modulation of brain apoptotic biomarkers by aerobic exercise and mesenchymal stem cell therapy in a rat model of osteoarthritis

Introduction: osteoarthritis is a degenerative joint disease causing irreversible structural and functional joint damage. recent studies indicate it may also affect the brain by altering apoptotic biomarkers like bcl-2 and bax. this study aimed to assess the effects of aerobic exercise and mesenchymal stem cell (msc) therapy, alone or combined, on brain apoptotic biomarkers in osteoarthritic rats.materials & methods: forty-eight male wistar rats were divided into six groups: healthy control (g0), osteoarthritis (gi), osteoarthritis with saline (gii), msc therapy (giii), aerobic exercise (giv), and combined therapy (gv). osteoarthritis was surgically induced, and mscs were injected intra-articularly. aerobic exercise included treadmill running for eight weeks. after intervention, brain tissue was collected and bcl-2 and bax levels were measured using elisa.results:  osteoarthritis significantly altered bcl-2 and bax levels in the brain compared to controls. msc therapy, aerobic exercise, and their combination improved these biomarkers. both individual treatments significantly reduced bax and increased bcl-2. the combined treatment improved biomarkers to a similar extent as individual therapies, with no statistically significant difference compared to msc therapy (p = 0.992 for bax, p = 0.732 for bcl-2) or aerobic exercise (p = 1.000 for both bax and bcl-2).conclusion:  this study shows that osteoarthritis can affect brain apoptotic pathways. both msc therapy and aerobic exercise effectively modulate these changes, suggesting their therapeutic potential. however, combining them did not enhance outcomes beyond individual treatments, highlighting the value of non-pharmacological interventions in osteoarthritis management.