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Targeting Adenosine Signalling in Knee Chondropathy: The Combined Action of Polydeoxyribonucleotide and Pulsed
Lorenzo Moretti1, Davide Bizzoca1,2, Alessandro Geronimo3
1Orthopaedics Unit-UOSD Vertebral Surgery, AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
Abstract:
Chondropathy of the knee is one of the most frequent degenerative cartilage pathologies with advancing age. Scientific research has, in recent years, advanced new therapies that target adenosine A2 receptors, which play a significant role in human health against many disease states by activating different protective effects against cell sufferance and damage. Among these, it has been observed that intra-articular injections of polydeoxyribonucleotides (PDRN) and Pulsed Electromagnetic Fields (PEMF) can stimulate the adenosine signal, with significant regenerative and healing effects. This review aims to depict the role and therapeutic modulation of A2A receptors in knee chondropathy. Sixty articles aimed at providing data for our study were included in this review. The present paper highlights how intra-articular injections of PDRN create beneficial effects by reducing pain and improving functional clinical scores, thanks to their anti-inflammatory action and the important healing and regenerating power of the stimulation of cell growth, production of collagen, and the extracellular matrix. PEMF therapy is a valid option in the conservative treatment of different articular pathologies, including early OA, patellofemoral pain syndrome, spontaneous osteonecrosis of the knee (SONK), and in athletes. PEMF could also be used as a supporting therapy after an arthroscopic knee procedure total knee arthroplasty to reduce the post-operative inflammatory state. The proposal of new therapeutic approaches capable of targeting the adenosine signal, such as the intra-articular injection of PDRN and the use of PEMF, has shown excellent beneficial results compared to conventional treatments. These are presented as an extra weapon in the fight against knee chondropathy.
Insights
New therapies targeting adenosine A2 receptors, like polydeoxyribonucleotides (PDRN) injections and Pulsed Electromagnetic Fields (PEMF), show promise for knee chondropathy. These treatments offer significant regenerative and healing effects, reducing pain and improving function.
Area of Science:
- Orthopedics and Regenerative Medicine
- Biochemistry and Molecular Biology
Background:
- Knee chondropathy is a prevalent age-related degenerative cartilage condition.
- Adenosine A2 receptors play crucial roles in cellular protection and disease states.
Purpose of the Study:
- To review the role and therapeutic modulation of adenosine A2A receptors in knee chondropathy.
- To evaluate novel treatments targeting the adenosine pathway for knee cartilage degeneration.
Main Methods:
- Systematic review of 60 scientific articles.
- Analysis of studies on intra-articular polydeoxyribonucleotides (PDRN) and Pulsed Electromagnetic Fields (PEMF) therapy.
Main Results:
- Intra-articular PDRN injections reduce pain and improve function by promoting anti-inflammatory effects, cell growth, collagen, and extracellular matrix production.
- PEMF therapy is effective for early osteoarthritis, patellofemoral pain syndrome, SONK, and as post-operative support, reducing inflammation.
Conclusions:
- Targeting the adenosine signal via PDRN and PEMF offers significant benefits for knee chondropathy compared to conventional treatments.
- These therapies represent valuable additions to the management of knee chondropathy.
