Osteoarthritis (OA) is a chronic joint disease characterized by irreversible cartilage degradation. MMP (matrix metalloproteinase) inhibitors represent a new approach to slowing OA progression by addressing cartilage degradation mechanisms. However, the success of preclinical studies failed to be translated into clinical application. One of the possible reasons is that the disease models in preclinical study can't reflect the biological complexity of human disease. Hydrogel-based cartilage constructs as in vitro models have shown promise as preclinical testing platforms due to their enhanced physiological relevance, improved prediction to human response, high-throughput drug screening, and ease of use. Metalloproteinase-13 (MMP-13) is thought to be a major contributor to the degradation of articular cartilage in OA by aggressively breaking down type II collagen. This study focused on testing MMP-13 inhibitors using a GelMA-alginate hydrogel-based OA model induced by cytokines interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α). The results demonstrated a significant inhibition of type II collagen breakdown by measuring C2C concentration using ELISA after treatment with MMP-13 inhibitors. Therefore, the study highlights the GelMA-alginate hydrogel-based OA model as an alternative to human-sourced cartilage explants for in vitro drug screening, which can improve the predictability and relevance of preclinical evaluations of MMP-13 inhibitors for osteoarthritis, thereby complementing existing 2D culture, cartilage explant, and animal model studies and addressing the translational gap observed in clinical trials.

Articular cartilage is a material with the appearance of simplicity and uniformity, but the chemical and biological structure of this material is very complex and not yet known in every detail. Our knowledge of cartilage wear behavior is limited and needs to be enlarged. Knowledge in this area could be important for the prevention and treatment of degenerative joint diseases. Within the framework of this thesis. a literature search focused on the key words joint lubrication and cartilage wear was conducted. The result of this search was that almost all studies and experiments which have been carried out to investigate tribilogical processes in synovial joints focused on friction behavior. Only a few tests dealing with cartilage wear were conducted. Most of the cartilage wear studies were carried out under exaggerated conditions which might change the wear mechanisms. Two studies were undertaken under conditions close to normal conditions occurring in natural joints; one in entire joints with a pendulum device, the other one with a cartilage-on-cartilage test system. The test devices used in these tests offered no or limited opportunities for the variation of the test parameters. Test parameters are, for example, the type of motion, applied load, velocity, variation of the velocity during each cycle, type of specimen, and test fluid composition. In consideration of the findings of the literature search, it was decided to design a new test device providing the capability of measuring friction, wear, and displacement due to wear and/or cartilage deformation. Furthermore, the new test device for cartilage wear studies, allows the variation of the above mentioned test parameters. / Master of Science

Young patients diagnosed with post-traumatic osteoarthritis (PTOA) face significant hurdles to restoring pain-free joint function. While surgical interventions exist for replacing damaged cartilage, few are able to offer complete replacement of the articular surface with a bearing material that maintains the longevity and mechanical properties of native articular cartilage necessary to prevent the need for costly and painful revision procedures. Osteochondral allograft technology has begun to address this need by allowing surgeons to resurface constrained small to medium articular defects with live tissue-bank-sourced cartilage tissue explants. A primary limitation surgeons face when choosing osteochondral allotransplantation to treat large articular surface deficits is the scarcity of high-quality live explant tissue with sufficient congruence to fully restore the biomechanical function in the affected joint. This dissertation asserts that augmentation of native tissues donated to tissue banks is a promising strategy for providing more physiologically appropriate tissue replacements for patients with PTOA, providing significant symptomatic relief and allowing young patients to delay or prevent invasive total joint arthroplasty treatments.This dissertation aims to improve treatment modalities for this patient population by developing a surgical technique that enables adaptive reshaping of the articular surface of donor osteochondral tissue explants. The driving hypothesis of this dissertation is that osteochondral allografts that conform better to the opposing articular surface result in better clinical outcomes than those with lesser