THE EFFECT OF CARBOXYTHERAPY AND ITS COMBINATION WITH DICLOFENAC SODIUM AND CHONDROITIN SULFATE ON TNF-Α AND TGF-Β1 EXPRESSION IN MONOIODOACETATE-INDUCED OSTEOARTHRITIS IN RATS
DOI:
https://doi.org/10.15674/0030-59872025384-90Keywords:
Оsteoarthritis, carboxytherapy, CO2, diclofenac sodium, chondroitin sulfate, TNF-α, TGF-β1, experimental model, monoiodoacetic acid, combined treatmentAbstract
Osteoarthritis remains one of the leading causes of disability worldwide, associated with chronic inflammation and progressive destruction of articular cartilage. Current therapeutic approaches show limited efficacy in restoring damaged tissues, which drives interest in novel adjuvant methods, particularly physiotherapeutic techniques such as carboxytherapy. Objective. To investigate the effects of carbon dioxide monotherapy and its combinations with diclofenac sodium or chondroitin sulfate on the expression of the pro-inflammatory cytokine TNF-α and the regenerative factor TGF-β1 in rats with experimentally induced osteoarthritis. Methods. An osteoarthritis model was induced by intra-articular injection of monoiodoacetic acid. Treatment included CO2 monotherapy or its combination with chondroitin sulfate or diclofenac sodium. On days 14 and 28, serum levels of TNF-α and TGF-β1 were measured using the ELISA method. Statistical analysis was performed using one-way ANOVA followed by Tukey’s post hoc test; 95 % confidence intervals and effect sizes (Cohen’s d) were calculated. Results. All interventions involving CO2 led to a statistically significant reduction in TNF-α levels on days 14 and 28 (ANOVA: F = 2551 and F = 4057, respectively; p < 0.001), with the most pronounced effect observed in the «CO2 + diclofenac» group (a decrease of –54.7 %). Concurrently, an increase in TGF-β1 levels was noted across all treatment groups (ANOVA: F = 1492 and F = 3492; p < 0.001), particularly in the «CO2 + chondroitin» group (+99.4 % compared to the pathology group). Large effect sizes were recorded for key comparisons (Cohen’s d > 0.8), indicating the clinical relevance of the observed changes. Conclusions. The combined application of carboxytherapy with diclofenac sodium or chondroitin sulfate promotes a reduction in inflammatory response and activation of regenerative mechanisms in an osteoarthritis model, supporting the rationale for further preclinical and clinical investigations.
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