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Mesenchymal stem cell-based therapy of osteoarthritis: Current knowledge and future perspectives. Biomed Pharmacother 2018; 109:2318-2326. [PMID: 30551490 DOI: 10.1016/j.biopha.2018.11.099] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/30/2018] [Accepted: 11/25/2018] [Indexed: 02/07/2023] Open
Abstract
Osteoarthritis (OA) is a chronic, prevalent, debilitating joint disease characterized by progressive cartilage degradation, subchondral bone remodeling, bone marrow lesions, meniscal damage, and synovitis. Innate immune cells (natural killer cells, macrophages, and mast cells) play the most important pathogenic role in the early inflammatory response, while cells of adaptive immunity (CD4 + Th1 lymphocytes and antibody producing B cells) significantly contribute to the development of chronic, relapsing course of inflammation in OA patients. Conventional therapy for OA is directed toward symptomatic treatment, mainly pain management, and is not able to promote regeneration of degenerated cartilage or to attenuate joint inflammation. Since articular cartilage, intra-articular ligaments, and menisci have no ability to heal, regeneration of these tissues remains one of the most important goals of new therapeutic approaches used for OA treatment. Due to their capacity for differentiation into chondrocytes and due to their immunomodulatory properties, mesenchymal stem cells (MSCs) have been the most extensively explored as new therapeutic agents in the cell-based therapy of OA. Simple acquisition, rapid proliferation, maintenance of differentiation potential after repeated passages in vitro, minor immunological rejection due to the low surface expression of major histocompatibility complex antigens, efficient engraftment and long-term coexistence in the host are the main characteristics of MSCs that enable their therapeutic use in OA. In this review article, we emphasized current knowledge and future perspectives regarding molecular and cellular mechanisms responsible for beneficial effects of autologous and allogeneic MSCs in the treatment of OA.
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Verboket R, Leiblein M, Seebach C, Nau C, Janko M, Bellen M, Bönig H, Henrich D, Marzi I. Autologous cell-based therapy for treatment of large bone defects: from bench to bedside. Eur J Trauma Emerg Surg 2018; 44:649-665. [PMID: 29352347 PMCID: PMC6182650 DOI: 10.1007/s00068-018-0906-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/08/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Reconstruction of long segmental bone defects is demanding for patients and surgeons, and associated with long-term treatment periods and substantial complication rates in addition to high costs. While defects up to 4-5 cm length might be filled up with autologous bone graft, heterologous bone from cadavers, or artificial bone graft substitutes, current options to reconstruct bone defects greater than 5 cm consist of either vascularized free bone transfers, the Masquelet technique or the Ilizarov distraction osteogenesis. Alternatively, autologous cell transplantation is an encouraging treatment option for large bone defects as it eliminates problems such as limited autologous bone availability, allogenic bone immunogenicity, and donor-site morbidity, and might be used for stabilizing loose alloplastic implants. METHODS The authors show different cell therapies without expansion in culture, with ex vivo expansion and cell therapy in local bone defects, bone healing and osteonecrosis. Different kinds of cells and scaffolds investigated in our group as well as in vivo transfer studies and BMC used in clinical phase I and IIa clinical trials of our group are shown. RESULTS Our research history demonstrated the great potential of various stem cell species to support bone defect healing. It was clearly shown that the combination of different cell types is superior to approaches using single cell types. We further demonstrate that it is feasible to translate preclinically developed protocols from in vitro to in vivo experiments and follow positive convincing results into a clinical setting to use autologous stem cells to support bone healing.
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Affiliation(s)
- R. Verboket
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - M. Leiblein
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - C. Seebach
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - C. Nau
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - M. Janko
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - M. Bellen
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - H. Bönig
- Department of Transfusion Medicine and Immune Hematology, University Hospital Frankfurt and DRK Blood Donor Service Baden-Württemberg-Hessen, Frankfurt, Germany
| | - D. Henrich
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - I. Marzi
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
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Xue K, Wang X, Yong PW, Young DJ, Wu YL, Li Z, Loh XJ. Hydrogels as Emerging Materials for Translational Biomedicine. ADVANCED THERAPEUTICS 2018. [DOI: 10.1002/adtp.201800088] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Kun Xue
- Institute of Materials Research and Engineering; Agency for Science,; Technology and Research; 2 Fusionopolis Way, #08-03 Innovis Singapore 138634 Singapore
| | - Xiaoyuan Wang
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology School of Pharmaceutical Sciences; Xiamen University; Xiamen 361102 China
| | - Pei Wern Yong
- Department of Materials Science and Engineering; National University of Singapore; 9 Engineering Drive 1 Singapore 117575 Singapore
| | - David James Young
- Faculty of Science; Health, Education and Engineering; University of the Sunshine Coast; Maroochydore Queensland 4558 Australia
| | - Yun-Long Wu
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology School of Pharmaceutical Sciences; Xiamen University; Xiamen 361102 China
| | - Zibiao Li
- Institute of Materials Research and Engineering; Agency for Science,; Technology and Research; 2 Fusionopolis Way, #08-03 Innovis Singapore 138634 Singapore
| | - Xian Jun Loh
- Institute of Materials Research and Engineering; Agency for Science,; Technology and Research; 2 Fusionopolis Way, #08-03 Innovis Singapore 138634 Singapore
- Department of Materials Science and Engineering; National University of Singapore; 9 Engineering Drive 1 Singapore 117575 Singapore
- Singapore Eye Research Institute; 11 Third Hospital Avenue Singapore 168751 Singapore
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Ranmuthu CDS, Ranmuthu CKI, Khan WS. Evaluating the Current Literature on Treatments Containing Adipose-Derived Stem Cells for Osteoarthritis: a Progress Update. Curr Rheumatol Rep 2018; 20:67. [PMID: 30203213 DOI: 10.1007/s11926-018-0776-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Recent studies have investigated the effect of treatments containing adipose-derived mesenchymal stem cells (ADMSCs) on human osteoarthritis. These have mostly used biologic adjuvants which may influence results. Thus, the purpose of this systematic review is to evaluate the current literature on these treatments when used in isolation. RECENT FINDINGS Five studies in this review used cultured ADMSCs, while four studies used stromal vascular fraction and three used micro-fragmented adipose tissue to deliver ADMSCs. No studies reported serious treatment-related adverse effects and all reported improvements in clinical measures for at least one dose. This was not necessarily reflected in imaging evaluations nor were improvements always maintained. Current low-level evidence is limited due to variability in study methodology but indicates that treatments containing ADMSCs, when used in isolation, are safe and have the potential to reduce pain and improve function. Randomized controlled trials are now needed.
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Affiliation(s)
| | | | - Wasim S Khan
- University of Cambridge, Cambridge, UK. .,Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
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Bouyoucef M, Rakic R, Gómez-Leduc T, Latire T, Marin F, Leclercq S, Carreiras F, Serpentini A, Lebel JM, Galéra P, Legendre F. Regulation of Extracellular Matrix Synthesis by Shell Extracts from the Marine Bivalve Pecten maximus in Human Articular Chondrocytes- Application for Cartilage Engineering. MARINE BIOTECHNOLOGY (NEW YORK, N.Y.) 2018; 20:436-450. [PMID: 29627869 DOI: 10.1007/s10126-018-9807-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
The shells of the bivalve mollusks are organo-mineral structures predominantly composed of calcium carbonate, but also of a minor organic matrix, a mixture of proteins, glycoproteins, and polysaccharides. These proteins are involved in mineral deposition and, more generally, in the spatial organization of the shell crystallites in well-defined microstructures. In this work, we extracted different organic shell extracts (acid-soluble matrix, acid-insoluble matrix, water-soluble matrix, guanidine HCl/EDTA-extracted matrix, referred as ASM, AIM, WSM, and EDTAM, respectively) from the shell of the scallop Pecten maximus and studied their biological activities on human articular chondrocytes (HACs). We found that these extracts differentially modulate the biological activities of HACs, depending on the type of extraction and the concentration used. Furthermore, we showed that, unlike ASM and AIM, WSM promotes maintenance of the chondrocyte phenotype in monolayer culture. WSM increased the expression of chondrocyte-specific markers (aggrecan and type II collagen), without enhancing that of the main chondrocyte dedifferentiation marker (type I collagen). We also demonstrated that WSM could favor redifferentiation of chondrocyte in collagen sponge scaffold in hypoxia. Thus, this study suggests that the organic matrix of Pecten maximus, particularly WSM, may contain interesting molecules with chondrogenic effects. Our research emphasizes the potential use of WSM of Pecten maximus for cell therapy of cartilage.
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Affiliation(s)
- Mouloud Bouyoucef
- Laboratoire Microenvironnement Cellulaire et Pathologies (MILPAT), Equipe MIPDF, EA 4652, Normandie University, UNICAEN, BIOTARGEN, 14000, Caen, France
| | - Rodolphe Rakic
- Laboratoire Microenvironnement Cellulaire et Pathologies (MILPAT), Equipe MIPDF, EA 4652, Normandie University, UNICAEN, BIOTARGEN, 14000, Caen, France
| | - Tangni Gómez-Leduc
- Laboratoire Microenvironnement Cellulaire et Pathologies (MILPAT), Equipe MIPDF, EA 4652, Normandie University, UNICAEN, BIOTARGEN, 14000, Caen, France
| | - Thomas Latire
- UMR BOREA, Biologie des Organismes et Ecosystèmes Aquatiques, MNHN, UPMC, UCN, CNRS-7208, IRD-207, UFR des Sciences, Normandie University, UNICAEN, 14000, Caen, France
| | - Frédéric Marin
- UMR 6282 CNRS "Biogéosciences", Université de Bourgogne Franche-Comté (UBFC), 6 Boulevard Gabriel, 21000, Dijon, France
| | - Sylvain Leclercq
- Département de Chirurgie Orthopédique, Clinique Saint-Martin, Caen, France
| | - Franck Carreiras
- Equipe de Recherche sur les Relations Matrice Extracellulaire Cellules (ERRMECe), EA 1391, Institut des Matériaux, Université de Cergy-Pontoise, 2 avenue Adolphe-Chauvin, 95000, Cergy-Pontoise cedex, France
| | - Antoine Serpentini
- UMR BOREA, Biologie des Organismes et Ecosystèmes Aquatiques, MNHN, UPMC, UCN, CNRS-7208, IRD-207, UFR des Sciences, Normandie University, UNICAEN, 14000, Caen, France
| | - Jean-Marc Lebel
- UMR BOREA, Biologie des Organismes et Ecosystèmes Aquatiques, MNHN, UPMC, UCN, CNRS-7208, IRD-207, UFR des Sciences, Normandie University, UNICAEN, 14000, Caen, France
| | - Philippe Galéra
- Laboratoire Microenvironnement Cellulaire et Pathologies (MILPAT), Equipe MIPDF, EA 4652, Normandie University, UNICAEN, BIOTARGEN, 14000, Caen, France.
| | - Florence Legendre
- Laboratoire Microenvironnement Cellulaire et Pathologies (MILPAT), Equipe MIPDF, EA 4652, Normandie University, UNICAEN, BIOTARGEN, 14000, Caen, France
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Lee JK, Choi IS, Oh TI, Lee E. Cell-Surface Engineering for Advanced Cell Therapy. Chemistry 2018; 24:15725-15743. [PMID: 29791047 DOI: 10.1002/chem.201801710] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/22/2018] [Indexed: 12/16/2022]
Abstract
Stem cells opened great opportunity to overcome diseases that conventional therapy had only limited success. Use of scaffolds made from biomaterials not only helps handling of stem cells for delivery or transplantation but also supports enhanced cell survival. Likewise, cell encapsulation can provide stability for living animal cells even in a state of separateness. Although various chemical reactions were tried to encapsulate stolid microbial cells such as yeasts, a culture environment for the growth of animal cells allows only highly biocompatible reactions. Therefore, the animal cells were mostly encapsulated in hydrogels, which resulted in enhanced cell survival. Interestingly, major findings of chemistry on biological interfaces demonstrate that cell encapsulation in hydrogels have a further a competence for modulating cell characteristics that can go beyond just enhancing the cell survival. In this review, we present a comprehensive overview on the chemical reactions applied to hydrogel-based cell encapsulation and their effects on the characteristics and behavior of living animal cells.
