Meta-Analysis of Adipose Tissue Derived Cell-Based Therapy for the Treatment of Knee Osteoarthritis

Abstract

Osteoarthritis (OA) is a degenerative disorder associated with cartilage loss and is a leading cause of disability around the world. In old age, the capacity of cartilage to regenerate is diminished. With an aging population, the burden of OA is set to rise. Currently, there is no definitive treatment for OA. However, cell-based therapies derived from adipose tissue are promising. A PRISMA systematic review was conducted employing four databases (MEDLINE, EMBASE, Cochrane, Web of Science) to identify all clinical studies that utilized adipose tissue derived mesenchymal stem cells (AMSCs) or stromal vascular fraction (SVF) for the treatment of knee OA. Eighteen studies were included, which met the inclusion criteria. Meta-analyses were conducted on fourteen of these studies, which all documented WOMAC scores after the administration of AMSCs. Pooled analysis revealed that cell-based treatments definitively improve WOMAC scores, post treatment. These improvements increased with time. The studies in this meta-analysis have established the safety and efficacy of both AMSC therapy and SVF therapy for knee OA in old adults and show that they reduce pain and improve knee function in symptomatic knee OA suggesting that they may be effective therapies to improve mobility in an aging population.

A Comparison of the Capacity of Mesenchymal Stromal Cells for Cartilage Regeneration Depending on Collagen-Based Injectable Biomimetic Scaffold Type

“…The chondrogenic differentiation medium included high-glucose DMEM (Gibco, USA), 10% ITS+ (Corning, USA), 1% sodium pyruvate (Sigma-Aldrich, USA), 0.25% ascorbate -2-phosphate (Sigma-Aldrich, USA), 100 nM dexamethasone (Sigma-Aldrich, USA), 0.002% TGF-β1 (PeproTech, USA) and 1% penicillin-streptomycin-glutamine (Gibco, USA). The scaffolds (5 mg decellularized porcine articular cartilage (DPC) or 0.25 ml MCH) were seeded with 1х10 6 MSCs by rotating in tubes with culture medium on the shaker Multi Bio 3D (Biosan, Latvia).…”

“…The application of autologous mesenchymal stem cells (MSCs) [4] may serve as an alternative therapeutic approach to the restoration of the cartilage tissue. The MSCs are multicomponent cells capable of differentiating into various types of cells, including chondrocytes, which allows to use them in the process of creating cartilage-like structures as substitutes for damaged areas [5,6]. On the other hand, the therapeutic effect of the MSCs is based on paracrine secretion of a broad repertoire of growth factors and cy-tokines, which stimulate the proliferation of chondrocytes and the synthesis of extracellular matrix (ECM) when injected into the joint [7].…”

Potential New Treatments for Knee OA: A Prospective Review of Registered Trials

“…It contains hematopoietic stem cells which stimulate the regeneration process and promote wound healing, MSCs and endothelial progenitor cells which support vascularization. It has higher concentration of interleukin 1 receptor antagonist (IL-1ra) compared to PRP [29][30][31][32][33][34]. In the USA, bone marrow aspirate concentrate is preferred as opposed to culture-expanded MSCs because it meets the FDA (Food and drug administration) standards as a minimally manipulated autologous source MSCs [29,31].…”

“…A step further is syringe emulsification which uses pressure and a dense mesh filter. Adipose tissue derived MSCs and stromal vascular fraction improve WOMAC (Western Ontario and McMaster Universities Arthritic Index) scores, reduce pain and improve function in old adults with symptomatic knee OA [33]. Gobbi et al administered a single injection of autologous microfragmented adipose tissue to 120 knees (75 patients) with a mean age of 69.6 years, BMI 28.4 and Kellgren Lawrence grades 2 to 4.…”

A Comparison of the Capacity of Mesenchymal Stromal Cells for Cartilage Regeneration Depending on Collagen-Based Injectable Biomimetic Scaffold Type

“…The application of autologous mesenchymal stem cells (MSCs) [ 4 ] may serve as an alternative therapeutic approach to the restoration of the cartilage tissue. The MSCs are multicomponent cells capable of differentiating into various types of cells, including chondrocytes, which allows us to use them in the process of creating cartilage-like structures as substitutes for damaged areas [ 5 , 6 ]. On the other hand, the therapeutic effect of the MSCs is based on paracrine secretion of a broad repertoire of growth factors and cytokines, which stimulate the proliferation of chondrocytes and the synthesis of the extracellular matrix (ECM) when injected into the joint [ 7 ].…”