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Nie M, Tian Y, Xiao Y, Lei S, Wu D. Enhancing high-quality fat survival: A novel strategy using cell-free fat extract. FASEB J 2024; 38:e23733. [PMID: 38995329 DOI: 10.1096/fj.202400523rrrr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 07/13/2024]
Abstract
High-quality fat (HQF) improves the survival rate of fat and volumetric filling compared to traditional Coleman fat. However, this HQF strategy inevitably leads to a significant amount of unused fat being wasted. "CEFFE" (cell-free fat extract) is an acellular aqueous-phase liquid, rich in bioactive proteins. The remaining fat from preparing HQF can be further processed into CEFFE to promote the survival of HQF. HQF was obtained and the remaining fat was processed into CEFFE, then HQF was transplanted subcutaneously in nude mice. Animal studies showed that CEFFE significantly improved the survival rate of HQF. Histological analysis revealed that CEFFE improved the survival rate of HQF, by enhancing cell proliferation activity, reducing apoptosis, increasing angiogenesis, and improving the inflammatory state. Under simulated anaerobic conditions, CEFFE also improved the viability of HQF. In vitro, studies demonstrated that CEFFE enhanced the survival rate of HQF through multiple mechanisms. Transcriptomic analysis and qPCR showed that CEFFE increased the expression of angiogenesis-related genes in ADSCs while enhancing their proliferation-related gene expression and suppressing the expression of three differentiation-related genes. Moreover, functional experiments demonstrated that CEFFE-induced ADSCs exhibited stronger proliferation and adipogenic differentiation abilities. Tube formation and migration assays revealed that CEFFE promoted tube formation and migration of HUVECs, indicating its inherent pro-angiogenic properties. CEFFE facilitated the development of M0 to M2 macrophages, suggesting its role in improving the inflammatory state. This innovative clinical strategy optimizes HQF transplantation strategy, minimizing fat wastage and enhancing the efficiency of fat utilization.
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Affiliation(s)
- Mengqi Nie
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P.R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, P.R. China
| | - Yi Tian
- Department of Plastic and Aesthetic (Burn) Surgery, Second Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Yutian Xiao
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P.R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, P.R. China
| | - Shaorong Lei
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P.R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, P.R. China
| | - Dingyu Wu
- Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha, P.R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, P.R. China
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2
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Αnatolitou A, Μavrogenis AF, Sideri KI, Psalla D, Krystalli AA, Prassinos NN. Comparison of allogeneic mesenchymal stem cells therapeutic potentials in rabbits' cartilage defects: Μacroscopic and histological outcomes. Res Vet Sci 2023; 162:104948. [PMID: 37478792 DOI: 10.1016/j.rvsc.2023.104948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/12/2023] [Accepted: 07/01/2023] [Indexed: 07/23/2023]
Abstract
Mesenchymal stem cells are safe and effective for treating joint injuries. However, the most suitable cell source remains controversial. This randomized controlled, double-blind study aimed to evaluate the potentials of rabbit allogeneic bone marrow- (BMSCs), adipose- (ASCs) and synovial membrane- (SDSCs) derived stem cells encapsulated in fibrin glue (FG) in vivo. The therapeutic properties of fibrin glue in critical-sized osteochondral defects (ODs) were also investigated. A 3 × 3 mm-sized OD was created in the femoral patellar groove on both knees of New Zealand rabbits, except from the left knees of the control group in which the OD was 2 × 3mm. The rabbits were randomly divided into four groups (right/left knee): 3 × 3 mm / 2 × 3 mm-sized OD control group, FG/FG with ASCs group, FG/FG with BMSCs group, FG/FG with SDSCs group. The International Cartilage Repair Society (ICRS) and the O'Driscoll scales were used to evaluate tissue characteristics after 12 weeks. FG promoted the production of reparative tissue with superior macroscopic features. Allogeneic MSCs combined with FG improved the macroscopic and histological scores more than the FG groups. The tissue in the SDSCs group was macroscopically and histologically better than the ASCs and BMSCs groups. The ICRS score differed among the SDSCs and the ASCs groups, while the empty critical-sized ODs were filled with inferior tissue compared to smaller ones. The preclinical feasibility of stem cells for OD regeneration in rabbits and the osteochondrogenic superiority of SDSCs was demonstrated. Additional tests and extended studies are required to reassure the long-term safety of these findings.
