Evaluation of a Single Intra-Articular Injection of Autologous Adipose Tissue for the Treatment of Osteoarthritis: A Prospective Clinical Study in Dogs

Pavarotti, Greta S.; Hivernaud, Vincent; Brincin, Mélanie; Roche, Régis; Barreau, P.; Festy, Franck; Gauthier, Olivier

doi:10.1055/s-0040-1708524

Cited by 12 publications

(18 citation statements)

References 36 publications

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“…In this study, seven patients experienced some degree of joint flare, and six out of seven of those patients were in the Allo-MSC group. This is similar to findings reported in other studies involving intra-articular injections, particularly repeat injections of Allo-MSC ( 18 , 38 ). Of the six joint flares in the Allo-MSC group, two were reported to have flare after both injections, two had flare only after the first injection, and another two had flare only after the second injection.…”

Section: Discussionsupporting

confidence: 91%

“…MSC are obtained from various sources (e.g., bone marrow, placenta, umbilical cord, etc. ), but adipose-derived MSC have the particular advantage of being both abundant and a more easily harvested resource ( 18 ). Both autologous and allogeneic adipose-derived MSC have been used in veterinary medicine, though to date, there is no consensus on which is safer and more effective ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

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Intra-Articular Injections of Allogeneic Mesenchymal Stromal Cells vs. High Molecular Weight Hyaluronic Acid in Dogs With Osteoarthritis: Exploratory Data From a Double-Blind, Randomized, Prospective Clinical Trial

et al. 2022

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This double-blind, randomized, prospective clinical trial was conducted to obtain exploratory data comparing the efficacy of intra-articular allogeneic mesenchymal stem/stromal cells (MSC) to high molecular weight hyaluronic acid (HA) for the treatment of pain associated with canine osteoarthritis (OA). Objective gait analysis (%Body Weight Distribution, %BWD), accelerometry, clinical metrology instruments and veterinary exams were used as outcome measures during various time points throughout the 48-week study period. Fourteen dogs with elbow or coxofemoral OA were enrolled and assigned in a 2:1 ratio to the treatment groups. Each patient received a set of two injections 4 weeks apart. Self-limiting joint flare was observed in seven patients, with six of these in the MSC group. Ten patients completed all follow-up appointments. Both treatment groups showed evidence of mild improvement following the treatment, but the results were inconsistent among the various outcome measures assessed. Overall, dogs enrolled in the HA group showed greater improvement compared to the MSC group. The primary outcome measure, %BWD, showed evidence of improvement, when compared to baseline values, at 36 weeks after injection for the HA group only (p = 0.048, estimated difference: 4.7). Similarly, when treatment groups were compared, evidence of a difference between treatment groups (with the HA-group showing greater improvement) were identified for weeks 24 and 36 (p = 0.02 and 0.01, respectively). The small sample size of this exploratory study does not allow firm conclusions. However, until studies with larger sample sizes are available, the current literature combined with our data do not support the clinical use of intra-articular MSC therapy over high molecular weight HA for the treatment of canine OA at this time.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Intra-Articular Injections of Allogeneic Mesenchymal Stromal Cells vs. High Molecular Weight Hyaluronic Acid in Dogs With Osteoarthritis: Exploratory Data From a Double-Blind, Randomized, Prospective Clinical Trial

et al. 2022

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“…Similarly, the long-term outcome showed a substantial decrease in pain severity and interference for the MFAT group supported by a statistical analysis and a statistical significance for pain interference after 180 days ( p < 0.0001). As in the literature on human medicine, an improvement in pain perception is validated in both the short and long term following joint infiltration with MFAT [ 81 , 82 , 83 , 84 ]. Additionally, recent veterinary literature suggests evidence of clinical pain control over 180 days due to intra-articular administration of autologous purified and microfragmented adipose tissue to treat OA in dogs [ 34 , 81 ].…”

Section: Discussionmentioning

confidence: 99%

“…As in the literature on human medicine, an improvement in pain perception is validated in both the short and long term following joint infiltration with MFAT [ 81 , 82 , 83 , 84 ]. Additionally, recent veterinary literature suggests evidence of clinical pain control over 180 days due to intra-articular administration of autologous purified and microfragmented adipose tissue to treat OA in dogs [ 34 , 81 ]. One of the authors’ main concerns was the impracticality of making the owner and clinician blind for the treatment group to which the patients belonged [ 85 , 86 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Intra-Articular Autologous Adipose Micrograft for the Treatment of Osteoarthritis in Dogs: A Prospective, Randomized, Controlled Study

