IADR Abstract Archives

Intra-articular MSC exosome-hyaluronic acid therapy alleviates TMJ-OA pain and degeneration

Objectives: To evaluate the efficacy of mesenchymal stem cell (MSC) exosomes with hyaluronic acid (HA) against HA alone in the treatment of temporomandibular joint osteoarthritis (TMJ-OA) in a rabbit model
Methods: MSC exosomes were prepared from an immortalized human MSC line. Nine rabbits (18 TMJs) were randomly assigned into three groups: (1) OA-HA, (2) OA-HA+Exo and (3) Sham. TMJ-OA was induced by intra-articular injection of mono-iodoacetate (MIA) in bilateral TMJs of 6 rabbits in OA-HA and OA-HA+Exo groups. Two weeks after OA induction, the rabbits received three weekly intra-articular injections of 50μl HA with 200μl phosphate-buffered saline (PBS) for the OA-HA group, or 50μl HA with 200μg exosomes in 200μl PBS for the OA-HA+Exo group. Rabbits in the sham group received only needle pricks. The effect of treatments on TMJ-OA pain was assessed weekly by measurements of the head withdrawal threshold (HWT) using an algometer. By the end of 8 weeks post-treatment, the rabbits were euthanized and the dissected TMJs were evaluated by micro-computed tomography (micro-CT) and histological assessment.
Results: OA-HA+Exo group showed gradual improvements in HWT, and the pain was reduced to baseline level of the sham animals as early as 4 weeks post-treatment. In contrast, OA-HA group showed minimal HWT improvement throughout the course of study. Notably, OA-HA+Exo group showed significantly better outcomes in the macroscopic score (P<0.05), OARSI histologic score (P<0.01) and synovial membrane inflammatory score (P<0.01) than that of OA-HA group, and were comparable to that of the sham group (P>0.05). As evidenced by micro-CT analysis, OA-HA+Exo group had a higher ratio of bone volume over total volume (BV/TV) than that of OA-HA group (P<0.01) and was comparable in BV/TV and trabecular thickness (Tb.Th) as the sham group (P>0.05).
Conclusions: This study shows that the combination of MSC exosomes and HA administered at a clinically acceptable frequency of 3 weekly intra-articular injections can suppress TMJ-OA inflammation and pain, while enhancing cartilage and subchondral bone repair, with significantly improved morphological and histological outcomes.

2023 South East Asian Division Meeting (Singapore)
Singapore
2023
011
Oral and Maxillofacial Surgery
  • Sng, Timothy  ( National University of Singapore, National University for Oral Health, Singapore , Singapore , Singapore , Singapore )
  • Jiang, Yuan Yuan  ( National University of Singapore, National University for Oral Health, Singapore , Singapore , Singapore , Singapore )
  • Zhang, Shipin  ( National University of Singapore, National University for Oral Health, Singapore , Singapore , Singapore , Singapore )
  • Wong, Raymond Chung Wen  ( National University of Singapore, National University for Oral Health, Singapore , Singapore , Singapore , Singapore )
  • Lim, Asher Ah Tong  ( National University of Singapore, National University for Oral Health, Singapore , Singapore , Singapore , Singapore )
  • Toh, Wei Seong  ( National University of Singapore, National University for Oral Health, Singapore , Singapore , Singapore , Singapore ;  Yong Loo Lin School of Medicine, National University of Singapore, Singapore , Singapore , Singapore )
  • NONE
    National University of Singapore, Faculty of Dentistry Grant (R - 221-000-046-101).
    Oral Session
    Oral Session-2: Oral Health Research - 1
    Thursday, 11/23/2023 , 11:00AM - 12:30PM