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Affiliation(s)
- Jungkyu K Lee
- Department of Chemistry and Green-Nano Materials Research Center, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, Korea
| | - Insung S Choi
- Department of Chemistry and Center for Cell-Encapsulation Research, KAIST, 291 Daehak-ro, Yuseong-gu, Daejeon, 34141, Korea
| | - Tong In Oh
- Department of Biomedical Engineering, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
| | - EunAh Lee
- Impedance Imaging Research Center (IIRC), Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
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Huang X, Zhong L, Post JN, Karperien M. Co-treatment of TGF-β3 and BMP7 is superior in stimulating chondrocyte redifferentiation in both hypoxia and normoxia compared to single treatments. Sci Rep 2018; 8:10251. [PMID: 29980690 PMCID: PMC6035177 DOI: 10.1038/s41598-018-27602-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/27/2018] [Indexed: 02/07/2023] Open
Abstract
Signaling by members of the transforming growth factor-β (TGF-β) superfamily, such as TGF-β3 and BMP7, and oxygen tension play a pivotal role in chondrocyte biology. The objective of this research was to investigate the endogenous BMP7 expression in human osteoarthritis (OA) cartilage and the effect of oxygen tension on the single or combined treatment with TGF-β3 and BMP7 on OA chondrocyte redifferentiation in three dimensional (3D) pellet cultures. The results showed the expression of BMP7 and its intracellular signaling target SMAD1/5/8 was decreased in early OA, while it was increased in later stages of OA. The combined treatment with TGF-β3 and BMP7, both in normoxia and hypoxia, was more effective than TGF-β3 or BMP7 alone in redifferentiating chondrocytes. This was reflected by Alcian blue/Safranin O staining and collagen type II protein expression, as well as by gene expression. Hypoxia elevated TGF-β3 and BMP7-induced matrix formation of OA chondrocytes and alleviated the catabolic gene expression. Interestingly, cells cultured under normoxia displayed mild signs of an inflammatory stress response, which was effectively counteracted by culturing the cells under low oxygen tension. Our data underscores the important modulatory role of oxygen tension on the chondrocyte's responsiveness to TGF-β3 and/or BMP7.
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Affiliation(s)
- Xiaobin Huang
- Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Leilei Zhong
- Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Janine N Post
- Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Marcel Karperien
- Developmental BioEngineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, 7500 AE, The Netherlands.
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Aurich M, Hofmann GO, Gras F, Rolauffs B. Human osteochondritis dissecans fragment-derived chondrocyte characteristics ex vivo, after monolayer expansion-induced de-differentiation, and after re-differentiation in alginate bead culture. BMC Musculoskelet Disord 2018; 19:168. [PMID: 29793458 PMCID: PMC5968539 DOI: 10.1186/s12891-018-2079-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/07/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Autologous chondrocyte implantation (ACI) is a therapy for articular cartilage and osteochondral lesions that relies on notch- or trochlea-derived primary chondrocytes. An alternative cell source for ACI could be osteochondritis dissecans (OCD) fragment-derived chondrocytes. Assessing the potential of these cells, we investigated their characteristics ex vivo and after monolayer expansion, as monolayer expansion is an integral step of ACI. However, as monolayer expansion can induce de-differentiation, we asked whether monolayer-induced de-differentiation can be reverted through successive alginate bead culture. METHODS Chondrocytes were isolated from the OCD fragments of 15 patient knees with ICRS grades 3-4 lesions for ex vivo analyses, primary alginate bead culture, monolayer expansion, and alginate bead culture following monolayer expansion for attempting re-differentiation. We determined yield, viability, and the mRNA expression of aggrecan and type I, II, and X collagen. RESULTS OCD fragment-derived chondrocyte isolation yielded high numbers of viable cells with a low type I:II collagen expression ratio (< 1) and a relatively high aggrecan and type II and X collagen mRNA expression, indicating chondrogenic and hypertrophic characteristics. As expected, monolayer expansion induced de-differentiation. Alginate bead culture of monolayer-expanded cells significantly improved the expression profile of all genes investigated, being most successful in decreasing the hypertrophy marker type X collagen to 1.5% of its ex vivo value. However, the chondrogenic phenotype was not fully restored, as the collagen type I:II expression ratio decreased significantly but remained > 1. CONCLUSION OCD fragment derived human chondrocytes may hold not yet utilized clinical potential for cartilage repair.
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Affiliation(s)
- Matthias Aurich
- Center for Orthopaedic and Trauma Surgery, Klinikum Mittleres Erzgebirge, Alte Marienberger, Str. 52, 09405, Zschopau, Germany
- Department of Trauma, Hand and Reconstructive Surgery, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Germany
- Department of Biochemistry, Rush Medical College, 1735 W. Harrison St, Chicago, IL, 60612, USA
| | - Gunther O Hofmann
- Department of Trauma, Hand and Reconstructive Surgery, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Florian Gras
- Department of Trauma, Hand and Reconstructive Surgery, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Bernd Rolauffs
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center - Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
- Massachusetts Institute of Technology, Center for Biomedical Engineering, 500 Technology Sq, Cambridge, MA, 02139, USA.
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Wuest SL, Caliò M, Wernas T, Tanner S, Giger-Lange C, Wyss F, Ille F, Gantenbein B, Egli M. Influence of Mechanical Unloading on Articular Chondrocyte Dedifferentiation. Int J Mol Sci 2018; 19:ijms19051289. [PMID: 29693628 PMCID: PMC5983850 DOI: 10.3390/ijms19051289] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/13/2018] [Accepted: 04/18/2018] [Indexed: 01/10/2023] Open
Abstract
Due to the limited self-repair capacity of articular cartilage, the surgical restoration of defective cartilage remains a major clinical challenge. The cell-based approach, which is known as autologous chondrocyte transplantation (ACT), has limited success, presumably because the chondrocytes acquire a fibroblast-like phenotype in monolayer culture. This unwanted dedifferentiation process is typically addressed by using three-dimensional scaffolds, pellet culture, and/or the application of exogenous factors. Alternative mechanical unloading approaches are suggested to be beneficial in preserving the chondrocyte phenotype. In this study, we examined if the random positioning machine (RPM) could be used to expand chondrocytes in vitro such that they maintain their phenotype. Bovine chondrocytes were exposed to (a) eight days in static monolayer culture; (b) two days in static monolayer culture, followed by six days of RPM exposure; and, (c) eight days of RPM exposure. Furthermore, the experiment was also conducted with the application of 20 mM gadolinium, which is a nonspecific ion-channel blocker. The results revealed that the chondrocyte phenotype is preserved when chondrocytes go into suspension and aggregate to cell clusters. Exposure to RPM rotation alone does not preserve the chondrocyte phenotype. Interestingly, the gene expression (mRNA) of the mechanosensitive ion channel TRPV4 decreased with progressing dedifferentiation. In contrast, the gene expression (mRNA) of the mechanosensitive ion channel TRPC1 was reduced around fivefold to 10-fold in all of the conditions. The application of gadolinium had only a minor influence on the results. This and previous studies suggest that the chondrocyte phenotype is preserved if cells maintain a round morphology and that the ion channel TRPV4 could play a key role in the dedifferentiation process.
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Affiliation(s)
- Simon L Wuest
- Lucerne University of Applied Sciences and Arts, School of Engineering and Architecture, Institute of Medical Engineering, Space Biology Group, CH-6052 Hergiswil, Switzerland.
- University of Bern, Institute for Surgical Technology and Biomechanics, Tissue and Organ Mechanobiology, CH-3014 Bern, Switzerland.
| | - Martina Caliò
- Lucerne University of Applied Sciences and Arts, School of Engineering and Architecture, Institute of Medical Engineering, Space Biology Group, CH-6052 Hergiswil, Switzerland.
- University of Bern, Institute for Surgical Technology and Biomechanics, Tissue and Organ Mechanobiology, CH-3014 Bern, Switzerland.
| | - Timon Wernas
- Lucerne University of Applied Sciences and Arts, School of Engineering and Architecture, Institute of Medical Engineering, Space Biology Group, CH-6052 Hergiswil, Switzerland.
| | - Samuel Tanner
- Lucerne University of Applied Sciences and Arts, School of Engineering and Architecture, Institute of Medical Engineering, Space Biology Group, CH-6052 Hergiswil, Switzerland.
| | - Christina Giger-Lange
- Lucerne University of Applied Sciences and Arts, School of Engineering and Architecture, Institute of Medical Engineering, Space Biology Group, CH-6052 Hergiswil, Switzerland.
| | - Fabienne Wyss
- Lucerne University of Applied Sciences and Arts, School of Engineering and Architecture, Institute of Medical Engineering, Space Biology Group, CH-6052 Hergiswil, Switzerland.
| | - Fabian Ille
- Lucerne University of Applied Sciences and Arts, School of Engineering and Architecture, Institute of Medical Engineering, Space Biology Group, CH-6052 Hergiswil, Switzerland.
| | - Benjamin Gantenbein
- University of Bern, Institute for Surgical Technology and Biomechanics, Tissue and Organ Mechanobiology, CH-3014 Bern, Switzerland.
| | - Marcel Egli
- Lucerne University of Applied Sciences and Arts, School of Engineering and Architecture, Institute of Medical Engineering, Space Biology Group, CH-6052 Hergiswil, Switzerland.
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Pudlas M, Koch S, Bolwien C, Walles H. Raman Spectroscopy as a Tool for Quality and Sterility Analysis for Tissue Engineering Applications like Cartilage Transplants. Int J Artif Organs 2018. [DOI: 10.1177/039139881003300407] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
At present, the production of tissue engineered cartilage requires the concurrent production of two identical transplants. One transplant is used for destructive quality control and the second one is implanted into the patient. A non-invasive characterization of such tissue engineering samples would be a promising tool to achieve a production process of just one transplant that is both implanted and tested. Raman spectroscopy is a method that satisfies this requirement by analyzing cells without lysis, fixation or the use of any chemicals. This pure optical technique is based on inelastic scattering of laser photons by molecular vibrations of biopolymers. Characteristic peaks in Raman spectra of cells could be assigned to typical biochemical molecules present in biological samples. For the analysis of chondrocytes present in cartilage transplants, the determination of the cell vitality as well as the discrimination of another cell type have been studied by Raman spectroscopy. Another bottleneck in such biological processes under GMP conditions is sterility control, as most of the commonly used methods require long cultivation times. Raman spectroscopy provides a good alternative to conventional methods in terms of time saving. In this study, the potential of Raman spectroscopy as a quality and sterility control tool for tissue engineering applications was studied by analyzing and comparing the spectra of cell and bacteria cultures.
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Affiliation(s)
- Marieke Pudlas
- Fraunhofer Institute for Interfacial Engineering and Biotechnology, Stuttgart - Germany
- University of Stuttgart, Medical Interfacial Engineering, Stuttgart - Germany
| | - Steffen Koch
- Fraunhofer Institute for Interfacial Engineering and Biotechnology, Stuttgart - Germany
- University of Stuttgart, Medical Interfacial Engineering, Stuttgart - Germany
| | - Carsten Bolwien
- Fraunhofer Institute for Physical Measurement Techniques, Freiburg - Germany
| | - Heike Walles
- Fraunhofer Institute for Interfacial Engineering and Biotechnology, Stuttgart - Germany
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Hoshi K, Fujihara Y, Yamawaki T, Harai M, Asawa Y, Hikita A. Biological aspects of tissue-engineered cartilage. Histochem Cell Biol 2018; 149:375-381. [PMID: 29511835 DOI: 10.1007/s00418-018-1652-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2018] [Indexed: 11/26/2022]
Abstract
Cartilage regenerative medicine has been progressed well, and it reaches the stage of clinical application. Among various techniques, tissue engineering, which incorporates elements of materials science, is investigated earnestly, driven by high clinical needs. The cartilage tissue engineering using a poly lactide scaffold has been exploratorily used in the treatment of cleft lip-nose patients, disclosing good clinical results during 3-year observation. However, to increase the reliability of this treatment, not only accumulation of clinical evidence on safety and usefulness of the tissue-engineered products, but also establishment of scientific background on biological mechanisms, are regarded essential. In this paper, we reviewed recent trends of cartilage tissue engineering in clinical practice, summarized experimental findings on cellular and matrix changes during the cartilage regeneration, and discussed the importance of further studies on biological aspects of tissue-engineered cartilage, especially by the histological and the morphological methods.
