Aims: Autologous conditioned serum (ACS; marketed as Orthokine®) is an autologous blood product that has previously shown efficacy in treatment of joint osteoarthritis, spinal radiculopathy, tendon and muscle injuries in randomized controlled trials. In this 24-week, randomized, double-blind study, we compared the efficacy and safety of ACS with glucocorticoid (betamethasone) injections in chronic supraspinatus tendinopathy patients.Material and methods: Thirty-two patients with chronic supraspinatus tendinopathy were enrolled in the study. The ACS group received four ACS injections once weekly over four weeks and the glucocorticoid group received three betamethasone injections once weekly over three weeks with a placebo (saline) injection at week 4 into the enthesis and paratenon of the supraspinatus tendon. Study endpoints were pain intensity (VAS) and Constant Shoulder Score (CSS) assessed at weeks 0, 4 and 24.Results: Shoulder pain intensity improved after 4 weeks and significantly improved after 24 weeks in patients treated with ACS compared with those treated with glucocorticoids (pain intensity week 4: ACS=22.0, glucocorticoid=32.0; week 24: ACS=15.0, glucocorticoid=40.0). CSS improved to a similar extent in both groups after 4 weeks. After 24 weeks, ACS patients exhibited significantly greater CSS improvements than glucocorticoid patients. Adverse events (n=8) were reported in betamethasone patients.Conclusions: Compared with betamethasone, ACS therapy improved joint function and reduced shoulder pain more effectively after 4 weeks of treatment; these improvements were sustained to week 24. Combined with its favorable safety profile, ACS appears to be a more effective treatment than glucocorticoids and could enhance the quality of life in patients with chronic rotator cuff tendinopathy

Cell therapies hold great promise for advancing wound healing; however, translating this promise into consistent clinical benefit has proven elusive. Numerous trials have failed to reproduce the robust outcomes suggested by preclinical studies, reflecting a landscape marked by hidden traps. These include the hostile wound microenvironment, the cytotoxicity of antimicrobial dressings, poor retention and engraftment, immune clearance, and the paradoxical risk of fibrosis and scarring. Across these challenges emerge paradoxes that redefine how traps are understood. The Scarring Paradox reveals that MSCs and EVs may either suppress or reinforce fibrosis, depending on the niche context. The Immune Double-Edged Sword captures the duality of clearance and regenerative modulation. These paradoxes illustrate that traps are not static obstacles but dynamic inflection points. Recognition of these paradoxes has inspired tricks: protective biomaterial carriers, preconditioning strategies, engineered exosomes, and combinatorial therapies with anti-fibrotic, neuromodulatory, or microbiome-targeted adjuncts. Case studies illustrate how classical traps manifest in clinical practice and how paradoxes guide innovation. Emerging adjuncts, ranging from herbal bioactives and bioelectric modulation to circadian synchronization and digital twins, point toward more unconventional but increasingly plausible frameworks for niche control. This perspective review demonstrates that the future of regenerative wound therapy depends not on avoiding traps but on reframing them through paradoxes and converting them into tricks. Stem cell and exosome therapy is thus moving beyond a linear “promise versus failure” narrative toward a systemic, context-aware, programmable approach in which paradoxes drive conceptual renewal and transformative paradigms in wound care.

Introduction: Rheumatoid arthritis (RA) remission remains a key treatment goal, but remission rates vary. Emerging evidence suggests that gut microbiota modulation via probiotics may influence systemic inflammation and improve outcomes in RA. The objective was to evaluate the effects of adjunctive probiotic supplementation on clinical outcomes in patients with newly diagnosed RA receiving conventional disease-modifying antirheumatic drugs (cDMARDs) over 12 months. Methodology: In this randomized, placebo-controlled trial, 100 patients with newly diagnosed RA were assigned to receive either probiotics containing Lactobacillus casei BLn2401, Lactobacillus salivarius BL2201, and Bifidobacterium breve BL3406 plus cDMARDs (experimental group); or cDMARDs alone (control). Clinical outcomes including disease activity score using 28 joints (DAS28), inflammatory markers (C-reactive protein, CRP; erythrocyte sedimentation rate, ESR), pain (visual analogue scale, VAS), functional disability (health assessment questionnaire, HAQ), and RA quality of life (RAQoL) questionnaire were assessed at baseline and follow-up. Remission rates and corticosteroid use were evaluated. Results: The probiotic group demonstrated faster and more sustained reductions in DAS28, CRP, ESR, pain, and disability scores; compared to controls. The probiotic group achieved near-remission (DAS28 2.3 ± 0.4) by 12 months, while the control group reverted to baseline disease activity. Probiotic use was the independent predictor of remission or low disease activity (HR = 2.703, p < 0.001). Patient-reported quality of life improved significantly, and corticosteroid dependence decreased in the probiotic group. Conclusions: Adjunctive probiotic supplementation with specific strains may enhance clinical outcomes, reduce inflammation, and increase remission rates in early RA, supporting probiotics as a safe, accessible adjunctive therapy.

