load is less.

50
Q

What factor determines whether we can synthesis or breakdown of cartilage?

A

Matrix synthesis/breakdown is totally controlled by chondrocytes

But this is dependent on the balance of loading

Normal dynamic loading; synthesis = breakdown

Greater loading; synthesis > breakdown

Cartilage degeneration; breakdown > > synthesis –> can cause permanent cartilage damage

Concept is illustrated by attached diagram

51
Q

What types of load increase chondrocyte synthesis?

A

Dynamic Load - stimulates synthesis whereas static load does not

Dynamic load increases the hydrostatic pressure in the fluid compartments in which the chondrocytes are located - stimulus is sensed and triggers increased synthesis.

Chondrocytes rely on integrins (linked to ECM - mechanotransduction) & stretch-sensitive ion channels to respond to these stimuli

52
Q

How is cartilage adapted to withstand load?

A

Articular cartilage has no vulnerable structures
1. avascular
2. aneural
3. alymphatic
4. No epithelium at cartilage surface
5. Low cell density (1-10%)
6. Complex ECM (fibre-reinforced gel) highly resilient – adapted to compressive and tensile forces.

All these adaptations are essential for load- bearing by articular cartilage.

53
Q

What are the principal components of articular cartilage?

A
  1. Collagens - hyaline mainly type II and type I mainly in fibrocartilage
  2. Proteoglycans - AGGRECAN - monomers of GAG - highly sulphated and acidic – large numbers of fixed negative charges - draws in water + Also small proteoglycans (decorin, fibromodulin etc.)
  3. Interstitial fluid - hypoxic, hyper-osmotic, acidic, cation concentrations higher, anions lower - changes during static load as fluid extruded.
  4. Chondrocytes - Entirely responsible for ECM synthesis/breakdown - NO chondrocyte division in skeletally mature healthy cartilage – healthy chondrocytes are for life.

Forms a basketweave structure stabilised by minor but important collagens (e.g. Type IX?)

54
Q

Do we expect high levels of dye penetration in a mobile joint?

A

Yes, mobile joints show higher levels of dye penetration when compared to immobile joints

55
Q

How do tendons and ligaments differ in terms of elasticity, toughness, fibroblast organisation, Collagen/proteoglycan/elastin content?

A
56
Q

Is the turnover of articular cartilage very slow?

A

Turnover of articular cartilage is very slow.

In skeletally-mature humans;
- t0.5 for proteoglycans 200-300 days
- t0.5 for collagens - decades - a lifetime?
- Cartilage does not repair effectively – new/repaired connective tissue produced is mechanically incompetent

57
Q

What is one of the first things to happen to OA joints and why do we think this happen?

A

Cartilage swelling - the first macroscopic event in OA

Human femoral head cartilage, 60% ↑ in water content in ‘early OA’

Enzymes comes along and breakdown type 9 collagen – leads to swelling