congruence with the native joint. The corollary hypothesis is that better conformity may be achieved by providing some measure of bending flexibility to the allograft, using streamlined tissue processing procedures to cut grooves in the bony substrate. To address these needs, we first developed, implemented, and validated the technology for milling grooves on the back of large human and canine osteochondral allografts. This resulted in the development of a process for milling grooves in patellar osteochondral samples using a computer-numerically controlled 3-axis milling machine. Sample-specific spatial information was captured within machining fixtures to generate machining paths. The curvature of human and canine osteochondral allografts was captured using a laser scanning system to fit B-Spline surfaces and generate articular curvature maps for the modified allografts. We hypothesize that due to the surface modification enabled by the bending method, bendable osteochondral allografts may provide better curvature matching for patella transplants in the patellofemoral joint. We used a cadaveric knee joint model to investigate patellofemoral joint congruence for unbent and bendable osteochondral allografts at various flexion angles. Shell and bendable allografts were machined from donor human patellae and inserted into the patellofemoral joint space of five knee joints, creating 25 femur-patella osteochondral allograft pairings. Patellofemoral joints with either shell or bendable allografts were loaded at 15-degree increments from 15 to 90 degrees flexion, and the resultant patellofemoral joint contact area was measured and compared against the native patellofemoral contact areas. On average, no significant difference in contact area was found between native patellofemoral joints and OCAs or BOCAs, indicating that both types of allografts restored native congruence. This result aligned with prior computational models of the behavior of bendable and shell allografts in the patellofemoral joint. This finding suggests that future investigations of the benefits of BOCA for allografting other joints could be initiated using computational methods, as the results of the current study suggest that the computational predictions may remain valid under the right set of conditions. Clinical studies of outcomes of osteochondral tissue transplantation indicate that maintenance of donor chondrocyte viability is crucial for the long-term success of the transplanted tissue. In order to assure that CNC machined allografts maintained appropriate chondrocyte viability and tissue sterility, we created a sterile environment for CNC milling of fresh canine patellar osteochondral allografts and quantified allograft chondrocyte viability for up to two weeks post-milling. Following machining and extended culture, bending of the allografts produced neither fracture of the samples nor resulted in loss of chondrocyte viability when compared to non-grooved controls. Therefore, these results provide basic scientific support for the clinical use of bendable osteochondral allografts. Having developed a method of bendable allografts and verifying the tissue viability and sterility, in addition to simulating joint contact in the cadaveric model, we ran a study to assess the performance of bendable osteochondral allografts and shell allografts in the contralateral stifle joints of purpose-bred dogs. This animal model was used to measure the clinical outcomes of bendable osteochondral allografts transplantation following in-vivo loading. Functional clinical outcomes were collected, including force mat kinematics, lameness scoring, range of motion, and pain scoring. At the termination of the study, allograft tissue and synovial fluid from the joint were recovered to assess the sterility, chondrocyte viability, chondrocyte morphology, and bony integration of the allograft. The allografts showed no signs of infection or rejection, and the CNC-machined shell allografts performed well in the joint. Unfortunately, the grooves machined for the bendable allograft patellae were more appropriate in width for the human patella. The removal of excess bony tissue destabilized the bendable allografts and led to fractures and fissures in the tissue. Based on the fissuring and fragmentation mode of failure noted in the canine BOCAs, the size and number of the machined grooves must be optimized for preclinical testing so the potential advantages of bendable OCAs can be realized without compromising their integrity and osteointegration during healing. Bulk mechanical properties and failure thresholds dependent on the width of allograft grooves must be established to reduce the risk of post-transplantation failure. Ongoing work aims to establish safe geometrically-based machining criteria and determine load-to-failure thresholds for osteochondral allografts to improve tissue integrity and functional viability post-transplantation. This aim will be addressed by loading canine bendable allografts with