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Arthritis Research & Therapy

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01.12.2013 | Review

An emerging player in knee osteoarthritis: the infrapatellar fat pad

verfasst von: Andreea Ioan-Facsinay, Margreet Kloppenburg

Erschienen in: Arthritis Research & Therapy | Ausgabe 6/2013

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Abstract

The role of inflammation in the development, progression, and clinical features of osteoarthritis has become an area of intense research in recent years. This led to the recognition of synovitis as an important source of inflammation in the joint and indicated that synovitis is intimately associated with pain and osteoarthritis progression. In this review, we discuss another emerging source of inflammation that could play a role in disease development/progression: the infrapatellar fat pad (IFP). The aim of this review is to offer a comprehensive view of the pathology of IFP as obtained from magnetic resonance studies, along with its characterization at both the cellular and the molecular level. Furthermore, we discuss the possible function of this organ in the pathological processes in the knee by summarizing the knowledge regarding the interactions between IFP and other joint tissues and discussing the pro- versus anti-inflammatory functions this tissue could have. We hope that this review will offer an overview of all published data regarding the IFP and will indicate novel directions for future research.

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Saddik D, McNally EG, Richardson M: MRI of Hoffa's fat pad. Skeletal Radiol. 2004, 33: 433-444.CrossRefPubMed

Smillie IS: Diseases of the Knee Joint. 1980, London: Churchill Livingstone

Clockaerts S, Bastiaansen-Jenniskens YM, Runhaar J, Van Osch GJ, Van Offel JF, Verhaar JA, De Clerck LS, Somville J: The infrapatellar fat pad should be considered as an active osteoarthritic joint tissue: a narrative review. Osteoarthritis Cartilage. 2010, 18: 876-882. 10.1016/j.joca.2010.03.014.CrossRefPubMed

Hoffa A: Influence of adipose tissue with regard to the pathology of the knee joint. JAMA. 1904, 43: 795-796.CrossRef

Jacobson JA, Lenchik L, Ruhoy MK, Schweitzer ME, Resnick D: MR imaging of the infrapatellar fat pad of Hoffa. Radiographics. 1997, 17: 675-691. 10.1148/radiographics.17.3.9153705.CrossRefPubMed

Dye SF, Vaupel GL, Dye CC: Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia. Am J Sports Med. 1998, 26: 773-777.PubMed

Bennell K, Hodges P, Mellor R, Bexander C, Souvlis T: The nature of anterior knee pain following injection of hypertonic saline into the infrapatellar fat pad. J Orthop Res. 2004, 22: 116-121. 10.1016/S0736-0266(03)00162-1.CrossRefPubMed

Schweitzer ME, Falk A, Pathria M, Brahme S, Hodler J, Resnick D: MR imaging of the knee: can changes in the intracapsular fat pads be used as a sign of synovial proliferation in the presence of an effusion?. AJR Am J Roentgenol. 1993, 160: 823-826. 10.2214/ajr.160.4.8456672.CrossRefPubMed

Hill CL, Gale DG, Chaisson CE, Skinner K, Kazis L, Gale ME, Felson DT: Knee effusions, popliteal cysts, and synovial thickening: association with knee pain in osteoarthritis. J Rheumatol. 2001, 28: 1330-1337.PubMed

10.

Hill CL, Hunter DJ, Niu J, Clancy M, Guermazi A, Genant H, Gale D, Grainger A, Conaghan P, Felson DT: Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis. Ann Rheum Dis. 2007, 66: 1599-1603. 10.1136/ard.2006.067470.PubMedCentralCrossRefPubMed

11.

Roemer FW, Zhang Y, Niu J, Lynch JA, Crema MD, Marra MD, Nevitt MC, Felson DT, Hughes LB, El-Khoury GY, Englund M, Guermazi A, Multicenter Osteoarthritis Study Investigators: Tibiofemoral joint osteoarthritis: risk factors for MR-depicted fast cartilage loss over a 30-month period in the multicenter osteoarthritis study. Radiology. 2009, 252: 772-780. 10.1148/radiol.2523082197.PubMedCentralCrossRefPubMed

12.

