Machine learning techniques for computer-aided classification of active inflammatory sacroiliitis in magnetic resonance imaging

Abstract Background: Currently, magnetic resonance imaging (MRI) is used to evaluate active inflammatory sacroiliitis related to axial spondyloarthritis (axSpA). The qualitative and semiquantitative diagnosis performed by expert radiologists and rheumatologists remains subject to significant intrapersonal and interpersonal variation. This encouraged us to use machine-learning methods for this task. Methods: In this retrospective study including 56 sacroiliac joint MRI exams, 24 patients had positive and 32 had negative findings for inflammatory sacroiliitis according to the ASAS group criteria. The dataset was randomly split with ∼ 80% (46 samples, 20 positive and 26 negative) as training and ∼ 20% as external test (10 samples, 4 positive and 6 negative). After manual segmentation of the images by a musculoskeletal radiologist, multiple features were extracted. The classifiers used were the Support Vector Machine, the Multilayer Perceptron (MLP), and the Instance-Based Algorithm, combined with the Relief and Wrapper methods for feature selection. Results: Based on 10-fold cross-validation using the training dataset, the MLP classifier obtained the best performance with sensitivity = 100%, specificity = 95.6% and accuracy = 84.7%, using 6 features selected by the Wrapper method. Using the test dataset (external validation) the same MLP classifier obtained sensitivity = 100%, specificity = 66.7% and accuracy = 80%. Conclusions: Our results show the potential of machine learning methods to identify SIJ subchondral bone marrow edema in axSpA patients and are promising to aid in the detection of active inflammatory sacroiliitis on MRI STIR sequences. Multilayer Perceptron (MLP) achieved the best results.(AU)

Hyaluronic acid has chondroprotective and joint-preserving effects on LPS-induced synovitis in horses

The intra-articular use of hyaluronic acid (HA) for the treatment of synovitis and osteoarthritis is still controversial. As a consequence, corticosteroids remain the most frequently employed therapeutic agents, despite their potential systemic and local deleterious effects. This study examined the anti-inflammatory, antioxidant, and chondroprotective activities of low and high molecular weight hyaluronic acid (LMW-HA and HMW-HA) on lipopolysaccharide (LPS)-induced synovitis in horses compared to triamcinolone acetonide (TA). LPS was injected in the metacarpophalangeal joints, which were treated intra-articularly with either TA (as control) or LMW-HA or HMW-HA. Joint clinical evaluation and synovial fluid (SF) analysis were performed at 0, 8, 24, and 48 h. The white blood cell counts (WBC), prostaglandin E2 (PGE2), interleukin (IL)-1, IL-6, IL-10, tumor necrosis factor-α, chondroitin sulfate (CS) and HA concentrations, oxidative burst, and HA molecular weights were measured. TA reduced the lameness, swelling, and PGE2 release but increased the SF CS concentrations enormously at 24h and 48h, and decreased the SF HA modal molecular weight. These results indicate the breakdown of articular cartilage aggrecan and SF HA. In contrast, LMW-HA and HMW-HA were less effective in reducing the inflammation symptoms, but preserved the joints because only a modest increase in CS occurred at 24 h, decreasing at 48 h, and the SF HA was maintained. The HA-treatment also had anti-inflammatory actions, and LMW-HA was the most effective in reducing the release of cytokine. In summary, the HA treatment inhibited efficiently the digestion of cartilage proteoglycans and SF HA breakdown.

Antinociceptive, anti-inflammatory and antiarthritic activities of Bungarus fasciatus venom in experimental animal models.

Pain and inflammation are intimately associated with rheumatoid arthritis, a growing bone-joint related problem of the modern society. Though several therapeutic managements are available for arthritis, their side effects not only limit their use, but also advocate the quest for natural therapies. In this study, we explored the antinociceptive, anti-inflammatory and antiarthritic activities of Bungarus fasciatus venom (BFV) in experimental animal models. Rheumatoid arthritis was induced by Freund’s complete adjuvant (FCA) in male Wistar albino rats. Lyophilized BFV was diluted in 0.9% NaCl. Antiarthritic activity showed that BFV significantly reduced the paw and ankle diameters; urinary hydroxyproline, glucosamine levels and serum ACP/ALP/TNF-α/IL-1β/IL-17/Cathepsin-K/MMP-1 levels. These parameters were significantly increased in FCA induced arthritic animals. Joint histopathology study indicated the partial restoration of joint structure. Treatment with BFV significantly reduced the mean latency time of tail flick response, acetic acid induced writhing response and formalin induced licking response in male albino mice. BFV treatment also significantly reduced carrageenan induced paw edema and xylene induced ear edema in male albino mice. The results indicated that BFV possess antinociceptive, anti-inflammatory and antiarthritic properties and further studies are warranted to find the active constituents present in BFV.