variable groove widths to assess the threshold for mechanical failure against simulated femoral trochlea. The aim of this study is to define allograft bulk mechanical properties and failure thresholds for producing bendable osteochondral allografts. The final chapter of this dissertation aims to assess the impact of sustained mechanical loading on the fluid exchange between the interfibrillar and extrafibrillar space in native articular cartilage, as the fluid load support in articular cartilage is crucial to the maintenance of the low coefficient of friction within the tissue. In our study, we developed a technique to measure water extruded from the interfibrillar space in articular cartilage by applying static compression to unconfined tissue. Preliminary results indicate that the loading and pressurization of the articular tissue can potentially make previously trapped interfibrillar water content more accessible

Après une perte importante d’un tissu cartilagineux, plusieurs possibilités s’offrent aux chirurgiens pour remplacer cette perte tissulaire. Parmi, cela nous trouvons, les greffes autologues ou allogéniques et l’utilisation de polymères biocompatibles. Sans oublier que jusqu’aujourd’hui, les propriétés et la structure du cartilage natif n’ont pas été entièrement imitées par l’ingénierie tissulaire. Étant donné les limitations des méthodes actuelles, telles que : la pénurie des donneurs, l’immunogénicité des greffons allogéniques, et le manque d’intégration des polymères l’ingénierie tissulaire du cartilage pourrait constituer une excellente alternative aux méthodes actuelles. Nos objectifs pour cette thèse sont (i) de produire une matrice composite constituée de polymères naturels; (ii) d’évaluer les propriétés physicochimiques de ces matrices composites, et (iii) d’évaluer les propriétés biologiques de ces matrices pour la production de tissu cartilagineux. Nous avons réalisé qu’une combinaison des deux biopolymères, le collagène et le chitosane, nous a permis d’obtenir une matrice avec des propriétés mécaniques et biologiques renforcées en comparaison à une matrice de collagène seul. La caractérisation physicochimique de nos matrices nous a permis de mieux comprendre les types de réactions chimiques produites entre les deux polymères et les différents autres constituants de la matrice utilisés pour des fins mécaniques, tel que le glutaraldéhyde, et pour des fins biologique, s tels que l’acide glutamique et la glycine. En second lieu, nos résultats portant sur la caractérisation biologique nous ont permis de confirmer que nos matrices composites produites, ensemencées de chondrocytes, favorisent l’adhésion et la prolifération de ces cellules. Nos résultats démontrent de façon tangible l’efficacité d’une combinaison entre le collagène et le chitosane pour la régénération in vitro de tissus cartilagineux. Ces résultats devront être confirmés in vivo en utilisant un modèle animal afin de confirmer la pertinence des membranes composite à base de collagène et de chitosane pour des applications biomédicales, dont le remplacement du cartilage endommagé. / Given the large number of patients suffering from cartilage damage, with different degrees of severity affecting all ages, a wide range of approaches has been designed. These include autologous or allogeneic grafts, the implementation of polymers, etc. However, each of these cartilage replacement do have significant limitations, such as the scarcity of donors, the risk of infection and disease transmission, the immunogenicity of the polymer implants and their reduced integration with native tissue. To overcome these limitations, tissue engineering cartilage could be an excellent alternative. The objectives of our studies are (i) to produce a natural composite matrix containing collagen and chitosan, (ii) evaluate the physicochemical properties of these composite matrices, and (iii) investigate the biological properties of these matrices for the production of cartilage tissue. Our structural and ultrastructural analyses demonstrated that collagen porous membrane can be coated with chitosan at different concentration leading to the formation of a natural composite matrix. The physicochemical characterization confirmed the chitosan interaction with collagen leading to a mechanically stable matrix that can easily be handled. It is also important to mention that the use of cross-linker such as glutaraldehyde improved the mechanical properties of the composite matrix. These designed composite matrixes were biocompatible allowing cell adhesion and growth. These biological activities were improved when composite matrix was pre-treated with glutamic acid and glycine. Such matrix offered appropriate condition allowing the adhesion and growth of chondrocytes. Overall, we were able to design a composite matrix by combining collagen membrane and chitosan solutions. Although very interesting, our in vitro data should be confirmed by in vivo studies using an animal model, prior to clinical applications.

