Amelioration of human osteoarthritis symptoms with topical 'biotherapeutics': a phase I human trial

• Published in: Cell stress & chaperones Vol. 20; no. 2; pp. 267 - 276
• Main Authors: Mahmoud, Fadia F., Al-Awadhi, Adel M., Haines, David D.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.03.2015; Springer Netherlands; Springer Nature B.V
• Subjects: Administration, Topical; Adult; Biochemistry; Biomedical and Life Sciences; Biomedicine; Blood; C-Reactive Protein - analysis; Cancer Research; Cell Biology; Cells, Cultured; Chondrocytes; Cytokines; Cytokines - metabolism; Drug Administration Schedule; Emulsions; Heme Oxygenase-1 - metabolism; Humans; Immunology; Leukocytes, Mononuclear - cytology; Leukocytes, Mononuclear - immunology; Leukocytes, Mononuclear - metabolism; Middle Aged; Neurosciences; Original Paper; Osteoarthritis; Osteoarthritis - diagnostic imaging; Osteoarthritis - drug therapy; Osteoarthritis - pathology; Oxidative stress; Pain; Pain Measurement; Placebo Effect; Placebos; Plant Extracts - chemistry; Plant Extracts - therapeutic use; Prunus; Prunus - chemistry; Prunus - metabolism; Radiography; Seeds - chemistry; Seeds - metabolism; Severity of Illness Index; T lymphocytes; Topical application; Treatment Outcome; Inflammation; Sour cherry; Cytokines; Osteoarthritis; Biotherapeutic agent; Heme oxygenase-1
• ISSN: 1355-8145; 1466-1268
• DOI: 10.1007/s12192-014-0553-0

Osteoarthritis (OA) treatments presently rely on analgesics, which manage pain but fail to restore imbalances between catabolic and anabolic processes that underlie OA pathogenesis. Recently, biologic (biotherapeutic) drugs, which alter the activity of catabolic agents such as nitric oxide and inflammatory cytokines in ways, allowing tissue regeneration, were evaluated for efficacy in OA treatment. These studies failed to demonstrate dramatic abatement of OA symptoms by these drugs, but suggested strategies by which biologic agents might be used to treat OA. The present review summarizes current understanding of OA pathogenesis and evolving treatments. Preliminary evaluations of a novel biotherapeutic strategy are presented here. Twenty OA patients receiving sour topical cherry seed extract (SCE), an inducer of heme oxygenase-1 (HO-1), a major physiological protectant against oxidative stress exhibited significantly decreased joint pain and activation of CD4+ T cells expressing inflammatory cytokines (p<0.05), significantly decreased peripheral blood C-reactive protein (CRP), and increased leukocyte HO-1 (p<0.05) in comparison with ten placebo-treated patients. SCE inhibits joint-damaging inflammatory mediator production. This agent therefore meets the main criterion for classification as a "biotherapeutic," or "biologic" agent. The negligible toxicity and low cost of such materials make them promising contributors to OA treatment, sustainable within resource limitations of a wide range of patients.