Non-homologous use of adipose-derived cell and tissue therapies: Osteoarthritis as a case study

Frazier, Trivia; March, Keith L.; Garza, Jaime R.; Bunnell, Bruce A.; Darr, Kevin F; Rogers, Emma; Hamel, Katie; Gimble, Jeffrey M.

doi:10.1016/j.bonr.2022.101601

Cited by 9 publications

(6 citation statements)

References 70 publications

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“…Our study has employed Patient Reported Outcome Measures (PROMs) extensively, which aligns with the increasing recognition of their importance in assessing therapeutic interventions[ 41 - 44 ]. PROMs provide insights into the patient's perception of their symptoms and the effects of treatment on their quality of life, enabling a more holistic evaluation of therapy effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of stromal vascular fraction for knee osteoarthritis: A prospective, single-centre, non-randomized study with 2 years follow-up

Jeyaraman,

Jayakumar

et al. 2024

World J Orthop

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BACKGROUND Current osteoarthritis (OA) treatments focus on symptom relief without addressing the underlying disease process. In regenerative medicine, current treatments have limitations. In regenerative medicine, more research is needed for intra-articular stromal vascular fraction (SVF) injections in OA, including dosage optimization, long-term efficacy, safety, comparisons with other treatments, and mechanism exploration. AIM To compare the efficacy of intra-articular SVF with corticosteroid (ICS) injections in patients with primary knee OA. METHODS The study included 50 patients with Kellgren-Lawrence grades II and III OA. Patients were randomly assigned (1:1) to receive either a single intra-articular SVF injection (group A) or a single intra-articular ICS (triamcinolone) (group B) injection. Patients were followed up at 1, 3, 6, 12, and 24 months. Visual analog score (VAS) and International Knee Documentation Committee (IKDC) scores were administered before the procedure and at all follow-ups. The safety of SVF in terms of adverse and severe adverse events was recorded. Statistical analysis was performed with SPSS Version 26.0, IBM Corp, Chicago, IL, United States. RESULTS Both groups had similar demographics and baseline clinical characteristics. Follow-up showed minor patient loss, resulting in 23 and 24 in groups A and B respectively. Group A experienced a notable reduction in pain, with VAS scores decreasing from 7.7 to 2.4 over 24 months, compared to a minor reduction from 7.8 to 6.2 in Group B. This difference in pain reduction in group A was statistically significant from the third month onwards. Additionally, Group A showed significant improvements in knee functionality, with IKDC scores rising from 33.4 to 83.10, whereas Group B saw a modest increase from 36.7 to 45.16. The improvement in Group A was statistically significant from 6 months and maintained through 24 months. CONCLUSION Our study demonstrated that intra-articular administration of SVF can lead to reduced pain and improved knee function in patients with primary knee OA. More adequately powered, multi-center, double-blinded, randomised clinical trials with longer follow-ups are needed to further establish safety and justify its clinical use.

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Section: Discussionmentioning

confidence: 99%

Efficacy of stromal vascular fraction for knee osteoarthritis: A prospective, single-centre, non-randomized study with 2 years follow-up

Jeyaraman,

Jayakumar

et al. 2024

World J Orthop

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“…Since the SVF cells obtained using the RBs device are similar to the ones obtained by enzymatic extraction, their successful and efficient use is anticipated in various indications in which the clinical efficacy of enzymatically extracted SVF was previously demonstrated such as CAL 30 and for the treatment of osteoarthritis. 16 , 31 Furthermore, the fact that it enables rapid extraction of SVF cells (~15 min) in a closed sterile device provides the RBs technology significant advantages over enzymatic SVF extraction methods for ioSVF use.…”

Section: Discussionmentioning

confidence: 99%

“… 11 , 12 Since the first reported use of SVF in 2007, in the aesthetic field, 13 its use has significantly expanded to a broad spectrum of clinical applications. 14 The leading clinical indications currently suggested and studied for the use of SVF are cell-assisted lipotransfer (CAL), in which SVF cells enhance fat survival following fat transplantation 15 ; treatment of osteoarthritis, 16 in which cells are intra-articularly injected into injured joints; wound treatment 17 , 18 ; and more.…”

