Journal
AMERICAN JOURNAL OF SPORTS MEDICINE
Volume 50, Issue 5, Pages 1389-1398Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/03635465221083610
Keywords
osteoarthritis; stromal cells; stem cells; NSAID; pain management; knee
Categories
Funding
- VA (SPiRE) [I21RX002372-01A1]
- United States (US) Department of Veterans Affairs Rehabilitation Research and Development Service
- DOD PRMRP Grant [PR171379]
- PHS Grant [UL1TR0 0 0454]
- Clinical and Translational Science Award Program, National Institutes of Health, National Center for Advancing Translational Sciences [1RO1 HL140223]
- National Institutes of Health
- Joe and Clara Tsai Foundation
- CDMRP [PR171379, 1101186] Funding Source: Federal RePORTER
Ask authors/readers for more resources
This study investigated the effects of pre- and post-treatment use of nonsteroidal anti-inflammatory drugs (NSAIDs) on the therapeutic efficacy of human mesenchymal stromal cell (hMSC) therapy for posttraumatic osteoarthritis (PTOA). The study found that pre-treatment with NSAIDs had minimal effects on therapeutic benefits, while post-treatment use of NSAIDs substantially reduced the efficacy of cellular treatment.
Background: Intra-articular injections of human mesenchymal stromal cells (hMSCs) have shown promise in slowing cartilage degradation in posttraumatic osteoarthritis (PTOA). Clinical use of cell therapies for osteoarthritis has accelerated in recent years without sufficient scientific evidence defining best-use practices. Common recommendations advise patients to avoid nonsteroidal anti-inflammatory drug (NSAID) use before and after cell injection over concerns that NSAIDs may affect therapeutic efficacy. Recommendations to restrict NSAID use are challenging for patients, and it is unclear if patients are compliant. Hypothesis: NSAIDs will reduce the efficacy of hMSC therapy in treating a preclinical model of PTOA. Study Design: Controlled laboratory study. Methods: Lewis rats underwent medial meniscal transection (MMT) surgery to induce PTOA or a sham (sham group) surgery that did not progress to PTOA. Rats received naproxen solution orally daily before (Pre-NSAID group) or after (Post-NSAID group) hMSC treatment, throughout the course of the experiment (Full-NSAID group), or received hMSCs without NSAIDs (No NSAID). Cartilage morphology and composition were quantified using contrast-enhanced micro-computed tomography and histology. Pain (secondary allodynia) was measured using a von Frey filament. Results: Injection of hMSCs attenuated cartilage degeneration associated with MMT. hMSCs prevented proteoglycan loss, maintained smooth cartilage surfaces, reduced cartilage lesions, reduced mineralized osteophyte formation, and reduced pain by week 7. The Pre-NSAID group had decreased proteoglycan levels compared with the hMSC group, although there were no other significant differences. Thus, pretreatment with NSAIDs had minimal effects on the therapeutic benefits of hMSC injections. The Post-NSAID and Full-NSAID groups, however, exhibited significantly worse osteoarthritis than the hMSC-only group, with greater proteoglycan loss, surface roughness, osteophyte volume, and pain. Conclusion: Use of NSAIDs before hMSC injection minimally reduced the therapeutic benefits for PTOA, which included preservation of cartilage surface integrity as well as a reduction in osteophytes. Use of NSAIDs after injections, however, substantially reduced the therapeutic efficacy of cellular treatment.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available