Assessment of synovial repair in primary knee osteoarthritis after platelet rich plasma (PRP) intra-articular injection … Original Research Article …

The Egyptian Journal of Immunology
E-ISSN (2090-2506)
Volume 31 (4), October 2024
Pages: 58–65.
www.Ejimmunology.org
https://doi.org/10.55133/eji.310406
Esraa M. Bastawy1, Mohamed G. Zaki1, Nevine Badr1, Fatma Abdallah2 and Nermin H. El-Gharbawy1
1Department of Physical Medicine, Rheumatology & Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

2Department of Clinical Pathology & Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Corresponding author:
Esraa M. Bastawy, Department of Physical Medicine, Rheumatology & Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Email: esraa.muhammad@med.asu.edu.eg.

 

Abstract

Primary knee osteoarthritis (KOA) is a persistent condition marked by the gradual deterioration of the joint and cartilage loss on its surfaces. Recently, platelet-rich plasma (PRP) was considered a biological intervention that alleviates symptoms and restricts the advancement of primary KOA in patients. This study aimed to evaluate the effect of intra-articular PRP injections on synovial repair through cytokine assays in 20 patients with primary KOA. Patients received two intra-articular PRP injections, spaced one month apart. The role of PRP was assessed by measuring Transforming growth factor beta (TGF-β) and interleukin-17 (IL-17) levels in synovial fluid before and after the injections. Both visual analogue scale and Western Ontario and McMaster Universities Osteoarthritis index were assessed before and after intervention. IL-17 and TGF-β levels were measured in the synovial fluid using sandwich ELISA technique before the first PRP intra-articular injection and one month after the second injection to assess the synovial repair after PRP injection. Our results showed that the synovial IL-17 levels significantly decreased by 75.21% (p<0.0001) after intra-articular knee injection, dropping from a range of 102.3–293 (median 173.5: 139.7– 224.5) to 17.86–106 (median 36.38: 23.57– 50.32). In contrast, synovial TGF-β levels significantly increased by 80.3% (p<0.0001) after intra-articular knee injection, rising from 124–545.5 (mean ± SD: 256.22 ± 123.56) to 693.3–3226 (mean ± SD: 1521.6 ± 765.46). In conclusion, intra-articular PRP administration in primary KOA patients is associated with increased levels of TGF-β and decreased levels of IL-17 in the synovial fluid of the joint. These changes in cytokine levels suggest that PRP treatment effectively reduces inflammation and may contribute to pain relief in primary KOA.

Keywords:
Primary Knee osteoarthritis, Interleukin-17, TGF-β, platelet rich plasma (PRP).

Date received: 15 March 2024; accepted: 29 August 2024

PMID:
39417741

 

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