Hayashi D, Roemer FW, Dhina Z, Kwoh CK, Hannon MJ, Moore C, Guermazi A: Longitudinal assessment of cyst-like lesions of the knee and their relation to radiographic osteoarthritis and MRI-detected effusion and synovitis in patients with knee pain. Arthritis Res Ther. 2010, 12: R172-10.1186/ar3132.PubMedCentralCrossRefPubMed

13.

Ai F, Yu C, Zhang W, Morelli JN, Kacher D, Li X: MR imaging of knee osteoarthritis and correlation of findings with reported patient pain. J Huazhong Univ Sci Technolog Med Sci. 2010, 30: 248-254. 10.1007/s11596-010-0223-0.CrossRefPubMed

14.

Zhang Y, Nevitt M, Niu J, Lewis C, Torner J, Guermazi A, Roemer F, McCulloch C, Felson DT: Fluctuation of knee pain and changes in bone marrow lesions, effusions, and synovitis on magnetic resonance imaging. Arthritis Rheum. 2011, 63: 691-699. 10.1002/art.30148.CrossRefPubMed

15.

Roemer FW, Kwoh CK, Hannon MJ, Green SM, Jakicic JM, Boudreau R, Crema MD, Moore CE, Guermazi A: Risk factors for magnetic resonance imaging-detected patellofemoral and tibiofemoral cartilage loss during a six-month period: the joints on glucosamine study. Arthritis Rheum. 2012, 64: 1888-1898. 10.1002/art.34353.CrossRefPubMed

16.

Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG: The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Ann Rheum Dis. 2008, 67: 206-211. 10.1136/ard.2006.066183.CrossRefPubMed

17.

Roemer FW, Guermazi A, Zhang Y, Yang M, Hunter DJ, Crema MD, Bohndorf K: Hoffa's Fat Pad: evaluation on unenhanced MR images as a measure of patellofemoral synovitis in osteoarthritis. AJR Am J Roentgenol. 2009, 192: 1696-1700. 10.2214/AJR.08.2038.CrossRefPubMed

18.

Subhawong TK, Eng J, Carrino JA, Chhabra A: Superolateral Hoffa's fat pad edema: association with patellofemoral maltracking and impingement. AJR Am J Roentgenol. 2010, 195: 1367-1373. 10.2214/AJR.10.4668.PubMedCentralCrossRefPubMed

19.

Jibri Z, Martin D, Mansour R, Kamath S: The association of infrapatellar fat pad oedema with patellar maltracking: a case–control study. Skeletal Radiol. 2012, 41: 925-931. 10.1007/s00256-011-1299-8.CrossRefPubMed

20.

Loeuille D, Sauliere N, Champigneulle J, Rat AC, Blum A, Chary-Valckenaere I: Comparing non-enhanced and enhanced sequences in the assessment of effusion and synovitis in knee OA: associations with clinical, macroscopic and microscopic features. Osteoarthritis Cartilage. 2011, 19: 1433-1439. 10.1016/j.joca.2011.08.010.CrossRefPubMed

21.

de Lange-Brokaar BJE, Ioan-Facsinay A, Yusuf E, Visser AW, Kroon HM, van Osch GJVM, Zuurmond A-M, Stojanovic-Susulic V, Bloem JL, Nelissen RGHH, Huizinga TWJ, Kloppenburg M: Different patterns of synovitis as seen on CE-MRI in patients with knee osteoarthritis. Osteoarthritis Cartilage. 2013, 21 (suppl): S16-CrossRef

22.

Loeuille D, Rat AC, Goebel JC, Champigneulle J, Blum A, Netter P, Gillet P, Chary-Valckenaere I: Magnetic resonance imaging in osteoarthritis: which method best reflects synovial membrane inflammation? Correlations with clinical, macroscopic and microscopic features. Osteoarthritis Cartilage. 2009, 17: 1186-1192. 10.1016/j.joca.2009.03.006.CrossRefPubMed

23.