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Affiliation(s)
- Kazuto Hoshi
- Department of Sensory and Motor System Medicine, Division of Tissue Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Yuko Fujihara
- Department of Sensory and Motor System Medicine, Division of Tissue Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takanori Yamawaki
- Department of Sensory and Motor System Medicine, Division of Tissue Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Motohiro Harai
- Department of Sensory and Motor System Medicine, Division of Tissue Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yukiyo Asawa
- Department of Sensory and Motor System Medicine, Division of Tissue Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Atsuhiko Hikita
- Department of Sensory and Motor System Medicine, Division of Tissue Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
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Siebold R, Suezer F, Schmitt B, Trattnig S, Essig M. Good clinical and MRI outcome after arthroscopic autologous chondrocyte implantation for cartilage repair in the knee. Knee Surg Sports Traumatol Arthrosc 2018; 26:831-839. [PMID: 28258330 DOI: 10.1007/s00167-017-4491-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/17/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE To analyze the clinical outcome and cartilage regeneration after all-arthroscopic Autologous Chondrocyte Implantation (ACI) using chondrospheres® (ACT3D) for the treatment of full-size articular cartilage lesions at the knee. METHODS Thirty consecutive patients treated by all-arthroscopic ACI for full-size articular cartilage lesions in an otherwise healthy knee were enrolled. The defects were located on the femoral condyles (n = 18), in the trochlea (n = 7) and at the patella (n = 5). Follow-up consisted of a clinical evaluation with assessment of subjective scores. Patient satisfaction was evaluated on a visual analog scale (VAS). 3-Tesla MRI and T2 mapping of the operated and the contralateral healthy knees were included to control the quality of the regenerated cartilage. The MOCART score was assessed by three blinded independent radiologists. RESULTS At the mean follow-up of 3 years ± 10.2 months 26 of the 30 patients (86.6%) were subjectively highly satisfied with the surgical result and assured they would undergo the same procedure again. The mean Lysholm score increased to 77.7 ± 14.6, the mean subjective IKDC significantly to 84.2 ± 5.6 (p < 0.05) and all five subgroups of the KOOS improved significantly (p < 0.05). The subjective outcome was not influenced by the duration of symptoms, age, location, size of defects nor dose of spheroids. The modified MOCART score was a mean of 60 ± 21 (0-80) points. Twenty-four patients (82.7%) were rated higher than 60 points. T2 mapping documented similar cartilage quality of the area of the ACI and the same location at the contralateral knee. Three patients had a MOCART score of 0 with few or no cartilage regeneration on MRI and were considered as failure of the ACI. CONCLUSION In this small cohort of 30 patients, minimal invasive all-arthroscopic ACT 3D using spheroids led to convincing clinical short-to-mid-term results with a significant increase in patients quality of life, satisfaction, reduction of pain, and improvement in knee function. The high morphologic integrity and quality of the ACI was reconfirmed by the Mocart Score and T2 mapping. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Rainer Siebold
- HKF, International Center for Hip-Knee-Foot Surgery, ATOS Hospital Heidelberg, Bismarckstrasse 9-15, 69115, Heidelberg, Germany. .,Institute for Anatomy and Cell Biology, INF, Karl-Ruprecht University Heidelberg, Heidelberg, Germany.
| | - Ferzan Suezer
- HKF, International Center for Hip-Knee-Foot Surgery, ATOS Hospital Heidelberg, Bismarckstrasse 9-15, 69115, Heidelberg, Germany.,Sporthopaedicum Berlin, Berlin, Germany
| | - Benjamin Schmitt
- MRI-Department, German Cancer Research Center (DKFZ), INF, Heidelberg, Germany.,Siemens Healthcare Pty Ltd, Sydney, Australia
| | - Siegfried Trattnig
- Department of Radiology, MR Center-High Field MR, Medical University Vienna, Vienna, Austria
| | - Marco Essig
- MRI-Department, German Cancer Research Center (DKFZ), INF, Heidelberg, Germany.,Department of Radiology, University of Manitoba, Winnipeg, Canada
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Armiento AR, Stoddart MJ, Alini M, Eglin D. Biomaterials for articular cartilage tissue engineering: Learning from biology. Acta Biomater 2018; 65:1-20. [PMID: 29128537 DOI: 10.1016/j.actbio.2017.11.021] [Citation(s) in RCA: 357] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 10/05/2017] [Accepted: 11/07/2017] [Indexed: 12/27/2022]
Abstract
Articular cartilage is commonly described as a tissue that is made of up to 80% water, is devoid of blood vessels, nerves, and lymphatics, and is populated by only one cell type, the chondrocyte. At first glance, an easy tissue for clinicians to repair and for scientists to reproduce in a laboratory. Yet, chondral and osteochondral defects currently remain an open challenge in orthopedics and tissue engineering of the musculoskeletal system, without considering osteoarthritis. Why do we fail in repairing and regenerating articular cartilage? Behind its simple and homogenous appearance, articular cartilage hides a heterogeneous composition, a high level of organisation and specific biomechanical properties that, taken together, make articular cartilage a unique material that we are not yet able to repair or reproduce with high fidelity. This review highlights the available therapies for cartilage repair and retraces the research on different biomaterials developed for tissue engineering strategies. Their potential to recreate the structure, including composition and organisation, as well as the function of articular cartilage, intended as cell microenvironment and mechanically competent replacement, is described. A perspective of the limitations of the current research is given in the light of the emerging technologies supporting tissue engineering of articular cartilage. STATEMENT OF SIGNIFICANCE The mechanical properties of articular tissue reflect its functionally organised composition and the recreation of its structure challenges the success of in vitro and in vivo reproduction of the native cartilage. Tissue engineering and biomaterials science have revolutionised the way scientists approach the challenge of articular cartilage repair and regeneration by introducing the concept of the interdisciplinary approach. The clinical translation of the current approaches are not yet fully successful, but promising results are expected from the emerging and developing new generation technologies.
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Affiliation(s)
- A R Armiento
- AO Research Institute Davos, Davos Platz, Switzerland.
| | - M J Stoddart
- AO Research Institute Davos, Davos Platz, Switzerland; University Medical Center, Albert-Ludwigs University, Freiburg, Germany.
| | - M Alini
- AO Research Institute Davos, Davos Platz, Switzerland.
| | - D Eglin
- AO Research Institute Davos, Davos Platz, Switzerland.
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Nixon AJ, Sparks HD, Begum L, McDonough S, Scimeca MS, Moran N, Matthews GL. Matrix-Induced Autologous Chondrocyte Implantation (MACI) Using a Cell-Seeded Collagen Membrane Improves Cartilage Healing in the Equine Model. J Bone Joint Surg Am 2017; 99:1987-1998. [PMID: 29206788 DOI: 10.2106/jbjs.16.00603] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Autologous chondrocyte implantation (ACI) using a collagen scaffold (matrix-induced ACI; MACI) is a next-generation approach to traditional ACI that provides the benefit of autologous cells and guided tissue regeneration using a biocompatible collagen scaffold. The MACI implant also has inherent advantages including surgical implantation via arthroscopy or miniarthrotomy, the elimination of periosteal harvest, and the use of tissue adhesive in lieu of sutures. This study evaluated the efficacy of the MACI implant in an equine full-thickness cartilage defect model at 1 year. METHODS Autologous chondrocytes were seeded onto a collagen type-I/III membrane and implanted into one of two 15-mm defects in the femoral trochlear ridge of 24 horses. Control defects either were implanted with cell-free collagen type-I/III membrane (12 horses) or were left ungrafted as empty defects (12 horses). An additional 3 horses had both 15-mm defects remain empty as nonimplanted joints. The repair was scored by second-look arthroscopy (12 weeks), and necropsy examination (53 weeks). Healing was assessed by arthroscopic scoring, gross assessment, histology and immunohistology, cartilage matrix component assay, and gene expression determination. Toxicity was examined by prostaglandin E2 formation in joint fluid, and lymph node morphology combined with histologic screening of organs. RESULTS MACI-implanted defects had improved gross healing and composite histologic scores, as well as increases in chondrocyte predominance, toluidine blue-stained matrix, and collagen type-II content compared with scaffold-only implanted or empty defects. There was minimal evidence of reaction to the implant in the synovial membrane (minor perivascular cuffing), subchondral bone, or cartilage. There were no adverse clinical effects, signs of organ toxicity, or evidence of chondrocytes or collagen type-I/III membrane in draining lymph nodes. CONCLUSIONS The MACI implant appeared to improve cartilage healing in a critical-sized defect in the equine model compared with collagen matrix alone. CLINICAL RELEVANCE These results indicate that the MACI implant is quick to insert, provides chondrocyte security in the defect, and improves cartilage healing compared with ACI.
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Affiliation(s)
- Alan J Nixon
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York
| | - Holly D Sparks
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York
| | - Laila Begum
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York
| | - Sean McDonough
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York
| | - Michael S Scimeca
- Comparative Orthopaedics Laboratory, Department of Clinical Sciences (A.J.N., H.D.S., L.B., and M.S.S.), and Department of Biomedical Sciences, College of Veterinary Medicine (S.M.), Cornell University, Ithaca, New York
| | - Nance Moran
- Histogenics Corporation, Waltham, Massachusetts
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Hoshi K, Fujihara Y, Saijo H, Kurabayashi K, Suenaga H, Asawa Y, Nishizawa S, Kanazawa S, Uto S, Inaki R, Matsuyama M, Sakamoto T, Watanabe M, Sugiyama M, Yonenaga K, Hikita A, Takato T. Three-dimensional changes of noses after transplantation of implant-type tissue-engineered cartilage for secondary correction of cleft lip-nose patients. Regen Ther 2017; 7:72-79. [PMID: 30271854 PMCID: PMC6147373 DOI: 10.1016/j.reth.2017.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 08/23/2017] [Accepted: 09/13/2017] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION We have developed an implant-type tissue-engineered cartilage using a poly-l-lactide scaffold. In a clinical study, it was inserted into subcutaneous areas of nasal dorsum in three patients, to correct cleft lip-nose deformity. The aim of this study was to helping evaluation on the efficacy of the regenerative cartilage. METHODS 3D data of nasal shapes were compared between before and after surgery in computed tomography (CT) images. Morphological and qualitative changes of transplants in the body were also evaluated on MRI, for one year. RESULTS The 3D data from CT images showed effective augmentation (>2 mm) of nasal dorsum in almost whole length, observed on the medial line of faces. It was maintained by 1 year post-surgery in all patients, while affected curves of nasal dorsum was not detected throughout the observation period. In magnetic resonance imaging (MRI), the images of transplanted cartilage had been observed until 1 year post-surgery. Those images were seemingly not straight when viewed from the longitudinal plain, and may have shown gentle adaptation to the surrounding nasal bones and alar cartilage tissues. CONCLUSION Those findings suggested the potential efficacy of this cartilage on improvement of cleft lip-nose deformity. A clinical trial is now being performed for industrialization.
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Affiliation(s)
- Kazuto Hoshi
- Oral and Maxillofacial Surgery, Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yuko Fujihara
- Oral and Maxillofacial Surgery, Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hideto Saijo
- Oral and Maxillofacial Surgery, Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kumiko Kurabayashi
- Oral and Maxillofacial Surgery, Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hideyuki Suenaga
- Oral and Maxillofacial Surgery, Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yukiyo Asawa
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Satoru Nishizawa
- Translation Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Sanshiro Kanazawa
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Sakura Uto
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Ryoko Inaki
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Mariko Matsuyama
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Tomoaki Sakamoto
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Makoto Watanabe
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Madoka Sugiyama
- Oral and Maxillofacial Surgery, Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kazumichi Yonenaga
- Oral and Maxillofacial Surgery, Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Atsuhiko Hikita
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Tsuyoshi Takato
- Oral and Maxillofacial Surgery, Department of Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
- Division of Tissue Engineering, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
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Schneider C, Lehmann J, van Osch GJVM, Hildner F, Teuschl A, Monforte X, Miosga D, Heimel P, Priglinger E, Redl H, Wolbank S, Nürnberger S. Systematic Comparison of Protocols for the Preparation of Human Articular Cartilage for Use as Scaffold Material in Cartilage Tissue Engineering. Tissue Eng Part C Methods 2017; 22:1095-1107. [PMID: 27846786 DOI: 10.1089/ten.tec.2016.0380] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Natural extracellular matrix-derived biomaterials from decellularized allogenic tissues are of increasing interest for tissue engineering because their structure and composition provide a complexity that is not achievable with current manufacturing techniques. The prerequisite to bring allogenic tissue from bench to bedside as a functional biomaterial is the full removal of cells while preserving most of its native characteristics such as structure and composition. The exceptionally dense structure of articular cartilage, however, poses a special challenge for decellularization, scaffold preparation, and reseeding. Therefore, we tested 24 different protocols aiming to remove cells and glycosaminoglycans (GAG) while preserving the collagen backbone and ultrastructure. The resulting matrices were analyzed for cell removal (DNA quantification, haematoxylin and eosin staining), GAG content (dimethyl methylene blue assay, Alcian blue staining and micro-computed tomography), collagen integrity (immunohistochemistry and ultrastructure), and biomechanics (compression test). Furthermore, seeding tests were conducted to evaluate cell viability and attachment to the scaffolds. Sodium dodecyl sulfate-based protocols yielded satisfactory reduction of DNA content, yet had negative effects on cell viability and attachment. Hydrochloric acid efficiently decellularized the scaffold and pepsin emerged as best option for GAG depletion. Combining these two reagents led to our final protocol, most efficient in DNA and GAG depletion while preserving the collagen architecture. The compressive modulus decreased in the absence of GAG to ∼1/3 of native cartilage, which is significantly higher than that by commercially available scaffolds tested as a reference (ranging from 1/25 to 1/100 of native cartilage). Cytocompatibility tests showed that human adipose-derived stromal cells readily adhered to the scaffold. In this study, we established a protocol combining freeze-thaw cycles, osmotic shock, and treatment with hydrochloric acid followed by a pepsin digestion step, achieving successful decellularization and GAG depletion within 1 week, resulting in a cytocompatible material with intact collagen structure. The protocol provides a basis for the generation of allogeneic scaffolds, potentially substituting manufactured scaffolds currently used in clinical articular cartilage treatment.
