Eman R. Al SawyMona M. SaberNoha N. NassarNesrine S. El Sayed2025-05-102025-05-102025-05-03Sawy, E. R. A., Saber, M. M., Nassar, N. N., & Sayed, N. S. E. (2025). Targeting TREM-1 receptors with metformin and pravastatin modulate monosodium iodoacetate-induced osteoarthritis. Inflammopharmacology. https://doi.org/10.1007/s10787-025-01738-6https://doi.org/10.1007/s10787-025-01738-6https://repository.msa.edu.eg/handle/123456789/6409SJR 2024 1.269 Q1 H-Index 74Osteoarthritis (OA), a degenerative joint condition, afects entire joints, including the tissues around it, causing pain, swelling and stifness. This study explored the combined therapeutic efects of metformin and pravastatin on knee OA induced by monosodium iodoacetate (MIA) in rats. The study encompassed fve animal groups (n=10 per group) which were allocated as follows: group 1 received 100 µL of sterile saline injected intra-articularly into the left knee joint (control group) while groups 2–5 were injected with 2 mg MIA in 100µL normal saline into the intraarticular space. After 2 weeks, group 3 received oral metformin (100 mg/kg) for 2 weeks, group 4 received oral pravastatin (10 mg/kg) for 2 weeks and group 5 received both metformin 100 mg/kg and pravastatin 10 mg/kg orally for 2 weeks. The combination of metformin and pravastatin showed to be the most efective in terms of improving radiologic and histologic fndings in knee OA. This combination also reduced both serum C reactive protein (CRP) and cartilage oligomeric matrix protein (COMP), while increasing serum collagen type II (COL2). Combining metformin and pravastatin also reduced AKT1, PI3K, STAT3 and IL-6 in the knee joint homogenate. TREM-1 levels showed the greatest reduction with the combination therapy. Furthermore, improvement was noted in oxidative stress markers with an increase in non-protein thiols and a decrease in malondialdehyde. In conclusion, the current study shows a therapeutic potential efect of combining metformin and pravastatin in OA, which could be partly attributed to TREM-1 signaling pathwayen-USOsteoarthritis · Metformin · Pravastatin · TREM-1 · COMP · PI3KArticlehttps://doi.org/10.1007/s10787-025-01738-6