Osteoarthritis is a frequent, age-associated disease affecting >10% of world's population over 60 years of age. This study intended to compare intra-articular whole blood clot secretome (autologous conditioned serum [ACS], recently re-named blood clot secretome [BCS]) to platelet-rich plasma (PRP) in knee osteoarthritis (OA). A clinical, nonrandomized open-label comparison of ACS versus PRP in knee OA with subclinical or moderate synovitis symptomology was performed. One hundred and twenty-three patients with knee OA, Kellgren and Lawrence grade II–III, were each treated with six i.a. injections of ACS or PRP. The clinical efficacy was measured by visual analog scale and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. The biochemical effects measured include synovial fluid (SF) viscosity, cytokines interleukin (IL)-1Ra and IL-1b, radical footprint NO₃, and conjugated dienes (CDs). At the 3-month follow-up, clinical efficacy of ACS was significant in all groups, versus PRP. PRP had significant versus baseline efficacy in subclinical, but not in moderate, synovitis cases. ACS was more effective than PRP regarding all analytical parameters. It induced endogenous IL-1Ra expression, downregulated IL-1b, and improved SF viscosity. ACS reduced—significantly stronger than PRP—the concentration of CDs—interpreted as reactive oxygen species footprints—and NO₃—interpreted as nitric oxide footprint—in SF. ACS displayed significant efficacy in all groups, which was clinically and biochemically superior to PRP. ACS appears to improve i.a. homeostasis. Strength of this open clinical study is the combination of clinical and biochemical data.

中文翻译：

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关节内注射全血凝块分泌组、自体条件化血清，比富含血小板的血浆具有更好的临床和生化功效，并能诱导与回春相关的关节代谢变化：慢性膝骨关节炎的前瞻性、受控开放标签临床研究

骨关节炎是一种常见的、与年龄相关的疾病，影响超过 10% 的世界 60 岁以上人口。本研究旨在比较膝关节骨关节炎 (OA) 中关节内全血凝块分泌组（自体条件化血清 [ACS]，最近更名为血凝块分泌组 [BCS]）与富含血小板的血浆 (PRP)。对具有亚临床或中度滑膜炎症状的膝 OA 进行了 ACS 与 PRP 的临床、非随机、开放标签比较。123 名膝关节 OA 患者，Kellgren 和 Lawrence II-III 级，每人接受 6 次 IA 注射 ACS 或 PRP。通过视觉模拟量表和西安大略和麦克马斯特大学关节炎指数（WOMAC）评分来衡量临床疗效。测量的生化效应包括滑液 (SF) 粘度、₃和共轭二烯 (CD)。在 3 个月的随访中，与 PRP 相比，ACS 在所有组中的临床疗效均显着。PRP 在亚临床滑膜炎病例中与基线相比具有显着疗效，但在中度滑膜炎病例中则不然。在所有分析参数方面，ACS 都比 PRP 更有效。它诱导内源性 IL-1Ra 表达，下调 IL-1b，并改善 SF 粘度。ACS比的PRP-浓度减小显著更强的CD-解释为反应性氧物质的脚印和NO ₃ -interpreted氧化氮足迹-在SF。ACS 在所有组中均显示出显着疗效，在临床和生化方面均优于 PRP。ACS 似乎可以改善 ia 体内平衡。这项开放式临床研究的优势在于结合了临床和生化数据。