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Affiliation(s)
- Cornelia Schneider
- 1 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology , Vienna, Austria .,2 Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Johannes Lehmann
- 3 Department of Otorhinolaryngology and Cell Biology, Erasmus MC, University Medical Center , Rotterdam, The Netherlands
| | - Gerjo J V M van Osch
- 4 Department of Otorhinolaryngology and Orthopaedics, Erasmus MC, University Medical Center , Rotterdam, The Netherlands
| | - Florian Hildner
- 2 Austrian Cluster for Tissue Regeneration, Vienna, Austria .,5 Red Cross Blood Transfusion Center of Upper Austria , Linz, Austria
| | - Andreas Teuschl
- 2 Austrian Cluster for Tissue Regeneration, Vienna, Austria .,6 Department of Biochemical Engineering, University of Applied Sciences Technikum Wien , Vienna, Austria
| | - Xavier Monforte
- 6 Department of Biochemical Engineering, University of Applied Sciences Technikum Wien , Vienna, Austria
| | - David Miosga
- 7 Department of Trauma Surgery, Medical University, Vienna, Austria
| | - Patrick Heimel
- 1 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology , Vienna, Austria .,2 Austrian Cluster for Tissue Regeneration, Vienna, Austria .,8 Karl Donath Laboratory for Hard Tissue and Biomaterial Research, School of Dentistry Medical University of Vienna , Austria
| | - Eleni Priglinger
- 1 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology , Vienna, Austria .,2 Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Heinz Redl
- 1 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology , Vienna, Austria .,2 Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Suanne Wolbank
- 1 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology , Vienna, Austria .,2 Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Sylvia Nürnberger
- 1 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology , Vienna, Austria .,2 Austrian Cluster for Tissue Regeneration, Vienna, Austria .,7 Department of Trauma Surgery, Medical University, Vienna, Austria .,9 Bernhard Gottlieb University Clinic of Dentistry , Vienna, Austria .,10 School of Dentistry Medical University of Vienna , Competence Center for Morphology, Vienna, Austria
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67
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Ma N, Wang H, Xu X, Wan Y, Liu Y, Wang M, Yu W, Dai Y, Peng J, Guo Q, Yu C, Lu S. Autologous-cell-derived, tissue-engineered cartilage for repairing articular cartilage lesions in the knee: study protocol for a randomized controlled trial. Trials 2017; 18:519. [PMID: 29110690 PMCID: PMC5674846 DOI: 10.1186/s13063-017-2251-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 10/07/2017] [Indexed: 12/22/2022] Open
Abstract
Background Spontaneous recovery from articular cartilage injury is difficult, and the ongoing progression of disease can eventually lead to osteoarthritis. Currently, there is no effective non-surgical treatment for articular cartilage injury. Arthroscopic debridement and microfracture surgery are performed for fibrocartilage repair. But fibrocartilage is different from normal articular cartilage, and functional recovery is not satisfactory. Therefore, it is necessary to develop more effective techniques for articular cartilage repair. Progress in material science, cell biology, biomechanics, and bioreactor technology has allowed the development of biomimetic, tissue-engineered osteochondral composites that have shown potential for the repair of damaged cartilage. We prepared biomimetic, tissue-engineered cartilage scaffolds optimized for biochemical composition and structural characteristics. Based on the experience of our pre-clinical studies on animals, a human articular cartilage acellular matrix scaffold was prepared and is in clinical use. The combination of autologous chondrocytes and scaffolds has shown satisfactory results in repairing cartilage defects in preliminary experiments. Methods This is a prospective randomized controlled trial. One hundred patients with full-thickness cartilage injury of the knee will be randomly divided into two groups to receive treatment with either tissue-engineered cartilage constructed using biomimetic cartilage extracellular-matrix-oriented scaffolds combined with autologous chondrocytes, or arthroscopic debridement and microfracture surgery. There will be five visiting time points: at baseline, then at 3, 6, 12, and 18 months postoperatively. The primary outcome will be therapeutic efficacy as assessed by the Lysholm score at 12 months postoperatively. The secondary outcomes will be the International Knee Documentation Committee score, Visual Analog Scale score, and cartilage injury and repair as assessed by magnetic resonance imaging as well as the incidence of postoperative adverse events. Discussion This trial will attempt to verify the use of tissue-engineered cartilage constructed using autologous chondrocytes combined with allogeneic, acellular cartilage matrix for the repair of cartilage defects, thereby providing favorable evidence for its use in clinical practice. Trial registration ClinicalTrials.gov, identifier: NCT02770209. Registered on 11 May 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2251-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ning Ma
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Hongxia Wang
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Xian Xu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yiqun Wan
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yufeng Liu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Mingjie Wang
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Wen Yu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Yongjing Dai
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Jiang Peng
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Quanyi Guo
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
| | - Changlong Yu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Shibi Lu
- Institute of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
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Mohan N, Mohanan PV, Sabareeswaran A, Nair P. Chitosan-hyaluronic acid hydrogel for cartilage repair. Int J Biol Macromol 2017; 104:1936-1945. [DOI: 10.1016/j.ijbiomac.2017.03.142] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/10/2017] [Accepted: 03/25/2017] [Indexed: 12/22/2022]
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69
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Mouser VHM, Dautzenberg NMM, Levato R, van Rijen MHP, Dhert WJA, Malda J, Gawlitta D. Ex vivo model unravelling cell distribution effect in hydrogels for cartilage repair. ALTEX-ALTERNATIVES TO ANIMAL EXPERIMENTATION 2017; 35:65-76. [PMID: 28884783 PMCID: PMC7116182 DOI: 10.14573/altex.1704171] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 09/04/2017] [Indexed: 12/21/2022]
Abstract
The implantation of chondrocyte-laden hydrogels is a promising cartilage repair strategy. Chondrocytes can be spatially positioned in hydrogels and thus in defects, while current clinical cell therapies introduce chondrocytes in the defect depth. The main aim of this study was to evaluate the effect of spatial chondrocyte distribution on the reparative process. To reduce animal experiments, an ex vivo osteochondral plug model was used and evaluated. The role of the delivered and endogenous cells in the repair process was investigated. Full thickness cartilage defects were created in equine osteochondral plugs. Defects were filled with (A) chondrocytes at the bottom of the defect, covered with a cell-free hydrogel, (B) chondrocytes homogeneously encapsulated in a hydrogel, and (C, D) combinations of A and B with different cell densities. Plugs were cultured for up to 57 days, after which the cartilage and repair tissues were characterized and compared to baseline samples. Additionally, at day 21, the origin of cells in the repair tissue was evaluated. Best outcomes were obtained with conditions C and D, which resulted in well-integrated cartilage-like tissue that completely filled the defect, regardless of the initial cell density. A critical role of the spatial chondrocyte distribution in the repair process was observed. Moreover, the osteochondral plugs stimulated cartilage formation in the hydrogels when cultured in the defects. The resulting repair tissue originated from the delivered cells. These findings confirm the potential of the osteochondral plug model for the optimization of the composition of cartilage implants and for studying repair mechanisms.
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Affiliation(s)
- Vivian H M Mouser
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Noël M M Dautzenberg
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Riccardo Levato
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mattie H P van Rijen
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Wouter J A Dhert
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Jos Malda
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Debby Gawlitta
- Department of Oral and Maxillofacial Surgery & Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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RNA Interference and BMP-2 Stimulation Allows Equine Chondrocytes Redifferentiation in 3D-Hypoxia Cell Culture Model: Application for Matrix-Induced Autologous Chondrocyte Implantation. Int J Mol Sci 2017; 18:ijms18091842. [PMID: 28837082 PMCID: PMC5618491 DOI: 10.3390/ijms18091842] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 12/29/2022] Open
Abstract
As in humans, osteoarthritis (OA) causes considerable economic loss to the equine industry. New hopes for cartilage repair have emerged with the matrix-associated autologous chondrocyte implantation (MACI). Nevertheless, its limitation is due to the dedifferentiation occurring during the chondrocyte amplification phase, leading to the loss of its capacity to produce a hyaline extracellular matrix (ECM). To enhance the MACI therapy efficiency, we have developed a strategy for chondrocyte redifferentiation, and demonstrated its feasibility in the equine model. Thus, to mimic the cartilage microenvironment, the equine dedifferentiated chondrocytes were cultured in type I/III collagen sponges for 7 days under hypoxia in the presence of BMP-2. In addition, chondrocytes were transfected by siRNA targeting Col1a1 and Htra1 mRNAs, which are overexpressed during dedifferentiation and OA. To investigate the quality of the neo-synthesized ECM, specific and atypical cartilage markers were evaluated by RT-qPCR and Western blot. Our results show that the combination of 3D hypoxia cell culture, BMP-2 (Bone morphogenetic protein-2), and RNA interference, increases the chondrocytes functional indexes (Col2a1/Col1a1, Acan/Col1a1), leading to an effective chondrocyte redifferentiation. These data represent a proof of concept for this process of application, in vitro, in the equine model, and will lead to the improvement of the MACI efficiency for cartilage tissue engineering therapy in preclinical/clinical trials, both in equine and human medicine.
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Aurich M, Hofmann GO, Rolauffs B. Tissue engineering-relevant characteristics of ex vivo and monolayer-expanded chondrocytes from the notch versus trochlea of human knee joints. INTERNATIONAL ORTHOPAEDICS 2017; 41:2327-2335. [PMID: 28828504 DOI: 10.1007/s00264-017-3615-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 08/09/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim was to analyse the biological characteristics of chondrocytes from the two biopsy sites notch vs. trochlea of human knee joints. The question was whether tissue engineering-relevant characteristics such as viability and mRNA expression profile would be comparable ex vivo and after monolayer expansion, as these are parts of routine autologous chondrocyte implantation (ACI). METHODS Biopsies from the intercondylar notch and the lateral aspect of the trochlea from 20 patients with ICRS grades 3 and 4 cartilage defects were harvested during arthroscopy. Collagen types 1, 2, and 10 mRNA were quantified by polymerase chain reaction. RESULTS Compared with notch chondrocytes, ex vivo trochlea chondrocytes had comparable cell numbers, vitality and aggrecan, collagen types 1, -2 and -10 mRNA expression. After monolayer expansion both notch and trochlea chondrocyte characteristics were comparably altered, regardless of their biopsy origin, and no significant differences in viability and mRNA expression were noted. CONCLUSIONS Collectively, these findings suggest that tissue engineering-relevant characteristics of notch and trochlea chondrocytes are comparable ex vivo and after monolayer expansion. Thus, trochlea chondrocytes promise clinical potential and chondrocytes for ACI could potentially be generated from both notch and trochlea biopsy sites.
