Alves J C, Santos Ana, Jorge Patrícia, Carreira L Miguel
Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal.
MED-Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal.
Animals (Basel). 2022 Nov 30;12(23):3358. doi: 10.3390/ani12233358.
Osteoarthritis (OA) is a growing welfare problem for dogs and a challenge to manage for the clinician, and most therapeutic options aim to control pain. In a randomized, double-blinded, placebo-controlled, 2-way, 2-period crossover study, we aimed to evaluate the use of Blood Cell Secretome (BCS) administrated intra-articularly, with or without the combination with triamcinolone, in dogs with bilateral hip OA. BCS is an acellular orthobiologic containing anti-inflammatory and anabolic proteins produced from the patient’s own blood through extended coagulation in a defined environment. Fifteen dogs were initially assigned to a BCS group (BCSG, n = 5), a triamcinolone group (TG, n = 5), or a combination group (BCS+TG, n = 5). All had bilateral hip OA. After a 180-day follow-up, the crossover was performed with BCSG (n = 7) and BCS+TG (n = 7). BCSG received a single intra-articular administration of 3 mL of Blood Cell Secretome, and BCS+TG received BCS plus 0.5 mL of triamcinolone acetonide (40 mg/mL). The volume in BCSG was corrected to 3.5 mL with saline. In all patients, both hips were treated. For treatment follow-up, a copy of the Canine Brief Pain Inventory (divided into pain interference score—PIS and Pain Severity Score—PSS), Liverpool Osteoarthritis in Dogs (LOAD), and Canine Orthopedic Index (COI, divided into function, gait, stiffness, and quality of life) was completed on days 0, 8, 15, 30, 60, 90, 120, 150, and 180. Results were analyzed with the Mann−Whitney U test, effect size, and Kaplan−Meier estimators, followed by the log-rank test. p was set at <0.05. Patients of the sample had a mean age of 9.6 ± 2.9 years and a body weight of 29.2 ± 3.9 kg. Seven hips were classified as severe osteoarthritis, and eight were classified as moderate. No differences were found between groups at T0. Significant differences were observed in PSS scores at +8d, with BCS+TG exhibiting better results. PIS, PSS, LOAD, stiffness, and function scores were also lower in BCS+TG from +15 to +60d. The two groups showed similar improvements from +90 to +120d. Kaplan−Meier estimators showed that dogs in BCS+TG showed clinically-important differences for longer, despite a positive result in BCSG. The intra-articular administration of BCS alone was able to improve the overall condition of OA patients. Its combined use with triamcinolone acetonide lead to a faster and longer-lasting improvement in pain scores.
骨关节炎（OA）对犬类来说是一个日益严重的健康问题，对临床医生而言也是一个治疗挑战，并且大多数治疗方案旨在控制疼痛。在一项随机、双盲、安慰剂对照、两因素、两阶段交叉研究中，我们旨在评估关节内注射血细胞分泌组（BCS），无论是否联合曲安奈德，对双侧髋关节OA犬的治疗效果。BCS是一种无细胞的生物制品，含有通过在特定环境中延长凝血从患者自身血液中产生的抗炎和合成代谢蛋白。15只犬最初被分为BCS组（BCSG，n = 5）、曲安奈德组（TG，n = 5）或联合组（BCS + TG，n = 5）。所有犬均患有双侧髋关节OA。经过180天的随访后，BCSG（n = 7）和BCS + TG（n = 7）进行了交叉。BCSG接受一次关节内注射3 mL血细胞分泌组，BCS + TG接受BCS加0.5 mL曲安奈德（40 mg/mL）。BCSG中的体积用生理盐水校正至3.5 mL。所有患者的双侧髋关节均接受治疗。在治疗随访中，在第0、8、15、30、60、90、120、150和180天完成犬简短疼痛量表（分为疼痛干扰评分 - PIS和疼痛严重程度评分 - PSS）、犬类利物浦骨关节炎（LOAD）和犬类骨科指数（COI，分为功能、步态、僵硬程度和生活质量）的副本。结果采用Mann - Whitney U检验、效应量和Kaplan - Meier估计量进行分析，随后进行对数秩检验。p值设定为<0.05。样本中的患者平均年龄为9.6 ± 2.9岁，体重为29.2 ± 3.9 kg。7个髋关节被分类为重度骨关节炎，8个被分类为中度。在T0时各组之间未发现差异。在第8天观察到PSS评分有显著差异，BCS + TG表现出更好的结果。从第15天到第60天，BCS + TG组的PIS、PSS、LOAD、僵硬程度和功能评分也较低。两组在第90天到第120天显示出相似的改善。Kaplan - Meier估计量显示，尽管BCSG组有阳性结果，但BCS + TG组的犬在临床上有更显著差异的时间更长。单独关节内注射BCS能够改善OA患者的整体状况。其与曲安奈德联合使用可使疼痛评分改善更快且持续时间更长。
