BACKGROUND:Osteoarthritis (OA) is a prevalent joint disorder, characterized by cartilage degradation driven by matrix metalloproteinases (MMPs) and dysregulated extracellular matrix (ECM) turnover. Biological macromolecules, such as ECM-derived scaffolds, offer therapeutic potential by mimicking native cartilage composition, yet their rapid enzymatic breakdown hampers regenerative potential. We hypothesized that embedding an MMP inhibitor within ECM could mitigate MMP-driven breakdown, thereby halting OA progression, while stabilizing ECM structure and boosting chondrogenesis. Thus, we developed doxycycline-loaded micronized dehydrated human amniotic membrane (Dox-mdHAM), leveraging doxycycline as an MMP inhibitor, to regulate cartilage homeostasis in OA.
METHODS:Dox-mdHAM was prepared by loading doxycycline onto human amniotic membrane, followed by dehydration and micronization. MMP activity and ECM content (collagen, glycosaminoglycans, growth factors) was assessed in Dox-mdHAM scaffolds. In vitro, C28/I2 human chondrocytes were cultured with Dox-mdHAM to assess cell morphology, chondrogenic marker expression, and TGFβ-1 levels. In vivo, Dox-mdHAM was injected intra-articularly in a monosodium iodoacetate-induced rat OA model to evaluate mobility, pain, and cartilage regeneration.
RESULTS:Dox-mdHAM characterization demonstrated reduced MMP-2 activity significantly, and enhanced ECM preservation with increased collagen and glycosaminoglycan content compared to untreated scaffolds. In vitro, Dox-mdHAM improved chondrogenic activity, notably upregulating expression of Collagen II, Aggrecan, and Sox9, while lowering TGFβ-1 levels. Moreover, in vivo, Dox-mdHAM supported cartilage regeneration with increased cartilage thickness and enhanced ECM deposition, while inhibiting degeneration, improving mobility and pain thresholds over time significantly.
CONCLUSION:Dox-mdHAM demonstrates a dual therapeutic action in OA by inhibiting cartilage degeneration through MMP suppression and TGFβ-1 reduction, while promoting regeneration via ECM preservation and enhanced chondrogenesis. These results underscore the potential of Dox-mdHAM in translational medicine as a promising disease-modifying therapy for OA.