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Affiliation(s)
- Matthias Aurich
- Center of Orthopaedic and Trauma Surgery, Klinikum Ingolstadt, Krumenauerstr. 25, 85049, Ingolstadt, Germany. .,Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Erlanger Allee 101, 07747, Jena, Germany. .,Department of Biochemistry, Rush Medical College, 1735 W. Harrison St., Chicago, IL, 60612, USA.
| | - Gunther Olaf Hofmann
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Erlanger Allee 101, 07747, Jena, Germany
| | - Bernd Rolauffs
- G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center - Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.,Massachusetts Institute of Technology, Center for Biomedical Engineering, 500 Technology Sq, Cambridge, MA, 02139, USA
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Aurich M, Hofmann GO, Best N, Rolauffs B. Induced Redifferentiation of Human Chondrocytes from Articular Cartilage Lesion in Alginate Bead Culture After Monolayer Dedifferentiation: An Alternative Cell Source for Cell-Based Therapies? Tissue Eng Part A 2017; 24:275-286. [PMID: 28610480 DOI: 10.1089/ten.tea.2016.0505] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Human chondrocytes isolated from articular cartilage (AC) lesions as an alternative cell source to the standard nonweight-bearing notch biopsy site may hold clinical potential for cell-based therapies. The aim was to characterize human AC lesion site chondrocytes, compare them to notch chondrocytes, and evaluate their redifferentiation potential after monolayer expansion and subsequent three-dimensional (3D) alginate bead culture. Lesion chondrocytes from knee joints of 20 patients with International Cartilage Repair Society (ICRS) grade 3 and 4 cartilage defects were analyzed ex vivo or cultured in primary alginate bead culture, monolayer expansion, or redifferentiated in alginate culture following monolayer expansion. The mRNA expression of the types I, II, and X collagen, and the proteoglycan aggrecan was compared between the four groups. In addition, notch chondrocytes of nine patients were compared to lesion chondrocytes ex vivo. AC lesion chondrocytes displayed ex vivo a nondegenerative phenotype, characterized by a relatively high mRNA expression of aggrecan and type II and X collagen, but a low type I collagen expression and a low ratio of type I to II collagen mRNA expression. Compared to notch chondrocytes, the mRNA expression of aggrecan and type II collagen was comparable and the ratio of type I to II collagen mRNA expression was below 1 in both groups, indicating a functional chondrocyte phenotype. Dedifferentiation led to a significantly altered degenerative mRNA expression profile. Induced redifferentiation in alginate beads after monolayer expansion significantly improved the mRNA expression of aggrecan, the type I and II collagen, and the type I to II collagen ratio, compared to monolayer expansion only. These data suggested that redifferentiating lesion chondrocytes after monolayer expansion in alginate beads resulted in a pool of cells with greater chondrogenic potential, compared to expanded dedifferentiated chondrocytes. Collectively, these data suggest that ex vivo and redifferentiated lesion chondrocytes may hold nonutilized clinical potential for the tissue engineering of AC.
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Affiliation(s)
- Matthias Aurich
- 1 Center for Orthopaedic and Trauma Surgery, Ingolstadt Hospital , Ingolstadt, Germany .,2 Department of Trauma, Hand and Reconstructive Surgery, Universitätsklinikum Jena , Jena, Germany .,3 Department of Biochemistry, Rush Medical College , Chicago, Illinois
| | - Gunther O Hofmann
- 2 Department of Trauma, Hand and Reconstructive Surgery, Universitätsklinikum Jena , Jena, Germany
| | - Norman Best
- 4 Institute of Physiotherapy, Universitätsklinikum Jena , Jena, Germany
| | - Bernd Rolauffs
- 5 G.E.R.N. Tissue Replacement, Regeneration & Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center, Albert-Ludwigs-University of Freiburg , Freiburg, Germany .,6 Faculty of Medicine, Albert-Ludwigs-University of Freiburg , Freiburg, Germany .,7 Massachusetts Institute of Technology , Center for Biomedical Engineering, Cambridge, Massachusetts
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73
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Go G, Han J, Zhen J, Zheng S, Yoo A, Jeon MJ, Park JO, Park S. A Magnetically Actuated Microscaffold Containing Mesenchymal Stem Cells for Articular Cartilage Repair. Adv Healthc Mater 2017; 6. [PMID: 28481009 DOI: 10.1002/adhm.201601378] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/15/2017] [Indexed: 12/21/2022]
Abstract
This study proposes a magnetically actuated microscaffold with the capability of targeted mesenchymal stem cell (MSC) delivery for articular cartilage regeneration. The microscaffold, as a 3D porous microbead, is divided into body and surface portions according to its materials and fabrication methods. The microscaffold body, which consists of poly(lactic-co-glycolic acid) (PLGA), is formed through water-in-oil-in-water emulsion templating, and its surface is coated with amine functionalized magnetic nanoparticles (MNPs) via amino bond formation. The porous PLGA structure of the microscaffold can assist in cell adhesion and migration, and the MNPs on the microscaffold can make it possible to steer using an electromagnetic actuation system that provides external magnetic fields for the 3D locomotion of the microscaffold. As a fundamental test of the magnetic response of the microscaffold, it is characterized in terms of the magnetization curve, velocity, and 3D locomotion of a single microscaffold. In addition, its function with a cargo of MSCs for cartilage regeneration is demonstrated from the proliferation, viability, and chondrogenic differentiation of D1 mouse MSCs that are cultured on the microscaffold. For the feasibility tests for cartilage repair, 2D/3D targeting of multiple microscaffolds with the MSCs is performed to demonstrate targeted stem cell delivery using the microscaffolds and their swarm motion.
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Affiliation(s)
- Gwangjun Go
- Medical Microrobot Center (MRC); Robot Research Initiative (RRI); Chonnam National University; Gwangju 500-480 South Korea
- School of Mechanical Systems Engineering; Chonnam National University; Gwangju 500-757 South Korea
| | - Jiwon Han
- Medical Microrobot Center (MRC); Robot Research Initiative (RRI); Chonnam National University; Gwangju 500-480 South Korea
| | - Jin Zhen
- Medical Microrobot Center (MRC); Robot Research Initiative (RRI); Chonnam National University; Gwangju 500-480 South Korea
- School of Mechanical Systems Engineering; Chonnam National University; Gwangju 500-757 South Korea
| | - Shaohui Zheng
- Medical Microrobot Center (MRC); Robot Research Initiative (RRI); Chonnam National University; Gwangju 500-480 South Korea
- School of Mechanical Systems Engineering; Chonnam National University; Gwangju 500-757 South Korea
| | - Ami Yoo
- Medical Microrobot Center (MRC); Robot Research Initiative (RRI); Chonnam National University; Gwangju 500-480 South Korea
| | - Mi-Jeong Jeon
- Medical Microrobot Center (MRC); Robot Research Initiative (RRI); Chonnam National University; Gwangju 500-480 South Korea
| | - Jong-Oh Park
- Medical Microrobot Center (MRC); Robot Research Initiative (RRI); Chonnam National University; Gwangju 500-480 South Korea
- School of Mechanical Systems Engineering; Chonnam National University; Gwangju 500-757 South Korea
| | - Sukho Park
- School of Mechanical Systems Engineering; Chonnam National University; Gwangju 500-757 South Korea
- Department of Robotics Engineering; Daegu Gyeongbuk Institute of Science and Technology; Daegu 711-873 South Korea
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Schuette HB, Kraeutler MJ, McCarty EC. Matrix-Assisted Autologous Chondrocyte Transplantation in the Knee: A Systematic Review of Mid- to Long-Term Clinical Outcomes. Orthop J Sports Med 2017; 5:2325967117709250. [PMID: 28620621 PMCID: PMC5464387 DOI: 10.1177/2325967117709250] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Matrix-assisted autologous chondrocyte transplantation (MACT) is a surgical treatment option for articular cartilage lesions of the knee joint. Purpose: To investigate mid- to long-term clinical outcomes of MACT in the patellofemoral (PF) and tibiofemoral (TF) joints. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed by searching PubMed, Embase, and the Cochrane Library to find studies evaluating minimum 5-year clinical outcomes of patients undergoing MACT in the knee joint. Search terms used were knee, matrix, and autologous chondrocyte. Patients were evaluated based on treatment failure rates, magnetic resonance imaging, and subjective outcome scores. Study methodology was assessed using the Modified Coleman Methodology Score (MCMS). Results: Ten studies (two level 1, one level 2, one level 3, and six level 4 evidence) were identified that met inclusion and exclusion criteria, for a total of 442 TF patients and 136 PF patients. Treatment failure occurred in 9.7% of all patients, including 4.7% of PF patients and 12.4% of TF patients (P = .037). Weighted averages of subjective outcome scores, including Knee injury and Osteoarthritis Outcome Score, Short Form–36 Health Survey, and Tegner scores, improved from baseline to latest follow-up in both TF and PF patients. The mean MCMS was found to be 57.4, with a standard deviation of 18.5. Conclusion: Patients undergoing MACT in the knee show favorable mid- to long-term clinical outcomes. A significantly higher treatment failure rate was found in patients undergoing MACT in the TF joint compared with the PF joint.
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Affiliation(s)
- Hayden B Schuette
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Matthew J Kraeutler
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Eric C McCarty
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
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Coccia M. Emerging Technology in Cartilage Repair: Analysis with a Substitution Model of Technological Change. SSRN ELECTRONIC JOURNAL 2017. [DOI: 10.2139/ssrn.2958484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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The comparison between the different generations of autologous chondrocyte implantation with other treatment modalities: a systematic review of clinical trials. Knee Surg Sports Traumatol Arthrosc 2016; 24:3912-3926. [PMID: 26003481 DOI: 10.1007/s00167-015-3649-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 05/15/2015] [Indexed: 12/11/2022]
Abstract
PURPOSE This paper aims to review the current evidence for autologous chondrocyte implantation (ACI) generations relative to other treatment modalities, different cell delivery methods and different cell source application. METHODS Literature search was performed to identify all level I and II studies reporting the clinical and structural outcome of any ACI generation in human knees using the following medical electronic databases: PubMed, EMBASE, Cochrane Library, CINAHL, SPORTDiscus and NICE healthcare database. The level of evidence, sample size calculation and risk of bias were determined for all included studies to enable quality assessment. RESULTS Twenty studies were included in the analysis, reporting on a total of 1094 patients. Of the 20 studies, 13 compared ACI with other treatment modalities, seven compared different ACI cell delivery methods, and one compared different cell source for implantation. Studies included were heterogeneous in baseline design, preventing meta-analysis. Data showed a trend towards similar outcomes when comparing ACI generations with other repair techniques and when comparing different cell delivery methods and cell source selection. Majority of the studies (80 %) were level II evidence, and overall the quality of studies can be rated as average to low, with the absence of power analysis in 65 % studies. CONCLUSION At present, there are insufficient data to conclude any superiority of ACI techniques. Considering its two-stage operation and cost, it may be appropriate to reserve ACI for patients with larger defects or those who have had inadequate response to other repair procedures until hard evidence enables specific clinical recommendations be made. LEVEL OF EVIDENCE II.
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Niemeyer P, Laute V, John T, Becher C, Diehl P, Kolombe T, Fay J, Siebold R, Niks M, Fickert S, Zinser W. The Effect of Cell Dose on the Early Magnetic Resonance Morphological Outcomes of Autologous Cell Implantation for Articular Cartilage Defects in the Knee: A Randomized Clinical Trial. Am J Sports Med 2016; 44:2005-14. [PMID: 27206690 DOI: 10.1177/0363546516646092] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although autologous chondrocyte implantation (ACI) has been established as a standard treatment for large full-thickness cartilage defects, the effect of different doses of autologous chondrocyte products on structural outcomes has never been examined. HYPOTHESIS In ACI, the dose level may have an influence on medium-term magnetic resonance morphological findings after treatment. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS A total of 75 patients who underwent ACI using a pure, autologous, third-generation matrix-associated ACI product were divided into 3 groups representing different doses: 3 to 7 spheroids/cm(2), 10 to 30 spheroids/cm(2), and 40 to 70 spheroids/cm(2). Magnetic resonance imaging was performed at 1.5, 3, 6, and 12 months after ACI and was evaluated by the magnetic resonance observation of cartilage repair tissue (MOCART) score and the Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS MOCART scores showed improvements after 3 months, with slight dose dependence, and further improvement after 12 months, although without significant dose dependence. The mean MOCART scores after 3 months (0 = worst, 100 = best) were 59.8, 64.5, and 64.7 for the low-, medium-, and high-dose groups, respectively, and 62.9 for all patients; at 12 months, these were 74.1, 74.5, and 68.8 for the respective dose groups and 72.4 for all patients. Several MOCART items (surface of repair tissue, structure of repair tissue, signal intensity of repair tissue, subchondral bone, and synovitis) showed a more rapid response with the medium and high doses than with the low dose, suggesting a potential dose relationship. No significant correlation between the MOCART (overall and subscores) with clinical outcomes as assessed by the overall KOOS was detected at 3- and 12-month assessments. CONCLUSION This study reveals a trend toward earlier recovery after treatment with higher spheroid doses in terms of better defect filling for full-thickness cartilage defects of the knee, while outcomes after 12 months were similar in all dose groups. However, a correlation with clinical outcomes or the failure rate at 1 year after ACI was not found. A longer follow-up will be required for more definite conclusions on the clinical relevance of ACI cell density to be drawn. REGISTRATION NCT01225575 (ClinicalTrials.gov identifier); 2009-016816-20 (EudraCT number).
