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Mesenchymal stem cells (MSCs) have shown chondroprotective effects in clinical models of osteoarthritis (OA). However, effects of MSC‐derived exosomes on OA remain unclear. The study aimed to investigate the therapeutic potential of exosomes from human bone marrow MSCs (BM‐MSCs) in alleviating OA. The anterior cruciate ligament transection (ACLT) and destabilization of the medial meniscus (DMM) surgery were performed on the knee joints of a rat OA model, followed by intra‐articular injection of BM‐MSCs or their exosomes. In addition, BM‐MSC‐derived exosomes were administrated to primary human chondrocytes to observe the functional and molecular alterations. Both of BM‐MSCs and BM‐MSC‐derived exosomes alleviated cartilage destruction and subchondral bone remodelling in OA rat model. Administration of BM‐MSCs and exosomes could reduce joint damage and restore the trabecular bone volume fraction, trabecular number and connectivity density of OA rats. In addition, in vitro assays showed that BM‐MSCs‐exosomes could maintain the chondrocyte phenotype by increasing collagen type II synthesis and inhibiting IL‐1β–induced senescence and apoptosis. Furthermore, exosomal lncRNA MEG‐3 also reduced the senescence and apoptosis of chondrocytes induced by IL‐1β, indicating that lncRNA MEG‐3 might partially account the anti‐OA effects of BM‐MSC exosomes. The exosomes from BM‐MSCs exerted beneficial therapeutic effects on OA by reducing the senescence and apoptosis of chondrocytes, suggesting that MSC‐derived exosomes might provide a candidate therapy for OA treatment.

AIM Sleep disturbances are common in primary Sjogren's syndrome (pSS) patients and may lead to disease aggravation and decreased health-related quality of life (HRQoL). There are currently no known reported studies related to the prevalence, correlates, and impact of sleep disturbance in pSS patients from China. Therefore, this study aims to assess the sleep quality in Chinese pSS patients and evaluate its relationship with the disease activity, quality of life and mood disorders. METHODS A self-report survey was administered to 221 pSS patients and 198 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Disease activity and damage were evaluated with the European League Against Rheumatism Sjogren's syndrome disease activity index (ESSDAI). Independent samples t tests, Chi-square analysis, logistic regression were used to analyze these data. RESULTS Our results found that the prevalence of poor sleep (PSQI ≥ 6) was 57.5% and the mean global score of PSQI was 6.57 (SD 3.19) in patients, which were significantly higher than the controls (32.3% and 4.93 [SD 2.86], respectively). When trying to fall asleep, patients with pSS had some sleep disturbances, reduced sleep efficiency, increased number of awakenings than controls. There were significant correlations among dryness, ocular surface disease, HRQoL, pain, disease activity, anxiety/depression and sleep quality in pSS patients. Meanwhile, logistic regression models identified depression and Short Form-36 mental composite score as predictors of poor sleep quality. CONCLUSIONS Sleep disturbances are commonly reported in pSS patients and sleep quality is lower in pSS patients than in healthy controls. The data suggested the need for holistic assessment and management of pSS patients.

Objective To evaluate the prevalence and severity of periodontal disease in Chinese rheumatoid arthritis patients. Subjects and methods This cross-sectional study included 128 RA and 109 healthy controls. Two dentists conducted periodontal status including Plaque index (PI), Gingival index (GI), pocket probing depths (PPDs), Clinical attachment level (CAL) and Bleeding on probing (BOP) independently. Sociodemographic, lifestyle, clinical parameters and use of medication were assessed. Data were analyzed by Student's t test, χ2 test, Wilcoxin-Mann- Whitney's test, Correlational Analysis, univariate or multivariate logistic regression. Results The periodontal status was significantly worse in RA, especially the condition of dental and gingival status. RA had 4.68-fold. After adjusted potential risk factors, RA had 10.26-fold. The independent variable related to GI was DAS28 (p = .05) negatively, to the contrary, ESR (p = .013) was positively associated; the independent variable positively and related to periodontitis was educational level (p = .021) and anti-CCP positivity (p = .002). Through multivariate logistic regression, age and swollen joint were the independent variable related to periodontitis of RA (OR 1.087, p = .044) and (OR 1.560, p = .008) respectively. Conclusions Chinese RA patients show higher odds of PD. It is important to take early interventions in combination with medical therapy.

