{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T04:26:46Z","timestamp":1793680006512,"version":"4.5.1"},"reference-count":45,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100007657","name":"univerza v ljubljani","doi-asserted-by":"publisher","award":["20240118"],"award-info":[{"award-number":["20240118"]}],"id":[{"id":"10.13039\/501100007657","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Internal funding of the Slovenian Institute for Transfusion Medicine","award":["SM-2922, recipient Urban \u0160vajger"],"award-info":[{"award-number":["SM-2922, recipient Urban \u0160vajger"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["CARTILAGE"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Umbilical cord-derived mesenchymal stromal cells (UC-MSCs) are a promising treatment for knee osteoarthritis (KOA). This study aimed to (1) characterize early synovial fluid biomarker changes after intra-articular UC-MSCs therapy in advanced KOA and (2) explore their relationship with short-term clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, single-arm case series, 15 patients with advanced KOA (Kellgren\u2013Lawrence III\u2013IV) scheduled for total knee arthroplasty received a single intra-articular injection of 20 \u00d7 10\n                      <jats:sup>6<\/jats:sup>\n                      allogeneic UC-MSCs. Synovial fluid was aspirated at baseline and approximately 6 weeks post-injection. A panel of 29 soluble biomarkers related to inflammation, matrix remodeling, immune signaling, angiogenesis, and metabolism was quantified using multiplex immunoassays. Clinical status was evaluated with Patient-Reported Outcome Measures (PROMs) before and at a mean of 48 \u00b1 18 days after the injection. Paired differences were analyzed using the Wilcoxon signed-rank tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant post-treatment differences were observed in biomarkers associated with extracellular matrix turnover (Matrix Metalloproteinase [MMP]-1, MMP-3, MMP-7, Cartilage Oligomeric Matrix Protein [COMP]), vascular remodeling (Vascular Endothelial Growth Factor [VEGF], Vascular Cell Adhesion Molecule [VCAM]-1), immune modulation (interleukin [IL]-8), and metabolic or structural regulation (Leptin, dickkopf [Dkk]-1). Most PROMs demonstrated significant improvements. These findings describe molecular changes in synovial fluid observed after intra-articular UC-MSC administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this prospective single-arm cohort, intra-articular UC-MSC administration was feasible and well tolerated, and we observed pre\u2013post changes in synovial fluid biomarkers and patient-reported outcomes. These findings do not establish causality and warrant confirmation in controlled studies. The study was registered at Clinicaltrials.gov: Mechanisms of Treatment Effects Using Cultured, Allogeneic Mesenchymal Stromal Stem Cells (MSCs) in Knee Osteoarthritis, NCT06078059,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT06078059?intr=NCT06078059\">https:\/\/clinicaltrials.gov\/study\/NCT06078059?intr=NCT06078059<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19476035261435793","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:00:36Z","timestamp":1777568436000},"page":"1484-1496","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Synovial Biomarker Modulation and Clinical Response to Umbilical Cord-Derived MSC Treatment in Knee Osteoarthritis: A Case Series Study"],"prefix":"10.1177","volume":"17","author":[{"given":"Urban","family":"\u0160vajger","sequence":"first","affiliation":[{"name":"Slovenian Institute for Transfusion Medicine, Ljubljana, Slovenia"},{"name":"Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0197-2744","authenticated-orcid":false,"given":"Matic","family":"Kolar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borut","family":"Pompe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrej","family":"Kobold","sequence":"additional","affiliation":[{"name":"Slovenian Institute for Transfusion Medicine, Ljubljana, Slovenia"},{"name":"Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3770-5990","authenticated-orcid":false,"given":"Matej","family":"Drobni\u010d","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1903768"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S154002"},{"issue":"11","key":"e_1_3_2_4_2","article-title":"Management of primary knee osteoarthritis and indications for total knee arthroplasty for general practitioners","volume":"112","author":"Van Manen MD","year":"2012","unstructured":"Van Manen MD, Nace J, Mont MA. 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