Конусно-променева томографічна оцінка модуляції протизапальної дії німесуліду та кеторолаку безклітинними кріоконсервованими біологічними засобами при експериментальному ревматоїдному артриті

Abstract

Rheumatoid arthritis is a chronic systemic immune-inflammatory disease accompanied by progressive joint damage, bone tissue remodeling, and persistent functional impairment. Non-steroidal anti-inflammatory drugs are widely used to control pain and inflammation; however, their action is mainly limited to mediator-dependent inflammatory pathways and does not affect the key immunopathogenetic mechanisms of the disease. Therefore, the development of combined therapeutic approaches that integrate pharmacological anti-inflammatory effects with the immunomodulatory potential of cell-free biological products, as well as the use of objective quantitative methods for assessing treatment efficacy, remains highly relevant.

Purpose – to evaluate the modulation of the anti-inflammatory effects of nimesulide and ketorolac by cell-free cryopreserved biological products, namely placental cryoextract and conditioned medium of mesenchymal stromal cells, in rats with experimental adjuvant-induced arthritis using quantitative analysis of joint volume changes based on cone-beam computed tomography.

Materials and Methods. The study was conducted on 42 male rats with induced adjuvant-induced arthritis, randomly allocated into 6 experimental groups. Treatment was administered from day 14 to day 28 of the experiment. Quantitative assessment of joint changes was performed using cone-beam computed tomography at baseline, day 14, and day 28, with calculation of the conditional volume of the metatarsophalangeal joint based on linear morphometric parameters.

Results. In rats with adjuvant-induced arthritis without treatment, joint volume increased by 147.4% by day 28 compared to baseline values, indicating progressive inflammatory development. Monotherapy with nimesulide or ketorolac reduced joint volume by 38.2% and 46.3%, respectively, compared to untreated animals; however, the values remained significantly higher than those observed in intact rats. Combined administration of nimesulide with placental cryoextract resulted in the most pronounced reduction in joint volume, exceeding intact levels by only 10.8%. The combination of ketorolac with conditioned medium of mesenchymal stromal cells also provided a significant reduction in inflammatory changes, with joint volume exceeding intact values by 14.9%. Both combined treatment regimens demonstrated significantly greater efficacy than monotherapy.

Conclusions. Combined administration of non-steroidal anti-inflammatory drugs with cell-free biological products is more effective in reducing joint inflammation in experimental adjuvant-induced arthritis than monotherapy. Cone-beam computed tomography with morphometric analysis allows objective quantitative assessment of the dynamics of inflammatory changes in joints.