Excellent histological results in terms of articular cartilage regeneration after spheroid-based autologous chondrocyte implantation (ACI)

Grevenstein, David; Mamilos, Andreas; Schmitt, Volker H.; Niedermair, Tanja; Wagner, Willi L.; Kirkpatrick, Charles James; Brochhausen, Christoph

doi:10.1007/s00167-020-05976-9

Cited by 23 publications

(20 citation statements)

References 22 publications

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“…In recent decades, modern medicine has greatly enhanced our capabilities and reached many milestones in improving TE approaches, including cartilage TE [30,31]. However, common treatment approaches such as endoprosthetics, multiple drilling, microfractures, autologous chondrocyte implantation (ACI), and joint replacement are associated with many side effects [32,33]. In addition, there are still many limitations in creating an adequate cellular microenvironment: The scaffolds used must be biocompatible, biodegradable, non-toxic, and have the desired mechanical properties, and the materials used can be expensive and have not yet been fully tested [25].…”

Section: Introductionmentioning

confidence: 99%

Herbal Remedies as Potential in Cartilage Tissue Engineering: An Overview of New Therapeutic Approaches and Strategies

et al. 2020

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It is estimated that by 2023, approximately 20% of the population of Western Europe and North America will suffer from a degenerative joint disease commonly known as osteoarthritis (OA). During the development of OA, pro-inflammatory cytokines are one of the major causes that drive the production of inflammatory mediators and thus of matrix-degrading enzymes. OA is a challenging disease for doctors due to the limitation of the joint cartilage’s capacity to repair itself. Though new treatment approaches, in particular with mesenchymal stem cells (MSCs) that integrate the tissue engineering (TE) of cartilage tissue, are promising, they are not only expensive but more often do not lead to the regeneration of joint cartilage. Therefore, there is an increasing need for novel, safe, and more effective alternatives to promote cartilage joint regeneration and TE. Indeed, naturally occurring phytochemical compounds (herbal remedies) have a great anti-inflammatory, anti-oxidant, and anabolic potential, and they have received much attention for the development of new therapeutic strategies for the treatment of inflammatory diseases, including the prevention of age-related OA and cartilage TE. This paper summarizes recent research on herbal remedies and their chondroinductive and chondroprotective effects on cartilage and progenitor cells, and it also emphasizes the possibilities that exist in this research area, especially with regard to the nutritional support of cartilage regeneration and TE, which may not benefit from non-steroidal anti-inflammatory drugs (NSAIDs).

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Section: Introductionmentioning

confidence: 99%

Herbal Remedies as Potential in Cartilage Tissue Engineering: An Overview of New Therapeutic Approaches and Strategies

et al. 2020

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“…The literature search yielded 34 publications in PubMed and 70 in Web of Science. After removing 29 duplicates and screening the titles and abstracts, the full texts of 21 publications were screened, after which 18 [7,[10][11][12][13][14][15][17][18][19][20][21][22][23][24][25][26][27] were included and 3 [28][29][30] were excluded due to the use of xenogeneic materials [28] or antibiotics [29] in the cell culture, or the spheroids were formed by pelleting cells with centrifugation [30]. Two additional articles [16,31] were identified from citations (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…It has to be noted here that the adolescent patients were treated with chondrosphere in Germany under the German regulations. ACI with spheroids provided good patient-reported outcome scores [15][16][17][18][19], MRI [15,16,18,19], macroscopic [17,22], and histological [20] evaluations in patients with a routine treatment (Table 3).…”

Section: Clinical Studiesmentioning

confidence: 99%

Role of Matrix-Associated Autologous Chondrocyte Implantation with Spheroids in the Treatment of Large Chondral Defects in the Knee: A Systematic Review

Vonk

Roël²,

Hernigou

et al. 2021

IJMS

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Autologous chondrocyte implantation (ACI) is a cell therapy for the treatment of focal cartilage defects. The ACI product that is currently approved for use in the European Union (EU) consists of spheroids of autologous matrix-associated chondrocytes. These spheroids are spherical aggregates of ex vivo expanded human autologous chondrocytes and their self-synthesized extracellular matrix. The aim is to provide an overview of the preclinical and nonclinical studies that have been performed to ensure reproducible quality, safety, and efficacy of the cell therapy, and to evaluate the clinical data on ACI with spheroids. A systematic review was performed to include all English publications on self-aggregated spheroids of chondrocytes cultured in autologous serum without other supplements. A total of 20 publications were included, 7 pre- and nonclinical and 13 clinical research publications. The pre- and nonclinical research publications describe the development from concept to in vivo efficacy and quality- and safety-related aspects such as biodistribution, tumorigenicity, genetic stability, and potency. The evaluation of clinical research shows short- to mid-term safety and efficacy for the ACI with spheroid-based treatment of cartilage defects in both randomized clinical trials with selected patients, as well as in routine treatment providing real-world data in more complex patients.

