Chapter seven - Role of Surface-Active Lipids in Cartilage Lubrication

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Abstract

The principles of cartilage lubrication have been studied for many decades, but the exact lubrication mechanism remains unclear. In the past decades, it has been proposed that surface-active phospholipids (SAPLs) serve as the major boundary lubricant. SAPL as amphiphilic molecule forms lamellar structures on the cartilage surface that reduce the coefficient of friction effectively and render the cartilage surface hydrophobic. SAPL may also act as general boundary lubricants in human body. However, the effective lubrication of synovial joint is multifactorial and includes active interactions of SAPL, hyaluronic acid, and lubricating proteins. SAPLs may become therapeutic agents as they have the potential to reduce friction in osteoarthritic joints and artificial joint replacements.

Section snippets

Cartilage Structure

The largest constituent of cartilage, water, provides load support through pressurization and energy dissipation by fluid flow in response to applied loading [10]. The second largest constituent, the collagen fibril, provides cartilage with its nonlinear properties in tension, which are inhomogeneously distributed with depth from tissue surface [1]. The water is confined in the collagen network by aggrecans. Negatively charged aggrecans trapped in the collagen network are responsible for large

Cartilage Lubrication

A classical paper of Wright and Dowson [15] describes two basic types of lubrication: that in which articulating surfaces are separated by a fluid film and that in which the load is supported by surface-to-surface contact. The former is denoted as the fluid film lubrication while the later is being denoted as the boundary lubrication (Fig. 2).

Fluid film lubrication can be related to joint motion which draws in film of fluid between the opposing cartilage surfaces. This type of lubrication is

Properties of Superficial Cartilage Layer

The upper-most layer of cartilage is crucial in boundary friction of cartilage. The composition, the function, and even the position of the surface of cartilage are the subject of controversy. The surface layer of cartilage is usually referred as lamina splendens. Definition of lamina splendens comes from the phase contrast microscopy where the bright line along the edge of cartilage is observed. However, it was suggested that the observed bright line is an artifact of the method as Fresnel

Lamellar Phospholipids Lubrication

Based on the fact that phospholipids have been identified in appreciable quantities in synovial fluid and cartilage SAL (Table 2), Hills [45] hypothesized that a lamellar phospholipid adsorbed to the articular surface contributes to joint lubrication. Phosphatidylcholines have a zwitterionic headgroup, as they have a negative charge on the phosphate group and a positive charge on the amine (Fig. 5B). Mobile cations with positive charge, for example, Ca2 +, can interact with the negatively

Synovial Fluid Constituents in Lamellar Lubrication

Oligolamellar lubrication assumes that SAPL serves as a major boundary lubricant by forming phospholipid bilayers. However, SAL is in direct contact with synovial fluid that contains also other molecules that were considered as the predominant boundary lubricants such as hyaluronic acid and lubricin. Molecules of cartilage matrix in the superficial zone of cartilage may also contribute to boundary lubrication [64].

Earlier models considered hyaluronic acid as the predominant boundary lubricant [

SAPL Lubrication in Disease and Therapy

The most frequent disease of joints is osteoarthritis. Osteoarthritis is a multifactorial disorder of synovial joints, which is characterized by escalated degeneration and loss of articular cartilage [74]. Treatment of osteoarthritis is a critical unmet need in medicine for regeneration of damaged articular cartilage in elderly [75]. It is highly desirable to keep the affected joint mobile and that includes maintaining efficient lubrication [69].

It is believed that excessive friction

Future Directions

SAPL lines the surface of articular cartilage and serves as a boundary lubricating agent by forming lamellar structures. However, the effective lubrication of synovial joint is multifactorial and includes active interactions of SAPL, hyaluronic acid, and lubricating proteins within the surface amorphous cartilage layer and in the synovial fluid. It seems that single lubrication molecule does not exist and synovial joint highly effective lubrication is a result of synergic effect of various

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