Combination therapy comprising a composition of mesenchymal stromal cells and hyaluronic acid for use in treatment of osteoarthritis

A method of modulating an inflammatory microenvironment in a joint of a subject having osteoarthritis, the method comprising administering to the joint a combination of:

• a composition comprising about 20 to 30 million mesenchymal stromal cells, about 1 ml of a multiple electrolyte solution and about 1 ml of protein free, serum free, animal component free formulation of about 2.5% to 5% dimethyl sulfoxide (DMSO),
• about 2 ml of mid molecular weight hyaluronic acid,
• wherein the mesenchymal stromal cells in the composition:
• (a) secrete prostaglandin E2 (PGE2) in response to pro-inflammatory cytokines to reduce levels of pro-inflammatory mediators;
• and
• (b) subsequently increase secretion of thrombospondin-2 (TSP-2) upon reduction of the pro-inflammatory cytokines to promote and maintain chondrogenesis in the joint.