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Affiliation(s)
- A Αnatolitou
- Surgery & Obstetrics Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece.
| | - A F Μavrogenis
- National and Kapodistrian University of Athens, First Department of Orthopaedics, School of Medicine, Athens, Greece
| | - K I Sideri
- Surgery Clinic, School of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | - D Psalla
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - A A Krystalli
- Surgery & Obstetrics Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - N N Prassinos
- Surgery & Obstetrics Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
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Zhang Y, Zhuang H, Ren X, Jiang F, Zhou P. Therapeutic effects of different intervention forms of human umbilical cord mesenchymal stem cells in the treatment of osteoarthritis. Front Cell Dev Biol 2023; 11:1246504. [PMID: 37635870 PMCID: PMC10448389 DOI: 10.3389/fcell.2023.1246504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023] Open
Abstract
Osteoarthritis (OA) is a common and disabling disease. For advanced OA, surgical treatment is still the main treatment. Human umbilical cord mesenchymal stem cells (hUC-MSCs) are self-regenerative pluripotent cells, that coordinate cartilage regeneration by secreting various trophic factors, which adjust the injured tissue environment. hUC-MSCs secret extracellular vesicles and participates in OA treatment by transmitting bioactive molecules related to migration, proliferation, apoptosis, inflammatory reaction, extracellular matrix synthesis and cartilage repair. In addition, the combination of multiple substances represented by cartilage matrix and hUC-MSCs also have a significant synergistic effect on OA treatment. Because hUC-MSCs have shown considerable promise in cartilage repair, some scholars have proposed transplanting mesenchymal stem cells into damaged cartilage to delay OA progression. This article reviews the application of hUC-MSCs as a treatment for OA. With the continuous development of routine clinical applications, more reliable intervention modalities for hUC-MSCs in OA treatment will be discovered for the time to come.
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Affiliation(s)
| | | | | | | | - Panghu Zhou
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
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4
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Mavrogenis AF, Karampikas V, Zikopoulos A, Sioutis S, Mastrokalos D, Koulalis D, Scarlat MM, Hernigou P. Orthobiologics: a review. INTERNATIONAL ORTHOPAEDICS 2023:10.1007/s00264-023-05803-z. [PMID: 37071148 DOI: 10.1007/s00264-023-05803-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/30/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE The use of biologic materials in orthopaedics (orthobiologics) has gained significant attention over the past years. To enhance the body of the related literature, this review article is aimed at summarizing these novel biologic therapies in orthopaedics and at discussing their multiple clinical implementations and outcomes. METHODS This review of the literature presents the methods, clinical applications, impact, cost-effectiveness, and outcomes, as well as the current indications and future perspectives of orthobiologics, namely, platelet-rich plasma, mesenchymal stem cells, bone marrow aspirate concentrate, growth factors, and tissue engineering. RESULTS Currently available studies have used variable methods of research including biologic materials as well as patient populations and outcome measurements, therefore making comparison of studies difficult. Key features for the study and use of orthobiologics include minimal invasiveness, great healing potential, and reasonable cost as a nonoperative treatment option. Their clinical applications have been described for common orthopaedic pathologies such as osteoarthritis, articular cartilage defects, bone defects and fracture nonunions, ligament injuries, and tendinopathies. CONCLUSIONS Orthobiologics-based therapies have shown noticeable clinical results at the short- and mid-term. It is crucial that these therapies remain effective and stable in the long term. The optimal design for a successful scaffold remains to be further determined.