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Affiliation(s)
- Philipp Niemeyer
- Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Freiburg, Germany
| | | | - Thilo John
- Clinic for Traumatology and Orthopedic Surgery, DRK Hospital Berlin Westend, Berlin, Germany
| | - Christoph Becher
- Department of Orthopedic Surgery, Medical University Annastift Hannover, Hannover, Germany
| | - Peter Diehl
- Department of Orthopedic Surgery, University of Rostock, Rostock, Germany
| | - Thomas Kolombe
- Traumatology and Reconstructive Surgery, DRK Hospital Luckenwalde, Luckenwalde, Germany
| | - Jakob Fay
- Department of Traumatology and Arthroscopic Surgery, Lubinus Clinicum Kiel, Kiel, Germany
| | - Rainer Siebold
- Center for Hip, Knee and Foot Surgery, ATOS Clinic Heidelberg, Heidelberg, Germany
| | - Milan Niks
- Department of Orthopedic Surgery and Traumatology, Mannheim University Hospital, Mannheim, Germany
| | | | - Wolfgang Zinser
- Department of Orthopedic Surgery and Traumatology, St Vinzenz-Hospital Dinslaken, Dinslaken, Germany
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Mundi R, Bedi A, Chow L, Crouch S, Simunovic N, Sibilsky Enselman E, Ayeni OR. Cartilage Restoration of the Knee: A Systematic Review and Meta-analysis of Level 1 Studies. Am J Sports Med 2016; 44:1888-95. [PMID: 26138733 DOI: 10.1177/0363546515589167] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Focal cartilage defects of the knee are a substantial cause of pain and disability in active patients. There has been an emergence of randomized controlled trials evaluating surgical techniques to manage such injuries, including marrow stimulation (MS), autologous chondrocyte implantation (ACI), and osteochondral autograft transfer (OAT). PURPOSE A meta-analysis was conducted to determine if any single technique provides superior clinical results at intermediate follow-up. STUDY DESIGN Systematic review and meta-analysis of randomized controlled trials. METHODS The MEDLINE, EMBASE, and Cochrane Library databases were systematically searched and supplemented with manual searches of PubMed and reference lists. Eligible studies consisted exclusively of randomized controlled trials comparing MS, ACI, or OAT techniques in patients with focal cartilage defects of the knee. The primary outcome of interest was function (Lysholm score, International Knee Documentation Committee score, Knee Osteoarthritis Outcome Score) and pain at 24 months postoperatively. A meta-analysis using standardized mean differences was performed to provide a pooled estimate of effect comparing treatments. RESULTS A total of 12 eligible randomized trials with a cumulative sample size of 765 patients (62% males) and a mean (±SD) lesion size of 3.9 ± 1.3 cm(2) were included in this review. There were 5 trials comparing ACI with MS, 3 comparing ACI with OAT, and 3 evaluating different generations of ACI. In a pooled analysis comparing ACI with MS, there was no difference in outcomes at 24-month follow-up for function (standardized mean difference, 0.47 [95% CI, -0.19 to 1.13]; P = .16) or pain (standardized mean difference, -0.13 [95% CI, -0.39 to 0.13]; P = .33). The comparisons of ACI to OAT or between different generations of ACI were not amenable to pooled analysis. Overall, 5 of the 6 trials concluded that there was no significant difference in functional outcomes between ACI and OAT or between generations of ACI. CONCLUSION There is no significant difference between MS, ACI, and OAT in improving function and pain at intermediate-term follow-up. Further randomized trials with long-term outcomes are warranted.
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Affiliation(s)
- Raman Mundi
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Asheesh Bedi
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Linda Chow
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Crouch
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Simunovic
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | | | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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79
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Autologe Knorpelzelltransplantation. ARTHROSKOPIE 2016. [DOI: 10.1007/s00142-016-0064-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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80
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Niemeyer P, Albrecht D, Andereya S, Angele P, Ateschrang A, Aurich M, Baumann M, Bosch U, Erggelet C, Fickert S, Gebhard H, Gelse K, Günther D, Hoburg A, Kasten P, Kolombe T, Madry H, Marlovits S, Meenen NM, Müller PE, Nöth U, Petersen JP, Pietschmann M, Richter W, Rolauffs B, Rhunau K, Schewe B, Steinert A, Steinwachs MR, Welsch GH, Zinser W, Fritz J. Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: A guideline by the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU). Knee 2016; 23:426-35. [PMID: 26947215 DOI: 10.1016/j.knee.2016.02.001] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/13/2016] [Accepted: 02/01/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Autologous chondrocyte implantation (ACI) is an established and well-accepted procedure for the treatment of localised full-thickness cartilage defects of the knee. METHODS The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning therapeutic consequences of primary cartilage lesions and the suitable indication for ACI. RESULTS Based on best available scientific evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than three to four square centimetres; in the case of young and active sports patients at 2.5cm(2), while advanced degenerative joint disease needs to be considered as the most important contraindication. CONCLUSION The present review gives a concise overview on important scientific background and the results of clinical studies and discusses the advantages and disadvantages of ACI. LEVEL OF EVIDENCE Non-systematic Review.
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Affiliation(s)
- P Niemeyer
- Department Orthopädie und Traumatologie, Universitätsklinikum Freiburg, Germany.
| | - D Albrecht
- Klinik im Kronprinzenbau, Reutlingen, Germany
| | - S Andereya
- Orthopädie und Unfallchirurgie, Ortho AC, Aachen, Germany
| | - P Angele
- Abteilung für Unfallchirurgie, Universitätsklinikum Regensburg, Germany; Sportopaedicum, Straubing, Berlin, Regensburg, München, Germany
| | - A Ateschrang
- Berufsgenossenschaftliche Unfallklinik Tübingen, Germany
| | - M Aurich
- Kliniken Leipziger Land GmbH, Klinikum Borna, Germany
| | - M Baumann
- Kreiskliniken Esslingen, Klinik f. Unfallchirurgie - Orthopädische Chirurgie, Esslingen, Germany
| | - U Bosch
- Zentrum f. Orthopädische Chirurgie, Sporttraumatologie, INI Hannover, Germany
| | - C Erggelet
- Center of Biologie Joint Repair, Zürich, Switzerland
| | - S Fickert
- Sportopaedicum, Straubing, Berlin, Regensburg, München, Germany
| | - H Gebhard
- Abteilung für Unfallchirurgie, Universitätsklinikum Regensburg, Germany
| | - K Gelse
- Abteilung für Unfallchirurgie, Universitätsklinikum Erlangen, Germany
| | - D Günther
- Klinik für Unfallchirurgie, Medizinische Hochschule Hannover (MHH), Germany
| | - A Hoburg
- Universitätsmedizin Berlin-Charite, Klinik für Orthopädie, Unfall u. Wiederherstellungschirurgie, Germany
| | - P Kasten
- Orthopädisch Chirurgisches Centrum, Tübingen, Germany
| | - T Kolombe
- Unfallchirurgie/Orthopädie, DRK Krankenhaus Luckenwalde, Germany
| | - H Madry
- Zentrum für Experimentelle Orthopädie, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - S Marlovits
- Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien und Austrian Cluster for Tissue Regeneration, Austria
| | - N M Meenen
- Sektion Pädiatrische Sportmedizin, Kinderorthopädie, Altonaer Kinderkrankenhaus Hamburg, Germany
| | - P E Müller
- Orthopädische Klinik, Ludwig-Maximiliams-Universität München, Germany
| | - U Nöth
- Evangelisches Waldkrankenhaus Spandau, Klinik f. Orthopädie und Unfallchirurgie, Berlin, Germany
| | - J P Petersen
- Zentrum f. operative Medizin, Klinik für Unfall-, Hand- u. Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Germany
| | - M Pietschmann
- Orthopädische Klinik, Ludwig-Maximiliams-Universität München, Germany
| | - W Richter
- Forschungszentrum für Experimentelle Orthopädie, Universitätsklinikum Heidelberg, Germany
| | - B Rolauffs
- Berufsgenossenschaftliche Unfallklinik Tübingen, Germany
| | | | - B Schewe
- Orthopädisch Chirurgisches Centrum, Tübingen, Germany
| | - A Steinert
- Orthopädische Klinik, König-Ludwig-Haus, Universität Würzburg, Germany
| | | | | | - W Zinser
- Klinik für Orthopädie und Unfallchirurgie, St. Vinzenz-Hospital Dinslaken, Germany
| | - J Fritz
- Orthopädisch Chirurgisches Centrum, Tübingen, Germany
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Oberbauer E, Steffenhagen C, Feichtinger G, Hildner F, Hacobian A, Danzer M, Gabriel C, Redl H, Wolbank S. A Luciferase-Based Quick Potency Assay to Predict Chondrogenic Differentiation. Tissue Eng Part C Methods 2016; 22:487-95. [DOI: 10.1089/ten.tec.2015.0435] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Eleni Oberbauer
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Carolin Steffenhagen
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Georg Feichtinger
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Biomaterials and Tissue Engineering Group, Department of Oral Biology, School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Florian Hildner
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Ara Hacobian
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Martin Danzer
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Red Cross Blood Transfusion Service of Upper Austria, Linz, Austria
| | - Christian Gabriel
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Red Cross Blood Transfusion Service of Upper Austria, Linz, Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Susanne Wolbank
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
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Whyte GP, McGee A, Jazrawi L, Meislin R. Comparison of Collagen Graft Fixation Methods in the Porcine Knee: Implications for Matrix-Assisted Chondrocyte Implantation and Second-Generation Autologous Chondrocyte Implantation. Arthroscopy 2016; 32:820-7. [PMID: 26725455 DOI: 10.1016/j.arthro.2015.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 10/05/2015] [Accepted: 10/05/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the fixation integrity at time zero of a type I/III collagen patch secured to a chondral defect in the porcine knee using methods typically employed in autologous chondrocyte implantation (ACI) and matrix-assisted chondrocyte implantation. METHODS Twenty-four porcine knee specimens underwent a medial parapatellar arthrotomy. A prefabricated template was used to create cartilage defects of 2 cm(2) in the medial femoral condyle. A size-matched collagen patch was fashioned. Four methods of fixation to the chondral defect were analyzed: group 1-saline, group 2-fibrin glue around the periphery of the patch, group 3-fibrin glue applied to the base of the defect and around the periphery of the patch, group 4-6-0 vicryl suture and fibrin glue around the periphery of the patch. Collagen patch fixation was assessed at intervals of 60, 300, 600, 900, and 1,200 cycles from full extension to 90° of flexion, performed manually without application of axial force. Patch fixation was evaluated by 2 independent observers using a customized scoring scale. RESULTS Mean peripheral detachment of the patch and chondral defect uncovering remained less than 25% for all groups. Area of defect uncovering was significantly increased in group 2 compared with group 4 after 900 and 1,200 cycles (P = .0014 and P = .0025, respectively). Fibrin glue applied to the base of the defect, or suturing of the patch, reduced deformation significantly after 900 cycles. CONCLUSIONS Suture increases the stability of fixation of a type I/III collagen patch to a chondral defect better than fibrin glue alone in the porcine knee after repetitive cycling, with respect to patch detachment and chondral defect uncovering. Application of fibrin glue to the base of the defect, or securing the patch with suture, decreases collagen patch deformation. CLINICAL RELEVANCE In cases where minimally invasive techniques do not allow suture fixation of the collagen patch, scaffold fixation may be compromised during articular motion protocols typically used after second- and third-generation ACI procedures.
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Affiliation(s)
- Graeme P Whyte
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, U.S.A..
| | - Alan McGee
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, U.S.A
| | - Laith Jazrawi
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, U.S.A
| | - Robert Meislin
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, U.S.A
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Rodenas-Rochina J, Kelly DJ, Gómez Ribelles JL, Lebourg M. Compositional changes to synthetic biodegradable scaffolds modulate the influence of hydrostatic pressure on chondrogenesis of mesenchymal stem cells. Biomed Phys Eng Express 2016. [DOI: 10.1088/2057-1976/2/3/035005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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84
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Zhang W, Ouyang H, Dass CR, Xu J. Current research on pharmacologic and regenerative therapies for osteoarthritis. Bone Res 2016; 4:15040. [PMID: 26962464 PMCID: PMC4772471 DOI: 10.1038/boneres.2015.40] [Citation(s) in RCA: 302] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 12/05/2015] [Accepted: 12/06/2015] [Indexed: 01/05/2023] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disorder commonly encountered in clinical practice, and is the leading cause of disability in elderly people. Due to the poor self-healing capacity of articular cartilage and lack of specific diagnostic biomarkers, OA is a challenging disease with limited treatment options. Traditional pharmacologic therapies such as acetaminophen, non-steroidal anti-inflammatory drugs, and opioids are effective in relieving pain but are incapable of reversing cartilage damage and are frequently associated with adverse events. Current research focuses on the development of new OA drugs (such as sprifermin/recombinant human fibroblast growth factor-18, tanezumab/monoclonal antibody against β-nerve growth factor), which aims for more effectiveness and less incidence of adverse effects than the traditional ones. Furthermore, regenerative therapies (such as autologous chondrocyte implantation (ACI), new generation of matrix-induced ACI, cell-free scaffolds, induced pluripotent stem cells (iPS cells or iPSCs), and endogenous cell homing) are also emerging as promising alternatives as they have potential to enhance cartilage repair, and ultimately restore healthy tissue. However, despite currently available therapies and research advances, there remain unmet medical needs in the treatment of OA. This review highlights current research progress on pharmacologic and regenerative therapies for OA including key advances and potential limitations.
