title: Tiludronate treatment improves structural changes and symptoms of osteoarthritis in the canine anterior cruciate ligament model.
abstract: BACKGROUND
  The aim of this prospective, randomized, controlled, double-blind study was to evaluate the effects of tiludronate (TLN), a bisphosphonate, on structural, biochemical and molecular changes and function in an experimental dog model of osteoarthritis (OA).
  
  
  METHODS
  Baseline values were established the week preceding surgical transection of the right cranial/anterior cruciate ligament, with eight dogs serving as OA placebo controls and eight others receiving four TLN injections (2 mg/kg subcutaneously) at two-week intervals starting the day of surgery for eight weeks. At baseline, Week 4 and Week 8, the functional outcome was evaluated using kinetic gait analysis, telemetered locomotor actimetry and video-automated behaviour capture. Pain impairment was assessed using a composite numerical rating scale (NRS), a visual analog scale, and electrodermal activity (EDA). At necropsy (Week 8), macroscopic and histomorphological analyses of synovium, cartilage and subchondral bone of the femoral condyles and tibial plateaus were assessed. Immunohistochemistry of cartilage (matrix metalloproteinase (MMP)-1, MMP-13, and a disintegrin and metalloproteinase domain with thrombospondin motifs (ADAMTS5)) and subchondral bone (cathepsin K) was performed. Synovial fluid was analyzed for inflammatory (PGE(2) and nitrite/nitrate levels) biomarkers. Statistical analyses (mixed and generalized linear models) were performed with an α-threshold of 0.05.
  
  
  RESULTS
  A better functional outcome was observed in TLN dogs than OA placebo controls. Hence, TLN dogs had lower gait disability (P = 0.04 at Week 8) and NRS score (P = 0.03, group effect), and demonstrated behaviours of painless condition with the video-capture (P < 0.04). Dogs treated with TLN demonstrated a trend toward improved actimetry and less pain according to EDA. Macroscopically, both groups had similar level of morphometric lesions, TLN-treated dogs having less joint effusion (P = 0.01), reduced synovial fluid levels of PGE(2) (P = 0.02), nitrites/nitrates (P = 0.01), lower synovitis score (P < 0.01) and a greater subchondral bone surface (P < 0.01). Immunohistochemical staining revealed lower levels in TLN-treated dogs of MMP-13 (P = 0.02), ADAMTS5 (P = 0.02) in cartilage and cathepsin K (P = 0.02) in subchondral bone.
  
  
  CONCLUSIONS
  Tiludronate treatment demonstrated a positive effect on gait disability and joint symptoms. This is likely related to the positive influence of the treatment at improving some OA structural changes and reducing the synthesis of catabolic and inflammatory mediators.
authors.affiliation: Research Group in Animal Pharmacology of Quebec-Department of Veterinary Biomedicine, Faculty of Veterinary Medicine-Université de Montréal, 1500 des vétérinaires St., St.-Hyacinthe, QC J2S 7C6, Canada.
authors.forename: Maxim
authors.initials: M
authors.lastname: Moreau
authors.forename: Pascale
authors.initials: P
authors.lastname: Rialland
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pelletier
authors.forename: Johanne
authors.initials: J
authors.lastname: Martel-Pelletier
authors.forename: Daniel
authors.initials: D
authors.lastname: Lajeunesse
authors.forename: Christielle
authors.initials: C
authors.lastname: Boileau
authors.forename: Judith
authors.initials: J
authors.lastname: Caron
authors.forename: Diane
authors.initials: D
authors.lastname: Frank
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lussier
authors.forename: Jerome R E
authors.initials: JR
authors.lastname: del Castillo
authors.forename: Guy
authors.initials: G
authors.lastname: Beauchamp
authors.forename: Dominique
authors.initials: D
authors.lastname: Gauvin
authors.forename: Thierry
authors.initials: T
authors.lastname: Bertaim
authors.forename: Dominique
authors.initials: D
authors.lastname: Thibaud
authors.forename: Eric
authors.initials: E
authors.lastname: Troncy
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000502:physiology / Q000601:surgery*; D018771:Arthralgia / Q000188:drug therapy* / Q000503:physiopathology; D001696:Biomechanical Phenomena / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000494:pharmacology*; D004164:Diphosphonates / Q000494:pharmacology*; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D005684:Gait / Q000187:drug effects / Q000502:physiology; D005712:Galvanic Skin Response / Q000187:drug effects / Q000502:physiology; D007719:Knee Joint / Q000187:drug effects / Q000473:pathology / Q000502:physiology; D008297:Male; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D013582:Synovial Fluid / Q000378:metabolism
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; C058651:tiludronic acid