Crema MD, Felson DT, Roemer FW, Niu J, Marra MD, Zhang Y, Lynch JA, El-Khoury GY, Lewis CE, Guermazi A: Peripatellar synovitis: comparison between non-contrast-enhanced and contrast-enhanced MRI and association with pain. The MOST study. Osteoarthritis Cartilage. 2013, 21: 413-418. 10.1016/j.joca.2012.12.006.CrossRefPubMed

24.

Roemer FW, Guermazi A, Felson DT, Niu J, Nevitt MC, Crema MD, Lynch JA, Lewis CE, Torner J, Zhang Y: Presence of MRI-detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: the MOST study. Ann Rheum Dis. 2011, 70: 1804-1809. 10.1136/ard.2011.150243.PubMedCentralCrossRefPubMed

25.

Vahlensieck M, Linneborn G, Schild H, Schmidt HM: Hoffa's recess: incidence, morphology and differential diagnosis of the globular-shaped cleft in the infrapatellar fat pad of the knee on MRI and cadaver dissections. Eur Radiol. 2002, 12: 90-93. 10.1007/s003300100982.CrossRefPubMed

26.

Chuckpaiwong B, Charles HC, Kraus VB, Guilak F, Nunley JA: Age-associated increases in the size of the infrapatellar fat pad in knee osteoarthritis as measured by 3 T MRI. J Orthop Res. 2010, 28: 1149-1154. 10.1002/jor.21125.PubMedCentralCrossRefPubMed

27.

Ioan-Facsinay A, Kwekkeboom JC, Westhoff S, Giera M, Rombouts Y, van Harmelen V, Huizinga TW, Deelder A, Kloppenburg M, Toes RE: Adipocyte-derived lipids modulate CD4(+) T-cell function. Eur J Immunol. 2013, 43: 1578-1587. 10.1002/eji.201243096.CrossRefPubMed

28.

Odegaard JI, Chawla A: Pleiotropic actions of insulin resistance and inflammation in metabolic homeostasis. Science. 2013, 339: 172-177. 10.1126/science.1230721.PubMedCentralCrossRefPubMed

29.

Kim CS, Lee SC, Kim YM, Kim BS, Choi HS, Kwon BS, Kawada T, Yu R: Visceral fat accumulation induced by a high-fat diet causes the atrophy of mesenteric lymph nodes in obese mice. Obesity (Silver Spring). 2008, 16: 1261-1269. 10.1038/oby.2008.55.CrossRef

30.

Ushiyama T, Chano T, Inoue K, Matsusue Y: Cytokine production in the infrapatellar fat pad: another source of cytokines in knee synovial fluids. Ann Rheum Dis. 2003, 62: 108-112. 10.1136/ard.62.2.108.PubMedCentralCrossRefPubMed

31.

Distel E, Cadoudal T, Durant S, Poignard A, Chevalier X, Benelli C: The infrapatellar fat pad in knee osteoarthritis: an important source of interleukin-6 and its soluble receptor. Arthritis Rheum. 2009, 60: 3374-3377. 10.1002/art.24881.CrossRefPubMed

32.

Klein-Wieringa IR, Kloppenburg M, Bastiaansen-Jenniskens YM, Yusuf E, Kwekkeboom JC, El-Bannoudi H, Nelissen RG, Zuurmond A, Stojanovic-Susulic V, Van Osch GJ, Toes RE, Ioan-Facsinay A: The infrapatellar fat pad of patients with osteoarthritis has an inflammatory phenotype. Ann Rheum Dis. 2011, 70: 851-857. 10.1136/ard.2010.140046.CrossRefPubMed

33.

Presle N, Pottie P, Dumond H, Guillaume C, Lapicque F, Pallu S, Mainard D, Netter P, Terlain B: Differential distribution of adipokines between serum and synovial fluid in patients with osteoarthritis. Contribution of joint tissues to their articular production. Osteoarthritis Cartilage. 2006, 14: 690-695. 10.1016/j.joca.2006.01.009.CrossRefPubMed

34.

