Injective mesenchymal stem cell-based treatments for knee osteoarthritis: from mechanisms of action to current clinical evidences

Zhang

Front. Bioeng. Biotechnol.

et al. 2020

Osteoarthritis (OA) is one of the most common refractory degenerative articular cartilage diseases. Human amniotic mesenchymal cells (hAMSCs) have emerged as a promising stem cell source for cartilage repair, and hyaluronic acid (HA) has proven to be a versatile regulator for stem cell transplantation. Herein, an effective and straightforward intraarticular injection therapy using a cocktail of hAMSCs and HA was developed to treat knee OA in a rat model. The injured cartilage was remarkably regenerated, yielding results comparable to normal cartilage levels after 56 days of treatment. Both hAMSCs and HA were indispensable organic components in this therapy, in which HA could synergistically enhance the effects of hAMSCs on cartilage repair. The regenerative mechanism was attributed to the fact that the addition of HA comprehensively enhances the activities of hAMSCs, including chondrogenic differentiation, proliferation, colonization, and regenerative modulation. This cocktail paves a new avenue for injection therapy to treat OA, holding the potential to realize rapid clinical translation.

Section: Introductionmentioning

confidence: 99%

Cocktail of Hyaluronic Acid and Human Amniotic Mesenchymal Cells Effectively Repairs Cartilage Injuries in Sodium Iodoacetate-Induced Osteoarthritis Rats

Zhang

Front. Bioeng. Biotechnol.

et al. 2020

“…18 Bone marrow (BM-MSCs) or adipose tissue (Ad-MSCs) are the most common sources of MSCs. 6 Many different devices are available which allow to harvest and concentrate MSCs, obtaining a mixed cell population, including also erythrocytes, leukocytes, and endothelial cells. After preparation, MSCs can be seeded on a scaffold or injected into the joint.…”

Section: Discussionmentioning

confidence: 99%

“…These products do not imply substantial cell manipulation, making their use easier and less expensive, because all the treatment can be performed in a single procedure. However, the amount of MSCs is usually lower compared to the other protocols, although this does not imply that it is less effective, 6 with several clinical and histological studies showing the formation of cartilage-like tissue, and good results at short-term follow up. 6, 19, 20 ,21 The second protocol consists into harvest, isolation and expansion in vitro of MSCs, prior to implantation with a scaffold or by injection.…”

Section: Discussionmentioning

confidence: 99%

“…According to our scaffold seeding protocol, 1x10 6 BM-MSCs with no more than P3 were seeded at day 1 on the porous side of the scaffold; the same quantity of cells was seeded on the smooth side of the scaffold on day 2, and on day 3, 1x10 6 cells were seeded again on the porous side of the scaffold.…”

Section: Bm-mentioning

confidence: 99%

“…3,4,5 Recently investigations have reported on the local implantation or intraarticular injection of concentrated bone marrow or adipose-derived MSCs, but the results are controversial. 6,7 We report the results of a novel treatment of full-thickness cartilage defects of the knee. Bone Marrow Mesenchymal Stem Cells (BM-MSCs) were harvested from the iliac crest, expanded in a laboratory facility, differentiated to chondrocytes on a collagen-based scaffold (Chondro-Gide®), and finally sutured on the cartilage defect of the knee.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

BM-MSCs differentiated to chondrocytes for treatment of full-thickness cartilage defect of the knee

Mardones¹,

Via

Pipino

et al. 2020

Preprint

Background Full-thickness articular cartilage injury of the knee is a major cause of disability. The aim of this study is to assess the results of patients treated with differentiated to chondrocytes bone marrow Mesenchymal Stem Cells (BM-MSCs) cultured on a collagen Type I/III (Chondro-Gide®) scaffold. The secondary aim was to confirm the absence of adverse events. Methods Fifteen patients (19 knees) with symptomatic full-thickness cartilage defects of the knee have been enrolled for the study. Bone marrow was harvested from the iliac crest, BM-MSCs were prepared, and expanded cells were grown in a standard medium or in a standard culture medium containing TGF-β. BM-MSCs differentiated to chondrocytes were seeded in a porcine collagen Type I/III scaffold (Chondro-Gide®), and cultured in TGF- β containing media. After 4 weeks, the membrane was sutured on the cartilage defect. All patients underwent plain radiographs of the knee (antero-posterior, lateral, and axial view of the patella), and MRI of the affected knee. The Oxford knee score, the Lyhsolm scale, and the VAS score were administered to all patients. At final follow-up a MRI for the study of articular cartilage was undertaken. Results The mean size of the cartilage lesions was 20 × 17 mm (range, 15 × 10 mm − 30 × 30 mm). At final follow-up, the median Oxford knee score and Lyhsolm scale scores significantly improved from 29 (range 12–39; SD 7,39) to 45 (range 24–48; SD 5,6) and from 55.5 (range 25–81; SD 17,7) to 94.5 (58–100; SD 10,8) respectively. Pain, according the VAS score, significantly improved. 60% of patients reported their satisfaction as excellent, 20% as good, 14% as fair, and 1 patient as poor. Conclusion The treatment of full-thickness chondral injuries of the knee with differentiated to chondrocytes BM-MSCs and Chondro-Gide® scaffold showed encouraging outcomes. Further studies involving more patients, and with longer follow-up, are required in order to evaluate the effectiveness of the treatment and the long-term results.

The effect of dextrose prolotherapy on patients diagnosed with knee osteoarthritis: A comprehensive systematic review and meta‐analysis of interventional studies

Khateri,

Nejad,

Kazemi

et al. 2024

Health Science Reports

Background and AimsThe primary objective of this systematic review and meta‐analysis was to assess the impact of dextrose prolotherapy on individuals diagnosed with knee osteoarthritis (KOA).MethodsTo conduct a thorough investigation, a variety of leading international databases were checked, including PubMed (Medline), Scopus, Web of Sciences, EMBASE (Elsevier), ClinicalTrials.gov, and the Cochrane Library. The search covered a period from January 2000 to the end of June 2023, which facilitated the collection of relevant studies.ResultsThe findings of the study revealed that when the studies utilizing the Western Ontario McMaster Universities Index tool (WOMAC) were combined, patients with KOA who received prolotherapy experienced an improvement in function compared with those who received other treatments (SMD: 0.20; 95% Confidence Interval [1]: −0.11, 0.51; p value SMD = 0.221; I2: 78.49%; pheterogeneity < 0.001). Additionally, there was a decrease in mean pain and stiffness among patients who received prolotherapy compared with those who received other treatments or a placebo [(SMD: −0.95; 95% CI: ‐1.14, −0.76; p value SMD < 0.001; I2: 59.35%; pheterogeneity = 0.070) and (SMD: −0.21; 95% CI: −0.32, −0.10; p value SMD < 0.001; I2: 88.11%; pheterogeneity < 0.001)]. Furthermore, based on the Visual Analog Scale (VAS) score, there was a reduction of 0.81 units out of 10 in mean pain for patients with KOA who received prolotherapy (SMD: −0.81; 95% CI: −5.63, 4.10; p value SMD = 0.693; I2: 48.54%; pheterogeneity = 0.08).ConclusionDrawing from the data analysis performed in this meta‐analysis, it is apparent that dextrose prolotherapy exhibits promising effectiveness in reducing joint pain and stiffness, as well as improving functional performance in individuals suffering from KOA. Furthermore, it is recommended that forthcoming studies incorporate follow‐up periods to guide decisions concerning the duration of prolotherapy's effects.