Ippolito Mariachiara, Spurio Giulia, Compagno Viviana, Rizzo Alessandra, Di Simone Marta, Corsale Anna Maria, Mazzola Giuseppina, Giarratano Antonino, Meraviglia Serena, Cortegiani Andrea, Alongi Antonietta
Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy.
Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy.
Br J Pain. 2023 Feb;17(1):103-111. doi: 10.1177/20494637221134169. Epub 2022 Oct 20.
Autologous conditioned serum is a product of blood origin, with fragmented evidence of therapeutic properties in osteoarthritis chronic pain. This pilot observational prospective study aimed to evaluate the feasibility of a treatment with conditional autologous serum (ACS) in patients with severe chronic pain and grade I-III osteoarthritis and to describe its cytokine content.
We prospectively collected data on consecutive patients affected by osteoarthritis grade I to III and treated with four weekly injections of ACS at our outpatient pain service. The primary outcome was pain intensity, measured with the visual analogic scale (VAS). Additional outcomes were symptoms evaluated using joint district-specific scales. The study also evaluated concentrations of 48 cytokines and chemokines involved in the balance pro-inflammation/anti-inflammation and tissue repair in the ACS.
We included 26 patients, mostly female (65.4%), with a median age of 63.5 years [IQR 58.25-73]. A median reduction of VAS of -3 cm [-5; -1.25] was observed 6 months after the first injection of ACS. The analysis showed a statistically significant difference between the values of VAS ( < .01; X = 69.6; df = 6, = 26) at the different time points. No adverse events were observed or reported by patients during the entire study period.
Conditional autologous serum may be a feasible option for patients with chronic pain due to grade I-III osteoarthritis refractory to other treatments. These preliminary findings should be confirmed in studies with adequate design.
自体条件血清是一种血液来源的产品，在骨关节炎慢性疼痛方面具有碎片化的治疗特性证据。这项前瞻性观察性试点研究旨在评估用条件自体血清（ACS）治疗重度慢性疼痛且患有I - III级骨关节炎患者的可行性，并描述其细胞因子含量。
我们前瞻性地收集了在我们门诊疼痛服务中心接受治疗的连续I至III级骨关节炎患者的数据，这些患者每周接受四次ACS注射。主要结局是使用视觉模拟量表（VAS）测量的疼痛强度。其他结局是使用特定关节区域量表评估的症状。该研究还评估了ACS中参与促炎/抗炎平衡和组织修复的48种细胞因子和趋化因子的浓度。
我们纳入了26例患者，大多数为女性（65.4%），中位年龄为63.5岁[四分位间距58.25 - 73]。首次注射ACS后6个月，观察到VAS中位数降低了 - 3 cm[-5； - 1.25]。分析显示不同时间点VAS值之间存在统计学显著差异（ <.01；X = 69.6；自由度 = 6， = 26）。在整个研究期间，患者未观察到或报告任何不良事件。
对于因I - III级骨关节炎导致慢性疼痛且对其他治疗无效的患者，条件自体血清可能是一种可行的选择。这些初步发现应在设计充分的研究中得到证实。