Chen WP, Bao JP, Feng J, Hu PF, Shi ZL, Wu LD: Increased serum concentrations of visfatin and its production by different joint tissues in patients with osteoarthritis. Clin Chem Lab Med. 2010, 48: 1141-1145.PubMed

35.

Gandhi R, Takahashi M, Virtanen C, Syed K, Davey JR, Mahomed NN: Microarray analysis of the infrapatellar fat pad in knee osteoarthritis: relationship with joint inflammation. J Rheumatol. 2011, 38: 1966-1972. 10.3899/jrheum.101302.CrossRefPubMed

36.

Shaikh SR, Jolly CA, Chapkin RS: n-3 Polyunsaturated fatty acids exert immunomodulatory effects on lymphocytes by targeting plasma membrane molecular organization. Mol Aspects Med. 2012, 33: 46-54. 10.1016/j.mam.2011.10.002.PubMedCentralCrossRefPubMed

37.

Wen H, Gris D, Lei Y, Jha S, Zhang L, Huang MT, Brickey WJ, Ting JP: Fatty acid-induced NLRP3-ASC inflammasome activation interferes with insulin signaling. Nat Immunol. 2011, 12: 408-415. 10.1038/ni.2022.PubMedCentralCrossRefPubMed

38.

Schmitz G, Ecker J: The opposing effects of n-3 and n-6 fatty acids. Prog Lipid Res. 2008, 47: 147-155. 10.1016/j.plipres.2007.12.004.CrossRefPubMed

39.

Cascio G, Schiera G, Di Liegro I: Dietary fatty acids in metabolic syndrome, diabetes and cardiovascular diseases. Curr Diabetes Rev. 2012, 8: 2-17. 10.2174/157339912798829241.CrossRefPubMed

40.

Serhan CN: The resolution of inflammation: the devil in the flask and in the details. FASEB J. 2011, 25: 1441-1448. 10.1096/fj.11-0502ufm.PubMedCentralCrossRefPubMed

41.

Klein-Wieringa IR, Andersen SN, Kwekkeboom JC, Giera M, de Lange-Brokaar BJ, van Osch GJ, Zuurmond AM, Stojanovic-Susulic V, Nelissen RG, Pijl H, Huizinga TW, Kloppenburg M, Toes RE, Ioan-Facsinay A: Adipocytes modulate the phenotype of human macrophages through secreted lipids. J Immunol. 2013, 191: 1356-1363. 10.4049/jimmunol.1203074.CrossRefPubMed

42.

Gierman LM, Wopereis S, van El B, Verheij ER, der Vat BJ W-v, Bastiaansen-Jenniskens YM, van Osch GJ, Kloppenburg M, Stojanovic-Susulic V, Huizinga TW, Zuurmond AM: Metabolic profiling reveals differences in concentrations of oxylipins and fatty acids secreted by the infrapatellar fat pad of end-stage osteoarthritis and normal donors. Arthritis Rheum. 2013, 65: 2606-2614.PubMed

43.

Caspar-Bauguil S, Cousin B, Galinier A, Segafredo C, Nibbelink M, André M, Casteilla L, Pénicaud L: Adipose tissues as an ancestral immune organ: site-specific change in obesity. FEBS Lett. 2005, 579: 3487-3492. 10.1016/j.febslet.2005.05.031.CrossRefPubMed

44.

Mathis D: Immunological goings-on in visceral adipose tissue. Cell Metab. 2013, 17: 851-859. 10.1016/j.cmet.2013.05.008.PubMedCentralCrossRefPubMed

45.

Zeyda M, Farmer D, Todoric J, Aszmann O, Speiser M, Györi G, Zlabinger GJ, Stulnig TM: Human adipose tissue macrophages are of an anti-inflammatory phenotype but capable of excessive pro-inflammatory mediator production. Int J Obes (Lond). 2007, 31: 1420-1428. 10.1038/sj.ijo.0803632.CrossRef

46.

