Alexander E Weber1, Ioanna K Bolia2, Nicholas A Trasolini2. 1. USC Epstein Family Center for Sports Medicine, Keck Medicine of USC, 1520 San Pablo st#2000, Los Angeles, CA, 90033, USA. weberae@usc.edu. 2. USC Epstein Family Center for Sports Medicine, Keck Medicine of USC, 1520 San Pablo st#2000, Los Angeles, CA, 90033, USA.
Abstract
PURPOSE: To provide an updated review of the literature on the use of orthobiologics as a potential treatment option to alleviate symptoms associated with osteoarthritis (OA), slow the progression of the disease, and aid in cartilage regeneration. METHODS: A comprehensive review of the literature was performed to identify basic science and clinical studies examining the role of orthobiologics in the diagnosis and management of osteoarthritis. RESULTS: Certain molecules (such as interleukin-6 (IL-6), interleukin-8 (IL-8), matrix metalloproteinase (MMPs), cartilage oligomeric matrix protein (COMP), and tumor necrosis factor (TNF), microRNAs, growth differentiation factor 11 (GDF-11)) have been recognized as biomarkers that are implicated in the pathogenesis and progression of degenerative joint disease (DJD). These biomarkers have been used to develop newer diagnostic applications and targeted biologic therapies for DJD. Local injection therapy with biologic agents such as platelet-rich plasma or stem cell-based preparations has been associated with significant improvement in joint pain and function in patients with OA and has increased in popularity during the last decade. The combination of PRP with kartogenin or TGF-b3 may also enhance its biologic effect. The mesenchymal stem cell secretome has been recognized as a potential target for the development of OA therapies due to its role in mediating the chondroprotective effects of these cells. Recent experiments have also suggested the modification of gut microbiome as a newer method to prevent OA or alter the progression of the disease. CONCLUSIONS: The application of orthobiologics for the diagnosis and treatment of DJD is a rapidly evolving field that will continue to expand. The identification of OA-specific and joint-specific biomarker molecules for early diagnosis of OA would be extremely useful for the development of preventive and therapeutic protocols. Local injection therapies with HA, PRP, BMAC, and other stem cell-based preparations are currently being used to improve pain and function in patients with early OA or those with progressed disease who are not surgical candidates. Although the clinical outcomes of these therapies seem to be promising in clinical studies, future research will determine the true role of orthobiologic applications in the field of DJS.
PURPOSE: To provide an updated review of the literature on the use of orthobiologics as a potential treatment option to alleviate symptoms associated with osteoarthritis (OA), slow the progression of the disease, and aid in cartilage regeneration. METHODS: A comprehensive review of the literature was performed to identify basic science and clinical studies examining the role of orthobiologics in the diagnosis and management of osteoarthritis. RESULTS: Certain molecules (such as interleukin-6 (IL-6), interleukin-8 (IL-8), matrix metalloproteinase (MMPs), cartilage oligomeric matrix protein (COMP), and tumor necrosis factor (TNF), microRNAs, growth differentiation factor 11 (GDF-11)) have been recognized as biomarkers that are implicated in the pathogenesis and progression of degenerative joint disease (DJD). These biomarkers have been used to develop newer diagnostic applications and targeted biologic therapies for DJD. Local injection therapy with biologic agents such as platelet-rich plasma or stem cell-based preparations has been associated with significant improvement in joint pain and function in patients with OA and has increased in popularity during the last decade. The combination of PRP with kartogenin or TGF-b3 may also enhance its biologic effect. The mesenchymal stem cell secretome has been recognized as a potential target for the development of OA therapies due to its role in mediating the chondroprotective effects of these cells. Recent experiments have also suggested the modification of gut microbiome as a newer method to prevent OA or alter the progression of the disease. CONCLUSIONS: The application of orthobiologics for the diagnosis and treatment of DJD is a rapidly evolving field that will continue to expand. The identification of OA-specific and joint-specific biomarker molecules for early diagnosis of OA would be extremely useful for the development of preventive and therapeutic protocols. Local injection therapies with HA, PRP, BMAC, and other stem cell-based preparations are currently being used to improve pain and function in patients with early OA or those with progressed disease who are not surgical candidates. Although the clinical outcomes of these therapies seem to be promising in clinical studies, future research will determine the true role of orthobiologic applications in the field of DJS.
Authors: Nazir M Khan; Abdul Haseeb; Mohammad Y Ansari; Pratap Devarapalli; Sara Haynie; Tariq M Haqqi Journal: Free Radic Biol Med Date: 2017-02-22 Impact factor: 7.376
Authors: E Ntoumou; M Tzetis; M Braoudaki; G Lambrou; M Poulou; K Malizos; N Stefanou; L Anastasopoulou; A Tsezou Journal: Clin Epigenetics Date: 2017-12-12 Impact factor: 6.551
Authors: Constance R Chu; Scott Rodeo; Nidhi Bhutani; Laurie R Goodrich; Johnny Huard; James Irrgang; Robert F LaPrade; Christian Lattermann; Ying Lu; Bert Mandelbaum; Jeremy Mao; Louis McIntyre; Allan Mishra; George F Muschler; Nicolas S Piuzzi; Hollis Potter; Kurt Spindler; John M Tokish; Rocky Tuan; Kenneth Zaslav; William Maloney Journal: J Am Acad Orthop Surg Date: 2019-01-15 Impact factor: 3.020
Authors: Filippo Migliorini; Francesco Cuozzo; Lucio Cipollaro; Francesco Oliva; Frank Hildebrand; Nicola Maffulli Journal: J Orthop Traumatol Date: 2022-02-07