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Affiliation(s)
- Wei Zhang
- Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Hangzhou 310058, China
- School of Pathology and Laboratory Medicine, The University of Western Australia, Perth WA 6009, Australia
| | - Hongwei Ouyang
- Center for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Crispin R Dass
- School of Pharmacy, Building 306, Curtin University, Bentley, Perth WA 6102, Australia
| | - Jiake Xu
- School of Pathology and Laboratory Medicine, The University of Western Australia, Perth WA 6009, Australia
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85
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Erten E, Sezgin Arslan T, Derkus B, Arslan YE. Detergent-free decellularization of bovine costal cartilage for chondrogenic differentiation of human adipose mesenchymal stem cells in vitro. RSC Adv 2016. [DOI: 10.1039/c6ra16647d] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In this study, we report a novel, detergent-free decellularization protocol for the preparation of intact cartilage ECM-based scaffolds (CEbS) during an effective decalcification process.
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Affiliation(s)
- Evren Erten
- Regenerative Biomaterials Laboratory
- Department of Bioengineering
- Engineering Faculty
- Canakkale Onsekiz Mart University
- Canakkale 17100
| | - Tugba Sezgin Arslan
- Regenerative Biomaterials Laboratory
- Department of Bioengineering
- Engineering Faculty
- Canakkale Onsekiz Mart University
- Canakkale 17100
| | - Burak Derkus
- Bioelectrochemistry Laboratory
- Department of Chemistry
- Ankara University
- Tandogan
- Turkey
| | - Yavuz Emre Arslan
- Regenerative Biomaterials Laboratory
- Department of Bioengineering
- Engineering Faculty
- Canakkale Onsekiz Mart University
- Canakkale 17100
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86
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Morphological and compositional monitoring of a new cell-free cartilage repair hydrogel technology - GelrinC by MR using semi-quantitative MOCART scoring and quantitative T2 index and new zonal T2 index calculation. Osteoarthritis Cartilage 2015; 23:2224-2232. [PMID: 26187572 DOI: 10.1016/j.joca.2015.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/24/2015] [Accepted: 07/07/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate cartilage repair tissue (RT) using MOCART scoring for morphological and T2 mapping for biochemical assessment following implantation of GelrinC, a biosynthetic, biodegradable hydrogel implant. DESIGN MR imaging (1.5/3T) was performed on 21 patients at six sites. Standard protocols were used for MOCART evaluation at 1 week (baseline) 1, 3, 6, 12, 18 and 24 months. Multi-echo SE was used for T2 mapping. Global (T2 in RT divided by T2 in normal cartilage) and zonal T2 index (deep T2 divided by superficial T2) of RT were calculated. RESULTS Average MOCART score was 71.8 (95% CI 62.2 to 81.3) at six, 75.2 (95% CI 62.8 to 87.5) at twelve, 71.8 (95% CI 55.4 to 88.2) at eighteen and 84.4 (95% CI 77.7 to 91.0) at twenty-four months. The global T2 index ranged between 0.8 and 1.2 (normal healthy cartilage) in 1/11 (9%) patients at baseline, 8/12 (67%) at 12 months, 11/13 (85%) at 18 months and 13/16 (81%) at 24 months. The zonal T2 index for RT was <20% difference to the zonal T2 index for normal cartilage in: 6/12 patients (50%) at 12 months, 7/13 (53.8%) at 18 months and 10/16 (63.5%) at 24 months. The standard deviation for T2 showed a significant decrease over the study. CONCLUSIONS The increase of MOCART scores over follow-up indicates improving cartilage repair tissue. Global and zonal T2 repair values at 24 months reached normal cartilage in 81% and 63.5% of the patients respectively, reflecting collagen organization similar to hyaline cartilage.
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87
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Hu X, Zhang J, Shao X, Luo E, Yu L. DAPT inhibits the chondrogenesis of human umbilical cord mesenchymal stem cells. Open Life Sci 2015. [DOI: 10.1515/biol-2015-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractNotch signaling plays a key role in cell
proliferation and differentiation, and is important
in several biological processes, but its role in the
chondrogenesis of human umbilical cord mesenchymal
stem cells (UC-MSCs) is still unknown. N-[N-(3,5-
difluorophenacetyl-L-alanyl)]-(S)-phenylglycinet-butyl
ester (DAPT) is the inhibitor of Notch pathway. The aim
of this study is to investgate the influence of DAPT on
the chondrogenesis of UC-MSCs. In our study, UC-MSCs
were isolated from human umbilical cord and their
characteristics were identified. The UC-MSCs were
induced to differentiate into chondrocytes in vitro and
treated with 5 μM DAPT. Glycosaminoglycan (GAG) and
collagen type II (COL-2A1) were analyzed qualitatively and
quantitatively. The gene expression of Notch-1, Hes-1, GAG
and COL-2A1 were analyzed by quantitative polymerase
chain reaction (qPCR). The UC-MSCs separated from
human umbilical cord, followed the characteristics of
Mesenchymal Stem Cells (MSCs). The gene expression of
Notch-1 and Hes-1 decreased after chondrogenic induction
but the percentage in G1 period and the content of GAG
and COL-2A1 increased. The expression of all tested Notch
signaling and proliferation genes declined when 5 μM
DAPT was added, also the content of GAG and COL-2A1
also decreased. Our study revealed that Notch signaling
exists in UC-MSCs and it may remain the proliferative
activity of UC-MSCs. Once the chondrogenesis begins,
Notch signaling strength decline evidently. DAPT inhibits
the chondrogenesis of UC-MSCs.
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Affiliation(s)
- Xiaoke Hu
- 1Department of Biochemistry, Medical School of Jinan University, Guangzhou, 510632, Guangdong Province, People’s Republic of China
| | - Jiawen Zhang
- 1Department of Biochemistry, Medical School of Jinan University, Guangzhou, 510632, Guangdong Province, People’s Republic of China
| | - Xinxin Shao
- 1Department of Biochemistry, Medical School of Jinan University, Guangzhou, 510632, Guangdong Province, People’s Republic of China
| | - Ermei Luo
- 1Department of Biochemistry, Medical School of Jinan University, Guangzhou, 510632, Guangdong Province, People’s Republic of China
| | - Li Yu
- 1Department of Biochemistry, Medical School of Jinan University, Guangzhou, 510632, Guangdong Province, People’s Republic of China
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Schoenbauer E, Szomolanyi P, Shiomi T, Juras V, Zbýň Š, Zak L, Weber M, Trattnig S. Cartilage evaluation with biochemical MR imaging using in vivo Knee compression at 3 T - comparison of patients after cartilage repair with healthy volunteers. J Biomech 2015; 48:3349-55. [DOI: 10.1016/j.jbiomech.2015.06.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 05/05/2015] [Accepted: 06/15/2015] [Indexed: 10/23/2022]
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90
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Li Z, Zhu T, Fan W. Osteochondral autograft transplantation or autologous chondrocyte implantation for large cartilage defects of the knee: a meta-analysis. Cell Tissue Bank 2015; 17:59-67. [DOI: 10.1007/s10561-015-9515-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 06/05/2015] [Indexed: 10/23/2022]
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91
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Felder JJ, Lattermann C. Advances and Current Concepts of Cartilage Repair in the Patellofemoral Joint. OPER TECHN SPORT MED 2015. [DOI: 10.1053/j.otsm.2015.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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92
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Nixon AJ, Rickey E, Butler TJ, Scimeca MS, Moran N, Matthews GL. A chondrocyte infiltrated collagen type I/III membrane (MACI® implant) improves cartilage healing in the equine patellofemoral joint model. Osteoarthritis Cartilage 2015; 23:648-60. [PMID: 25575968 DOI: 10.1016/j.joca.2014.12.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 12/23/2014] [Accepted: 12/27/2014] [Indexed: 02/07/2023]
Abstract
UNLABELLED Autologous chondrocyte implantation (ACI) has improved outcome in long-term studies of joint repair in man. However, ACI requires sutured periosteal flaps to secure the cells, which precludes minimally-invasive implantation, and introduces complications with arthrofibrosis and graft hypertrophy. This study evaluated ACI on a collagen type I/III scaffold (matrix-induced autologous chondrocyte implantation; MACI(®)) in critical sized defects in the equine model. METHODS Chondrocytes were isolated from horses, expanded and seeded onto a collagen I/III membrane (ACI-Maix™) and implanted into one of two 15-mm defects in the femoral trochlear ridge of six horses. Control defects remained empty as ungrafted debrided defects. The animals were examined daily, scored by second look arthroscopy at 12 weeks, and necropsy examination 6 months after implantation. Reaction to the implant was determined by lameness, and synovial fluid constituents and synovial membrane histology. Cartilage healing was assessed by arthroscopic scores, gross assessment, repair tissue histology and immunohistochemistry, cartilage glycosaminoglycan (GAG) and DNA assay, and mechanical testing. RESULTS MACI(®) implanted defects had improved arthroscopic second-look, gross healing, and composite histologic scores, compared to spontaneously healing empty defects. Cartilage GAG and DNA content in the defects repaired by MACI implant were significantly improved compared to controls. Mechanical properties were improved but remained inferior to normal cartilage. There was minimal evidence of reaction to the implant in the synovial fluid, synovial membrane, subchondral bone, or cartilage. CONCLUSIONS The MACI(®) implant appeared to improve cartilage healing in a critical sized defect in the equine model evaluated over 6 months.
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Affiliation(s)
- A J Nixon
- Comparative Orthopedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
| | - E Rickey
- Comparative Orthopedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - T J Butler
- Genzyme-Sanofi, 500 Kendall St, Cambridge, MA, USA
| | - M S Scimeca
- Comparative Orthopedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - N Moran
- Genzyme-Sanofi, 500 Kendall St, Cambridge, MA, USA
| | - G L Matthews
- Genzyme-Sanofi, 500 Kendall St, Cambridge, MA, USA
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93
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Uppanan P, Thavornyutikarn B, Kosorn W, Kaewkong P, Janvikul W. Enhancement of chondrocyte proliferation, distribution, and functions within polycaprolactone scaffolds by surface treatments. J Biomed Mater Res A 2014; 103:2322-32. [DOI: 10.1002/jbm.a.35370] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 11/11/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Paweena Uppanan
- Biomedical Engineering Research Unit; National Metal and Materials Technology Center; Pathumthani Thailand
| | - Boonlom Thavornyutikarn
- Biomedical Engineering Research Unit; National Metal and Materials Technology Center; Pathumthani Thailand
| | - Wasana Kosorn
- Biomedical Engineering Research Unit; National Metal and Materials Technology Center; Pathumthani Thailand
| | - Pakkanun Kaewkong
- Biomedical Engineering Research Unit; National Metal and Materials Technology Center; Pathumthani Thailand
| | - Wanida Janvikul
- Biomedical Engineering Research Unit; National Metal and Materials Technology Center; Pathumthani Thailand
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94
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Vonk LA, de Windt TS, Kragten AHM, Beekhuizen M, Mastbergen SC, Dhert WJA, Lafeber FPJG, Creemers LB, Saris DBF. Enhanced cell-induced articular cartilage regeneration by chondrons; the influence of joint damage and harvest site. Osteoarthritis Cartilage 2014; 22:1910-7. [PMID: 25151084 DOI: 10.1016/j.joca.2014.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 06/30/2014] [Accepted: 08/13/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Interactions between chondrocytes and their native pericellular matrix provide optimal circumstances for regeneration of cartilage. However, cartilage diseases such as osteoarthritis change the pericellular matrix, causing doubt to them as a cell source for autologous cell therapy. METHODS Chondrons and chondrocytes were isolated from stifle joints of goats in which cartilage damage was surgically induced in the right knee. After 4 weeks of regeneration culture, DNA content and proteoglycan and collagen content and release were determined. RESULTS The cartilage regenerated by chondrons isolated from the damaged joint contained less proteoglycans and collagen compared to chondrons from the same harvest site in the nonoperated knee (P < 0.01). Besides, chondrons still reflected whether they were isolated from a damaged joint, even if they where isolated from the opposing or adjacent condyle. Although chondrocytes did not reflect this diseased status of the joint, chondrons always outperformed chondrocytes, even when isolated from the damaged joints (P < 0.0001). Besides increased cartilage production, the chondrons showed less collagenase activity compared to the chondrocytes. CONCLUSION Chondrons still outperform chondrocytes when they were isolated from a damaged joint and they might be a superior cell source for articular cartilage repair and cell-induced cartilage formation.