Objective The purpose of this meta-analysis was to systematically review the literature to evaluate the impact of systemic sclerosis (SSc) on the health-related quality of life (HRQoL) assessed by the Medical Outcomes Short-Form-36 questionnaire (SF-36). Methods A systematic literature search was performed on PubMed, Web of Science and Embase until April 2017 to obtain eligible studies. Random effect model was performed to summarize the scores of each domain. Scores from the SF-36 questionnaire were used as the outcome measurements, and mean differences with 95% confidence intervals were calculated. Results In total, seven studies were eligible for inclusion criteria, comprising 795 SSc patients and 1154 healthy controls. The SF-36 questionnaire score of each domain (physical function, role physical function, emotional role function, vitality, mental health, social function, body pain, general health) was lower in SSc patients than in healthy controls, meanwhile, physical component scale (PCS) and mental component scale (MCS) scores were all lower in patients with SSc than in healthy controls. Likewise, pooled mean scores of PCS and MCS ranged from 31.20 to 52.80, 37.40 to 68.30, respectively. Additionally, the score of PCS was lower than that of MCS in SSc patients. Conclusions This meta-analysis showed that SSc patients had lower HRQoL than healthy controls, and SSc had negative influence on the HRQoL of patients. This indicates that clinical workers should pay more attention to SSc patients' HRQoL, so as to improve global health of patients with SSc.

UNLABELLED Recent studies showed that bone marrow mesenchymal stem cells (BM-MSCs) from nonobese diabetic (NOD) mice exhibited the phenomenon of apoptosis. However, the mechanisms of apoptosis remained largely unknown. In this study, endoplasmic reticulum (ER) stress and autophagy were evidenced in BM-MSCs from NOD mice for the first time. We found the ER stress-mediated apoptosis was supported by the up-regulation of ER stress markers including augmented phosphorylation of phosphorylated protein kinase RNA-like ER kinase and eukaryotic translation initiator factor 2α as well as cleavage of caspase-3. Evidence of autophagy included the formation of the acidic vesicular organelles and increase of LC3 accumulation. Intriguingly, blockage of ER stress could reduce the apoptosis of BM-MSCs from NOD mice and alleviated accumulation of LC3, which indicated that ER stress induced apoptosis and autophagy. Furthermore, our results showed that the mechanism of ER stress-induced autophagy was associated with the decrease of p-S6 (a marker of mTOR activity). Here, we demonstrated that ER stress-induced cell death was mediated by autophagy that was partly attributed to the inactivation of the mammalian target of rapamycin. SIGNIFICANCE PARAGRAPH We report for the first time that endoplasmic reticulum (ER) stress mediated apoptosis of bone marrow mesenchymal stem cells (BM-MSCs) from nonobese diabetic (NOD) mice. The evidence of autophagy was also found in BM-MSCs from NOD mice, included the formation of the acidic vesicular organelles and increase of LC3 accumulation. Furthermore, we demonstrated that ER stress-induced cell death was mediated by autophagy that was partly attributed to the inactivation of the mammalian target of rapamycin. Deciphering the mechanisms of ER stress signalling involved in the apoptosis of BM-MSCs from NOD mice will help improve transplantation efficacy of BM-MSCs in type 1 diabetes patients.

Recent studies showed that allogeneic bone marrow (BM)-mesenchymal stem cells transplantation (MSCT) was effective in systemic lupus erythematosus (SLE) patients and lupus-prone mice. However, syngeneic BM-MSCT was ineffective. Previous studies, including ours, revealed that BM-MSCs from SLE patients exhibited early signs of senescence and apoptosis such as slow proliferation, increasing senescence-associated β-galactosidase (SA-β-gal)-positive cells and Annexin V-positive cells, and caspase cascade activation. The abnormalities of BM-MSCs might be associated with the pathogenesis of SLE. In this study, we aimed to determine the molecular mechanism of senescent BM-MSCs from SLE patients. We found that the expression of protein 27 kinase inhibition protein 1(p27(kip1) ) increased significantly, which was regulated by phosphatase and tensin homology deleted on chromosome 10 (PTEN)/protein kinase B (Akt) signaling in SLE BM-MSCs. Knockdown of PTEN or p27(kip1) could reverse the senescent features of BM-MSCs via down-regulating p27(kip1) expression. When purified CD4(+) T cells were incubated with PTEN or p27(kip1) -silenced SLE BM-MSCs, the ratio of regulatory T (Treg)/T helper type 17 (Th17) cells increased significantly by enhancing regulatory cytokines (IL-10 and TGF-β) and reducing pro-inflammatory cytokines (IL-17 and IL-6). Taken together, we demonstrated that PTEN/Akt signaling played an essential role in the senescent and apoptotic BM-MSCs from SLE patients by up-regulating p27(kip1) expression.