Le phénotype des chondrocytes peut être modulé par des facteurs de croissance comme par des contraintes mécaniques. Nous avons caractérisé le potentiel chondrogénique de la "Bone Morphogenetic Protein" (BMP)-2 sur des chondrocytes murins primaires amplifiés en culture monocouche sur plastique. Nous avons aussi développé un nouveau modèle d’étude de la mécanotransduction par la compression dynamique de ces cellules incluses en hydrogel d’agarose. Nous avons ainsi confirmé l’implication des voies ERK1/2 et p38 dans ces mécanismes, révélé l’activation de Smad2/3 en réponse à la compression et identifié de nouveaux gènes mécano-sensibles. Par ailleurs, nous avons mis en évidence le rôle des intégrines-bêta-1 dans la rigidité du tissu cartilagineux. Nos résultats complètent la connaissance fondamentale des mécanismes de régulation du phénotype chondrocytaire, mais peuvent également contribuer à l'amélioration des techniques de reconstruction du cartilage dans le domaine de l'ingénierie tissulaire. / Chondrocytes phenotype can be modulated by growth factors as well as mechanical stress. We characterised Bone Morphogenetic Protein (BMP)-2 chondrogenic potential on mouse primary chondrocytes expanded in monolayer on culture plastic. Also, we developed a new model to investigate mechanotransduction by applying dynamic compression on these cells embedded in agarose hydrogel. Hence, we confirmed ERK1/2 and p38 pathways implication in such mechanisms, we revealed Smad2/3 activation in response to compression and we identified new mechanosensitive genes. Besides, we highlighted the role of beta-1-integrins in cartilage stiffness. Our results completed the basic knowledge of regulation mechanisms underlying chondrocytes phenotype, but could also contribute to improve techniques for cartilage reconstruction in the field of tissue engineering.

Ce travail s’inscrit dans le contexte général de l’ingénierie tissulaire du cartilage (culture in vitro) bien que la physique employée puisse s’appliquer à d’autres domaines. Après un rappel du modèle macroscopique de dispersion réactive obtenu en employant la prise de moyenne volumique, les problèmes de fermeture sont résolus numériquement afin de déterminer la macro-dispersion. Les solutions numériques sont tout d’abord validées dans des cas sans advection et/ou sans réaction. L’étude de la dispersion passive (sans réaction) sur des micro-géométries simples illustre la dépendance des coefficients de dispersion macroscopiques vis-à-vis de la géométrie (porosité, croissance directionnelle ou homothétique). Enfin, la simulation du cas complet (incluant la réaction) nous a permis de montrer l’influence de plusieurs paramètres : nombre cinétique, nombre de Sherwood, structure géométrique microscopique. / Abstract

Différentes techniques d'imagerie par contraste de phase des rayons X ont été récemment développées. Contrairement aux méthodes conventionnelles, qui mesurent les propriétés d'absorption des tissus, ces techniques donnent aussi le contraste du déphasage introduit par l'échantillon. Puisque le changement dans la phase peut être important même quand les différences en atténuation sont faibles ou absentes, le contraste d'image obtenable peut être considérablement augmenté, notamment pour les tissus mous biologiques. Ces méthodes sont donc très prometteuses pour une application dans le domaine médical. Cette Thèse a le but de contribuer à une compréhension plus profonde de ces techniques, en particulier la propagation-based imaging (PBI), la analyzer-based imaging (ABI) et la grating interferometry (GIFM), et d'étudier leur potentiel et la meilleure implémentation pratique pour les applications médicales. Une partie importante de cette Thèse est dédiée à l'utilisation d'algorithmes mathématiques pour l'extraction, à partir des images acquises, d'informations quantitatives (absorption, réfraction et diffusion) concernant l'échantillon. En particulier, cinq parmi les algorithmes les plus connus pour la technique ABI sont analysés théoriquement et comparés expérimentalement, dans les modalités planaire et tomographique, en utilisant des fantômes et des échantillons de tissu mammaire et d'os-cartilage. Une méthode semi-quantitative pour l'acquisition et la reconstruction d'images tomographiques dans les techniques ABI et GIFM est aussi proposée. Les conditions de validité sont analysées en détail et la méthode, permettant une simplification considérable de l'implémentation pratique, est vérifiée expérimentalement sur des fantômes et des échantillons humains. Enfin, une comparaison théorique et expérimentale des techniques PBI, ABI et GIFM est présentée. Les avantages et les désavantages de chacune des techniques sont mis en évidence. Les résultats obtenus par cette analyse peuvent être très utiles pour déterminer quelle technique est la plus adaptée à une application donnée. / Several X-ray phase-contrast techniques have recently been developed. Unlike conventional X-ray methods, which measure the absorption properties of the tissues, these techniques derive contrast also from the modulation of the phase produced by the sample. Since the phase shift can be significant even for small details characterized by weak or absent absorption, the achievable image contrast can be greatly increased, notably for the soft biological tissues. These methods are therefore very promising for applications in the medical domain. The aim of this Thesis is to contribute to a deeper understanding of these techniques, in particular propagation-based imaging (PBI), analyzer-based imaging (ABI) and grating interferometry (GIFM), and to study their potential and the best practical implementation for medical imaging applications. An important part of this Thesis is dedicated to the use of mathematical algorithms for the extraction, from the acquired images, of quantitative sample information (the absorption, refraction and scattering sample properties). In particular, five among the most known algorithms based on the geometrical optics approximation have been theoretically analysed and experimentally compared, in planar and tomographic modalities, by using geometrical phantoms and human bone-cartilage and breast samples. A semi-quantitative method for the acquisition and reconstruction of tomographic images in the ABI and GIFM techniques has also been proposed. The validity conditions are analyzed in detail and the method, enabling a considerable simplification of the imaging procedure, is experimentally verified on phantoms and human samples. Finally, a theoretical and experimental comparison of the PBI, ABI and GIFM techniques is presented. The advantages and drawbacks of each of these techniques are discussed. The results obtained from this analysis can be very useful for determining the most adapted technique for a given application.

L'arthrose est caractérisée par une dégénérescence progressive du cartilage articulaire. Elle est caractérisée par l'augmentation des cytokines pro-inflammatoires en particulier l'interleukine-1ß (IL-1ß) qui inhibe la synthèse des protéoglycanes (PGs) et augmente leur dégradation conduisant à l'érosion du cartilage. Cependant, les mécanismes moléculaires de cette inhibition ne sont pas encore élucidés. Nous avons étudié l'effet de l'IL-1ß sur l'expression du gène de la xylosyltransférase I (XT-I), enzyme qui joue un rôle essentiel dans la régulation de la synthèse des PGs au niveau du cartilage. Nous avons montré que l'IL-1ß est capable de réguler l'expression de la XT-I en deux phases : une phase précoce d'induction et une phase tardive d'inhibition. L'étude de la régulation du promoteur du gène humain de la XT-I par l'IL-1ß a permis de montrer que la