Adipose Tissue-Derived Mesenchymal Stem Cells as a Potential Restorative Treatment for Cartilage Defects: A PRISMA Review and Meta-Analysis

Abstract

Cartilage defects are a predisposing factor for osteoarthritis. Conventional therapies are mostly palliative and there is an interest in developing newer therapies that target the disease’s progression. Mesenchymal stem cells (MSCs) have been suggested as a promising therapy to restore hyaline cartilage to cartilage defects, though the optimal cell source has remained under investigation. A PRISMA systematic review was conducted utilising five databases (MEDLINE, EMBASE, Cochrane Library, Scopus, Web of Science) which identified nineteen human studies that used adipose tissue-derived MSC (AMSC)-based therapies, including culture-expanded AMSCs and stromal vascular fraction, to treat cartilage defects. Clinical, imaging and histological outcomes, as well as other relevant details pertaining to cartilage regeneration, were extracted from each study. Pooled analysis revealed a significant improvement in WOMAC scores (mean difference: −25.52; 95%CI (−30.93, −20.10); p < 0.001), VAS scores (mean difference: −3.30; 95%CI (−3.72, −2.89); p < 0.001), KOOS scores and end point MOCART score (mean: 68.12; 95%CI (62.18, 74.05)), thus showing improvement. The studies in this review demonstrate the safety and efficacy of AMSC-based therapies for cartilage defects. Establishing standardised methods for MSC extraction and delivery, and performing studies with long follow-up should enable future high-quality research to provide the evidence needed to bring AMSC-based therapies into the market.

The role of BMP4 in adipose-derived stem cell differentiation: A minireview

“…Clinical applications of ADSC in stem cell therapy has been studied in the last decades. In vivo studies have successfully differentiated ADSC into neuronal cells in animal model, as well as chondrocyte and epithelial cells in human study (Meng et al, 2021;Wu et al, 2021). However, in vitro differentiation of ADSC becomes the main focus in stem cell studies since it allows the researcher to expand the ADSC population, survival rate and differentiation capacity toward multiple lineages.…”

The Effect of Human Bone Marrow Mesenchymal Stem Cell-Derived Exosomes on Cartilage Repair in Rabbits

“…In addition, MSCs could secrete anti-inflammatory cytokines to modulate immune response, by which a favorable microenvironment was constructed during cartilage repair [ 9 ]. To date, MSCs from different sources including bone marrow [ 10 ], adipose tissue [ 11 ], peripheral blood [ 12 ], umbilical cord blood [ 13 ], and umbilical cord [ 14 ] have been shown promising effects in cartilage tissue engineering. Of them, bone marrow MSCs are considered as the preferred seed cells for treating osteochondral defects due to their advantages in proliferation, chondrogenic differentiation, and easy collection [ 15 ].…”

Autologous Adipose-Derived Tissue Stromal Vascular Fraction (AD-tSVF) for Knee Osteoarthritis

“…Recent systemic reviews and a meta-analysis [ 53 , 76 , 85 , 97 , 110 , 132 , 133 , 257 , 258 , 259 , 260 , 261 , 262 ] summarized the state of micro- and nano-fragmented fat tissue grafts, AD-cSVF, AD-tSVF, and ADMSCs. Here, we focused on autologous AD-tSVF applications in knee OA obtained from abdominal fat by liposuction.…”

“…Here, we focused on autologous AD-tSVF applications in knee OA obtained from abdominal fat by liposuction. Meng et al [ 257 ] listed the study design, interventional details, and outcomes of clinical studies that used autologous and allogenic ADMSCs obtained from the infrapatellar fat pad, gluteus, and abdomen. The lowest and the highest cell counts were 1.2 × 10 6 and 1.0 × 10 8 cells per mL, respectively.…”