Mesenchymal stem cells for subchondral bone marrow lesions: From bench to bedside

Pasculli, Rosa M.; Kenyon, Charles D.; Berrigan, William A.; Mautner, Kenneth; Hammond, Kyle E.; Jayaram, Prathap

doi:10.1016/j.bonr.2022.101630

Cited by 8 publications

(5 citation statements)

References 123 publications

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“…Mesenchymal stem cells (MSCs), obtained from adult bone marrow (BM-MSC) or adipose tissue (AD-MSC), has been recently included in possible treatment strategies via intra-articular injection [ 46 ]. The benefits depend on the MSCs ability to regulate a variety of trophic factors that help prevent oxidative damage, apoptosis, and inflammatory pathways [ 46 ].…”

Section: Introductionmentioning

confidence: 99%

Bone marrow edema of the knee: a narrative review

Villari,

Digennaro,

Panciera

et al. 2024

Arch Orthop Trauma Surg

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Bone marrow edema (BME) is a frequent MRI finding in patients with knee pain. According to the etiology, BME of the knee can be classified into three main categories: ischemic, mechanic, and reactive. The diagnosis may be difficult, because of the specificity of symptoms and the poor radiographic findings. MRI is the gold standard, showing an area of altered signal of the bone with an high signal intensity on fat-suppressed, T2 weighted images, usually in combination with an intermediate or low signal intensity on T1 weighted images. Bone marrow edema tends to be self-limiting and, in most cases, resolves without any consequences in a varying amount of time. However, since it may evolve to complete joint destruction, early diagnosis and correct treatment are crucial to prevent the articular degeneration. Conservative therapy is the first step, with no weight-bearing for 3 to 6 weeks on the affected side, in combination with the administration of anti-inflammatory drugs or painkillers to manage symptoms. In non-responding forms and more advanced stages, minimally invasive preservative surgery can provide significant results, with subchondroplasty and core decompression being the two main procedures available. Knee arthroplasty, both total (TKA) or unicompartmental (UKA), is the only effective option when the degradation of cartilage is diffuse and in patients with subchondral bone collapse.

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Section: Introductionmentioning

confidence: 99%

Bone marrow edema of the knee: a narrative review

Villari,

Digennaro,

Panciera

et al. 2024

Arch Orthop Trauma Surg

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“…For the treatment of musculoskeletal disorders, orthobiologics are a valuable option [16] since they can be obtained in an office setting and are highly enriched in biologic substances and bio-active cellular components, including MSCs. Orthobiologics have shown promising outcomes in managing tissue damage and inflammation, including the amelioration of bone marrow lesions [17][18][19]. These lesions, which are often challenging to treat, can be visualized with advanced imaging techniques, such as spectral CT or MRI [20].…”

Section: Discussionmentioning

confidence: 99%

Stable Housekeeping Genes in Bone Marrow, Adipose Tissue, and Amniotic Membrane-Derived Mesenchymal Stromal Cells for Orthopedic Regenerative Medicine Approaches

Ragni,

Piccolo,

Papait

et al. 2024

IJMS

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The therapeutic effect of mesenchymal stromal cells (MSCs) has been described for a variety of disorders, including those affecting musculoskeletal tissues. In this context, the literature reports several data about the regenerative effectiveness of MSCs derived from bone marrow, adipose tissue, and an amniotic membrane (BMSCs, ASCs, and hAMSCs, respectively), either when expanded or when acting as clinical-grade biologic pillars of products used at the point of care. To date, there is no evidence about the superiority of one source over the others from a clinical perspective. Therefore, a reliable characterization of the tissue-specific MSC types is mandatory to identify the most effective treatment, especially when tailored to the target disease. Because molecular characterization is a crucial parameter for cell definition, the need for reliable normalizers as housekeeping genes (HKGs) is essential. In this report, the stability levels of five commonly used HKGs (ACTB, EF1A, GAPDH, RPLP0, and TBP) were sifted into BMSCs, ASCs, and hAMSCs. Adult and fetal/neonatal MSCs showed opposite HKG stability rankings. Moreover, by analyzing MSC types side-by-side, comparison-specific HKGs emerged. The effect of less performant HKG normalization was also demonstrated in genes coding for factors potentially involved in and predicting MSC therapeutic activity for osteoarthritis as a model musculoskeletal disorder, where the choice of the most appropriate normalizer had a higher impact on the donors rather than cell populations when compared side-by-side. In conclusion, this work confirms HKG source-specificity for MSCs and suggests the need for cell-type specific normalizers for cell source or condition-tailored gene expression studies.

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“…As previously mentioned, ASCs have gained popularity owing to their ease of isolation, abundance in adipose tissue, anti-inflammatory properties, and proliferative potential[ 17 ]. Furthermore, the intraarticular delivery of adipose-derived therapies, including SVF and MFAT, is conducive to relatively noninvasive treatment techniques[ 79 ]. However, various challenges exist in translating adipose-derived regenerative therapies from trial settings to clinical practice.…”

Section: Future Challengesmentioning

confidence: 99%

Adipose-derived regenerative therapies for the treatment of knee osteoarthritis

Epanomeritakis,

Khan

2024

World J Stem Cells

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Knee osteoarthritis is a degenerative condition with a significant disease burden and no disease-modifying therapy. Definitive treatment ultimately requires joint replacement. Therapies capable of regenerating cartilage could significantly reduce financial and clinical costs. The regenerative potential of mesenchymal stromal cells (MSCs) has been extensively studied in the context of knee osteoarthritis. This has yielded promising results in human studies, and is likely a product of immunomodulatory and chondroprotective biomolecules produced by MSCs in response to inflammation. Adipose-derived MSCs (ASCs) are becoming increasingly popular owing to their relative ease of isolation and high proliferative capacity. Stromal vascular fraction (SVF) and micro-fragmented adipose tissue (MFAT) are produced by the enzymatic and mechanical disruption of adipose tissue, respectively. This avoids expansion of isolated ASCs ex vivo and their composition of heterogeneous cell populations, including immune cells, may potentiate the reparative function of ASCs. In this editorial, we comment on a multicenter randomized trial regarding the efficacy of MFAT in treating knee osteoarthritis. We discuss the study’s findings in the context of emerging evidence regarding adipose-derived regenerative therapies. An underlying mechanism of action of ASCs is proposed while drawing important distinctions between the properties of isolated ASCs, SVF, and MFAT.

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Mesenchymal stem cells for subchondral bone marrow lesions: From bench to bedside

Cited by 8 publications

References 123 publications

Bone marrow edema of the knee: a narrative review

Bone marrow edema of the knee: a narrative review

Stable Housekeeping Genes in Bone Marrow, Adipose Tissue, and Amniotic Membrane-Derived Mesenchymal Stromal Cells for Orthopedic Regenerative Medicine Approaches

Adipose-derived regenerative therapies for the treatment of knee osteoarthritis

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