INTRA-ARTICULAR CORTICOSTEROID INJECTION BENEFITS FOR PATIENTS WITH OSTEOARTHRITIS

Osteoarthritis (OA) is one of the most common and leading causes of disability and pain in the world. With an increasingly aging population, its prevalence in the future is expected to increase dramatically. Medical treatment strategies currently in use are primarily aimed at controlling the pain symptoms rather than modifying the disease. Surgical procedures are also used for permanently treating the pain, such as joint replacement. However, these approaches have not been very popular and are more invasive than therapeutic options. This is where mesenchymal stem cell therapy shines the most.

MSC, in the beginning, was used only for regenerative aims due to its differentiation competence, but after several in-depth studies, MSC has been found to reduce pain and help patients regain joint mobility. The degeneration of cartilage causes movement limitation in the joint. Other reasons may include damaging of synovial membrane or other joint components. Depend on the severity of the condition, various medications such as nonsteroidal anti-inflammatory drugs, glucosamine, platelet-rich plasma (PRP), or intra-articular injection of hyaluronic acid are applied.

However, the irreversible damage of the cartilage remains one of the biggest challenges in the treatment of pain relief, especially in OA. However, tissue engineering is considered to be a promising and innovative therapy for pain relief. Out of all the cell therapies, mesenchymal stem cell (MSC) therapy appears to hold promise. The therapy has the ability to differentiate different types of cells, including adipose, cartilage, and bone cells. Additionally, MSCs are immunoprivileged owing to their low immunogenicity.

Benefits of MSC in Therapeutic Pain Relief

In recent years, numerous investigations using mesenchymal stem cells (MSC) have been undertaken to aim to regenerate joint cartilage degenerated and injured during the course of osteoarthritis and other joint pathologies. Most of these studies have focused on cartilage regeneration and proliferation. Still, studies from the viewpoint of the anti-inflammatory effect of MSC on the joint, pain control, and cartilage preservation are also needed. They may make possible non-invasive conservative therapy instead of surgical intervention whenever feasible.

MSC also exerts a potent anti-inflammatory effect, which has recently begun to be exploited in various fields. MSC produces the anti-inflammatory protein TSG-6, which has been reported to suppress the excessive inflammatory reaction occurring at ischemic sites in the myocardium, thereby exerting a myocardium-preserving effect. Although the postoperative results of artificial joints have been improving in relatively young persons, their durability is still problematic, with multiple surgeries including revision often becoming necessary at comparatively young ages.

References

Ichiseki, T., Shimasaki, M., Ueda, Y., Ueda, S., Tsuchiya, M., Souma, D., Kaneuji, A. and Kawahara, N., 2018. Intraarticularly-injected mesenchymal stem cells stimulate anti-inflammatory molecules and inhibit pain related protein and chondrolytic enzymes in a monoiodoacetate-induced rat arthritis model. International journal of molecular sciences, 19(1), p.203.

Ichiseki, T., Ueda, S., Souma, D., Shimasaki, M., Ueda, Y. and Kawahara, N., 2019. Intraarticularly Injected Mesenchymal Stem Cells Stimulate Anti-Inflammatory Molecules and Inhibit Pain and Chondrolytic Enzymes in a Rat Model of Arthritis. Journal of Shoulder and Elbow Surgery, 28(11), p.e389.