Effects of Joint Lavage with Dimethylsulfoxide on LPS-Induced Synovitis in Horses—Clinical and Laboratorial Aspects

Abstract

Several studies in human and equine medicine have produced controversial results regarding the role of dimethylsulfoxide (DMSO) as a therapeutic agent. This study aimed to evaluate the effect of joint lavage with different DMSO concentrations on biomarkers of synovial fluid inflammation and cartilage degradation in joints with lipopolysaccharide (LPS)-induced synovitis. Twenty-six tibiotarsal joints of 13 horses were randomly distributed into four groups (lactated Ringer’s solution; 5% DMSO in lactated Ringer’s; 10% DMSO in lactated Ringer’s; and sham). All animals were evaluated for the presence of lameness, and synovial fluid analyses were performed at 0 h, 1 h, 8 h, 24 h, and 48 h (T0, T1, T8, T24, and T48, respectively). The white blood cell counts (WBC), total protein (TP), urea, prostaglandin E2 (PGE2), interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor-α (TNF-α), hyaluronic acid (HA), and chondroitin sulfate (CS) concentrations were measured. The WBC counts and PGE2, IL-1β, IL-6, and TP concentrations increased in all groups at T8 compared to baseline values (p < 0.05). At T48, only the 5% DMSO and 10% DMSO groups showed a significant decrease in WBC counts (p < 0.05). Furthermore, the 10% DMSO group had lower concentrations of PGE2 and IL-1β at T48 than at T8 (p < 0.05) and presented lower IL-6 levels than the5% DMSO and lactated Ringer’s groups at T24. All groups showed an increase in CS concentration after LPS-induced synovitis. Joint lavage with 10% DMSO in lactated Ringer’s has anti-inflammatory but not chondroprotective effects.

Allogeneic chondrogenic‐induced mesenchymal stem cells for the treatment of tarsometatarsal lameness in horses

“…The presence of DMSO as an excipient in the Dulbecco's modified Eagle medium has the potential to act as an anti-inflammatory in its own right. 33 The conclusion of the CVMP assessment report for Arti-Cell Forte was that the final quantity of 5% DMSO, as well as DMEM-LG, was so low that no clinically significant pharmacological effect was anticipated. 23 The presence of platelets in the allogeneic plasma component might also have been anticipated to have some benefit.…”

“…No horses in either group were reported by owners to have experienced any detectable adverse reaction to treatment. First re-examination was 38 days (95% CI: 38-49), with no difference between groups: CIMSC 42 (35-45), control 34(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42), p = 0.11. All CIMSC horses and 79 controls F I G U R E 1 Violin plot showing the range of radiographic severity for the 67 horses treated with chondrocyte-induced mesenchymal stem cells (CIMSC) and 100 control horses treated with intra-articular corticosteroids.…”

Investigation of Synovial Fluid Lubricants and Inflammatory Cytokines in the Horse: a Comparison of Recombinant Equine Interleukin 1β-induced Synovitis and Joint Lavage Models

“…LPS-induced equine synovitis models have shown decreased HA over a 48-hour period, and a quantitative intercompartmental synovial joint model predicted that HA would take longer to reach a steady state concentration than lubricin following intra-articular lavage. [42][43][44] While intra-articular lavage resulted in loss of HA, either due to synovial uid washout, increased degradation, or decreased production, it was surprising that lavage resulted in an increase in synovial uid lubricin given prior in vitro data in bovine cartilage explants. 45 We hypothesized that intra-articular lavage would result in synovial uid washout due to removal of synovial uid from the joint, at least in the early post-lavage period.…”

“…Repeated arthrocentesis is necessary for studies designed to measure changes in synovial uid constituents over time and has been employed in nearly all studies evaluating IL-1β or LPS-induced synovitis in horse. 24,28,29,42,44 However, arthrocentesis is not an innocuous procedure and can lead to contamination of the joint with hair and debris, in addition to hemorrhage and trauma to the cartilage and synovium. 54 Increased joint circumference has been reported following 4 repeated arthrocenteses over a 24 hour period in horses.…”

Osteoarthritis: a common disease that should be avoided in the athletic horse’s life

“…Although dimethylsulfoxide (DMSO) is not classified as anti-inflammatory, it has analgesic and anti-inflammatory properties and is commonly applied in the equine routine in joint lavages as an additional treatment for synovium inflammation. In an experimental study, joint lavage using a diluted DMSO solution decreased lameness, inflammatory cell count, PGE 2 , and proinflammatory cytokines (IL-1β and IL-6) compared to solution without DMSO ( Sotelo et al, 2020 ).…”