Curat CA, Miranville A, Sengenès C, Diehl M, Tonus C, Busse R, Bouloumié A: From blood monocytes to adipose tissue-resident macrophages: induction of diapedesis by human mature adipocytes. Diabetes. 2004, 53: 1285-1292. 10.2337/diabetes.53.5.1285.CrossRefPubMed

47.

Duffaut C, Zakaroff-Girard A, Bourlier V, Decaunes P, Maumus M, Chiotasso P, Sengenès C, Lafontan M, Galitzky J, Bouloumié A: Interplay between human adipocytes and T lymphocytes in obesity: CCL20 as an adipochemokine and T lymphocytes as lipogenic modulators. Arterioscler Thromb Vasc Biol. 2009, 29: 1608-1614. 10.1161/ATVBAHA.109.192583.CrossRefPubMed

48.

Bastiaansen-Jenniskens YM, Clockaerts S, Feijt C, Zuurmond AM, Stojanovic-Susulic V, Bridts C, de Clerck L, DeGroot J, Verhaar JA, Kloppenburg M, van Osch GJ: Infrapatellar fat pad of patients with end-stage osteoarthritis inhibits catabolic mediators in cartilage. Ann Rheum Dis. 2012, 71: 288-294. 10.1136/ard.2011.153858.CrossRefPubMed

49.

Chanda D, Kumar S, Ponnazhagan S: Therapeutic potential of adult bone marrow-derived mesenchymal stem cells in diseases of the skeleton. J Cell Biochem. 2010, 111: 249-257. 10.1002/jcb.22701.PubMedCentralCrossRefPubMed

50.

Young HE, Steele TA, Bray RA, Hudson J, Floyd JA, Hawkins K, Thomas K, Austin T, Edwards C, Cuzzourt J, Duenzl M, Lucas PA, Black AC: Human reserve pluripotent mesenchymal stem cells are present in the connective tissues of skeletal muscle and dermis derived from fetal, adult, and geriatric donors. Anat Rec. 2001, 264: 51-62. 10.1002/ar.1128.CrossRefPubMed

51.

Strioga M, Viswanathan S, Darinskas A, Slaby O, Michalek J: Same or not the same? Comparison of adipose tissue-derived versus bone marrow-derived mesenchymal stem and stromal cells. Stem Cells Dev. 2012, 21: 2724-2752. 10.1089/scd.2011.0722.CrossRefPubMed

52.

Wickham MQ, Erickson GR, Gimble JM, Vail TP, Guilak F: Multipotent stromal cells derived from the infrapatellar fat pad of the knee. Clin Orthop Relat Res. 2003, 412: 196-212.CrossRefPubMed

53.

Dragoo JL, Samimi B, Zhu M, Hame SL, Thomas BJ, Lieberman JR, Hedrick MH, Benhaim P: Tissue-engineered cartilage and bone using stem cells from human infrapatellar fat pads. J Bone Joint Surg Br. 2003, 85: 740-747.PubMed

54.

Alegre-Aguaron E, Desportes P, Garcia-Alvarez F, Castiella T, Larrad L, Martinez-Lorenzo MJ: Differences in surface marker expression and chondrogenic potential among various tissue-derived mesenchymal cells from elderly patients with osteoarthritis. Cells Tissues Organs. 2012, 196: 231-240.PubMed

55.

English A, Jones EA, Corscadden D, Henshaw K, Chapman T, Emery P, McGonagle D: A comparative assessment of cartilage and joint fat pad as a potential source of cells for autologous therapy development in knee osteoarthritis. Rheumatology (Oxford). 2007, 46: 1676-1683. 10.1093/rheumatology/kem217.CrossRef

56.

Khan WS, Adesida AB, Hardingham TE: Hypoxic conditions increase hypoxia-inducible transcription factor 2alpha and enhance chondrogenesis in stem cells from the infrapatellar fat pad of osteoarthritis patients. Arthritis Res Ther. 2007, 9: R55-10.1186/ar2211.PubMedCentralCrossRefPubMed

57.

