Zimmer Biomet, 56 East Bell Drive, Warsaw, IN 46580, USA.
Owl Manor, 720 East Winona Avenue, Warsaw, IN 46580, USA.
Int J Mol Sci. 2021 Mar 8;22(5):2726. doi: 10.3390/ijms22052726.
Osteoarthritis (OA) is a progressive degenerative disease that manifests as pain and inflammation and often results in total joint replacement. There is significant interest in understanding how intra-articular injections made from autologous blood or bone marrow could alleviate symptoms and potentially intervene in the progression of the disease. There is in vitro an in vivo evidence that suggests that these therapies, including platelet-rich plasma (PRP), autologous anti-inflammatories (AAIs), and concentrated bone marrow aspirate (cBMA), can interrupt cartilage matrix degradation driven by pro-inflammatory cytokines. This review analyzes the evidence for and against inclusion of white blood cells, the potential role of platelets, and the less studied potential role of blood plasma when combining these components to create an autologous point-of-care therapy to treat OA. There has been significant focus on the differences between the various autologous therapies. However, evidence suggests that there may be more in common between groups and perhaps we should be thinking of these therapies on a spectrum of the same technology, each providing significant levels of anti-inflammatory cytokines that can be antagonists against the inflammatory cytokines driving OA symptoms and progression. While clinical data have demonstrated symptom alleviation, more studies will need to be conducted to determine whether these preclinical disease-modifying findings translate into clinical practice.
骨关节炎（OA）是一种进行性退行性疾病，表现为疼痛和炎症，通常导致全关节置换。人们对理解如何使用自体血液或骨髓制成的关节内注射来缓解症状并可能干预疾病进展非常感兴趣。有体外和体内证据表明，这些治疗方法，包括富含血小板的血浆（PRP）、自体抗炎药（AAIs）和浓缩骨髓抽吸物（cBMA），可以阻断由促炎细胞因子驱动的软骨基质降解。这篇综述分析了纳入白细胞的证据和反对意见，血小板的潜在作用，以及在组合这些成分以创建用于治疗 OA 的自体即时治疗时，研究较少的血浆的潜在作用。人们非常关注各种自体疗法之间的差异。然而，有证据表明，各组之间可能有更多的共同点，也许我们应该将这些疗法视为同一种技术的一系列治疗方法，每种方法都提供了大量的抗炎细胞因子，这些细胞因子可以作为对抗驱动 OA 症状和进展的炎症细胞因子的拮抗剂。虽然临床数据已经证明了症状的缓解，但还需要进行更多的研究来确定这些临床前的疾病修饰发现是否转化为临床实践。
