What is the clinically significant ideal mesenchymal stromal cell count in the management of osteoarthritis of the knee? – Meta-analysis of randomized controlled trials

Muthu, Sathish; Mir, Ayaz; Kumar, Rakesh; Yadav, Vijendra; Jeyaraman, Madhan; Khanna, Manish

doi:10.1016/j.jcot.2021.101744

Cited by 14 publications

(11 citation statements)

References 53 publications

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“…Here in, 14 studies including 564 patients were analysed and it was determined that the range of cell dose with the most therapeutic effect was 5-7×10 7 MSCs. 81 The lack of standardization among clinical trials contributes to the varying results of therapeutic efficacy of stem cell treatment for OA. It has been recommended that dose-escalation clinical trials be conducted to better standardize the use of stem cells in the treatment of OA.…”

Section: Cell Therapies For Cartilage Regenerationmentioning

confidence: 99%

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Cell Therapy Approaches for Articular Cartilage Regeneration

Makarczyk

2023

Organogenesis

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Articular cartilage is a common cartilage type found in a multitude of joints throughout the human body. However, cartilage is limited in its regenerative capacity. A range of methods have been employed to aid adults under the age of 45 with cartilage defects, but other cartilage pathologies such as osteoarthritis are limited to non-steroidal anti-inflammatory drugs and total joint arthroplasty. Cell therapies and synthetic biology can be utilized to assist not only cartilage defects but have the potential as a therapeutic approach for osteoarthritis as well. In this review, we will cover current cell therapy approaches for cartilage defect regeneration with a focus on autologous chondrocyte implantation and matrix autologous chondrocyte implantation. We will then discuss the potential of stem cells for cartilage repair in osteoarthritis and the use of synthetic biology to genetically engineer cells to promote cartilage regeneration and potentially reverse osteoarthritis.

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Section: Cell Therapies For Cartilage Regenerationmentioning

confidence: 99%

“…It has been recommended that dose-escalation clinical trials be conducted to better standardize the use of stem cells in the treatment of OA. 81 …”

Section: Cell Therapies For Cartilage Regenerationmentioning

confidence: 99%

Cell Therapy Approaches for Articular Cartilage Regeneration

Makarczyk

2023

Organogenesis

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“…Table 1 summarizes systematic reviews and meta-analyses on the clinical efficacy of intraarticular injections of MSCs in knee OA [ 19 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ].…”

Section: Efficacy Of Intraarticular Mscs Injections In Knee Osteoarth...mentioning

confidence: 99%

Intraarticular Injections of Mesenchymal Stem Cells in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Efficacy

Rodríguez-Merchán

2022

IJMS

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More than 10% of the world’s population suffers from osteoarthritis (OA) of the knee, with a lifetime risk of 45%. Current treatments for knee OA pain are as follows: weight control; oral pharmacological treatment (non-steroidal anti-inflammatory drugs, paracetamol, opioids); mechanical aids (crutches, walkers, braces, orthotics); therapeutic physical exercise; and intraarticular injections of corticosteroids, hyaluronic acid, and platelet-rich plasma (PRP). The problem is that such treatments usually relieve joint pain for only a short period of time. With respect to intraarticular injections, corticosteroids relieve pain for several weeks, while hyaluronic acid and PRP relieve pain for several months. When the above treatments fail to control knee pain, total knee arthroplasty (TKA) is usually indicated; however, although a very effective surgical technique, it can be associated with medical and postoperative (surgery-related) complications. Therefore, it seems essential to look for safe and effective alternative treatments to TKA. Recently, there has been much research on intraarticular injections of mesenchymal stem cells (MSCs) for the management of OA of the knee joint. This article reviews the latest information on the molecular mechanisms of action of MSCs and their potential therapeutic benefit in clinical practice in patients with painful knee OA. Although most recent publications claim that intraarticular injections of MSCs relieve joint pain in the short term, their efficacy remains controversial given that the existing scientific information on MSCs is indecisive. Before recommending intraarticular MSCs injections routinely in patients with painful knee OA, more studies comparing MSCs with placebo are needed. Furthermore, a standard protocol for intraarticular injections of MSCs in knee OA is needed.

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“…An analysis of clinical trials with intravenous administrated MSCs between 2004 and 2018, which reported positive outcomes, indicated minimal effective doses ranging from 70 to 190 million MSCs [ 18 ]. The MSC count in the management of knee osteoarthritis is slightly lower; in the meta-analysis of results of clinical trials, the group of patients with 50–100 million MSCs delivered to the target site showed significant improvement in pain and functional outcomes, while a higher dose was less effective [ 19 ]. Multiple administrations of MSCs with up to several hundred million cells are needed for certain patients and diseases to achieve the desired therapeutic effect [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

An Overview of Mesenchymal Stem Cell Heterogeneity and Concentration

Maličev,

Jazbec

2024

Pharmaceuticals

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Mesenchymal stem cells (MSCs) are of great interest in cell therapies due to the immunomodulatory and other effects they have after autologous or allogeneic transplantation. In most clinical applications, a high number of MSCs is required; therefore, the isolated MSC population must be expanded in the cell culture until the desired number is reached. Analysing freshly isolated MSCs is challenging due to their rareness and heterogeneity, which is noticeable among donors, tissues, and cell subpopulations. Although the phenotype of MSCs in tissue can differ from those of cultured cells, phenotyping and counting are usually performed only after MSC proliferation. As MSC applicability is a developing and growing field, there is a need to implement phenotyping and counting methods for freshly isolated MSCs, especially in new one-step procedures where isolated cells are implanted immediately without cell culturing. Only by analysing harvested cells can we correctly evaluate such studies. This review describes multilevel heterogeneity and concentrations of MSCs and different strategies for phenotype determination and enumeration of freshly isolated MSCs.

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What is the clinically significant ideal mesenchymal stromal cell count in the management of osteoarthritis of the knee? – Meta-analysis of randomized controlled trials

Abstract: What is the clinically significant ideal mesenchymal stromal cell count in the management of osteoarthritis of the knee? -Meta-analysis of randomised controlled trials

Cited by 14 publications

References 53 publications

Cell Therapy Approaches for Articular Cartilage Regeneration

Cell Therapy Approaches for Articular Cartilage Regeneration

Intraarticular Injections of Mesenchymal Stem Cells in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Efficacy

An Overview of Mesenchymal Stem Cell Heterogeneity and Concentration

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