Insulin-like growth factor 1 (IGF-1) is a multifunctional peptide that can enhance osteogenic differentiation of bone marrow mesenchymal stem cells (BMMSCs). However, it remains unclear whether IGF-1 can promote osteogenic differentiation of human dental pulp stem cells (DPSCs). In our study, DPSCs were isolated from the impacted third molars, and treated with IGF-1. Osteogenic differentiation abilities were investigated. We found that IGF-1 activated the mTOR signaling pathway during osteogenic differentiation of DPSCs. IGF-1 also increased the expression of runt-related transcription factor 2 (RUNX2), osteocalcin (OCN), osterix (OSX) and collagen type I (COL I) during this process. Rapamycin, an mTOR inhibitor, blocked osteogenic differentiation induced by IGF-1. Meanwhile, CCK-8 assay and flow cytometry results demonstrated that 10-200 ng/mL IGF-1 could enhance proliferation ability of DPSCs and 100 ng/mL was the optimal concentration. In summary, IGF-1 could promote proliferation and osteogenic differentiation of DPSCs via mTOR pathways, which might have clinical implications for osteoporosis.

Dental pulp stem cells (DPSCs) are a type of mesenchymal stem cells (MSCs) characterised by self-renewal and multi-lineage differentiation, including chondrocytes, adipocytes, neural cells and osteoblasts, which make it an attractive choice for tissue engineering purposes. Tumour necrosis factor α (TNF-α) had the positive effect on the mineralisation of bone marrow MSCs and stromal cells derived from human adipose tissue. However, the effect of TNF-α on DPSCs is unclear. We found that TNF-α activated the NF-κB pathway during the osteogenic differentiation of DPSCs. TNF-α also increased mineralisation and the expression of bone morphogenetic protein 2 (BMP2), alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2) and collagen type I (COL I) during this process. PDTC, an NF-κB inhibitor, blocked the osteogenic differentiation induced by TNF-α. No effect of TNF-α on proliferation of DPSCs or cell cycle was detected. In summary, TNF-α promotes mineralisation and mineralisation-related gene expression through the NF-κB signalling pathway in DPSCs, which may provide a foundation for autologous transplantation of DPSCs.

Background Ankylosing spondylitis (AS) is a painful inflammatory disease of the axial skeleton that can cause body image disturbance (BID) and may lead to psychological changes in AS patients. Objective This study investigated the effect of AS patient physical and psychological status on BID and quality of life (QOL). Methods Overall, 112 AS patients (84 males, 28 females; mean age, 32.8 ± 10.8) and 127 healthy age-matched individuals (control group; 78 males, 49 females; mean age, 36.9 ± 12.6) were screened for inclusion in the single-centre study. Multiple instruments assessing physical function, psychological function, body image, and QOL were applied. Multivariate stepwise regression analyses were used to determine factors associated with BID, anxiety, and depression. Results Of 103 AS patients and 121 control subjects, AS patients exhibited greater BID-associated social function, social life, and role function impairments (BID Questionnaire [BIDQ] 2.42 vs. 1.02; 2.20 vs. 1.19; 2.54 vs. 0.72, respectively), lower behavioural avoidance (BIDQ 3.07 vs. 3.49), and similar decreases in vitality and mental health (p

T1DM (type 1 diabetes mellitus) is an autoimmune disease characterized by T-cell-mediated damage of islet β-cells. The pathology of NOD (non-obese diabetic) mouse involves the insulitis induced by infiltration of T-cells, a similar pathogenic mechanism in T1DM patient. BM-MSCs (bone marrow mesenchymal stem cells) are multipotent progenitor cells that can be isolated from a number of sources. Recent studies have shown that transplantation of MSCs to the NOD mice could prevent the process and have the therapeutic effects on T1DM. In our studies, we have found that migration and adhesion of BM-MSCs from NOD mice were suppressed compared with the BM-MSCs from ICR (imprinting control region) mice, accompanying with the abnormal distribution of FAK (focal adhesion kinase) and F-actin (filamentous actin). Further, we have found that the activation of PI3K (phosphoinositide 3-kinase)-Akt pathway was suppressed in BM-MSCs from NOD mice. When the PI3K-Akt pathway was inhibited by LY294002, the adhesion and migration of BM-MSCs from ICR mice were suppressed as well. These results indicated that the suppression of PI3K-Akt pathway is involved in the decreased adhesion and migration of BM-MSCs from NOD mice.