Joseph A. Buckwalter

J. F. Stoltz

Martin K. Lotz

"Osteoarthritis is a major public health issue due to its impact in term of handicap. Moreover, Ageing of the world population and outbreak of obesity in industrialized and non-industrialized countries will dramatically increase its incidence in the next years. Regarded as a multi-factorial disease, today mechanistic and inflammatory theories are no more opposed but, on the contrary, are framed within the same continuum: osteoarthritis, inflammation and degeneration. In order to collect major information in a benchmark book on the fundamental aspects of this disease, internationally well-known authors, from multiple specialties, gathered to analyse, dissect and finally try to understand the secrets of a disease which should no more be regarded as the common and relentless result of ageing or of passive wear but much more as an active disease able to benefit from the best targeted pharmacological (anti-cytokines, inhibitors of signalling pathways, inhibitors of proteases, etc.) and non-pharmacological (cellular therapy, gene therapy, cartilage engineering etc.) therapies, current and future."

A Continuum

Osteoarthritis, Inflammation and Degradation

Mechanobiology is now a vigorous branch of biomechanics and biorheology which is mainly concerned with the study of the influence of mechanical forces on cells and tissues and their clinical or therapeutical applications. As we are now at the age of proteomics and genomics and of cell micromechanical approaches, using methods like laser tweezers or confocal microscopy, mechanobiology brings new challenges. With these new researches, mechanobiology is the promise of new diagnostic and therapeutic approaches. The most recent work shows that the incidence of mechanical forces is specific to the system under scrutiny and that stresses are implicated in tissue physiology (for example by the production of the extracellular matrix), secretions (i.e. production of NO and prostaglandins by endothelial cells), or for the induction of specific functions via intercellular communication; hence the interest from pharmacology in studies on new molecules. Moreover, these new findings have led to the development of tissue engineering, which is the concept of substitute tissue developed in vitro, from bioresorbable or non-bioresorbable scaffolds and from cells harvested in a physiologic mechanical environment such as from cartilage, bone and vessels. At the same time, the problem of cell grafting in tissue repair and especially the use of stem cells have led to new therapeutic fields.

Cartilage and Chondrocyte

Mechanobiology

"Over recent years, there has been increasing interest in the fundamental role played by local mechanical parameters in chondrocyte regulation and cartilage dysfunction as a first step in the development of osteoarthritis. This is how the idea of mechanobiology and the concept of mechanotransduction were born in the 90s. Indeed, a broad diversity of physiological phenomena is induced by mechanical stimuli (hearing, orientation to gravity, touch, tissue remodelling...) but the mechanism by which mechanical forces may regulate a physiological response is still unknown. In other respects, the concept of regenerative medicine has recently developed in parallel to this. Regenerative medicine is an emerging multidisciplinary field involving medicine, biology, chemistry, mechanics and engineering that is likely to revolutionize the ways we improve the health and quality of life by restoring, maintaining or enhancing tissue and organ functions. Indeed, human tissues do not regenerate spontaneously and healing is only a stopgap that may be associated with contraction which in turn may prevent regeneration. Tissue engineering through the in vitro preparation of biotissues presents an interesting alternative. Today, the in vitro preparation of biological tissues such as cartilage, bone, tendon, vessel, heart muscle, skin, brings out major expectations for the next decade. However, to each type of tissue correspond a large number of potential methods related to the support, the cells used (tissular cells or stem cells) and to the conditions of the environment (culture medium and mechanical forces). The aim of this publication is to provide a thoughtful and balanced dissertation on new crucial concepts with clinical implications."

This book covers the proceedings of the Fifth Symposium on Mechanobiology of Cartilage and Chondrocyte. Mechanobiology can be now considered as a vigorous branch of biomechanics, biorheology and physiology mainly concerned with the study of the influence of mechanical forces on cells and tissues and their clinical or therapeutical applications. As we are now in the age of proteomics, genomics and cell micro mechanical approaches, suing methods like laser tweezers or confocal microscopy, mechanobiology brings new challenges. With such new research, mechanobiology promises new diagnostic and therapeutic approaches. In other respect there has been increasing interest over recent years in the fundamental role played by local mechanical parameters in chondrocyte regulations and cartilage dysfunctions as a first step in the development of osteoarthritis. These proceedings are sub-divided into four parts: Theoretical approaches and mechanobiology of chondrocyte; Cartilage and chondrocyte studies; Osteoarthritis: inflammation degradation and clinical approaches; and, Cartilage engineering

Claude Rivat

There are today five major proteins in plasma fractioning. In the near future, other fractions could also be used as therapeutic agents. But perhaps they could be used for alternative, non-therapeutic applications? For example, producing human culture media with specific ingredients for biotechnology research might also be of use. Whatever the future may hold, there is one essential question: in today's world of cellular and genetic engineering, are extracted therapeutic proteins still of any relevance? For a clear and up-to-date view of recent developments in blood-protein-separation technology, this book will prove an invaluable resource.

J. F. Stoltz

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