The Effect of Early Application of a Combined Therapy of Bone Marrow Mesenchymal Stem Cells and Platelet-Rich Plasma on Blood and Bone Parameters in Ovariectomized Rats

Osteoporosis is a common bone disorder with marked morbidity and mortality that occurs frequently in women after menopause. Inadequacy of current treatments and their side effects has driven the search for improved approaches. This study attempted to evaluate the early use of either bone marrow-derived mesenchymal stem cells (BM-MSCs), or platelet-rich plasma (PRP), or both combined to slow down bone loss, and improve bone formation in rats following ovariectomy. In our study, female rats were divided into five groups: sham-operated (SHO) control, ovariectomized (OVX) untreated group, OVX-MSCs treated group, OVX-PRP treated group, and OVX-MSCs/PRP treated group. Body mass index (BMI) had been measured in all groups; furthermore, serum calcium (Ca 2+ ), phosphorus (P), alkaline phosphatase (ALP), collagen type 1 cross-linked C-telopeptide (CTx-1), malondialdehyde (MDA), and tumor necrosis factor alpha (TNF-α) were assessed. Additionally, specimens of tibia were analysed by light microscopy, morphometry and immunohistochemical staining for osteopontin (OPN). The results showed a significant increase of the final BMI in all groups. The OVX untreated group showed an insignificant change in the serum Ca 2+ level, while the serum P level, together with ALP, CTX 1, MDA and TNF-α, showed a significant elevation. Administration of either BM-MSCs, or PRP, or their combination, significantly reduced serum levels of Ca 2+ , ALP, CTX-1, MDA, and TNF-α, however, the combination therapy showed most significant results, including the final BMI. Histological examination also confirmed rapid bone formation in the combined therapy group with in vivo osteogenesis demonstrated via positive immunohistochemical staining of OPN. In conclusion, the present study demonstrates that early administration of a combination therapy can have a therapeutic benefit over every monotherapy for the treatment of osteoporosis.