Effects of medical mud-pack therapy on inflammatory gene expression and clinical outcomes in patients with knee osteoarthritis


Kahraman M., Karabulut S. S., Gumussu K., Bozdogan Polat S. H., Sahin A., Misirlioglu F. N., ...Daha Fazla

INTERNATIONAL JOURNAL OF BIOMETEOROLOGY, cilt.70, sa.8, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 70 Sayı: 8
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1007/s00484-026-03258-6
  • Dergi Adı: INTERNATIONAL JOURNAL OF BIOMETEOROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Zoological Record, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Earth, Atmospheric, & Aquatic Science Collection (ProQuest), Health Research Premium Collection (ProQuest)
  • İstanbul Üniversitesi Adresli: Evet

Özet

This study aimed to evaluate the association of medical mud-pack therapy with changes in gene expression of key inflammatory markers, miRNA and clinical outcomes in patients with knee osteoarthritis. Thirty-two patients with knee osteoarthritis were assigned to a medical mud-pack therapy (MMT) group (n = 16) or control group (n = 16). Molecular assessments used quantitative PCR for key cytokines and miRNA expressions. Clinical outcomes were evaluated with the VAS for pain and WOMAC for function. Pre- and post-treatment measurements were obtained, with the MMT group receiving mud-pack therapy plus standard care, while controls performed exercise only. The MMT group showed significant reductions in gene expression of TNF-alpha (1.90 +/- 0.41 to 1.43 +/- 0.33, p < 0.05), IL-6 (1.34 +/- 0.31 to 0.93 +/- 0.27, p < 0.05), and IL-1 beta (2.20 +/- 0.40 to 1.81 +/- 0.34, p < 0.05), whereas the control group showed no significant molecular changes. Between-group comparisons showed greater reductions in the MMT group for all cytokines (Delta difference: -0.38 to - 0.51, 95% CI not crossing zero, p < 0.05) with large effect sizes (d = 0.88-1.12). miR-140 expression remained unchanged in both groups (p > 0.05). Clinically, the MMT group showed significant VAS pain reduction after adjustment for baseline values (ANCOVA: post-treatment and first-month VAS both p < 0.001), while the control group showed minimal change. Groups were similar in age and sex distribution. Medical mud-pack therapy combined with exercise was associated with reduced expression of key inflammatory cytokines and pain relief in knee osteoarthritis. Further studies are required to explore underlying molecular mechanisms of mud-pack interventions.