phase précoce d'induction est médiée par le facteur AP-1 alors que la phase d'inhibition implique le facteur de transcription Sp3. Nous avons également étudié les mécanismes moléculaires impliqués dans l'inhibition de l'anabolisme des PGs et de l'induction de la dédifférenciation chondrocytaire par Wnt3a. Nous avons montré que Wnt-3a inhibe l'expression du PG, syndécan 4 dans le cartilage et dans les chondrocytes humain en culture via la voie de signalisation non canonique, ERK1/2. Nous avons montré que l'inhibition de l'expression du collagène II par Wnt-3a est médiée par le syndécan 4 et que ce dernier est essentiel à l'activation des voies non canoniques par Wnt-3a probablement via une interaction avec la protéine régulatrice Dishevelled. Enfin, nous avons montré que les effets délétères de l'IL-1ß sur les PGs et le collagène II sont atténués par Wnt-3a en inhibant l'expression de l'ADMTS4 et de la MMP13 / Osteoarthritis is characterized by progressive degeneration of articular cartilage. It is characterized by the increase in pro-inflammatory cytokines, in particular interleukin 1ß (IL- 1ß ) which inhibits the synthesis of proteoglycans (PGs ) and increases their degradation leading to erosion of cartilage. However, the molecular mechanism of this inhibition is not yet elucidated. We studied the effect of IL-1ß on gene expression of the xylosyltransferase I ( XT- I), an enzyme which plays an essential role in regulating the synthesis of PGs in the cartilage. We showed that IL-1ß regulates the expression of the XT-I gene into two phases: an early phase of induction and a late phase of inhibition. The study of the regulation of the promoter of the human XT-I gene showed that the early induction phase by IL-1ß is mediated by AP-1 while the late inhibition phase involves the Sp3 transcription factor. We also investigated the molecular mechanisms involved in the inhibition of PG anabolism and induction of chondrocyte dedifferentiation by Wnt-3a. We showed that Wnt-3a inhibits expression of the PG syndecan 4 in human cartilage and in cultured chondrocytes via the non-canonical signaling pathway involving the kinase ERK1/2. We also showed that inhibition of the expression of collagen II by Wnt-3a is mediated by syndecan 4, probably via interaction with a regulatory protein Dishevelled and that syndecan 4 is essential for non-canonical Wnt pathway signaling. Finally, we demonstrated that the deleterious effects of IL-1ß on PGs and collagen II are reduced by Wnt-3a by inhibiting the expression of ADMTS4 and MMP13

Cartilage est un tissu unique, caractérisé par la matrice extracellulaire abondante et un seul type de cellule, le chondrocytes. Les modifications du phénotype chondrocytes, tels que la prolifération et de l'hypertrophie, sont des événements physiologiques survenant au cours du développement squelettique et cartilage articulaire adulte. Dans la plaque de croissance, la division active et l'expansion des chondrocytes est le mécanisme principal lors du processus de l’ossification endochondrale. Les chondrocytes jouent un rôle essentiel dans ce processus. Le comportement et les caractéristiques cellulaires des chondrocytes de la plaque de croissance sont régulées à tous les stades de l'ossification endochondrale par un réseau complexe d'interactions entre les hormones circulantes, les facteurs de croissance produits localement et la matrice extracellulaire sécrétée par les chondrocytes. Dans le cartilage articulaire, les chondrocytes forment des régions morphologiquement distinctes et maintiennent l'équilibre entre production et dégradation des composants de la matrice extracellulaire. Cependant, l'altération pathologique du phénotype des chondrocytes pourrait entraîner de nombreuses maladies squelettiques et articulaires humaines, y compris les chondrodysplasies et l'arthrose. Dans ce contexte, mon