title: Can pain intensity in osteoarthritis joint be indicator of the impairment of endothelial function?
abstract: We propose that pathological remodeling in joint tissues of osteoarthritis (OA) patients persistently stimulates local secretion of pro-inflammatory mediators, which overflow into the blood, activating leukocytes that impair endothelial function and accelerate the atherosclerotic process. During periods of pain, endothelial dysfunction progresses more aggressively due to elevated secretion of these pro-inflammatory mediators, which are involved in both atherosclerosis and the sensation of pain. Concentrations of pro-inflammatory cytokines and their antagonists, activating and decoy receptors of the broad interleukin (IL)-1 and IL-17 families, IL-15, and monocyte chemotactic protein-1 should be measured in peripheral blood samples of OA patients and compared with (I) OA clinical severity; (II) subclinical parameters of atherosclerosis; (III) ischemic heart disease risk factors; (IV) soluble factors indicating endothelial dysfunction; (V) degree of bone destruction; and (VI) results of a six-minute walk test. Arthroscopy and joint replacement surgery provide an opportunity to estimate mRNA and protein expression of inflammatory mediators in specimens of synovial fluid, synovial membrane, cartilage, and/or subarticular bone. A range of methods, including questionnaires, X-ray, computed tomography, ultrasound, enzyme-linked immunosorbent assay, immunohistology, immunofluorescence, and reverse transcription and in situ polymerase chain reaction are available. Understanding the inflammatory and immune mechanisms underlying OA may allow the early identification of patients at high risk of cardiovascular disease, independently of classical coronary risk factors. Pain may constitute an extrinsic indicator of currently worsening endothelial function.
authors: Department of Physiology and Immunology, Medical Faculty, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia; Department of Rheumatology, Rehabilitation, and Physical Medicine, Hospital for Medical Rehabilitation of Hearth and Lung Diseases and Rheumatism "Thalassotherapia-Opatija", 51410 Opatija, M. Tita 188, Croatia. Electronic address: Gordana.Laskarin@medri.uniri.hr.
authors: Gordana
authors: G
authors: Laskarin
authors: Division of Cardiology, Hospital for Medical Rehabilitation of the Hearth and Lung Diseases and Rheumatism "Thalassotherapia - Opatija", 51410 Opatija, M. Tita 188, Croatia; Department of Medical Rehabilitation, Medical Faculty, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia.
authors: Viktor
authors: V
authors: Persic
authors: Department of Rheumatology, Rehabilitation, and Physical Medicine, Hospital for Medical Rehabilitation of Hearth and Lung Diseases and Rheumatism "Thalassotherapia-Opatija", 51410 Opatija, M. Tita 188, Croatia.
authors: Sandra Rusac
authors: SR
authors: Kukic
authors: Department of Rheumatology, Rehabilitation, and Physical Medicine, Hospital for Medical Rehabilitation of Hearth and Lung Diseases and Rheumatism "Thalassotherapia-Opatija", 51410 Opatija, M. Tita 188, Croatia; Department of Medical Rehabilitation, Medical Faculty, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia.
authors: Drazen
authors: D
authors: Massari
authors: Department of Rheumatology, Rehabilitation, and Physical Medicine, Hospital for Medical Rehabilitation of Hearth and Lung Diseases and Rheumatism "Thalassotherapia-Opatija", 51410 Opatija, M. Tita 188, Croatia; Department of Medical Rehabilitation, Medical Faculty, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia.
authors: Anita
authors: A
authors: Legovic
authors: Division of Cardiology, Hospital for Medical Rehabilitation of the Hearth and Lung Diseases and Rheumatism "Thalassotherapia - Opatija", 51410 Opatija, M. Tita 188, Croatia; Department of Medical Rehabilitation, Medical Faculty, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia.
authors: Marko
authors: M
authors: Boban
authors: Division of Cardiology, Hospital for Medical Rehabilitation of the Hearth and Lung Diseases and Rheumatism "Thalassotherapia - Opatija", 51410 Opatija, M. Tita 188, Croatia.
authors: Rajko
authors: R
authors: Miskulin
authors: Department of Rheumatology, Rehabilitation, and Physical Medicine, Hospital for Medical Rehabilitation of Hearth and Lung Diseases and Rheumatism "Thalassotherapia-Opatija", 51410 Opatija, M. Tita 188, Croatia.
authors: Marija
authors: M
authors: Rogoznica
authors: Department of Rheumatology, Rehabilitation, and Physical Medicine, Hospital for Medical Rehabilitation of Hearth and Lung Diseases and Rheumatism "Thalassotherapia-Opatija", 51410 Opatija, M. Tita 188, Croatia; Department of Medical Rehabilitation, Medical Faculty, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia; Department of Physiotherapy, Faculty of Health Studies, University of Rijeka, 51000 Rijeka, V. cara Emina 5, Croatia.
authors: Tatjana
authors: T
authors: Kehler
mesh_terms: D000818:Animals; D001182:Arthroscopy; D050197:Atherosclerosis / Q000503:physiopathology; D018925:Chemokines / Q000378:metabolism; D004727:Endothelium / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007378:Interleukins / Q000378:metabolism; D007596:Joints / Q000503:physiopathology*; D008297:Male; D008962:Models, Theoretical; D010003:Osteoarthritis / Q000378:metabolism / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000503:physiopathology; D010146:Pain; D010147:Pain Measurement; D013582:Synovial Fluid / Q000378:metabolism; D013583:Synovial Membrane / Q000378:metabolism
chemical_list: D018925:Chemokines; D007378:Interleukins
keywords: Endothelial dysfunction; Interleukin-1; Interleukin-15; Interleukin-17; Monocyte chemotactic protein-1; Osteoarthritis