Osteoarthritis is the most widespread, chronic, progressive and debilitating joint disease of the elderly population. A majority of people over the age of 65 show signs of osteoarthritis. Essentially all joints may be affected, but the most commonly affected are joints in hips, knees, fingers and spine. Initial inflammation has been shown to have a major role in cartilage breakdown in osteoarthritis. Exhaustion of the endogenous reparative potential of  mesenchymal stem cells, and in particular their chondrogenic potential is  demonstrated in patients with advanced osteoarthritis.  Our study shows that  Belinal® boosts the chondrogenic potential of mesenchymal stem cells  from patients with osteoarthritis, under both non-inflammatory and inflammatory  conditions.


Patients with hip osteoarthritis under routine hip replacement and healthy donors with no evidence of musculoskeletal disorder were included in the study. Primary cells were isolated from subchondral trabecular bone harvested from femoral  head in patients with osteoarthritis, and from the medial tibia in the post-mortem donors.

Chondrogenic differentiation was determined using micromass assays and Alcian blue staining  (Diagram 1). In the mesenchymal stem cells  from  patients with hip osteoarthritis, Belinal® showed higher chondrogenesis in comparison  with Pycnogenol® and  significantly higher absorbance (increased chondrogenesis) in comparison with the control and the polyphenols Resveratrol  and Quercetin. 

The chondrogenesis of mesenchymal stem cells  derived from healthy donors was lower and there were no such significant differences seen between the treatments with the Belinal®, Pycnogenol®, Resveratrol and Quercetin.  See diagram 1.

Diagram 1: Effects on chondrogenesis under non-inflammatory conditions
Q – Quercetin,  R- Resveratrol,  P- Pycnogenol, B – Belinal

Inflammation has been shown to have a pivotal role in cartilage degradation, with particular interest focussed on the anti-inflammatory actions of natural compounds, such as polyphenols. Polyphenols represent a wide variety of compounds that are found in fruit, vegetables, red wine, tea, and plant oils. Inflammatory conditions were induced using lipopolysaccharide from Escherichia coli. Lipopolysaccharide  were added to primary mesenchymal stem cells from the patients with hip osteoarthritis, which were left for 18hours to simulate inflammatory conditions. After 18hours, the cell medium was changed and the tested polyphenolic  extracts and polyphenols were added at 375 mg/mL. Chondrogenesis was higher for primary human stem cells treated with Belinal® in comparison with Pycnogenol® and  significantly enhanced in comparison to Resveratrol, Quercetin and control. See diagram 2.

Diagram 2: Effects on chondrogenesis under inflammatory conditions
Q – Quercetin,  R- Resveratrol,  P- Pycnogenol, B – Belinal

This study thus shows that Belinal® can boost the chondrogenic potential of mesenchymal stem cells  from patients with osteoarthritis. Belinal® could play an important role in the future treatment and prevention of joint disease.