projet de doctorat a été conçu pour étudier I) les modifications des phénotypes chondrocytaires déclenchés par les déterminants génétiques et le stress métabolique et par conséquent II) la participation des deux conditions pathologiques au développement de la maladie et/ou à la progression / Cartilage is a unique tissue characterized by abundant extracellular matrix and a single cell type, the chondrocyte. Modifications of chondrocyte phenotype, such as proliferation and hypertrophy, are physiological events occuring during skeletal development and in adult articular cartilage. In growth plate cartilage, the active division and expansion of chondrocytes is the primary mechanism during the process of endochondral bone formation. Chondrocytes play a central role in this process, through a combination of proliferation, extracellular matrix secretion and hypertrophy. The behaviour and cellular features of growth plate chondrocytes are regulated at all stages of endochondral ossification by a complex network of interactions between circulating hormones, locally produced growth factors and the extracellular matrix secreted by the chondrocytes. In articular cartilage, the chondrocytes form morphologically distinct regions, including a superficial region of flattened cells, a sparsely populated middle layer, and a deep zone of hypertrophic chondrocytes. In mature articular cartilage, these chondrocytes maintain the balance of production and degradation of extracellular matrix components. However, pathological alteration of chondrocyte phenotype could lead to numerous human skeletal and articular diseases, including chondrodysplasias and osteoarthritis. In this context, my PhD project was designed to study I) the modifications of chondrocyte phenotypes triggered by genetic determinants and metabolic stress and consequently II) the participation of both pathologic conditions to disease development and/or progression

Background: The impairment of articular cartilage caused by trauma or degenerative pathology is one of the most challenging issues in clinical Orthopedics because of the limited intrinsic regenerative capability of this tissue. Hypoxia is a major stimulus to initiate gene programs in regulating chondrogenic lineage cell functions during cartilage development and regeneration. Hypoxia-inducible factor-1α (HIF-1α), the key transcription factor to sense oxygen fluctuations of cells, is abundantly expressed in the cartilage and considered as a potential therapeutic target for cartilage tissue homeostasis or repair. However, the molecular mechanisms and therapeutic efficacy of targeting the HIF-1α pathway remain to be well defined. / Methods: Osteochondral defect mouse model was generated to examine the hypoxia states during articular cartilage repair with the Hypoxyprobe. Specific HIF-1α deletion in the repairing tissue was established to determine its regulatory role during cartilage restoration. Deferoxamine (DFO), stabilizing HIF-1α from proteolysis by inhibiting the prolyl hydroxylases (PHDs), was investigated systemically on the function of chondroprogenitors and mesenchymal stem cells (MSCs) in vitro. Alcian blue staining determined the proteoglycan synthesis. HIF components, chondrogenic related genes and proteins were examined by quantitative PCR, western blotting and immunohistochemistry, respectively. The proliferation, differentiation and migration assays were performed to determine the influence of DFO onchondroprogenitors and MSCs. The recruitment or engraftment of MSCs in the injured site was traced by transplantation of GFP-labeled MSCs adjacent to the defect region, and examined by immunofluorescence staining. DFO incorporated in a 3D alginate-gelfoam scaffold was analyzed for its therapeutic effects on the articular cartilage regeneration. At 6 and 12 weeks following surgery, the