Adipose-derived stem cells in orthopaedic pathologies

Usuelli, Federico Giuseppe; D’Ambrosi, Riccardo; Maccario, Camilla; Indino, Cristian; Manzi, Luigi; Maffulli, Nicola

doi:10.1093/bmb/ldx030

Cited by 29 publications

(38 citation statements)

References 77 publications

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“…These MSCs respond by producing bioactive signaling molecules which act in a paracrine fashion to exhibit immunomodulatory, antimicrobial, angiogenic, and trophic/regenerative effects on tissue [5,14]. This ultimately results in localized and tissue-specific change that encourages regeneration and healing [10].…”

Section: Introductionmentioning

confidence: 99%

Patient-Centered Outcomes of Microfragmented Adipose Tissue Treatments of Knee Osteoarthritis: An Observational, Intention-to-Treat Study at Twelve Months

Heidari¹,

Noorani²,

Slevin

et al. 2020

Stem Cells International

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Introduction. Microfragmented adipose tissue (MFAT) has been shown to benefit osteoarthritic patients by reducing pain and supporting tissue regeneration through a mesenchymal stem cell (MSC)-related paracrine mechanism. This observational study of 110 knees assessed patient-centered outcomes of pain, functionality, and quality of life, analyzing their variation at twelve months following one ultrasound-guided intra-articular injection of autologous MFAT for the treatment of knee osteoarthritis (KOA). Method. Inclusion criteria were as follows: VAS >50, and the presence of KOA as diagnosed on X-ray and MRI. Exclusion criteria included the following: recent injury (<3 months) of the symptomatic knee, intra-articular steroid injections performed within the last three months, and hyaluronic acid injections prior to this treatment. Changes in VAS, OKS, and EQ-5D were scored at baseline and twelve months following a single intra-articular injection of autologous MFAT. Score variation was analyzed utilizing a nonparametric paired samples Wilcoxon test. The statistical analysis is reproducible with Open Access statistical software R (version 4.0.0 or higher). The study was carried out with full patient consent, in a private practice setting. Results. Median VAS (pain) improved from 70 (IQR 20) to 30 (IQR 58) (p<0.001); median OKS (function) improved from 25 (IQR 11) to 33.5 (IQR 16) (p<0.001); and median EQ-5D (quality of life) improved from 0.62 (IQR 0.41) to 0.69 (IQR 0.28) (p<0.001). No adverse events were reported during the intraoperative, recovery, or postoperative periods. Conclusions. For patients with all grades of knee osteoarthritis who were treated with intra-articular injections of MFAT, statistically significant improvements in pain, function, and quality of life were reported. Although further research is warranted, the results are encouraging and suggest a positive role for intra-articular injection of MFAT as a treatment for knee osteoarthritis.

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Section: Introductionmentioning

confidence: 99%

Patient-Centered Outcomes of Microfragmented Adipose Tissue Treatments of Knee Osteoarthritis: An Observational, Intention-to-Treat Study at Twelve Months

Heidari¹,

Noorani²,

Slevin

et al. 2020

Stem Cells International

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“…There is no high-quality research, merely case series in which BMC or SVF are used as adjuvants to arthroscopy (reviewed in [27] and [87]. An RCT [88] showed that outcomes after microfractures were better if patients received PRP 6-24 h after the index procedure.…”

Section: Joint Conditionsmentioning

confidence: 99%

How far have biological therapies come in regenerative sports medicine?

Andı́a

Maffulli

2018

Expert Opinion on Biological Therapy

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Regular engagement in sports produces many health benefits, but also exposes to increased injury risk. The quality of medical care available is crucial not only for sports trauma but also to avoid overuse syndromes and post-traumatic degenerative conditions. Areas covered: We provide background information on some clinical needs in sport injuries and describe the main families of biological products used in clinical practice. We also discuss limitations of the current clinical experience. Expert opinion: Sport and exercise impairment affects different segments of the population with different needs. The exceptional demands of elite athletes and subsequent media coverage have created hype around regenerative therapies. Statistical evidence, whether weak (cell products) or moderate (PRPs), is not enough to drive medical decisions because of the heterogeneity of the biological products available and their application procedures. Moreover, the specific needs of the different segments of the population along with the available clinical evidence for each musculoskeletal condition should be considered in the decision-making process. There is urgent need to develop regenerative protocols combined with post-intervention rehabilitation, and gather meaningful clinical data on the safety and efficacy of these interventions in the different populations segments.

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“…The number of MSCs in the bone marrow (bone marrow mesenchymal stem cells, and BMSCs) is limited (0.001–0.01%) and are also known to display characteristics of early senescence [ 15 ]. Adipose-derived stem cells (ADSCs) harvest also requires the patient to undergo an invasive procedure and are considered to be in the preliminary steps of clinical investigation requiring more randomized clinical trials to prove their efficacy and safety [ 16 ]. DP MSCs have several limitations as well due to their limited availability in adult humans and lack of regeneration after extraction [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Umbilical cord: an allogenic tissue for potential treatment of COVID-19

Rodriguez

Gupta²,

Cavazos-Escobar

et al. 2020

Human Cell

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The COVID-19 pandemic has placed an unprecedented burden on health care systems and economies around the globe. Clinical evidences demonstrate that SARS-CoV-2 infection produces detrimental levels of pro-inflammatory cytokines and chemokines that can lead to acute respiratory distress syndrome (ARDS) and significant systemic organ damage. Currently, there is no definitive therapy for COVID-19 or associated complications, and with the hope of a safe and effective vaccine in the distant future, the search for an answer is paramount. Mesenchymal stem cells (MSCs) provide a viable option due to their immunomodulatory effects and tissue repair and regeneration abilities. Studies have demonstrated that compassionate use of MSCs can reduce symptoms associated with SARS-CoV-2 infection, eliminate fluid buildup, and act as a regenerative technique for alveolar damage; all in a safe and effective way. With multiple autologous sources available for MSCs, each with their own respective limitations, allogenic umbilical cord (UC) and/or UC-derived Wharton's jelly (WJ) seem to be best positioned source to harvest MSCs to treat COVID-19 and associated symptoms. As an allogenic source, UC is readily available, easily obtainable, and is rich in immunomodulatory and regenerative factors. In this manuscript, we reviewed the current evidences and explored the potential therapeutic use of allogenic UC and/or WJ-derived MSCs for the treatment of COVID-19. Although, preliminary preclinical and clinical studies indicate that their use is safe and potentially effective, more multi-center, randomized, controlled trials are needed to adequately assess the safety and efficacy of UC and/or WJderived MSCs for the treatment of COVID-19.

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Adipose-derived stem cells in orthopaedic pathologies

Abstract: Level IV-Study of Level I, II, III, IV.

Cited by 29 publications

References 77 publications

Patient-Centered Outcomes of Microfragmented Adipose Tissue Treatments of Knee Osteoarthritis: An Observational, Intention-to-Treat Study at Twelve Months

Patient-Centered Outcomes of Microfragmented Adipose Tissue Treatments of Knee Osteoarthritis: An Observational, Intention-to-Treat Study at Twelve Months

How far have biological therapies come in regenerative sports medicine?

Umbilical cord: an allogenic tissue for potential treatment of COVID-19

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