Divergent effects of distinct perivascular cell subsets for intra-articular cell therapy in posttraumatic osteoarthritis

A Novel Burn / Synovectomy Mouse Model for Temporomandibular Joint Osteoarthritis

Temporomandibular Disorders (TMDs) is present in 33% of the U.S. population. Currently available animal models do not faithfully simulate the native disease progression of TMJ OA. The initiation of TMJ OA requires both local trauma and systemic inflammation. In this study, we present a novel mouse model which reproduces these two conditions. This is achieved by a procedure involving both synovectomy (local trauma) and a distant burn injury (systemic inflammation). Its efficacy at inducing TMJ OA was assessed with histomorphology and radiographic evaluation at 1,3, and 9 weeks after the procedure. We found that burn/synovectomy mice demonstrated significantly more degenerative changes in TMJ than uninjured control mice or synovotomy mice. The observed histology in burn/synoectomy mice mimicked native TMJ OA disease progression in a faithful manner. This animal model is invaluable in future research of the mechanism and risk factors of TMJ OA.

Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 1: adipose tissue-derived cell-based injectable therapies

PURPOSE

The aim of this systematic review was to determine if adipose tissue-derived cell-based injectable therapies can induce disease-modifying effects in joints affected by osteoarthritis (OA).

METHODS

A systematic review was performed on three electronic databases (PubMed, Web of Science, Embase) according to PRISMA guidelines. A synthesis of the results was performed investigating disease-modifying effects in preclinical studies comparing injectable adipose-derived products with OA controls or other products, different formulations or injection intervals, and the combination with other products. The risk of bias was assessed according to the SYRCLE's tool.

RESULTS

Seventy-one studies were included (2,086 animals) with an increasing publication trend over time. Expanded cells were used in 65 studies, 3 studies applied point of care products, and 3 studies investigated both approaches. Overall, 48 out of 51 studies (94%) reported better results with adipose-derived products compared to OA controls, with positive findings in 17 out of 20 studies (85%) in macroscopic, in 37 out of 40 studies (93%) in histological, and in 22 out of 23 studies (96%)  in immunohistochemical evaluations. Clinical and biomarker evaluations showed positive results in 14 studies out of 18 (78%) and 12 studies out of 14 (86%), while only 9 studies out of 17 (53%) of the imaging evaluations were able to detect differences versus controls. The risk of bias was low in 38% of items, unclear in 51%, and high in (11%).

CONCLUSION

The current preclinical models document consistent evidence of disease-modifying effects of adipose-derived cell-based therapies for the treatment of OA. The high heterogeneity of the published studies highlights the need for further targeted research to provide recommendations on the optimal methodologies for a more effective application of these injective therapies for the treatment of OA in clinical practice.

LEVEL OF EVIDENCE

II.