cartilage tissue repair was scored and the expression of proliferating cell nuclear antigen (PCNA), Sox9 and collagen typeⅡ(Col2) was examined by immunohistochemistry. / Results: Hypoxia states and the expression of HIF-1α in the repair tissue were ubiquitously existed in the osteochondral defect model. DFO significantly upregulated HIF-1α expression and nuclear localization, and increased the levels of PHDs. DFO increased chondroprogenitor cell proliferation as visualized by colony forming unit assay, which was in accord with the upregulation of cyclin D1. DFO significantly induced chondrogenic differentiation indexed by increased Col2 and Sox9 protein expression and elevated proteoglycan synthesis. With sustained upregulation of HIF-1α DFO was supposed to effectively promote chondrogenesis in mimic of hypoxic microenvironment. DFO also increased the migration of MSCs, and elevated the expression of tissue inhibitor metalloproteinase-3 (TIMP3) through transcriptional control by HIF-1α. Furthermore, DFO initiated MSCs membrane protrusion through regulating the expression and interaction of the key focal adhesion proteins vinculin and paxillin. In vivo study showed that DFO dramatically facilitated the recruitment and functional engraftment of MSCs to the lesion site compared with the controls. Alginate-gelfoam scaffold incorporated with DFO enhanced articular cartilage repair through increasing chondrogenic cell proliferation, differentiation and proteoglycan synthesis. The enhanced therapeutic effect of DFO on articular cartilage repair was eliminated following HIF-1α deletion in the repairing cells of the cartilage lesion. The results indicate that the positive effect of DFO on articular cartilage repair is at least partially mediated by HIF-1α. / Conclusion: HIF-1α is an essential mediator during articular cartilage repair. Activation of HIF-1α by PHD inhibitor DFO increases chondroprogenitor cell proliferation, differentiation and migration in vitro. DFO enhances articular cartilage repair through coordinating MSCs migration, chondrogenic differentiation and functional engraftment. The results provide proof of principle that targeting the HIF-1α pathway may serve as a novel approach for promoting articular cartilage regeneration. / 背景：关节软骨自愈能力非常有限，由创伤或退行性病变引起关节软骨损伤的治疗是骨科领域的一大难题。在软骨发育和再生过程中，低氧条件对启动基因表达及调控软骨系细胞功能至关重要。低氧诱导因子-1α（HIF-1α）作为关键的转录因子可感应细胞外氧含量变化，广泛存在于软骨组织中，并被认为对维持软骨组织内稳态及促进软骨修复有重要作用。然而，以HIF-1α 通路为靶点的小分子靶向药物的分子机制与治疗效果尚不明确。 / 方法：本课题系统性地研究了HIF 信号通路激活剂去铁胺（DFO）对软骨损伤的作用。我们构建了骨软骨缺损模型，应用缺氧探针检测了软骨缺损过程中修复组织的低氧状态，并特异性敲除软骨修复组织中HIF-1α 表达，研究其在软骨再生过程中的调节作用。我们用阿利新蓝染色检测软骨细胞蛋白多糖的合成及分泌。通过实时荧光定量聚合酶链式反应，免疫印迹以及免疫组化等方法检测了HIF 家族成员和软骨分化标志物的基因和蛋白含量变化。通过增殖及迁移实验检测了DFO 对软骨细胞或者骨髓间充质干细胞（MSC）功能的影响。另外，我们还将GFP 标记的MSC 注射到与小鼠软骨缺损区域相邻的软骨下骨中，观察其在软骨缺损模型中的募集及功能性植入。我们以藻酸盐和明胶海绵复合物为给药系统，包载DFO 并作用于关节软骨缺损部位。术后6 周及12 周取材，以番红O 染色检测DFO 对小鼠关节软骨缺损的修复效果，并通过免疫组化检测增殖细胞核抗原（PCNA），Sox9 以及Col2 等蛋白的表达。 / 结果：低氧状态和HIF-1α 在骨软骨缺损模型中的软骨缺损区域广泛存在和表达。DFO 显著提高了HIF-1α 蛋白表达及转运入核，增加了脯氨酸羟化酶（PHD）表达。在软骨祖细胞中，DFO 可提高其增殖、克隆能力，并增加周期蛋白D1的表达。同时，DFO 能明显促进软骨祖细胞分化，增加软骨分化标志物基因以及Sox9 和Col2 蛋白表达，提高蛋白多糖分泌。通过持续性激活HIF-1α，DFO可模仿低氧微环境来提高软骨细胞增殖、分化能力。分子机制研究发现，DFO激活HIF-1α 后，HIF-1α 作用在靶基因金属蛋白酶组织抑制剂-3 启动子上，增加其转录和蛋白表达，进而提高MSC 的迁移能力。另外，激活HIF-1α 蛋白可增加黏着斑蛋白，桩蛋白表达以及它们的相互作用，促进MSC 伪足延伸。体内实验中，通过追踪小鼠体内GFP 标记的MSC 发现， DFO 可在软骨损伤早期（7 天及14 天）提高受损部位MSC 募集数量，并促进其向软骨细胞谱系分化。通过增加软骨系细胞增殖、分化、蛋白多糖合成，包载DFO 的藻酸盐明胶海绵给药系统显著提高了软骨缺损组织的修复效果。而在软骨修复组织中特异性敲除HIF-1α 蛋白后，明显降低了DFO 对软骨缺损的治疗效果，提示DFO对软骨修复的作用至少部分由HIF-1α 介导。 / 结论：HIF-1α 是关节软骨修复过程中的重要调控因子。PHD 抑制剂DFO 可以激活HIF-1α 表达，增加软骨祖细胞增殖、分化和迁移。DFO 通过调控MSC 募集、软骨细胞谱系分化以及功能性植入，明显改善关节软骨再生修复的效果。本研究为HIF-1α 信号通路作为一种新的治疗靶点促进关节软骨再生提供了重要证据。 / Shu, Yinglan. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 155-181). / Abstracts also in Chinese. / Title from PDF title page (viewed on 09, September, 2016). / Shu, Yinglan. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.