Effects of hyaluronic acid on Th lymphocytes concentration in knee and hip osteoarthritis

Effects of hyaluronic acid (HA) viscosupplementation on peripheral Th cells in knee and hip osteoarthritis. A Randomized, clinical study

Article specifications

This clinical study was published in 2015 in journal of Osteoarthritis and cartilage 23 (IF2015: 4.165) by Italian orthopedics. In this study researchers determine TH lymphocytes concentration in patients with knee or hip osteoarthritis (OA) and evaluate their change after HA viscosupplementation. 86 patients with early primary knee or hip OA (ACR Criteria) were recruited in two groups: 49 in group A (35 knee OA, 14 hip OA), 23 in Control Group was only observed longitudinally, 37 in Group B (24 knee OA, 13 hip OA) was treated with a course of three weekly intra-articular injections of HA. A healthy control group gender and age matched was enrolled too. All subjects were followed for 3 months. Flow cytometry was performed from blood samples to assess T cells subpopulations (CD3, CD4, CD8, CCR6, CD38, CxCR3, HLA DR) at baseline and at 3-months visit.

Results

Results of the study showed that activated CD4 T cells (CD4‏CD38‏DR‏, CD4‏CD38_DR‏), Th2 (CD4‏CXCR3_CCR6_), Th1 (CD4‏CXCR3‏CCR6_) were higher at baseline in group A and B than in control group. After the HA course activated T cells were lower in group B than in group A. Th17 (CD4‏CXCR3_CCR6‏) at baseline were higher in groups A and B than in control group and decreased levels in Group B after the HA course were observed so in conclusion this study showed that HA injections could lower the levels of activated T cells, and so regulate the articular milieu.
These data suggest an anti-inflammatory effect of HA. In summary, this exploratory study suggests that HA IA injections may modify the knee or hip joint metabolism in patients with OA resulting in a decrease in proinflammatory T cells concentrations. In particular it can reduce synovial inflammation and restore the rheological properties of synovial fluid.