Harmon Katrina A, Kimmerling Kelly A, Mowry Katie C
Department of Research and Development, Organogenesis, Birmingham, Alabama, USA.
J Orthop Res. 2024 Oct;42(10):2159-2171. doi: 10.1002/jor.25872. Epub 2024 May 23.
Placental-derived allografts have been of interest as a potential nonsurgical treatment to reduce pain and improve function in knee osteoarthritis (OA). The purpose of this study was to evaluate the effect of single and repeat injection of amniotic suspension allograft (ASA) on pain, function, and cytokine levels using a destabilization of the medial meniscus (DMM) rat model of OA. Post-DMM surgery, animals were treated with a single injection of either ASA, vehicle, or triamcinolone, or repeated injection of either ASA or vehicle. Behavioral testing including knee swelling, pain threshold, dynamic weight bearing (DWB), and gait analysis were evaluated during the in-life phase. Postsacrifice, histopathology and serum and synovial fluid analyses were evaluated. Significant improvements in both DWB differentials and pain threshold were seen in response to repeated injection of ASA, while a single injection of ASA and triamcinolone resulted in significant improvements in pain threshold. Histopathology analysis found no significant differences regardless of treatment compared to vehicle, except for an increase in synovitis following repeated injection of ASA. A single injection of ASA and triamcinolone resulted in increased anti-inflammatory cytokines; repeated ASA injection resulted in significant increases in several immune-modulating factors relevant to OA. When comparing the impact of single and repeat ASA treatments on behavioral testing, repeated injection provided significant additional improvements in both pain and function. This study provides evidence demonstrating the impact of a second injection while also providing additional data for evaluating the use of ASA as a nonsurgical treatment for knee OA.
胎盘来源的同种异体移植物作为一种潜在的非手术治疗方法，可减轻膝关节骨关节炎（OA）的疼痛并改善功能，已引起人们的关注。本研究的目的是使用OA的内侧半月板不稳定（DMM）大鼠模型，评估单次和重复注射羊膜悬浮同种异体移植物（ASA）对疼痛、功能和细胞因子水平的影响。DMM手术后，动物接受单次注射ASA、赋形剂或曲安奈德，或重复注射ASA或赋形剂。在实验阶段评估包括膝关节肿胀、疼痛阈值、动态负重（DWB）和步态分析在内的行为测试。处死后，评估组织病理学以及血清和滑液分析。重复注射ASA后，DWB差异和疼痛阈值均有显著改善，而单次注射ASA和曲安奈德可显著改善疼痛阈值。组织病理学分析发现，与赋形剂相比，无论何种治疗，均无显著差异，但重复注射ASA后滑膜炎有所增加。单次注射ASA和曲安奈德可增加抗炎细胞因子；重复注射ASA可使与OA相关的几种免疫调节因子显著增加。比较单次和重复ASA治疗对行为测试的影响时，重复注射在疼痛和功能方面均有显著的额外改善。本研究提供了证据，证明了第二次注射的影响，同时也为评估ASA作为膝关节OA的非手术治疗方法提供了更多数据。