Botto

Riccio

Galosi

et al. 2022

Animals

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The purpose of this study was to estimate the safety, feasibility, and efficacy of the intra-articular treatment of autologous microfragmented adipose tissue in dogs with spontaneous osteoarthritis (OA) in comparison with hyaluronic acid (HA), the standard intra-articular treatment. Specifically, it clinically evaluated pain and lameness, the radiographic progression of osteoarthritis, and synovial fluid inflammation. This was a prospective, single-center, parallel-group, randomized, controlled, in vivo clinical study. Participants (n = 40) received either a single intra-articular injection of microfragmented adipose tissue or a single intra-articular injection of HA (1:1). Clinical outcomes were determined using a specialistic clinician assessment obtained by the completion of a specific clinical form based on the Vesseur modified lameness classification system, a pain evaluation using the Visual Analogue Scale (VAS), the measurement of the range of motion (ROM) of the affected joint, limb circumference, and the owners’ score evaluation using the Canine Brief Pain Inventory (CBPI) for up to 6 months after the time of injection. Patients underwent a radiographic examination to establish the degree of OA in the affected joint, and synovial fluid samples were collected to assess the biochemical environment of the joint and evaluate and quantify the cellular population and the presence of three specific inflammation biomarkers for up to 60 days. The results of this study suggest that microfragmented autologous adipose tissue is safe and can effectively relieve pain and improve function in dogs with spontaneous articular OA. This one-step procedure is simple, timesaving, cost-effective, minimally invasive, and eliminates the need for complex and time-intensive cell culture processing. Furthermore, the clinical evidence and cytological results suggest better long-term pain control, resulting in an improvement in joint function, compared to HA treatment. The canine spontaneous OA model could play a key role in developing successful treatments for human medicine.

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“…The clinical application of MSC-based therapy in veterinary medicine comprises of multiple target diseases, with the vast majority being focused on musculoskeletal conditions such as osteoarthritis (8,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), cruciate ligament disease (9,(35)(36)(37)(38), hip dysplasia (39), bone fractures and lesions (40,41), muscle tears (42,43) and tendinopathies (44,45). Canine clinical studies have also shown promising results for the treatment of diseases of the gastro-intestinal tract (46)(47)(48), central nervous system (49)(50)(51)(52)(53), cardiovascular system (54,55), cutaneous (56)(57)(58)(59) and ocular conditions (60)(61)(62)(63), resulting in encouraging safety and efficacy data (Figure 2).…”

Section: Mesenchymal Stromal Cellsmentioning

confidence: 99%

Manufacturing Mesenchymal Stromal Cells for the Treatment of Osteoarthritis in Canine Patients: Challenges and Recommendations

et al. 2022

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The recent interest in advanced biologic therapies in veterinary medicine has opened up opportunities for new treatment modalities with considerable clinical potential. Studies with mesenchymal stromal cells (MSCs) from animal species have focused on in vitro characterization (mostly following protocols developed for human application), experimental testing in controlled studies and clinical use in veterinary patients. The ability of MSCs to interact with the inflammatory environment through immunomodulatory and paracrine mechanisms makes them a good candidate for treatment of inflammatory musculoskeletal conditions in canine species. Analysis of existing data shows promising results in the treatment of canine hip dysplasia, osteoarthritis and rupture of the cranial cruciate ligament in both sport and companion animals. Despite the absence of clear regulatory frameworks for veterinary advanced therapy medicinal products, there has been an increase in the number of commercial cell-based products that are available for clinical applications, and currently the commercial use of veterinary MSC products has outpaced basic research on characterization of the cell product. In the absence of quality standards for MSCs for use in canine patients, their safety, clinical efficacy and production standards are uncertain, leading to a risk of poor product consistency. To deliver high-quality MSC products for veterinary use in the future, there are critical issues that need to be addressed. By translating standards and strategies applied in human MSC manufacturing to products for veterinary use, in a collaborative effort between stem cell scientists and veterinary researchers and surgeons, we hope to facilitate the development of quality standards. We point out critical issues that need to be addressed, including a much higher level of attention to cell characterization, manufacturing standards and release criteria. We provide a set of recommendations that will contribute to the standardization of cell manufacturing methods and better quality assurance.

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Evaluation of a Single Intra-Articular Injection of Autologous Adipose Tissue for the Treatment of Osteoarthritis: A Prospective Clinical Study in Dogs

Cited by 12 publications

References 36 publications

Intra-Articular Injections of Allogeneic Mesenchymal Stromal Cells vs. High Molecular Weight Hyaluronic Acid in Dogs With Osteoarthritis: Exploratory Data From a Double-Blind, Randomized, Prospective Clinical Trial

Intra-Articular Injections of Allogeneic Mesenchymal Stromal Cells vs. High Molecular Weight Hyaluronic Acid in Dogs With Osteoarthritis: Exploratory Data From a Double-Blind, Randomized, Prospective Clinical Trial

Effects of Intra-Articular Autologous Adipose Micrograft for the Treatment of Osteoarthritis in Dogs: A Prospective, Randomized, Controlled Study

Manufacturing Mesenchymal Stromal Cells for the Treatment of Osteoarthritis in Canine Patients: Challenges and Recommendations

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