Editorial Commentary: Could Biological Treatments Be the Game-Changing Factor for Osteoarthritis?

Abstract

The realization of the presence of an inflammatory component in cartilage degeneration together with the promising application of platelet-rich plasma and amnion as "healing agents" opened a new window of opportunity for biological treatments in osteoarthritis. If the goal is to delay or even cease the degenerative process, then treating the cause rather than the symptom is a key factor for this biological intervention to be successful. As new biological agents arise, there are 3 crucial milestones that need to be met in laboratory and clinical studies: safety, reasonable cost, and improved effectiveness in comparison with alternatives.

Editorial Commentary: Exosomes—A New Word in the Orthopaedic Vocabulary?

“…1 We will continue to recommend positive and negative control groups, addition of more quantitative versus qualitative data, adherence to the principles of biomechanical testing, and careful interpretation of findings for what they actually prove, rather than allowing our enthusiasm to bias our conclusions. [8][9][10] However, limitations in the translation of these promising findings into human trials include the potential high cost that needs, of course, to be evaluated, together with effectiveness, as well as the potential of an immune response because the mediators contained in the exosomes may still have an antigenic profile, even though this is generally considered of low immunogenicity. 8,11,12 Another potential concern is the lack of reproducibility of the effect, which could be attributed to the fact that exosomes are highly dependent on the characteristics of the parental mesenchymal stem cells, such as gene expression profile and level of differentiation, but also to the complexity of the methods involved in exosome isolation and purification.…”

“…[8][9][10] However, limitations in the translation of these promising findings into human trials include the potential high cost that needs, of course, to be evaluated, together with effectiveness, as well as the potential of an immune response because the mediators contained in the exosomes may still have an antigenic profile, even though this is generally considered of low immunogenicity. 8,11,12 Another potential concern is the lack of reproducibility of the effect, which could be attributed to the fact that exosomes are highly dependent on the characteristics of the parental mesenchymal stem cells, such as gene expression profile and level of differentiation, but also to the complexity of the methods involved in exosome isolation and purification. 11 Finally, we continue to encourage high level of evidence clinical translational studies that will test the safety, feasibility, and efficiency of all new biologic treatments for orthopaedic conditions.…”

Efficacy and safety of anti-interleukin-1 therapeutics in the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

“…IL-1β is involved in the pathogenesis of cartilage loss and destructive OA [34][35][36]. With the deepening of basic research, it has become an established fact that IL-1 triggers KOA; therefore, whether anti-IL-1 therapy could treat KOA has aroused great interest from researchers [37,38].…”