E. Antonioli (São Paulo, BR)
Hospital Israelita Albert Einstein Programa LocomotorPresenter Of 2 Presentations
10.3.8 - Can osteoarthritis biomarkers monitor clinical improvement?
Abstract
Purpose
There is no cure or disease modifying drugs available to treat osteoarthritis (OA). Therefore, effective biomarkers and diagnostic tests are direly needed to monitor the disease progression and treatment. The objective of this study is to identify and evaluate mediators that serve as biomarkers of OA progression and treatment.
Methods and Materials
The rehabilitation protocol for patients with mild to moderate knee OA consisted of muscle strengthening exercises activating: hamstrings, quadriceps, and gluteal muscles, during 8 weeks (3 session/week). The efficacy of protocol was evaluated by functional scale (WOMAC), quality of life questionnaire (EuroQol), pain scale (VAS), and physical function tests (TUG, isokinetic dynamometer). Serum levels of COMP (cartilage oligomeric matrix protein), CS846 (aggrecan neoepitope), C2C (cleavage of type II collagen), IL-6,-8 and-10, and, HMGB1 (High mobility group box 1) were evaluated by ELISA. All outcomes were performed before and after the rehabilitation program. A correlation of physical improvement and serum biomarkers was performed. Statistical analyzes were performed by Student's t-Test, one/two-way ANOVA and Pearson's Correlation.
Results
Thirty six individuals (23 women and 13 man) with moderate knee OA (KL 2-3; age: 55.1 ± 5.29 years; BMI: 28.9 ± 3.8 Kg/m2; Mean ± SD), were evaluated. After the treatment, the subjects reached 50% reduction in the WOMAC scale, significantly showing an improvement in pain, stiffness, mobility, and functional test performance. And also an increased maximal strength production and maximal strength lift capacity for the knee extensor and flexor muscles and improved muscle balance. There was no significant difference in levels of serum biomarkers after the treatment and no evidence of correlation between biomarkers serum levels and clinical improvement.
Conclusion
Physical exercise resistance was sufficient to reduce pain, increase strength production, improve functional performance and muscle balance of OA subjects. However, biomarkers do not present evidence to monitor clinical improvement after conservative treatment.
23.4.2 - Different ways to treat osteoarthritis with mesenchymal stromal cells injection: an animal model
Abstract
Purpose
Osteoarthritis(OA) treatment using mesenchymal stromal cells(MSC) has been extensively used and still there is no consensus regarding the number of cells applications and the best transplantation route. Using destabilization of the medial meniscus(DMM) as a model of OA, the aims of this study was to track MSC after intra-articular(IA) and intravenous(IV) injections, analyzing cytokines kinetics and histological structure.
Methods and Materials
OA was induced in female Wistar Kyoto rats via the DMM surgery. Rat bone marrow MSC was transduced with Luciferase transgene. Animals were treated with MSC after 9 weeks of surgery, via IA-MSC (2x106cells/kg) and IV-MSC (4x106cells/kg) injection. In vivo assay was acquired using the imaging system IN-VIVO MSFX PRO and the luminescence kinetic curve. Serum cytokines concentrations were determined with multiplex assay. Images and cytokines were analyzed at time intervals between 2h to 1 week after the transplant. After 4 and 12 weeks post-MSC treatment, knee was assessed by cartilage histology by OARSI score. Statistical analyzes were performed by Student's t-Test, one/two-way ANOVA.
Results
Viable MSC was observed in the OA knee until 1 week after the IA-MSC injection, and only until 8h in IV-MSC injection. The cytokines showed a different fluctuation concentration depended on the method of administration and time. IV-MSC injection increases MIP-1alpha and IL10 after 2h, decreasing in 24h, while MCP1 decreases after 2h. The opposite was observed with IA-MSC injection which increases MCP1 at the same time point, in addition to increase IL18 after 24h. Both cytokines decreased after 1 week. The OARSI score was better in both cell treatments than placebo. However, the IA-MSC showed a trend to reduce cartilage degeneration over time.
Conclusion
There is a possible homing capacity of MSC to the OA injury joint when injected IV. Taken together the results suggest that there is a longer lasting effect of MSC when injected via IA.