Rheological evaluation of the mechanical properties of equine synovial fluid from tarsocrural joints injected with hyaluronic acid (HA) Heidi Schmidt Advisors: Dr. Skip Rochefort PhD and *Dr. Jill Parker VMD DACVS Danielle Leiske, Jocelyn Frey, and *Autumn Rankin Dept. of Chemical Engineering and *College of Veterinary Medicine Oregon State University Corvallis, OR Outline •Motivation •Background •What is HA •Horse and synovial fluid overview •Information about HA supplementation via Hyvisc® •Experimental Design •Tests •Steady Shear Viscometry •Dynamic Oscillatory Shear Rheometry •Capillary Viscometry •Results Motivation • • • Lameness: Limping, abnormal gait, or hobbling resulting from partial loss of function in a leg Osteoarthritis is a significant cause of equine lameness, resulting in the deterioration of joint cartilage and formation of painful bone spurs Economic Impact: Approximately $1 billion a year in losses due to lameness Background Synovial Fluid • Viscous liquid present in all articular joints • Properties • Viscosity relates to joint lubrication • Elasticity relates to impact resistance (i.e. “shock absorbance”) • HA (hyaluronic acid) is the major contributor to the viscoelastic properties of synovial fluid. Hyaluronic Acid (HA) • • • • Biopolyelectrolyte from rooster combs, human umbilical cords, and bacterial fermentation processes High molecular weight (0.2-2 million Da) $450,000/lb (from Sigma Chemicals) Exhibits viscoelastic properties Joint Supplementation • • Intra-articular injection of HA is a common treatment for controlling symptoms of osteoarthritis. Mechanisms are not well understood • Supplementation may stimulate increased production of endogenous high molecular weight HA • It may protect endogenous HA from enzymatic degradation in osteoarthritic joints ® Hyvisc HA Concentration Molecular Weight Viscosity at g = 0.1 . Cost Source vs. Synovial Fluid Hyvisc® Synovial Fluid 11 mg/ml 0.5 – 5.0 mg/mL 1.5 – 3 million Da 2 – 10 million Da 800 P 0.1 – 1.0 P $50 / 2 mL N/A Rooster Combs Synovial Joints Objective • • Compare the mechanical properties of synovial fluid from horses treated with HA to synovial fluid from untreated horses. Studies on normal, healthy joints Experimental Design • Five horses (10 healthy hocks) divided into three groups • Treatment Group (4 hock joints) • Received 2 mL (22 mg) HA supplementation (Hyvisc®) • Negative Control Group (3 hock joints) • Received no joint supplementation • Positive Control Group (3 hock joints) • Received 2 mL of sterile Lactated Ringers Solution (LRS) Experimental Design • • • Synovial fluid collections: • Treatment day (before injections) • 7 days post treatment • 14 days post treatment The horses were monitored daily for any signs of disease Cytology was performed on all of the synovial fluid samples to monitor the health of the joints during the study. Experimental Design • Test Measurements • Steady Shear Tests : Viscosity • Dilute Capillary Viscometer Tests : Relative Viscosity • Dynamic Oscillatory Shear Tests: Viscosity & Elasticity Rheometer Geometries Rheometrics Fluids Spectrometer II Steady Shear Tests • Bottom plate rotates at a constant speed (shear rate) Torque measured on upper cone (shear stress) Viscosity = Shearstress shear stress shear rate Shearrate 0.100 Newtonian Plateau Viscosity (Pas) • 0.010 Shear Thinning (Non-Newtonian) 0.001 1 10 100 Shear Rate (1/s) 1000 Viscosity (P) HA Treated Horse Steady Shear Test Pre-treatment 1 Wk. Post Treatment 2 Wks. Post Treatment 10.00 1.00 0.10 Data Analysis Data Analysis 0.01 0.1 1.0 10.0 Shear Rate (1/s) 100.0 Dynamic Oscillatory Shear Tests Hyvisc® Moduli (dyne/cm^2) 10000 1000 100 G’’ G’ 10 1 0.01 0.10 •Cone oscillates •Measures strain, stress •G’: Elastic Modulus G’ •G”: Viscous Modulus G’’ •G’<G”: Viscous •Acts as a lubricant Cross-over •G’>G”: Elastic Point G' G" •Behaves like a shock 1.00 10.00 absorber Frequency (Hz) Moduli (dyne/cm^2) HA Treated Horse Dynamic Oscillatory Shear Test 100.000 10.000 1.000 0.100 0.010 Data Analysis 0.001 0.10 1.00 10.00 100.00 Frequency (Hz) G' Pre-treatment G' 1 Wk. Post Treatment G' 2 Wks. Post Treatment G'' Pre-treatment G'' 1 Wk. Post Treatment G'' 2 Wks. Post Treatment Dilute Solution Capillary Viscometer • Timing Lines • Measures relative viscosity in dilute polymer solutions Flow times differ because of variations in concentration and molecular weight of HA Capillary Relative Viscosity = Solution flow time Solvent flow time HA Treated Horse Relative Viscosity Comparison 4.5 Pre-treatment 1 Wk. Post Treatment 2 Wks. Post Treatment Relative Viscosity 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.0 0.1 0.2 0.3 0.4 Fraction of Pure Synovial Fluid 0.5 0.6 Relative Viscosity Average Relative Viscosity Values at 0.5 Concentration 5 4 3 2 1 0 Week 0 Week 1 Week 2 Weeks After Injection HA + Control - Control Viscosity (P) Average Viscosity at g = 0.1 1.40 1.20 1.00 0.80 0.60 0.40 0.20 0.00 Week 0 Week 1 Week 2 Weeks After Injection HA + Control - Control Percent Change of Synovial Fluid Properties 1 Week Post-Treatment 1 200% HA Group Percent Change 150% 100% + Control Group 50% - Control Group 0% -50% -100% G' G'' . Viscosity at γ = 0.1 . Viscosity at γ = 10 Relative viscosity Percent Change of Synovial Fluid Properties 2 Weeks Post-Treatment Percent Change 200% 150% 100% 50% HA Group 0% + Control Group - Control Group 1 -50% -100% G' G'' . Viscosity at γ= 0.1 . Viscosity at γ = 10 Relative viscosity Conclusion Hyaluronic Acid supplementation has a positive affect on the rheological properties of synovial fluid one week post-treatment Future Work •Extend research to a larger test group •Study the effects of intravenous HA injections •Perform light scattering tests to find specific HA concentration and molecular weight •Explore the effects of HA supplements at different molecular weights Acknowledgements •Howard Hughes Medical Institute •Dr. Skip Rochefort, OSU ChE Dept •Danielle Leiske and Jocelyn Frey •Dr. Jill Parker and Autumn Rankin, OSU College of Veterinary Medicine •Kevin Ahern Questions? Danielle Leiske and Autumn Rankin Preparing the joint for an injection