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Affiliation(s)
- Andreas F Mavrogenis
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
| | - Vasileios Karampikas
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Alexandros Zikopoulos
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Spyridon Sioutis
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Mastrokalos
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Koulalis
- First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Lv Z, Cai X, Bian Y, Wei Z, Zhu W, Zhao X, Weng X. Advances in Mesenchymal Stem Cell Therapy for Osteoarthritis: From Preclinical and Clinical Perspectives. Bioengineering (Basel) 2023; 10:bioengineering10020195. [PMID: 36829689 PMCID: PMC9952673 DOI: 10.3390/bioengineering10020195] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/21/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
The prevalence of osteoarthritis (OA), a degenerative disorder of joints, has substantially increased in recent years. Its key pathogenic hallmarks include articular cartilage destruction, synovium inflammation, and bone remodeling. However, treatment outcomes are unsatisfactory. Until recently, common therapy methods, such as analgesic and anti-inflammatory treatments, were aimed to treat symptoms that cannot be radically cured. Mesenchymal stem cells (MSCs), i.e., mesoderm non-hematopoietic cells separated from bone marrow, adipose tissue, umbilical cord blood, etc., have been intensively explored as an emerging technique for the treatment of OA over the last few decades. According to existing research, MSCs may limit cartilage degradation in OA by interfering with cellular immunity and secreting a number of active chemicals. This study aimed to examine the potential mechanism of MSCs in the treatment of OA and conduct a thorough review of both preclinical and clinical data.
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Affiliation(s)
- Zehui Lv
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xuejie Cai
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yixin Bian
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Zhanqi Wei
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Wei Zhu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xiuli Zhao
- Department of Medical Genetics, Institute of Basic Medical Sciences, School of Basic Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China
- Correspondence: (X.Z.); (X.W.)
| | - Xisheng Weng
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Department of State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Correspondence: (X.Z.); (X.W.)
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Yu H, Huang Y, Yang L. Research progress in the use of mesenchymal stem cells and their derived exosomes in the treatment of osteoarthritis. Ageing Res Rev 2022; 80:101684. [PMID: 35809775 DOI: 10.1016/j.arr.2022.101684] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/08/2022] [Accepted: 07/05/2022] [Indexed: 12/21/2022]
Abstract
Osteoarthritis (OA), as a common orthopedic disease with cartilage injury as its main pathological feature, has a complex pathogenesis and existing medical technology remains unable to reverse the progress of cartilage degeneration caused thereby. In recent years, mesenchymal stem cells (MSCs) and their secreted exosomes have become a focus of research into cartilage regeneration. MSCs have the potential to differentiate into a variety of cells. Under specific conditions, they can be promoted to differentiate into chondrocytes and maintain the function and stability of chondrocytes. Exosomes secreted by MSCs, as an intercellular messenger, can treat OA in a variety of ways through bioactive factors carried therewith, such as protein, lipid, mRNA, and miRNA. This study reviewed the application of MSCs and their exosomes from different sources in the prevention of OA, which provides a new idea for the treatment of OA.
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Affiliation(s)
- Hongxia Yu
- Departments of Geriatrics, First Affiliated Hospital of China Medical University, Shenyang, China.
| | - Yuling Huang
- Departments of Geriatrics, First Affiliated Hospital of China Medical University, Shenyang, China.
| | - Lina Yang
- Departments of Geriatrics, First Affiliated Hospital of China Medical University, Shenyang, China.
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Jeyaraman M, Muthu S, Jeyaraman N, Ranjan R, Jha SK, Mishra P. Synovium Derived Mesenchymal Stromal Cells (Sy-MSCs): A Promising Therapeutic Paradigm in the Management of Knee Osteoarthritis. Indian J Orthop 2022; 56:1-15. [PMID: 35070137 PMCID: PMC8748553 DOI: 10.1007/s43465-021-00439-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/03/2021] [Indexed: 02/05/2023]
Abstract
Synovium-derived mesenchymal stromal cell (Sy-MSC) is a newer member of the mesenchymal stromal cell families. The first successful demonstration of the mesenchymal stromal cell from the human synovial membrane was done in 2001 and since then its potential role for musculoskeletal regeneration has been keenly documented. The regenerative effects of Sy-MSCs are through paracrine signaling, direct cell-cell interactions, and extracellular vehicles. Sy-MSCs possess superior chondrogenicity than other sources of mesenchymal stromal cells. This article aims to outline the advancement of synovium-derived mesenchymal stromal cells along with a specific insight into the application for managing osteoarthritis knee.
