TGF-β 3 as a potential biomarker of therapeutic efficacy of hyaluronic acid injections in knee osteoarthritis

Shilina K.G., Vykhrystenka L.R.

Vitebsk State Medical University, Vitebsk, Belarus

Knee osteoarthritis (OA) is a common disease often treated with intra-articular injections of hyaluronic acid (HA); however, clinical response to such therapy can vary. Preliminary data suggest that serum levels of TGF-β3 may serve as a biomarker of therapeutic efficacy.

The aim of this study was to evaluate the influence of serum TGF-β3 levels on clinical symptoms of knee OA following intra-articular HA injections.

Materials and methods. The study included 40 women with knee OA stages I-III. Serum TGF-β3 levels were assessed prior to HA injection and 6 months after. Clinical outcomes such as pain, joint function, stiffness were monitored according to Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and need for NSAIDs for one year. Depending on the duration of the therapeutic effect of local HA therapy, patients were divided into two groups: group 1 (17 individuals) – with a good response (reduction in pain and stiffness, improvement in joint function over one year), and group 2 (23 patients) – with no or minimal response to HA injection.

Results. In patients of group 1 with a good response to HA injection, a higher serum level of TGF-β3 was observed both at baseline and after 6 months compared to group 2 (p₁-₂ = 0,047 and p₁-₂ = 0,009, respectively). All patients in group 1 (17/17) demonstrated a reduced frequency of NSAIDs use (p<0,001), a significant reduction in WOMAC (p<0,001). Patients with concomitant varicose veins of the lower extremities exhibited lower TGF-β3 levels (p=0,007, rs=-0,428).

Conclusions. Higher serum TGF-β3 values in patients with knee OA may be associated with a more significant and prolonged therapeutic effect of intra-articular HA injection. Varicose veins of the lower extremities combined with low TGF-β3 levels in patients with knee OA may be associated with reduced efficacy of local HA therapy.