Introduction: To evaluate physical activity (PA) levels in patients with psoriatic arthritis (PsA) and their associations with cardiovascular (CV) risk factors, psychosocial parameters, and functional status, and to identify distinct patient subgroups using latent class analysis. Material and methods: In this cross-sectional study, 62 adults with PsA fulfilling Classification Criteria for Psoriatic Arthritis (CASPAR) were consecutively recruited from the Institute of Rheumatology. Phy­sical activity was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and categorized as low, moderate, or high. Cardiovascular risk factors, fatigue (Functional Assessment of Chronic Illness Therapy Fatigue Scale – FACIT-F), functional status (Health Assessment Questionnaire Disability Index – HAQ-DI), depression (Patient Health Questionnaire-9 – PHQ-9), an­xiety (Beck Anxiety Inventory – BAI), kinesiophobia (Tampa Scale for Kinesiophobia – TSK), and sarcopenia risk (SARC-F) were evaluated. Disease activity was measured using the clinical Disease Activity Index for Psoriatic Arthritis (cDAPsA). Latent class analysis was applied to identify patient subgroups based on PA, comorbidities, and psychosocial variables. Results: Mean age was 44.5 ±10.3 years; 52% were female. Physical activity was low in 19.4%, mode­rate in 67.7%, and high in 12.9%. Lower PA was associated with older age (p = 0.04), higher fatigue (FACIT-F 29 ±7 vs. 43 ±6.4, p = 0.01), and greater disability (HAQ-DI 0.9 vs. 0.1, p = 0.03). The prevalence of obesity was 51.6% (n = 32), hypertension (HT) 23% (n = 16), dyslipidemia 30% (n = 19), and diabetes mellitus type 2 12.9% (n = 8). Latent class analysis identified two classes: class I – younger, predominantly female (56%), higher education (82%), moderate PA (75%), lower cardiometabolic burden (obesity 46%, HT 14%, dyslipidemia 10%), and lower psychosocial impact; class II – broader age range, male predominance (54%), lower PA (30% low, 60% moderate), higher cardiometabolic burden (HT 86%, obesity 56%, dyslipidemia 35%), greater kinesiophobia (74%), and sarcopenia risk (19%). Conclusions: In PsA, low PA is associated with higher fatigue, functional impairment, and cardiometabolic and psychosocial burden. Latent class analysis revealed distinct subgroups, suggesting the need for personalized, multidisciplinary interventions targeting physical and psychological barriers. Integrating tailored PA promotion alongside pharmacological control may improve both joint and CV outcomes.

Introduction. The effect of lipid profile on AMI is well known. On the other hand, the role of testosterone (T) as one of the possible predictive factors in men with acute myocardial infarction and his interplay with lipid profile in AMI is still controversial. The aim of the study was to measure the level of testosterone in men with AMI and in the same patients 6 months after AMI, and to compare with testosterone levels of healthy control. Also we correlate testosterone levels with lipid profile in AMI and 6 months after AIM. Methods. The study was designed as prospective study. Patients were divided into III groups: Group I included 35 men, aged value (55.00±3.00 years) with AMI. Group II included the same 35 males, analyzed 6 months after the AMI. The Group III, control group consists of 20 healthy men aged value( 57±2.12 years). The blood samples for the Group I (AMI) were taken in the first 12 hours of AIM, and also 6 months after the AIM (Group II). Following analyses were performed: total cholesterol, triglycerides, low density lipoproteins, high density lipoprotein, lipoprotein, apolipoprotein A-1, apolipoprotein B and testosterone level. Results. By comparing the values of testosterone (T) in patients with acute myocardial infarction, Group I (16,86±7.18nmol/l) and the values of testosterone in the same patient 6 months after the AMI, Group II (18,12±7.96nmol/l), with testosterone values in control, Group III (27.11±10.48nmol/), a high statistically significant difference was obtained, p<0.001. Testosterone values in a patient with AIM as well as 6 months after AIM were lower than those in a healthy population of the same age (p <0.001). In the Group I, statisticaly significant positive correlation were found for tetsosterone and HDL (r 0.403, p<0.05), and high statistical significant positive correlation of T with ApoA1(r 0.747, p<0.01). In Group II, statistical significant positive correlation was found for T and HDL(r 0.388, p<0.05) and for tetsoterone and ApoA1(r 0.354, p<0.05). Conclusion. This study showed that men over 40 years of age with AMI have high statistically significant lower concentrations of endogenous testosterone compared to a healthy male population of the same age. Also the concentration of testosterone in same patient after 6 months from AMI maintain statistically significant lower values in comparison to control.