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Affiliation(s)
- L A Vonk
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - T S de Windt
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A H M Kragten
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Beekhuizen
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S C Mastbergen
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W J A Dhert
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands; Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - F P J G Lafeber
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L B Creemers
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D B F Saris
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands; Tissue Regeneration, MIRA Institute, University Twente, Enschede, The Netherlands
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95
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Leyh M, Seitz A, Dürselen L, Schaumburger J, Ignatius A, Grifka J, Grässel S. Subchondral bone influences chondrogenic differentiation and collagen production of human bone marrow-derived mesenchymal stem cells and articular chondrocytes. Arthritis Res Ther 2014; 16:453. [PMID: 25296561 PMCID: PMC4209060 DOI: 10.1186/s13075-014-0453-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 09/05/2014] [Indexed: 11/30/2022] Open
Abstract
Introduction Osteoarthritis (OA) is characterized by an imbalance in cartilage and underlying subchondral bone homeostasis. We hypothesized that signals from the subchondral bone may modulate production of matrix components, alter chondrogenic differentiation potential of cocultured bone marrow-derived mesenchymal stem cells (BMSC) and induce a phenotypic shift in differentiated OA chondrocytes. Methods We established a novel coculture model between BMSC, mixed cultures (BMSC and chondrocytes) and chondrocytes embedded in fibrin gel with OA and normal subchondral bone explants (OAB and NB). Tissues and cells were either derived from OA or trauma patients. In addition, we used adipose-derived stem cells (ASC) from liposuction. With gene expression analysis, biochemical assays, immunofluorescence and biomechanical tests we characterized the properties of newly generated extracellular matrix (ECM) from chondrocytes and chondrogenically differentiating BMSC cocultured with OAB or NB in comparison with monocultures (cultures without bone explants). Results Overall, gene expression of collagens of OAB and NB cocultured cells was reduced compared to monocultures. Concomitantly, we observed significantly lower collagen I, II and III and glycosaminoglycan (GAG) production in OAB cocultured cell lysates. In parallel, we detected increased concentrations of soluble GAGs and basic fibroblast growth factor (bFGF), interleukin (IL)-6 and IL-8 in supernatants of OAB and NB cocultures mainly at early time points. IL-1ß concentration was increased in supernatants of OAB cocultures, but not in NB cocultures. Cell-free NB or OAB explants released different amounts of IL-1ß, bFGF and soluble GAG into cell culture supernatants. In comparison to cocultures, monocultures exhibited higher Young’s modulus and equilibrium modulus. Stimulation of monocultures with IL-1ß led to a downregulation of aggrecan (ACAN) gene expression and in general to induced matrix metalloprotease (MMP)2, MMP3 and MMP-13 gene expression while IL-6 and IL-8 stimulation partly reduced ACAN, MMP3 and MMP-13 gene expression. Conclusions Our results suggest an alteration of molecular composition and mechanical properties of the newly formed ECM in subchondral bone cocultures. We suggest that soluble factors, that is interleukins and bFGF, released in cocultures exert inhibitory effects on collagen and temporary effects on proteoglycan production, which finally results in a reduction of mechanical strength of newly formed fibrillar networks. Electronic supplementary material The online version of this article (doi:10.1186/s13075-014-0453-9) contains supplementary material, which is available to authorized users.
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96
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Lee EJ, Wi H, McEwan AL, Farooq A, Sohal H, Woo EJ, Seo JK, Oh TI. Design of a microscopic electrical impedance tomography system for 3D continuous non-destructive monitoring of tissue culture. Biomed Eng Online 2014; 13:142. [PMID: 25286865 PMCID: PMC4196084 DOI: 10.1186/1475-925x-13-142] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 09/27/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-destructive continuous monitoring of regenerative tissue is required throughout the entire period of in vitro tissue culture. Microscopic electrical impedance tomography (micro-EIT) has the potential to monitor the physiological state of tissues by forming three-dimensional images of impedance changes in a non-destructive and label-free manner. We developed a new micro-EIT system and report on simulation and experimental results of its macroscopic model. METHODS We propose a new micro-EIT system design using a cuboid sample container with separate current-driving and voltage sensing electrodes. The top is open for sample manipulations. We used nine gold-coated solid electrodes on each of two opposing sides of the container to produce multiple linearly independent internal current density distributions. The 360 voltage sensing electrodes were placed on the other sides and base to measure induced voltages. Instead of using an inverse solver with the least squares method, we used a projected image reconstruction algorithm based on a logarithm formulation to produce projected images. We intended to improve the quality and spatial resolution of the images by increasing the number of voltage measurements subject to a few injected current patterns. We evaluated the performance of the micro-EIT system with a macroscopic physical phantom. RESULTS The signal-to-noise ratio of the developed micro-EIT system was 66 dB. Crosstalk was in the range of -110.8 to -90.04 dB. Three-dimensional images with consistent quality were reconstructed from physical phantom data over the entire domain. From numerical and experimental results, we estimate that at least 20 × 40 electrodes with 120 μm spacing are required to monitor the complex shape of ingrowth neotissue inside a scaffold with 300 μm pore. CONCLUSION The experimental results showed that the new micro-EIT system with a reduced set of injection current patterns and a large number of voltage sensing electrodes can be potentially used for tissue culture monitoring. Numerical simulations demonstrated that the spatial resolution could be improved to the scale required for tissue culture monitoring. Future challenges include manufacturing a bioreactor-compatible container with a dense array of electrodes and a larger number of measurement channels that are sensitive to the reduced voltage gradients expected at a smaller scale.
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Affiliation(s)
| | | | | | | | | | | | | | - Tong In Oh
- Department of Biomedical Engineering and Impedance Imaging Research Center, Kyung Hee University, 46-701 Yongin, Korea.
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97
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Bhardwaj N, Devi D, Mandal BB. Tissue-engineered cartilage: the crossroads of biomaterials, cells and stimulating factors. Macromol Biosci 2014; 15:153-82. [PMID: 25283763 DOI: 10.1002/mabi.201400335] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/25/2014] [Indexed: 02/06/2023]
Abstract
Damage to cartilage represents one of the most challenging tasks of musculoskeletal therapeutics due to its limited propensity for healing and regenerative capabilities. Lack of current treatments to restore cartilage tissue function has prompted research in this rapidly emerging field of tissue regeneration of functional cartilage tissue substitutes. The development of cartilaginous tissue largely depends on the combination of appropriate biomaterials, cell source, and stimulating factors. Over the years, various biomaterials have been utilized for cartilage repair, but outcomes are far from achieving native cartilage architecture and function. This highlights the need for exploration of suitable biomaterials and stimulating factors for cartilage regeneration. With these perspectives, we aim to present an overview of cartilage tissue engineering with recent progress, development, and major steps taken toward the generation of functional cartilage tissue. In this review, we have discussed the advances and problems in tissue engineering of cartilage with strong emphasis on the utilization of natural polymeric biomaterials, various cell sources, and stimulating factors such as biophysical stimuli, mechanical stimuli, dynamic culture, and growth factors used so far in cartilage regeneration. Finally, we have focused on clinical trials, recent innovations, and future prospects related to cartilage engineering.
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Affiliation(s)
- Nandana Bhardwaj
- Seri-Biotechnology Unit, Life Science Division, Institute of Advanced Study in Science and Technology, Guwahati, 781035, India
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98
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Oh TI, Kim C, Karki B, Son Y, Lee E, Woo EJ. Non-destructive label-free continuous monitoring of in vitro chondrogenesis via electrical conductivity and its anisotropy. Biotechnol Bioeng 2014; 112:422-7. [DOI: 10.1002/bit.25350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/09/2014] [Accepted: 07/17/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Tong In Oh
- Department of Biomedical Engineering; Kyung Hee University; Gyeonggi-do Korea
| | - Changhwan Kim
- College of Life Science and Graduate School of Biotechnology; Kyung Hee University; 1732 Deogyeong-daero Giheung-gu Gyeonggi-do 446-701 Korea
| | - Bishal Karki
- Department of Biomedical Engineering; Kyung Hee University; Gyeonggi-do Korea
| | - Youngsook Son
- College of Life Science and Graduate School of Biotechnology; Kyung Hee University; 1732 Deogyeong-daero Giheung-gu Gyeonggi-do 446-701 Korea
| | - EunAh Lee
- College of Life Science and Graduate School of Biotechnology; Kyung Hee University; 1732 Deogyeong-daero Giheung-gu Gyeonggi-do 446-701 Korea
| | - Eung Je Woo
- Department of Biomedical Engineering; Kyung Hee University; Gyeonggi-do Korea
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Nam S, Cho W, Cho H, Lee J, Lee E, Son Y. Xiphoid process-derived chondrocytes: a novel cell source for elastic cartilage regeneration. Stem Cells Transl Med 2014; 3:1381-91. [PMID: 25205841 DOI: 10.5966/sctm.2014-0070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Reconstruction of elastic cartilage requires a source of chondrocytes that display a reliable differentiation tendency. Predetermined tissue progenitor cells are ideal candidates for meeting this need; however, it is difficult to obtain donor elastic cartilage tissue because most elastic cartilage serves important functions or forms external structures, making these tissues indispensable. We found vestigial cartilage tissue in xiphoid processes and characterized it as hyaline cartilage in the proximal region and elastic cartilage in the distal region. Xiphoid process-derived chondrocytes (XCs) showed superb in vitro expansion ability based on colony-forming unit fibroblast assays, cell yield, and cumulative cell growth. On induction of differentiation into mesenchymal lineages, XCs showed a strong tendency toward chondrogenic differentiation. An examination of the tissue-specific regeneration capacity of XCs in a subcutaneous-transplantation model and autologous chondrocyte implantation model confirmed reliable regeneration of elastic cartilage regardless of the implantation environment. On the basis of these observations, we conclude that xiphoid process cartilage, the only elastic cartilage tissue source that can be obtained without destroying external shape or function, is a source of elastic chondrocytes that show superb in vitro expansion and reliable differentiation capacity. These findings indicate that XCs could be a valuable cell source for reconstruction of elastic cartilage.
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Affiliation(s)
- Seungwoo Nam
- Department of Genetic Engineering, College of Life Science and Graduate School of Biotechnology, Kyung Hee University, Seoul, Republic of Korea; R&D Institute, Modern Cell and Tissue Technologies Inc., Seoul, Republic of Korea
| | - Wheemoon Cho
- Department of Genetic Engineering, College of Life Science and Graduate School of Biotechnology, Kyung Hee University, Seoul, Republic of Korea; R&D Institute, Modern Cell and Tissue Technologies Inc., Seoul, Republic of Korea
| | - Hyunji Cho
- Department of Genetic Engineering, College of Life Science and Graduate School of Biotechnology, Kyung Hee University, Seoul, Republic of Korea; R&D Institute, Modern Cell and Tissue Technologies Inc., Seoul, Republic of Korea
| | - Jungsun Lee
- Department of Genetic Engineering, College of Life Science and Graduate School of Biotechnology, Kyung Hee University, Seoul, Republic of Korea; R&D Institute, Modern Cell and Tissue Technologies Inc., Seoul, Republic of Korea
| | - EunAh Lee
- Department of Genetic Engineering, College of Life Science and Graduate School of Biotechnology, Kyung Hee University, Seoul, Republic of Korea; R&D Institute, Modern Cell and Tissue Technologies Inc., Seoul, Republic of Korea
| | - Youngsook Son
- Department of Genetic Engineering, College of Life Science and Graduate School of Biotechnology, Kyung Hee University, Seoul, Republic of Korea; R&D Institute, Modern Cell and Tissue Technologies Inc., Seoul, Republic of Korea
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Designer functionalised self-assembling peptide nanofibre scaffolds for cartilage tissue engineering. Expert Rev Mol Med 2014; 16:e12. [PMID: 25089851 DOI: 10.1017/erm.2014.13] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Owing to the limited regenerative capacity of cartilage tissue, cartilage repair remains a challenge in clinical treatment. Tissue engineering has emerged as a promising and important approach to repair cartilage defects. It is well known that material scaffolds are regarded as a fundamental element of tissue engineering. Novel biomaterial scaffolds formed by self-assembling peptides consist of nanofibre networks highly resembling natural extracellular matrices, and their fabrication is based on the principle of molecular self-assembly. Indeed, peptide nanofibre scaffolds have obtained much progress in repairing various damaged tissues (e.g. cartilage, bone, nerve, heart and blood vessel). This review outlines the rational design of peptide nanofibre scaffolds and their potential in cartilage tissue engineering.
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