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“…The most promising method for overcoming hyaline articular cartilage's limited intrinsic healing potential is autologous chondrocyte implantation (ACI) (Grevenstein et al, 2021). In ACI, chondrocytes are applied to the damaged area together with a membrane, such as the tibial periosteum or a biomembrane.…”

Section: Introductionmentioning

confidence: 99%

Early Efficacy of Type I Collagen-Based Matrix-Assisted Autologous Chondrocyte Transplantation for the Treatment of Articular Cartilage Lesions

Qian

et al. 2021

Front. Bioeng. Biotechnol.

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Background: Articular cartilage is a complex structure that allows for low frictional gliding and effective shock absorption. Various sports injuries and inflammatory conditions can lead to lesions in the articular cartilage, which has limited regenerative potential. Type I collagen combined with autologous chondrocytes in a three-dimensional culture were used to induce the regeneration of single-layer autologous expanded chondrocytes without chondrogenic differentiation.Purpose: To assess the clinical, radiological, and histological changes following collagen-based autologous chondrocyte transplantation (MACT) for chondral knee lesions.Methods: The study prospectively enrolled 20 patients with symptomatic knee chondral lesions (mean size lesion was 2.41 ± 0.43 cm2, range: 2.0–3.4 cm2) in the lateral femoral condyle and femoral groove who underwent type I collagen-based MACT between July 2017 and July 2019. knee injury and osteoarthritis outcome score (KOOS) was assessed before the procedure, and periodic clinical follow-up was conducted every 3 months for a maximum of 12 months following the procedure and at 1-year intervals thereafter. Magnetic resonance imaging (MRI) T2 mapping of repaired cartilage was also used for the quantitative analysis of regeneration. In one patient, second-look arthroscopy was performed to assess cartilage regeneration characteristics, and a portion of regenerated cartilage was harvested for histological evaluation 12 months after implantation.Results: At pre-operation and at three, six, 12, and 24 months after the operation, KOOS pain, symptoms, daily life activities, sports and recreation, as well as the quality of life were significantly improved between every two time points. Hematoxylin and eosin (HE) staining indicated that the newly formed cartilage was comprised of naive chondrocytes. Safranin O-fast (S-O) green staining of the regenerated tissue revealed fibroblast-like cells surrounded by glycosaminoglycans. Immunohistochemistry (IHC) analysis indicated that collagen type II was uniformly distributed at the deep zone of articular cartilage and type I collagen mainly depositing in the superficial cartilage layer. The T2 values for repaired tissue gradually decreased, eventually approaching near-average values.Conclusion: The present study demonstrated that type I collagen-based MACT is a clinically effective treatment for improving functionality and pain levels. Histological evidence confirmed hyaline cartilage induction and showed that repaired cartilage tended to emerge from the deep to the superficial layer. The quantitative MRI T2 mapping test indicated that there still was a difference between the transplanted cartilage and the surrounding hyaline cartilage. Taken together, the current method represents an efficient approach for the restoration of knee cartilage lesions.

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Excellent histological results in terms of articular cartilage regeneration after spheroid-based autologous chondrocyte implantation (ACI)

Cited by 23 publications

References 22 publications

Herbal Remedies as Potential in Cartilage Tissue Engineering: An Overview of New Therapeutic Approaches and Strategies

Herbal Remedies as Potential in Cartilage Tissue Engineering: An Overview of New Therapeutic Approaches and Strategies

Role of Matrix-Associated Autologous Chondrocyte Implantation with Spheroids in the Treatment of Large Chondral Defects in the Knee: A Systematic Review

Early Efficacy of Type I Collagen-Based Matrix-Assisted Autologous Chondrocyte Transplantation for the Treatment of Articular Cartilage Lesions

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