Abstract
The low molecular weight fraction of commercial human serum albumin (LMWF5A) has been shown to successfully relieve pain and inflammation in severe osteoarthritis of the knee (OAK). LMWF5A contains at least three active components that could account for these anti-inflammatory and analgesic effects.We summarize in vitro experiments in bone marrow–derived mesenchymal stem cells, monocytic cell lines, chondrocytes, peripheral blood mononuclear cells, fibroblast-like synoviocytes, and endothelial cells on the biochemistry of anti-inflammatory changes induced by LMWF5A. We then look at four of the major pathways that cut across cell-type considerations to examine which biochemical reactions are affected by mTOR, COX-2, CD36, and AhR pathways. All three components show anti-inflammatory activities in at least some of the cell types.The in vitro experiments show that the effects of LMWF5A in chondrocytes and bone marrow–derived stem cells in particular, coupled with recent data from previous clinical trials of single and multiple injections of LMWF5A into OAK patients demonstrated improvements in pain, function, and Patient Global Assessment (PGA), as well as high responder rates that could be attributed to the multiple mechanism of action (MOA) pathways are summarized here. In vitro and in vivo data are highly suggestive of LMWF5A being a disease-modifying drug for OAK.
Highlights
Very often, trial and error, together with clinical observations, lead to the development of novel therapeutic agents
We summarize in vitro experiments in bone marrow–derived mesenchymal stem cells, monocytic cell lines, chondrocytes, peripheral blood mononuclear cells, fibroblast-like synoviocytes, and endothelial cells on the biochemistry of anti-inflammatory changes induced by LMWF5A
We propose a multifaceted mode of action for a novel therapeutic agent containing at least three active ingredients and show how each component contributes to the overall anti-inflammatory and analgesic effects of the biological product, a low molecular weight fraction of commercial human serum albumin referred to as LMWF5A
Summary
Trial and error, together with clinical observations, lead to the development of novel therapeutic agents. This is certainly true in traditional medicine in both Western culture and China. We propose a multifaceted mode of action for a novel therapeutic agent containing at least three active ingredients and show how each component contributes to the overall anti-inflammatory and analgesic effects of the biological product, a low molecular weight fraction of commercial human serum albumin referred to as LMWF5A. We describe the various biochemical pathways involving the known components of LMWF5A on multiple cell types and their relevance to the observed clinical effects in patients with severe OAK
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