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Platelet-derived biomaterial with hyaluronic acid alleviates temporal-mandibular joint osteoarthritis: clinical trial from dish to human
Type
article
Resource
J Biomed Sci 30; 77 (2023)
Date Issued
2023-11
Author(s)
彭伯宇
Peng, Bou-Yue;Singh, Abhinay Kumar;Tsai, Ching-Yu;Chan, Chun-Hao;Deng, Yue-Hua;Wu, Chi-Ming;Chou, Yen-Ru;Tsao, Wen;Deng, Chia-Yu Wu & Win-Ping
Subjects
牙醫學系
期刊論文
Description
【112-2 升等】臺北醫學大學教師升等專門著作
職別：專任
送審等級：副教授
著作送審
代表著作名稱：《Platelet-derived biomaterial with hyaluronic acid alleviates temporal-mandibular joint osteoarthritis: clinical trial from dish to human》
Trial registration Taipei Medical University Hospital (TMU-JIRB No. N201711041). Registered 24 November 2017. https://tmujcrc.tmu.edu.tw/inquiry_general.php.
Abstract
Background
Bioactive materials have now raised considerable attention for the treatment of osteoarthritis (OA); such as knee OA; rheumatoid OA; and temporomandibular joint (TMJ) OA. TMJ-OA is a common disease associated with an imbalance of cartilage regeneration; tissue inflammation; and disability in mouth movement. Recently; biological materials or molecules have been developed for TMJ-OA therapy; however; ideal treatment is still lacking. In this study; we used the combination of a human platelet rich plasma with hyaluronic acid (hPRP/HA) for TMJ-OA therapy to perform a clinical trial in dish to humans.
Method
Herein; hPRP was prepared; and the hPRP/HA combined concentration was optimized by MTT assay. For the clinical trial in dish; pro-inflammatory-induced in-vitro and in-vivo mimic 3D TMJ-OA models were created; and proliferation; gene expression; alcian blue staining; and IHC were used to evaluate chondrocyte regeneration. For the animal studies; complete Freund’s adjuvant (CFA) was used to induce the TMJ-OA rat model; and condyle and disc regeneration were investigated through MRI. For the clinical trial in humans; 12 patients with TMJ-OA who had disc displacement and pain were enrolled. The disc displacement and pain at baseline and six months were measured by MRI; and clinical assessment; respectively.
Results
Combined hPRP/HA treatment ameliorated the proinflammatory-induced TMJ-OA model and promoted chondrocyte proliferation by activating SOX9; collagen type I/II; and aggrecan. TMJ-OA pathology–related inflammatory factors were efficiently downregulated with hPRP/HA treatment. Moreover; condylar cartilage was regenerated by hPRP/HA treatment in a proinflammatory-induced 3D neocartilage TMJ-OA-like model. During the animal studies; hPRP/HA treatment strongly repaired the condyle and disc in a CFA-induced TMJ-OA rat model. Furthermore; we performed a clinical trial in humans; and the MRI data demonstrated that after 6 months of treatment; hPRP/HA regenerated the condylar cartilage; reduced disc displacement; alleviated pain; and increased the maximum mouth opening (MMO). Overall; clinical trials in dish to human results revealed that hPRP/HA promoted cartilage regeneration; inhibited inflammation; reduced pain; and increased joint function in TMJ-OA.
Conclusion
Conclusively; this study highlighted the therapeutic potential of the hPRP and HA combination for TMJ-OA therapy; with detailed evidence from bench to bedside.
Bioactive materials have now raised considerable attention for the treatment of osteoarthritis (OA); such as knee OA; rheumatoid OA; and temporomandibular joint (TMJ) OA. TMJ-OA is a common disease associated with an imbalance of cartilage regeneration; tissue inflammation; and disability in mouth movement. Recently; biological materials or molecules have been developed for TMJ-OA therapy; however; ideal treatment is still lacking. In this study; we used the combination of a human platelet rich plasma with hyaluronic acid (hPRP/HA) for TMJ-OA therapy to perform a clinical trial in dish to humans.
Method
Herein; hPRP was prepared; and the hPRP/HA combined concentration was optimized by MTT assay. For the clinical trial in dish; pro-inflammatory-induced in-vitro and in-vivo mimic 3D TMJ-OA models were created; and proliferation; gene expression; alcian blue staining; and IHC were used to evaluate chondrocyte regeneration. For the animal studies; complete Freund’s adjuvant (CFA) was used to induce the TMJ-OA rat model; and condyle and disc regeneration were investigated through MRI. For the clinical trial in humans; 12 patients with TMJ-OA who had disc displacement and pain were enrolled. The disc displacement and pain at baseline and six months were measured by MRI; and clinical assessment; respectively.
Results
Combined hPRP/HA treatment ameliorated the proinflammatory-induced TMJ-OA model and promoted chondrocyte proliferation by activating SOX9; collagen type I/II; and aggrecan. TMJ-OA pathology–related inflammatory factors were efficiently downregulated with hPRP/HA treatment. Moreover; condylar cartilage was regenerated by hPRP/HA treatment in a proinflammatory-induced 3D neocartilage TMJ-OA-like model. During the animal studies; hPRP/HA treatment strongly repaired the condyle and disc in a CFA-induced TMJ-OA rat model. Furthermore; we performed a clinical trial in humans; and the MRI data demonstrated that after 6 months of treatment; hPRP/HA regenerated the condylar cartilage; reduced disc displacement; alleviated pain; and increased the maximum mouth opening (MMO). Overall; clinical trials in dish to human results revealed that hPRP/HA promoted cartilage regeneration; inhibited inflammation; reduced pain; and increased joint function in TMJ-OA.
Conclusion
Conclusively; this study highlighted the therapeutic potential of the hPRP and HA combination for TMJ-OA therapy; with detailed evidence from bench to bedside.