A Pilot Clinical Study of Hyperacute Serum Treatment in Osteoarthritic Knee Joint: Cytokine Changes and Clinical Effects.

Isabel Olmos Calvo,Eszter Fodor,István Hornyák,Stefan Nehrer,Olga Kuten-Pella,Krisztián Magos,Dorottya Kardos,Adél Hinsenkamp,Zsuzsanna Gyevnár,Gábor Erdélyi,György Béres,Tamás Mirkó Paukovits,Tamás Bárdos,Zsombor Lacza

doi:10.3390/cimb43020046

Abstract

The serum fraction of platelet-rich fibrin (hyperacute serum) has been shown to improve cartilage cell proliferation in in vitro osteoarthritic knee joint models. We hypothesize that hyperacute serum may be a potential regenerative therapeutic for osteoarthritic knees. In this study, the cytokine milieu at the synovial fluid of osteoarthritic knee joints exposed to hyperacute serum intraarticular injections was investigated. Patients with knee osteoarthritis received three injections of autologous hyperacute serum; synovial fluid was harvested before each injection and clinical monitoring was followed-up for 6 months. Forty osteoarthritic-related cytokines, growth factors and structural proteins from synovial fluid were quantified and analysed by Multivariate Factor Analysis. Hyperacute serum provided symptomatic relief regarding pain and joint stability for OA patients. Both patients “with” and “without effusion knees” had improved VAS, KOOS and Lysholm-Tegner scores 6 months after of hyperacute serum treatment. Synovial fluid analysis revealed two main clusters of proteins reacting together as a group, showing strong and significant correlations with their fluctuation patterns after hyperacute serum treatment. In conclusion, hyperacute serum has a positive effect in alleviating symptoms of osteoarthritic knees. Moreover, identified protein clusters may allow the prediction of protein expression, reducing the number of investigated proteins in future studies.

Highlights

In our previous studies we have extensively investigated platelet-rich plasma (PRP) varieties and observed that hyperacute serum has a more reliable effect than PRP when comparing proliferation of various cells and tissues [22,23]
ToIL-15, investigate whether serum directly induced benefits in CCL-3/MIP-1α, OA knees, 5/RANTES, fractalkine/CX3CL1, CD-163, TNFα, OSM, patients wereCXCL-8/IL-8, monitored up CXCL-10/IP-10, to 6 months and the effects were evaluated with patient resistin/ADSF, vascular endothelial growth factor A (VEGF-A), IL-13, MMP-1, MMP-2, MMP-3, MM
We investigated whether there were any sigpain level and betterinmobility bylevels the beginning of before the therapy compared to patien nificant changes the cytokine of the patients and afterwhen treatment

Summary

Introduction

Osteoarthritis (OA) is a degenerative musculoskeletal disease that mainly affects weight-bearing joints leading to articular cartilage and subchondral bone destruction. Knees are one of the most affected joints in OA, reaching a prevalence of 3.64% of the worldwide population (which equals to 250 million people) [1]. With an expected increase in human lifespan, the prevalence of OA will rise in the decades, leading to a significant economic burden increment. Once the OA joint is injured, pharmacologic treatments are focused on alleviating symptoms and as a last resort, the joint is replaced

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