Low-dose intra-articular autologous conditioned serum in treatment of primary knee osteoarthritis

Abstract

Background Interleukin-1 (IL-1) plays an important role in the pathogenesis of osteoarthritis. Hence, agents that inhibit such cytokine have a high therapeutic potential. A method of therapy depends on competitive inhibition of IL-1 at the receptor level - that is, IL-1 receptor antagonist; such antagonist is called Orthokin, which is a normal product of monocytes and is prepared within autologous conditioned serum (ACS) from the patient′s own blood cells. It is capable of blocking the effects of IL-1, including the induction of matrix metalloproteinases, prostaglandin E 2 synthesis, and expression of other cytokines. Objective The aim of the study was to clinically evaluate the effect of intra-articular injection of low-dose ACS enriched with Orthokin on primary knee osteoarthritis to assess its validity in treatment. Patients and methods This study included 30 knees with primary osteoarthritis. Baseline clinical evaluation using WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score was performed. Then ACS enriched with Orthokin (IL-1 receptor antagonist) was prepared. The knee joint was injected with 1 ml ACS weekly for 3 successive weeks. Patients were assessed using WOMAC questionnaire (1 week after each injection for 3 weeks and monthly after the last injection for 3 months). Results On comparing WOMAC score with baseline data, there was a highly significant improvement in all scores, where P was less than 0.01 during all assessment periods and improvement persisted until the end of follow-up after 3 months in comparison with baseline data. Conclusion The synthesis and introduction of interleukin-1 receptor antagonists derived from own blood cells established a promising strategy in the treatment of osteoarthritis.

Keywords

• autologous conditioned serum, interleukin-1 receptor antagonist, osteoarthritis, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index)