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Affiliation(s)
- Madhan Jeyaraman
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh India
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh India
- International Association of Stemcell and Regenerative Medicine (IASRM), New Delhi, India
| | - Sathish Muthu
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh India
- International Association of Stemcell and Regenerative Medicine (IASRM), New Delhi, India
- Department of Orthopaedics, Government Medical College & Hospital, Dindigul, Tamil Nadu India
| | - Naveen Jeyaraman
- International Association of Stemcell and Regenerative Medicine (IASRM), New Delhi, India
- Department of Orthopaedics, Kasturba Medical College, MAHE University, Manipal, Karnataka India
| | - Rajni Ranjan
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh India
- International Association of Stemcell and Regenerative Medicine (IASRM), New Delhi, India
| | - Prabhu Mishra
- International Association of Stemcell and Regenerative Medicine (IASRM), New Delhi, India
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Anti-hypertrophic effect of synovium-derived stromal cells on costal chondrocytes promotes cartilage repairs. J Orthop Translat 2021; 32:59-68. [PMID: 34934627 PMCID: PMC8645424 DOI: 10.1016/j.jot.2021.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 01/08/2023] Open
Abstract
Background Costal chondrocytes (CCs), as a promising donor cell source for cell-based therapy for cartilage repair, have strong tendency of hypertrophy and calcification, which limited CCs from further application in cartilage regenerative medicine. Synovium-derived stromal cells (SDSCs), have shown their beneficial effect for chondrocytes to maintain phenotype. This study aims to investigate whether SDSCs could help CCs to maintain chondrogenic phenotype and suppress hypertrophic differentiation in cartilage repairs. Methods CCs were directly cocultured with SDSCs in pellet or indirectly cocultured using a conditioned medium in vitro for 3 weeks. Cartilage matrix formation and hypertrophic differentiation of CCs were analyzed by RT-PCR, biochemical assays, and histological staining. Cocultured pellets were implanted into the osteochondral defects made on the femoral groove of the rats. Then, macroscopic and histological evaluations were performed. Results Pellets formed by CCs alone and CCs cocultured with SDSCs reveal equal cartilage matrix deposition. However, the gene expression of type X collagen was significantly downregulated in cocultured pellets. Immunohistochemistry analysis revealed suppressed expression of type X collagen in cocultured pellets, indicating SDSCs may suppress hypertrophic differentiation of chondrocytes. Further in indirect coculture experiment, SDSCs suppressed type X collagen expression as well and promoted the proliferation of CCs, indicating SDSCs may influence CCs by paracrine mechanism. The pellets implanted in the osteochondral defects showed good restoration effects, whereas the grafts constructed with CCs and SDSCs showed lower type X expression levels. Conclusion These results suggest that SDSCs may maintain the phenotype of CCs and prevent the hypertrophic differentiation of CCs in cartilage repair. The Translational Potential of this Article: CCs is a promising donor cell source for cell-based therapy for cartilage repair. Based on our study, cocultured with SDSCs weakened the tendency of hypertrophy and calcification of CCs, which provide a potential usage of SDSCs in CCs-based cartilage repair therapy to suppress newly formed cartilage calcification and improve clinical outcomes.
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Lee J, Jang S, Kwon J, Oh TI, Lee E. Comparative Evaluation of Synovial Multipotent Stem Cells and Meniscal Chondrocytes for Capability of Fibrocartilage Reconstruction. Cartilage 2021; 13:980S-990S. [PMID: 32748647 PMCID: PMC8804725 DOI: 10.1177/1947603520946367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Meniscus tissue is composed of highly aligned type I collagen embedded with cartilaginous matrix. This histological feature endows mechanical properties, such as tensile strength along the direction of the collagen alignment and endurance to compressive load induced by weight bearing. The main objective of this study was to compare the fibrocartilage construction capability of different cell sources in the presence of mechanical stimuli. DESIGN Synovial multipotent stem cells (SvMSCs) and meniscal chondrocytes (MCs) from immature and mature rabbits were maintained under similar conditions for comparative evaluation of growth characteristics and senescence tendency. The differentiation potential of cell sources, including fibrocartilage generation, were comparatively evaluated. To determine the capability of fibrocartilage generation, cultured cell sheets were rolled up to produce cable-form tissue and subjected to chondrogenic induction in the presence or absence of static tension. RESULTS Although SvMSCs showed superior cell growth characteristics during in vitro cell expansion, senescence-associated β-galactosidase expression was consistently higher, compared with MCs. MCs showed glycosaminoglycan (GAG)-rich matrix formation during default in vitro chondrogenesis. While application of static tension significantly reduced GAG production, MCs continued to show robust tissue growth. SvMSCs showed inferior chondrogenic differentiation and diminished tissue growth in the presence of static tension. CONCLUSIONS While SvMSCs produced fibrous tissue during default in vitro chondrogenesis, their fibrocartilage generation potential in the presence of static tension was significantly lower, compared with MCs. Our results support evaluation of cellular response to tensile stimulus as a decisive factor in determining the ideal cell source for fibrocartilage reconstruction.
