Modulation of Synovial Fluid-Derived Mesenchymal Stem Cells by Intra-Articular and Intraosseous Platelet Rich Plasma Administration.

Emma Muiños-López,Beatriz Aizpurua,Sabino Padilla,Froilán Granero-Moltó,Nicolás Fiz,Eduardo Anitua,Bruno Paiva,Felipe Prósper,Pello Sánchez,Diego Delgado,Jorge Guadilla,Mikel Sánchez

doi:10.1155/2016/1247950

Abstract

The aim of this study was to evaluate the effect of intra-articular (IA) or a combination of intra-articular and intraosseous (IO) infiltration of Platelet Rich Plasma (PRP) on the cellular content of synovial fluid (SF) of osteoarthritic patients. Thirty-one patients received a single infiltration of PRP either in the IA space (n = 14) or in the IA space together with two IO infiltrations, one in the medial femoral condyle and one in the tibial plateau (n = 17). SF was collected before and after one week of the infiltration. The presence in the SF of mesenchymal stem cells (MSCs), monocytes, and lymphocytes was determined and quantified by flow cytometry. The number and identity of the MSCs were further confirmed by colony-forming and differentiation assays. PRP infiltration into the subchondral bone (SB) and the IA space induced a reduction in the population of MSCs in the SF. This reduction in MSCs was further confirmed by colony-forming (CFU-F) assay. On the contrary, IA infiltration alone did not cause variations in any of the cellular populations by flow cytometry or CFU-F assay. The SF of osteoarthritic patients contains a population of MSCs that can be modulated by PRP infiltration of the SB compartment.

Highlights

Knee osteoarthritis (OA) encompasses a cluster of degenerative joint conditions with different biochemical, inflammatory, and genetic signatures generating distinct subtypes
The choice of IA or IO modality treatment was made based on the failure of previous medical treatments; namely, the patients who had been oriented toward a total knee replacement as the only solution for their OA were allocated in the IO group
In the IO group, we found a significant reduction in CFU-F from 477.51 ± 253.44 CFU/mL before IO injections to 222.95±151.36 CFU/mL one week after infiltration (p < 0.01) (Figure 2(b))

Summary

Introduction

Knee osteoarthritis (OA) encompasses a cluster of degenerative joint conditions with different biochemical, inflammatory, and genetic signatures generating distinct subtypes. It is essential to develop novel treatments that slow or stop the progression of this disease and even reverse the damage. Current treatments such as analgesics, nonsteroidal anti-inflammatory drugs, intra-articular infiltrations of steroids, or hyaluronic acid just relieve the symptoms, and, in advanced cases of OA, joint replacement is the only solution for these patients [2]. The knee joint is a complex biological system composed of synovial fluid (SF), synovial membrane (SM), meniscus, ligaments, subchondral bone (SB), and articular cartilage (AC). AC is an avascular tissue that lies functionally sandwiched between the SM, which generates the SF, and the

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Conclusion