Library - Osteoarthritis
Cell Transplant. 2015 Jan 20. doi: 10.3727/096368915X686760. [Epub ahead of print]
Autologous adipose tissue-derived stromal vascular fraction cells application in patients with osteoarthritis.
Michalek J1, Moster R, Lukac L, Proefrock K, Petrasovic M, Rybar J, Capkova M, Chaloupka A, Darinskas A, Michalek J Sr, Kristek J, Travnik J, Jabandziev P, Cibulka M, Holek M, Jurik M, Skopalik J, Kristkova Z,Dudasova Z.
11International Consortium for Cell Therapy and Immunotherapy, Brno, Czech Republic,.
Abstract
Stromal vascular fraction (SVF), containing large amount of stem cells and other regenerative cells, can be easily obtained from loose connective tissue that is associated with adipose tissue. Here we evaluated safety and clinical efficacy of freshly isolated autologous SVF cells in a case control study in patients with grade 2-4 degenerative osteoarthritis (OA). A total of 1128 patients underwent standard liposuction under local anesthesia and SVF cells were isolated and prepared for application into 1-4 large joints. A total of 1856 joints, mainly knee and hip joints, were treated with a single dose of SVF cells. 1114 patients were followed for 12.1-54.3 months (median 17.2 months) for safety and efficacy. Modified KOOS/HOOS Clinical Score was used to evaluate clinical effect and was based on pain, non-steroid analgesic usage, limping, extent of joint movement, and stiffness evaluation before and at 3, 6, and 12 months after the treatment. No serious side effects, systemic infection or cancer was associated with SVF cell therapy. Most patients gradually improved 3-12 months after the treatment. At least 75% Score improvement was noticed in 63% of patients and at least 50% Score improvement was documented in 91% of patients 12 months after SVF cell therapy. Obesity and higher grade of OA were associated with slower healing. In conclusion, here we report a novel and promising treatment approach for patients with degenerative OA that is safe, cost-effective, and relying only on autologous cells.
Biores Open Access. 2016 Aug 1;5(1):192-200. doi: 10.1089/biores.2016.0024. eCollection 2016.
Regeneration of Cartilage in Human Knee Osteoarthritis with Autologous Adipose Tissue-Derived Stem Cells and Autologous Extracellular Matrix.
Pak J1, Lee JH2, Park KS3, Jeong BC3, Lee SH3.
1Stems Medical Clinic, Seoul, Republic of Korea.; TEDA-Puhua International Hospital, Tianjin, China.; Life Science Institute, Komplek Permata Senayan, Jalan Tentara Pelajar, Jakarta Selatan, Indonesia.
2Stems Medical Clinic, Seoul, Republic of Korea.; National Leading Research Laboratory, Department of Biological Sciences, Myongji University, Yongin, Republic of Korea.
3National Leading Research Laboratory, Department of Biological Sciences, Myongji University , Yongin, Republic of Korea.
Abstract
This clinical case series demonstrates that percutaneous injections of autologous adipose tissue-derived stem cells (ADSCs) and homogenized extracellular matrix (ECM) in the form of adipose stromal vascular fraction (SVF), along with hyaluronic acid (HA) and platelet-rich plasma (PRP) activated by calcium chloride, could regenerate cartilage-like tissue in human knee osteoarthritis (OA) patients. Autologous lipoaspirates were obtained from adipose tissue of the abdominal origin. Afterward, the lipoaspirates were minced to homogenize the ECM. These homogenized lipoaspirates were then mixed with collagenase and incubated. The resulting mixture of ADSCs and ECM in the form of SVF was injected, along with HA and PRP activated by calcium chloride, into knees of three Korean patients with OA. The same affected knees were reinjected weekly with additional PRP activated by calcium chloride for 3 weeks. Pretreatment and post-treatment magnetic resonance imaging (MRI) data, functional rating index, range of motion (ROM), and pain score data were then analyzed. All patients’ MRI data showed cartilage-like tissue regeneration. Along with MRI evidence, the measured physicaltherapy outcomes in terms of ROM, subjective pain, and functional status were all improved. This study demonstrates that percutaneous injection of ADSCs with ECM contained in autologous adipose SVF, in conjunction with HA and PRP activated by calcium chloride, is a safe and potentially effective minimally invasive therapy for OA of human knees.