Hui W, Litherland GJ, Elias MS, Kitson GI, Cawston TE, Rowan AD, Young DA: Leptin produced by joint white adipose tissue induces cartilage degradation via upregulation and activation of matrix metalloproteinases. Ann Rheum Dis. 2012, 71: 455-462. 10.1136/annrheumdis-2011-200372.CrossRefPubMed

58.

Bastiaansen-Jenniskens YM, Wei W, Feijt C, Waarsing JH, Verhaar JA, Zuurmond AM, Hanemaaijer R, Stoop R, van Osch GJ: Infrapatellar fat pad of OA patients stimulates fibrotic processes in cultured synoviocytes; a possible role for prostaglandin F. Arthritis Rheum. 2013, 65: 2070-2080. 10.1002/art.37996.CrossRefPubMed

59.

Clockaerts S, Bastiaansen-Jenniskens YM, Feijt C, De Clerck L, Verhaar JA, Zuurmond AM, Stojanovic-Susulic V, Somville J, Kloppenburg M, van Osch GJ: Cytokine production by infrapatellar fat pad can be stimulated by interleukin 1beta and inhibited by peroxisome proliferator activated receptor alpha agonist. Ann Rheum Dis. 2012, 71: 1012-1018. 10.1136/annrheumdis-2011-200688.CrossRefPubMed

60.

Manferdini C, Maumus M, Gabusi E, Piacentini A, Filardo G, Peyrafitte JA, Jorgensen C, Bourin P, Fleury-Cappellesso S, Facchini A, Noël D, Lisignoli G: Adipose-derived mesenchymal stem cells exert antiinflammatory effects on chondrocytes and synoviocytes from osteoarthritis patients through prostaglandin E2. Arthritis Rheum. 2013, 65: 1271-1281. 10.1002/art.37908.CrossRefPubMed

61.

Blaber SP, Webster RA, Hill CJ, Breen EJ, Kuah D, Vesey G, Herbert BR: Analysis of in vitro secretion profiles from adipose-derived cell populations. J Transl Med. 2012, 10: 172-10.1186/1479-5876-10-172.PubMedCentralCrossRefPubMed

62.

de Lange-Brokaar BJ, Ioan-Facsinay A, van Osch GJ, Zuurmond AM, Schoones J, Toes RE, Huizinga TW, Kloppenburg M: Synovial inflammation, immune cells and their cytokines in osteoarthritis: a review. Osteoarthritis Cartilage. 2012, 20: 1484-1499. 10.1016/j.joca.2012.08.027.CrossRefPubMed

63.

Cooper AM, Khader SA: IL-12p40: an inherently agonistic cytokine. Trends Immunol. 2007, 28: 33-38. 10.1016/j.it.2006.11.002.CrossRefPubMed

64.

Huebner JL, Kraus VB: Assessment of the utility of biomarkers of osteoarthritis in the guinea pig. Osteoarthritis Cartilage. 2006, 14: 923-930. 10.1016/j.joca.2006.03.007.CrossRefPubMed

65.

Vernal R, Velasquez E, Gamonal J, Garcia-Sanz JA, Silva A, Sanz M: Expression of proinflammatory cytokines in osteoarthritis of the temporomandibular joint. Arch Oral Biol. 2008, 53: 910-915. 10.1016/j.archoralbio.2008.04.004.CrossRefPubMed

66.

Van Beeck A, Clockaerts S, Somville J, Van Heeswijk JH, Van Glabbeek F, Bos PK, Reijman M: Does infrapatellar fat pad resection in total knee arthroplasty impair clinical outcome? A systematic review. Knee. 2013, 20: 226-231. 10.1016/j.knee.2013.01.005.CrossRefPubMed

Titel: An emerging player in knee osteoarthritis: the infrapatellar fat pad
verfasst von: Andreea Ioan-Facsinay
Margreet Kloppenburg
Publikationsdatum: 01.12.2013
Verlag: BioMed Central
Erschienen in: Arthritis Research & Therapy / Ausgabe 6/2013
Elektronische ISSN: 1478-6362
DOI: https://doi.org/10.1186/ar4422

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