Section: Introductionmentioning

confidence: 99%

A Closed-system Technology for Mechanical Isolation of High Quantities of Stromal Vascular Fraction from Fat for Immediate Clinical Use

Solodeev

Meilik

Gur

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Adipose tissue stromal vascular fraction (SVF) is increasingly used in the clinic. SVF separation from fat by enzymatic disruption is currently the gold standard for SVF isolation. However, enzymatic SVF isolation is time-consuming (~1.5 h), costly and significantly increases the regulatory burden of SVF isolation. Mechanical fat disruption is rapid, cheaper, and less regulatory challenging. However, its reported efficacy is insufficient for clinical use. The current study evaluated the efficacy of a novel rotating blades (RBs) mechanical SVF isolation system. Methods: SVF cells were isolated from the same lipoaspirate sample (n = 30) by enzymatic isolation, massive shaking (wash), or engine-induced RBs mechanical isolation. SVF cells were counted, characterized by flow cytometry and by their ability to form adipose-derived stromal cells (ASCs). Results: The RBs mechanical approach yielded 2 × 10 5 SVF nucleated cells/mL fat, inferior to enzymatic isolation (4.17 × 10 5 ) but superior to cells isolating from fat by the "wash" technique (0.67 × 10 5 ). Importantly, RBs SVF isolation yield was similar to reported yields achieved via clinical-grade enzymatic SVF isolation. RBs-isolated SVF cells were found to contain 22.7% CD45 -CD31 − CD34 + stem cell progenitor cells (n = 5) yielding quantities of multipotent ASCs similar to enzymatic controls. Conclusions: The RBs isolation technology provided for rapid (<15 min) isolation of high-quality SVF cells in quantities similar to those obtained by enzymatic digestion. Based on the RBs platform, a closed-system medical device for SVF extraction in a rapid, simple, safe, sterile, reproducible, and costeffective manner was designed.

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“… 114 On the other hand, adipose tissue could be used as a good source of heterogeneous cell populations, including lymphoid, adipose-derived stromal/stem cells, and myeloid cells and scaffolds, for OA treatment. 115 …”

Section: Pathogenesismentioning

confidence: 99%

Osteoarthritis: pathogenic signaling pathways and therapeutic targets

Yao

Tao

et al. 2023

Sig Transduct Target Ther

417

147

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Osteoarthritis (OA) is a chronic degenerative joint disorder that leads to disability and affects more than 500 million population worldwide. OA was believed to be caused by the wearing and tearing of articular cartilage, but it is now more commonly referred to as a chronic whole-joint disorder that is initiated with biochemical and cellular alterations in the synovial joint tissues, which leads to the histological and structural changes of the joint and ends up with the whole tissue dysfunction. Currently, there is no cure for OA, partly due to a lack of comprehensive understanding of the pathological mechanism of the initiation and progression of the disease. Therefore, a better understanding of pathological signaling pathways and key molecules involved in OA pathogenesis is crucial for therapeutic target design and drug development. In this review, we first summarize the epidemiology of OA, including its prevalence, incidence and burdens, and OA risk factors. We then focus on the roles and regulation of the pathological signaling pathways, such as Wnt/β-catenin, NF-κB, focal adhesion, HIFs, TGFβ/ΒΜP and FGF signaling pathways, and key regulators AMPK, mTOR, and RUNX2 in the onset and development of OA. In addition, the roles of factors associated with OA, including MMPs, ADAMTS/ADAMs, and PRG4, are discussed in detail. Finally, we provide updates on the current clinical therapies and clinical trials of biological treatments and drugs for OA. Research advances in basic knowledge of articular cartilage biology and OA pathogenesis will have a significant impact and translational value in developing OA therapeutic strategies.

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Non-homologous use of adipose-derived cell and tissue therapies: Osteoarthritis as a case study

Cited by 9 publications

References 70 publications

Efficacy of stromal vascular fraction for knee osteoarthritis: A prospective, single-centre, non-randomized study with 2 years follow-up

Efficacy of stromal vascular fraction for knee osteoarthritis: A prospective, single-centre, non-randomized study with 2 years follow-up

A Closed-system Technology for Mechanical Isolation of High Quantities of Stromal Vascular Fraction from Fat for Immediate Clinical Use

Osteoarthritis: pathogenic signaling pathways and therapeutic targets

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