BackgroundEarly knee osteoarthritis, which causes the degeneration of articular cartilage and subchondral bone, is a disease that worsens with time and is a major contributor to physical disability. Several inflammatory cytokines released by chondrocytes work in concert to trigger the production of enzymes that break down cartilage. A pro-inflammatory cytokine called interleukin-1β (IL-1 β ) accelerates cartilage breakdown after trauma, reduces matrix production, and results in chondrocyte death. Dendritic cells and macrophages are the main sources of IL-1β. On the other hand, osteoblasts, periodontal ligament cells, and gingival fibroblasts have the ability to release IL-1β. Treatment pure-platelet rich plasma (P-PRP) effectiveness of transforming growth factor, platelet-derived growth factor, type I insulin-like growth factor, and the vascular endothelial growth factor is thought to be related to their release. Because of their capacity to increase matrix formation, growth factors have been widely researched for OA and cartilage regeneration. Hyaluronic acid (HA) is a glycosaminoglycan polymer composed of N-acetyl glucosamine and D-glucuronic acid disaccharide molecules. Early embryonic development, inflammatory, wound repair, cell differentiation, and viscoelasticity are all affected by HA, and other biological processes. Materials and MethodsElabscience kits were used to assess the serum IL-1β level. The experimental investigation included 18 control groups, 10 HA injections, and 21 pure PRP injections. age ranged from 30 to 80. The study was excluded all individuals with advanced osteoarthritis in the knee, COVID-19, diabetes, and autoimmune diseases. the time frame running from November 2021 until June 2022. Other variables in our research were age, gender, family history, use of antihypertensive medications or medications for other disorders, and body mass index (BMI). ResultsThe findings of this study demonstrate elevated IL-1β levels in patients with early KOA before treatments injection compared with the healthy control. After treatments injection, the level of IL-1β was decreased compared with before injection.Conclusions IL-1β could be one of the prognostic signs of early KOA

Background : The knee is one of the largest and most complicated joints in the body. Knee osteoarthritis is a common disease for many people in many countries, especially those who have an unbalanced and unhealthy lifestyle, where they suffer from pain and difficulty in movement. Given that treatments and medicines generally have side effects, it was possible to search for an alternative treatment that is safer and it has the greatest effect. Platelet-rich plasma therapy is an important and useful treatment by injecting it locally into the knee joint, which allows for repairing the damage in the joint and rebuilding it at the level of the microenvironment. Significant disappearance of symptoms the innate immune system stimulates interleukin-4, an anti-inflammatory cytokine secreted by the body in response to the inflammation that occurs in the affected area of the body, where it works to stimulate the repair of damage.Patients and procedure This non-randomized controlled pilot study included 32 patients (18 females and 14 males) with knee osteoarthritis and 16 healthy subjects (5 females and 11 male) from November 2021 to June 2022. All KOA patients diagnosed by orthopedic specialists were based on clinical treatment and radiological findings (X-rays). They were divided into two groups based on the type of PRP; they received: 21 patients received a single injection of pure-PRP in the knee joint and 11 patients received a single injection of LR-PRP in the knee joint. The PRP were received by patients was 4 ml in the case of both groups. The ages of the participants (patients and control group) ranged between 35-75 years old. Outcomes were measured at two points at baseline and six months after injection with IL-4 as an indicator. ResultsThe results of this study were showed that the concentration of IL-4 was significantly higher in KOA patients as compared to control subjects, and both the pure-PRP injected group and the LR-PRP injected group showed a significant decrease in the concentration of IL-4 after six weeks of intervention, but the pure-PRP injected group showed a higher reduction in the serum level of IL-4 as compared to the LR-PRP injected group. ConclusionsIn conclusion, pure-PRP and LR-PRP showed benefits in terms of inflammation reduction. In both groups, there was a significant reduction in the concentration of IL-4, but the pure-PRP gave a superior outcome as compared to the LR-PRP.

Background:Having lower back discomfort is common. Back tension may cause sciatica. Low back, or lumbar region, begins below the ribs. Most people will have low back discomfort. Disk damage, structural issues, and atherosclerosis also contribute. Rest, physical therapy, and medicine relieve pain. Weight management and exercise reduce low back pain risk. Epidural steroids alleviate leg and back pain (ESIs). Their extensive history makes them a good nonsurgical sciatica and back pain treatment. ESI may relieve radiculopathy.Human interleukin-18 (IL18) is an interferon-gamma-inducing factor. Gene generates inflammatory cytokine.The Aim: The study was aimed at the effect of epidural steroid injection on the concentrations of IL-18 in patients with LBP.Materials and Methods: Serum Interleukin-18 was measured using Elabscience® kits. In a case-control study, 36 healthy people and 22 LBP patients (13 men and 9 women) were compared (23 males and 13 females). Our research included 30 to 79-year-olds. All patients in this research were diagnosed by specialists based on their histories and clinical features. A patient's file includes ages, genders, family history, ailments (such as diabetes and hypertension), medicines, weight, height, and BMI (BMI). Participants with COVID-19, autoimmune disorders, diabetes mellitus, acute or chronic liver disease, renal disease, thyroid function abnormalities, or kidney disease were eliminated.Results: Interleukin-18 (IL-18) was substantially greater in patients with LBP (250.87 ±29.72 pg/mL) than following injection and control (157.94± 47.23), (132.40 ±22.58) pg/mL, respectively. Our investigation found a very significant difference (p-value < 0.0001) in IL-18 concentrations compared to L Also, mean values before and after injection were significantly different (p-value 0.0001). There is a significant difference in mean values before and after injection (p-value < 0.0001) and after injection and control (p = 0.0012). Conclusion:Epidural steroid treatment positively impacts LBP patients by decreasing IL-18 levels, which could be played an essential role in repairing damaged tissues.

Background: knee osteoarthritis (KOA) is a complex disease that causes metabolic, structural, biochemical, and functional alterations in afflicted tissues. Physical examination and radiological findings are the present methods for the diagnosis of knee osteoarthritis. Traditionally, KOA medication focused on symptom management. Clinical trials focused on delaying or reversing disease development have gained popularity in recent years. PRP is among the medicinal approaches used to manage KOA.Purpose: By assessing the cartilage degradation marker collagen-II, the study's aim was to figure out whether the use of pure-PRP may help KOA patients' damaged cartilage layers regenerate. Methods: This non-randomized controlled trial study involved 66 patients with knee OA and 28 healthy control subjects from December 2021 to February 2022. There were 2 categories of knee OA patients: 34 with moderate (grade-3) and 32 with mild (grade-2) KOA. So, every group of KOA patients is divided into three subgroups based to the frequency of injections (single, double, or triple) in addition to severity. Based on clinical and radiological data using the Kellgren-Lawence (KL) 0-4 grading system, the patients' diagnoses and classifications are made. This study was designed at AL-Imam Ali hospital, Babylon governorate, Iraq and approved by the medical human research ethics committee at Al-Qadisiyah university/ collage of medicine. Result: The findings of this investigation show that the serum collagen type-II content was considerably greater in KOA patients were compared to control subjects, and in moderate compared to mild KOA as the severity of the disease progressed. But following pure-PRP injection, the serum level of collagen type-II did not significantly decrease, and increasing the number of injections had no better effect. Conclusions: PRP therapy was generally acceptable for patients in terms of improving symptoms and there were no complications following injection. However, there is insufficient indication that platelet rich plasma regenerates cartilage damage in knee OA patients, as there was no significant decrease in the amount of collagen type-II.