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Affiliation(s)
- Jisoo Lee
- Department of Medical Engineering,
Graduate School, Kyung Hee University, Seoul, South Korea
| | - Seoyoung Jang
- Department of Medical Engineering,
Graduate School, Kyung Hee University, Seoul, South Korea
| | - JunPyo Kwon
- Department of Medical Engineering,
Graduate School, Kyung Hee University, Seoul, South Korea
| | - Tong In Oh
- Department of Biomedical
Engineering, School of Medicine, Kyung Hee University, Seoul, South
Korea
| | - EunAh Lee
- Impedance Imaging Research Center,
Kyung Hee University, Seoul, South Korea,EunAh Lee, Impedance Imaging
Research Center, Kyung Hee Uiversity, 26, Kyungheedae-ro,
Dongdaemun-gu, Seoul, 02447, South Korea.
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Isolation and Characterization of Human Synovial Fluid-Derived Mesenchymal Stromal Cells from Popliteal Cyst. Stem Cells Int 2020; 2020:7416493. [PMID: 33014069 PMCID: PMC7519976 DOI: 10.1155/2020/7416493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/03/2020] [Accepted: 08/21/2020] [Indexed: 12/02/2022] Open
Abstract
Mesenchymal stem cells (MSCs) are multipotent progenitor cells in adult tissues. The aim of this study is to isolate and identify synovial fluid-derived mesenchymal stromal cells (SF-MSCs) from the popliteal cyst fluid of pediatric patients. SF-MSCs were collected from the popliteal cyst fluid of pediatric patients during cystectomy surgery. After cyst fluid extraction and adherent culturing, in vitro morphology, growth curve, and cell cycle were observed. The expression of stem cell surface markers was analyzed by flow cytometry, and expression of cell marker protein was detected by immunofluorescence. SF-MSCs were cultured in osteogenic, adipogenic, and chondrogenic differentiation medium. The differentiation potential of SF-MSCs was analyzed by alkaline phosphatase (Alizarin Red), Oil Red O, and Alcian blue. Antibody detection of human angiogenesis-related proteins was performed compared with bone marrow mesenchymal stem cells (BM-MSCs). The results show that SF-MSCs from the popliteal cyst fluid of pediatric patients showed a shuttle appearance and logarithmic growth. Flow cytometry analysis revealed that SF-MSCs were negative for hematopoietic lineage markers (CD34, CD45) and positive for MSC markers (CD44, CD73, CD90, and CD105). Interstitial cell marker (vimentin) and myofibroblast-like cell marker alpha-smooth muscle actin (α-SMA) were positive. These cells could differentiate into osteogenic, adipogenic, and chondrogenic lineages, respectively. Several types of human angiogenesis-related proteins were detected in the cell secretory fluid. These results show that we successfully obtained SF-MSCs from the popliteal cyst fluid of pediatric patients, which have the potential to be a valuable source of MSCs.