KEYWORDS:
adipose tissue-derived stem cells; extracellular matrix; human cartilage regeneration; osteoarthritis
Clin Transl Med. 2016 Dec;5(1):27. doi: 10.1186/s40169-016-0112-7. Epub 2016 Aug 10.
Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis.
Burke J1, Hunter M1, Kolhe R2, Isales C1,3, Hamrick M4,3, Fulzele S5,6,7.
1Department of Orthopedics, Georgia Regents University, Augusta, GA, USA.
2Department of Pathology, Georgia Regents University, Augusta, GA, USA.
3Institute of Regenerative and Reparative Medicine, Georgia Regents University, Augusta, GA, USA.
4Department of Cell Biology and Anatomy, Georgia Regents University, Augusta, GA, USA.
5Department of Orthopedics, Georgia Regents University, Augusta, GA, USA. sfulzele@augusta.edu.
6Institute of Regenerative and Reparative Medicine, Georgia Regents University, Augusta, GA, USA. sfulzele@augusta.edu.
7Department of Orthopedics Surgery, Augusta University, Augusta, GA, 30904, USA.
Abstract
Osteoarthritis (OA) is a chronic degenerative disease affecting articular cartilage in joints, and it is a leading cause of disability in the United States. Current pharmacological treatment strategies are ineffective to prevent the OA progression; however, cellular therapies have the potential to regenerate the lost cartilage, combat cartilage degeneration, provide pain relief, and improve patient mobility. One of the most promising sources of cellular regenerative medicine is from mesenchymal stem cells (MSCs). MSCs can be isolated from adipose tissue, bone marrow, synovial tissue, and other sources. The aim of this review is to compile recent advancement in cellular based therapy more specifically in relation to MSCs in the treatment of osteoarthritis.
KEYWORDS:
ADSC; Cell therapy; Osteoarthritis; Stem cell
J Orthop Surg Res. 2016 Apr 12;11:42. doi: 10.1186/s13018-016-0378-x.
Stem cells in articular cartilage regeneration.
Filardo G1, Perdisa F1, Roffi A2, Marcacci M1,3, Kon E1,3.
1II Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy.
2Nanobiotechnology Laboratory, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136, Bologna, Italy. a.roffi@biomec.ior.it.
3Nanobiotechnology Laboratory, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136, Bologna, Italy.
Abstract
Mesenchymal stem cells (MSCs) have emerged as a promising option to treat articular defects and early osteoarthritis (OA) stages. However, both their potential and limitations for a clinical use remain controversial. Thus, the aim of this systematic review was to examine MSCs treatment strategies in clinical settings, in order to summarize the current evidence of their efficacy for the treatment of cartilage lesions and OA.Among the 60 selected studies, 7 were randomized, 13 comparative, 31 case series, and 9 case reports; 26 studies reported the results after injective administration, whereas 33 used surgical implantation. One study compared the two different modalities. With regard to the cell source, 20 studies concerned BMSCs, 17 ADSCs, 16 BMC, 5 PBSCs, 1 SDSCs, and 1 compared BMC versus PBSCs. Overall, despite the increasing literature on this topic, the evidence is still limited, in particular for high-level studies. On the other hand, the available studies allow to draw some indications. First, no major adverse events related to the treatment or to the cell harvest have been reported. Second, a clinical benefit of using MSCs therapies has been reported in most of the studies, regardless of cell source, indication, or administration method. This effectiveness has been reflected by clinical improvements and also positive MRI and macroscopic findings, whereas histologic features gave more controversial results among different studies. Third, young age, lower BMI, smaller lesion size for focal lesions, and earlier stages of OA joints have been shown to correlate with better outcomes, even though the available data strength does not allow to define clear cutoff values. Finally, definite trends can be observed with regard to the delivery method: currently cultured cells are mostly being administered by i.a. injection, while one-step surgical implantation is preferred for cell concentrates. In conclusion, while promising results have been shown, the potential of these treatments should be confirmed by reliable clinical data through double-blind, controlled, prospective and multicenter studies with longer follow-up, and specific studies should be designed to identify the best cell sources, manipulation, and delivery techniques, as well as pathology and disease phase indications.