Role of synovial lymphatic function in osteoarthritis.

BACKGROUND: Osteoarthritis (OA) affects the entire joint, initially with a low degree of inflammation. Synovitis is correlated with the severity of OA clinical symptoms and cartilage degradation. The synovial lymphatic system (SLS) plays a prominent role in clearing macromolecules within the joint, including the pro-inflammatory cytokines in arthritic status. Scattered evidence shows that impaired SLS drainage function leads to the accumulation of inflammatory factors in the joint and aggravates the progression of OA, and the role of SLS function in OA is less studied. DESIGN: This review summarizes the current understanding of synovial lymphatic function in OA progression and potential regulatory pathways and aims to provide a framework of knowledge for the development of OA treatments targeting lymphatic structure and functions. RESULTS: SLS locates in the subintima layer of the synovium and consists of lymphatic capillaries and lymphatic collecting vessels. Vascular endothelial growth factor C (VEGF-C) is the most critical regulating factor of lymphatic endothelial cells (LECs) and SLS. Nitric oxide production-induced impairment of lymphatic muscle cells (LMCs) and contractile function may attribute to drainage dysfunction. Preclinical evidence suggests that promoting lymphatic drainage may help restore intra-articular homeostasis to attenuate the progression of OA. CONCLUSION: SLS is actively involved in the homeostatic maintenance of the joint. Understanding the drainage function of the SLS at different stages of OA development is essential for further design of therapies targeting the function of these vessels.

Association of serum 25(OH)Vit-D levels with risk of pediatric fractures: a systematic review and meta-analysis.

The association between the risk of fractures and suboptimal vitamin D (Vit-D) status remains controversial in children. This meta-analysis suggested that serum 25(OH)Vit-D levels were lower in pediatric cases with fractures. 25-hydroxyvitamin D (25(OH)Vit-D) levels less than 50 nmol/L were associated with increased fracture risk in children. INTRODUCTION: This study aimed to assess the association between serum 25(OH)Vit-D and the risk of fractures in children, and to explore the sources of heterogeneity and investigate their impact on results. METHODS: Systematic review and meta-analysis were conducted for observational studies comparing serum 25(OH)Vit-D levels between fracture and non-fracture pediatric cases. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Analysis on 17 case-control and 6 cross-sectional studies (2929 fracture cases and 5000 controls) suggested that 25(OH)Vit-D was lower in fracture cases than in controls (pooled mean difference (MD) = - 3.51 nmol/L; 95% confidence interval (CI): - 5.60 to - 1.42) with a heterogeneity (I2) of 73.9%. The sensitivity analysis which merged the case-control studies that had a NOS score ≥ 4 showed a pooled MD of - 4.35 nmol/L (95% CI: - 6.64 to - 2.06) with a heterogeneity (I2) of 35.9%. Pooled odds ratio of fracture in subjects with 25(OH)Vit-D ≤ 50 nmol/L compared to subjects with 25(OH)Vit-D > 50 nmol/L was 1.29 (95% CI: 1.10 to 1.53; I2 < 1%). CONCLUSION: This study indicated that serum 25(OH)Vit-D levels were lower in pediatric patients with fractures. 25(OH)Vit-D ≤ 50 nmol/L was associated with increased fracture risk in children.

Kinesiology tape does not promote vertical jumping performance: A deceptive crossover trial.

BACKGROUND: Kinesiology tape (KINTAPE) is one of the most common adhesive therapeutic tapes. Apart from clinical applications, KINTAPE claims to be able to enhance functional performance by muscle activity facilitation. However, emerging evidence suggests that the isokinetic muscle strength remains similar when the placebo effect is eliminated. OBJECTIVES: In view of the weak relationship between functional performance and isokinetic muscle strength, this study investigated the true effects of KINTAPE on functional performance. DESIGN: Deceptive, randomized, and crossover trial. METHOD: Sixty four experienced volleyball players performed vertical jumping test under three taping conditions: true facilitative KINTAPE, sham KINTAPE, and no KINTAPE. Under the pretense of applying adhesive muscle sensors, KINTAPE was applied to their quadriceps and gastrocnemius in the first two conditions. Mean maximum jump height and peak jump power were averaged from three attempts. Within-subject comparisons were conducted by repeated measure ANOVA. RESULTS: Out of 64 participants, 30 of them were successfully deceived and they were ignorant about KINTAPE. No significant differences were found in both maximum jump height (η(2) = 0.001; p = 0.241) and peak jump power (η(2) = 0.001; p = 0.134) between three taping conditions. CONCLUSIONS: The results showed that KINTAPE did not facilitate muscle performance by generating higher jumping power or yielding a better jumping performance. These findings reinforce that previously reported muscle facilitatory effects or functional enhancement using KINTAPE may be attributed to placebo effects.