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Investigating the mechanism of dextrose prolotherapy in vitro: fibroblast proliferation and production of growth factors

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 35. doi: Subito , type of study: Base

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

dextrose prolotherapy [1]
fibroblasts [14]
injections [6]
osteoarthritis [28]
baseline study [22]

Abstract:

Introduction/Background: Dextrose prolotherapy injections represent a promising treatment option for patients with osteoarthritis. However, the mechanism and optimal concentration of dextrose prolotherapy is not well understood. Objective: Therefore, we investigated how the response of dextrose-exposed fibroblasts impacts other cells that were not exposed to dextrose, and what factors they secreted. We hypothesize that hypertonic solutions of 10-25% dextrose will incite an initial inflammatory response followed by the production of growth factors and enhanced fibroblast proliferation. Methods: We exposed MRC-5 fibroblasts to dextrose concentrations (5-25%) and a media control for 15 minutes-2 hours, removed the supernatant fluid, and then added fresh media (without dextrose) for 8 hours to collect any secreted factors in response to treatment. After 8 hours, the media from the dextrose-treated fibroblasts was transferred to nascent MRC-5 fibroblasts (not exposed to dextrose) for 48 hours. Then cell viability was quantified using an XTT assay and analyzed using ANOVA. Additionally, we used the supernatant fluid collected 8 hours post-treatment to run ELISAs for BMP-12/ GDF-7 and CXCL12/SDF-1. Results: Supernatant fluid from fibroblasts treated with 5-20% dextrose concentrations have a positive impact on cell viability of nascent fibroblasts (not directly exposed to dextrose). Production of BMP-12 and CXCL12 increases with higher concentrations of dextrose (<1 hour of exposure) but decreases with longer exposure (>1 hour). Discussion/Conclusion: These preliminary results support the hypothesis that dextrose prolotherapy initially stimulates the production of growth factors and cellular proliferation. As this is an in vitro study using fibroblasts, further research using other cell and animal models are needed to better understand the mechanism by which prolotherapy may improve function and reduce pain in osteoarthritis.


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