Emerging Ideas: Treatment of Precollapse Osteonecrosis Using Stem Cells and Growth Factors

Cui, Quanjun; Botchwey, Edward A.

doi:10.1007/s11999-010-1738-1

Cited by 38 publications

(32 citation statements)

References 31 publications

(61 reference statements)

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“…Because these typically “pro-regenerative” MP subpopulations predominate the SS as early as day 7, increasing their recruitment may offer only modest therapeutic efficacy for muscle degeneration, which occurs over weeks. A more promising strategy may be to bias recruited cells toward pro-regenerative cytokine secretion using appropriately engineered delivery of immune modulatory molecules[44], [49], [50]. …”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Immune Cell Subset Infiltration of Supraspinatus Muscle After Severe Rotator Cuff Injury

Krieger

Tellier

Ollukaren

et al. 2017

Regen. Eng. Transl. Med.

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Rotator cuff tears cause muscle degeneration that is characterized by myofiber atrophy, fatty infiltration, and fibrosis and is minimally responsive to current treatment options. The underlying pathogenesis of rotator cuff muscle degeneration remains to be elucidated, and increasing evidence implicates immune cell infiltration as a significant factor. Because immune cells are comprised of highly heterogeneous subpopulations that exert divergent effects on injured tissue, understanding trafficking and accumulation of immune subpopulations may hold the key to more effective therapies. The present study quantifies subpopulations of immune cells infiltrating the murine supraspinatus muscle after severe rotator cuff injury that includes tenotomy and denervation. Rotator cuff injury stimulates dramatic infiltration of mononuclear phagocytes, enriches mononuclear phagocytes in non-classical subpopulations, and enriches T lymphocytes in TH and Treg subpopulations. The combination of tenotomy plus denervation significantly increases mononuclear phagocyte infiltration, enriches macrophages in the non-classical subpopulation, and decreases T lymphocyte enrichment in TH cells compared to tenotomy alone. Depletion of circulating monocytes via liposomal clodronate accelerates supraspinatus atrophy after tenotomy and denervation. The study may aid rational design of immunologically smart therapies that harness immune cells to enhance outcomes after rotator cuff tears.

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Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Immune Cell Subset Infiltration of Supraspinatus Muscle After Severe Rotator Cuff Injury

Krieger

Tellier

Ollukaren

et al. 2017

Regen. Eng. Transl. Med.

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“…Growth factors are critical for osteoinduction, a central process for bone repair, as occurs in fracture healing. To ensure successful bone healing, the induction of angiogenesis is needed, and marrow stromal cells (MSCs) are also used to induce bone formation (15–20). Mesenchymal elements express factors like Vascular Endothelial Growth Factor (VEGF), and it has been demonstrated that MSCs from healthy subjects are characterized by a signature profile of VEGF expression distinct from patients affected by Osteonecrosis (ON) of the hip and by Osteoarthritis (OA) (14).…”

Section: Endothelial and Bone Cells The Molecular Basis Of Their Intmentioning

confidence: 99%

Bone Vascularization in Normal and Disease Conditions

Carulli¹,

Innocenti²,

Brandi³

2013

Front. Endocrinol.

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Bone vasculature is essential for many processes, such as skeletal development and growth, bone modeling and remodeling, and healing processes. Endothelium is an integral part of bone tissue, expressing a physiological paracrine function via growth factors and chemokines release, and interacting with several cellular lines. Alterations of the complex biochemical interactions between vasculature and bone cells may lead to various clinical manifestations. Two different types of pathologies result: a defect or an excess of bone vasculature or endothelium metabolism. Starting from the molecular basis of the interactions between endothelial and bone cells, the Authors present an overview of the recent acquisitions in the physiopathology of the most important clinical patterns, and the modern therapeutic strategies for their treatments.

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“…This phenomenon led to a lack of osteogenesis and revascularization may contribute to the insufficient reconstruction repair after CD. For this reason, local application of stem cells may be one of the solutions [28]. BMMCs are highly enriched with BMMSCs in terms of fibroblast colony-forming units [10].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of targeted intraarterial delivery of concentrated autologous bone marrow containing mononuclear cells in the treatment of osteonecrosis of the femoral head: A five year follow-up study

Mao¹,

Jin²,

Liao³

et al. 2013

Bone

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Objective To investigate the efficacy and safety of targeted delivery of autologous bone marrow mononuclear cells (BMMCs), which are highly enriched with mesenchymal stem cells (BMMSCs), via medial circumflex femoral artery in the treatment of osteonecrosis of the femoral head (ONFH). Methods 62 patients (78 hips) with ONFH were recruited in this study. All of these patients were treated with BMMCs perfusion via medial circumflex femoral artery. The concentrated BMMCs (30–60 ml) were gained from autologous bone marrow (100–200 ml) harvested from anterior iliac crest and then were intra-arterially perfused into the femoral head. Ficat stage was used to classify the radiological stage of ONFH. Harris hip score was used to evaluate the clinical symptoms of osteonecrosis. Ficat stage and Harris hip scores were assessed at onset of treatment at 6, 12, 24, 36, 48 and 60 months after the initial treatment. Total hip arthroplasty (THA) was also assessed as an endpoint at each follow-up. Results A follow-up on the patient was done at the end of five years, and 92.31% (72 of 78) of hips achieved a satisfactory clinical result while only 6 hips (7.69%) progressed to clinical failure and required THA. Radiological progression was noted in 34 of 78 hips (43.59%); the overall rate of collapse was 38.24% (26 of 68 hips) in stage-I and stage-II hip combinations and 12.5% (2 of 16)in stage-I hips and 46.15% (24 of 52) in stage-II hips. The mean time of conversion to THA was 3 years (1 to 5 years) and the average time to collapse were 3.5 years (1–5 years). The mean Harris hip score increased from 59 points at baseline to 75 points at 12 months, 82 points at 24 months, 81 points at 36 months, 79 points at 48 months and 74 points at 60 months. Five years after the treatment, 3 of 10 hips (30%) in stage-III had deteriorated to clinical failure whereas only 3 of 68 hips (4.41%) in stage-I and II combination had progressed to clinical failure (p < 0.05). Kaplan–Meier survival analysis showed a significant difference in the time to failure between the pre-collapse hips (Ficat stage-I and II) and the post-collapse hips (Ficat stage-III) at five years follow-up (Log-rank test; p < 0.01). No complication was found in any patients. Conclusions Autologous BMMSC perfusion via the medial circumflex femoral artery can relieve symptoms, improve hip function and delay the progression of ONFH. The clinical outcome is better when it is applied prior to the collapse. This work demonstrates that autologous BMMSC perfusion via the medial circumflex femoral artery is a safe, effective and minimally invasive treatment strategy for early-stage ONFH.

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Emerging Ideas: Treatment of Precollapse Osteonecrosis Using Stem Cells and Growth Factors

Abstract: Background Osteonecrosis (

Cited by 38 publications

References 31 publications

Quantitative Analysis of Immune Cell Subset Infiltration of Supraspinatus Muscle After Severe Rotator Cuff Injury

Quantitative Analysis of Immune Cell Subset Infiltration of Supraspinatus Muscle After Severe Rotator Cuff Injury

Bone Vascularization in Normal and Disease Conditions

The efficacy of targeted intraarterial delivery of concentrated autologous bone marrow containing mononuclear cells in the treatment of osteonecrosis of the femoral head: A five year follow-up study

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