Work

Synovial Biomarker Modulation and Clinical Response to Umbilical Cord-Derived MSC Treatment in Knee Osteoarthritis: A Case Series Study

Year: 2026

Type: article

Abstract: Objective Umbilical cord-derived mesenchymal stromal cells (UC-MSCs) are a promising treatment for knee osteoarthritis (KOA). This study aimed to (1) characterize early synovial fluid biomarker changes after intra-articular UC-MSCs therapy in advanced KOA and (2) explore their relationship with short-term clinical outcomes. Methods In this prospective, single-arm case series, 15 patients with advanced KOA (Kellgren–Lawrence III–IV) scheduled for total knee arthroplasty received a single intra-articular injection of 20 × 10 6 allogeneic UC-MSCs. Synovial fluid was aspirated at baseline and approximately 6 weeks post-injection. A panel of 29 soluble biomarkers related to inflammation, matrix remodeling, immune signaling, angiogenesis, and metabolism was quantified using multiplex immunoassays. Clinical status was evaluated with Patient-Reported Outcome Measures (PROMs) before and at a mean of 48 ± 18 days after the injection. Paired differences were analyzed using the Wilcoxon signed-rank tests. Results Significant post-treatment differences were observed in biomarkers associated with extracellular matrix turnover (Matrix Metalloproteinase [MMP]-1, MMP-3, MMP-7, Cartilage Oligomeric Matrix Protein [COMP]), vascular remodeling (Vascular Endothelial Growth Factor [VEGF], Vascular Cell Adhesion Molecule [VCAM]-1), immune modulation (interleukin [IL]-8), and metabolic or structural regulation (Leptin, dickkopf [Dkk]-1). Most PROMs demonstrated significant improvements. These findings describe molecular changes in synovial fluid observed after intra-articular UC-MSC administration. Conclusions In this prospective single-arm cohort, intra-articular UC-MSC administration was feasible and well tolerated, and we observed pre–post changes in synovial fluid biomarkers and patient-reported outcomes. These findings do not establish causality and warrant confirmation in controlled studies. The study was registered at Clinicaltrials.gov: Mechanisms of Treatment Effects Using Cultured, Allogeneic Mesenchymal Stromal Stem Cells (MSCs) in Knee Osteoarthritis, NCT06078059, https://clinicaltrials.gov/study/NCT06078059?intr=NCT06078059 .

Source: Cartilage

DOI: 10.1177/19476035261435793

Authors: Urban Švajger, Matic Kolar, Borut Pompe, Andrej Kobold, Matej Drobnič

Institutions: University of Ljubljana, Blood Transfusion Centre of Slovenia, Ljubljana University Medical Centre

Language: English

Topic: Osteoarthritis Treatment and Mechanisms

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $2,650