Cell-Based Therapy in the Repair of Osteochondral Defects: A Novel Use for Adipose Tissue

Abstract

Mesenchymal stem cells are currently procured from periosteum and bone marrow. The procurement of stem cells from these sources is tedious and gives a low yield of cells. This study was aimed at circumventing these problems and allowing for a method that would be more acceptable in the clinical setting. Tissue for transplantation was harvested from a single New Zealand White rabbit. Cells were more readily obtained from adipose tissue than from bone marrow or periosteum. The present method also provided a better yield of cells through culture. In vitro studies were performed to assess the differentiation potential of these cells. Successful in vitro transformation into alternative mesenchymal cell lines including cardiomyocytes revealed these cells to have wide differentiation potential. Further characterization morphologically, immunohistochemically, and via gene transfection showed features consistent with mesenchymal stem cells. Cultured cells were then transplanted into defects created in the left medial femoral condyle. The femora were harvested at various intervals and the repair tissue was assessed. Gross osteochondral defect reconstitution and histological grading was superior to periosteum-derived stem cell repair and repair by native mechanisms. Biomechanically, the repair tissue approximated intact cartilage and was superior to osteochondral autografts and repair by innate mechanisms.

Characterization of Transplanted Green Fluorescent Protein+ Bone Marrow Cells into Adipose Tissue

“…ASCs are easy to obtain and have demonstrated plasticity in differentiating to cells of mesenchymal lineage [11,[25][26][27][28][29][30]. Cells derived from discarded human fat have many properties that make them ideal for tissue engineering applications, such as immunocompatibility, multipotency, abundance, amenable to gene therapy, and capability of self-renewal.…”

Once fat was fat and that was that : our changing perspectives on adipose tissue

“…90,93 Consequently, there is considerable interest in these adipose-derived stromal cells (ADSCs) 93,94 for regenerative medicine. This is not only for the replacement of damaged fat, 97 bone, 98-100 muscle 101 and cartilage, 102 for it has been found that ADSCs also secrete cytokines, such as VEGF, HGF and SDF-19, 103,104 which stimulate angiogenesis. These cells may therefore be used to treat ischaemic disease, 105 such as fibrosis and osteoradionecrosis, which are late complications of radiotherapy.…”

Chondrogenic differentiation of adipose tissue‐derived mesenchymal stem cells: Greater doses of growth factor are necessary

“…Although bone marrow provides the most universal source of MSC, adipose tissue also offers an abundant and easily accessible pool of MSCs. [4][5][6] It has been reported that adipose tissue-derived mesenchymal stem cells (ATMSCs) obtained from lipoaspirates have the multilineage potential to differentiate into adipogenic, chondrogenic, myogenic, and osteogenic cells. 4,7,8 ATMSCs also show surface marker profiles similar to bone marrow-derived mesenchymal stem cells (BMMSCs).…”

“…Since the pioneering studies demonstrated chondrogenic differentiation from ATMSCs, 5,6,8 subsequent investigations including one from the authors' group failed to achieve comparable results using the combination of growth factors currently known to induce chondrogenesis from BMMSCs. [11][12][13][14] One study that compared chondrogenesis in ATMSCs and BMMSCs from the same individual reported that after 2 weeks of pellet culture, the amount of GAG and the expression of type II collagen mRNA was 120% and 500-to 5000-fold higher in BMMSCs than in ATMSCs.…”