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Increased Expression of Sox9 during Balance of BMSCs/Chondrocyte Bricks in Platelet-Rich Plasma Promotes Construction of a Stable 3-D Chondrogenesis Microenvironment for BMSCs. Stem Cells Int 2020; 2020:5492059. [PMID: 32565827 PMCID: PMC7271054 DOI: 10.1155/2020/5492059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/03/2020] [Accepted: 03/17/2020] [Indexed: 11/17/2022] Open
Abstract
Sox9 is an intrinsic transcription factor related to the determination and maintenance of chondrogenic lineage of bone marrow mesenchymal stem cells (BMSCs). In recent research, we have proved that fragmented chondrocyte aggregates (cell bricks) could promote chondrogenesis of BMSCs in vivo. However, it is still unknown whether the ratio of BMSCs/chondrocyte bricks has a significant influence on 3-D cartilage regeneration and related molecular mechanism. To address this issue, the current study subcutaneously injected three groups of cell complex with different rabbit BMSCs/chondrocyte bricks' ratios (1 : 2, 1 : 1, and 2 : 1) into nude mice. Gross morphology observation, histological and immunohistochemical assays, biochemical analysis, gene expression analysis, and western blot were used to compare the influence of different BMSCs/chondrocyte bricks' ratios on the properties of tissue-engineered cartilage and explore the related molecular mechanism. The constructs of 1 : 1 BMSCs/chondrocyte bricks, (B1CB1) group resulted in persistent chondrogenesis with appropriate morphology and adequate central nutritional perfusion without ossification. The related mechanism is that increased expression of Sox9 in the B1C1 group promoted chondrogenesis and inhibited the osteogenesis of BMSCs through upregulating Col-II as well as downregulating RUNX2 and downstream of Col-X and Col-I by upregulating Nkx3.2. This study demonstrated that BMSCs/chondrocyte bricks 1:1 should be a suitable ratio and the Sox9-Nkx3.2-RUNX2 pathway was a related mechanism which played an important role in the niche for stable chondrogenesis of BMSCs constructed by chondrocyte bricks and PRP.
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12
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Mantripragada VP, Bova WA, Piuzzi NS, Boehm C, Obuchowski NA, Midura RJ, Muschler GF. Native-Osteoarthritic Joint Resident Stem and Progenitor Cells for Cartilage Cell-Based Therapies: A Quantitative Comparison With Respect to Concentration and Biological Performance. Am J Sports Med 2019; 47:3521-3530. [PMID: 31671273 DOI: 10.1177/0363546519880905] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cell-based therapy for cartilage repair is a promising approach and is becoming an established technique. Yet, there is no consensus on the optimal cell source. PURPOSE To provide a donor-matched quantitative comparison of the connective tissue progenitors (CTPs) derived from cartilage (Outerbridge grade 1-3 [G1-2-3]), bone marrow aspirate concentrate (BMC), infrapatellar fat pad (IPFP), synovium, and periosteum with respect to (1) cell concentration ([Cell], cells/mL), (2) CTP prevalence (PCTP, colonies per million cells), and (3) biological performance based on in vitro proliferation potential (cells per colony) colony density, and differentiation potential (expression of negatively charged extracellular matrix: glycosaminoglycan-rich extra cellular matrix [GAG-ECM]). STUDY DESIGN Descriptive laboratory study. METHODS Tissues were obtained from 10 patients undergoing total knee arthroplasty (mean age, 59 years; women, n = 6). Automated quantitative colony-forming unit analysis was used to compare [Cell], PCTP, and CTP biological performance across tissue sources. RESULTS [Cell] was highest in grade 3 cartilage (P = .002) and BMC (P = .001). Median PCTP was highest in IPFP (P = .001), synovium (P = .003), and G1-2 cartilage (P = .02). Proliferation was highest in synovium-derived CTPs (P < .001). Median colony density was highest in G1-2-3 (P < .001). Median GAG-ECM was highest in G1-2-3 (P < .001). Within each patient, CTPs derived from all tissues were highly heterogeneous in biological performance as determined by cells per colony, density, and GAG-ECM. CONCLUSION Tissue sources differ in [Cell], PCTP, and biological attributes. The data presented in this study suggest that cartilage (G1-2-3) is the preferred tissue source for cartilage repair based on PCTP and GAG-ECM, followed by synovium, IPFP, BMC, and periosteum. However, due to the heterogeneous mixture of CTPs within each tissue source, there exists a subset of CTPs with biological performance similar to G1-2-3 cartilage, particularly in synovium and IPFP. Performance-based clonal selection and expansion of preferred CTPs and their progeny will potentially lead to improved cell population with predictive future. CLINICAL RELEVANCE Optimal tissue regeneration strategies will require informed decisions regarding which of the available tissue sources to use. Optimizing cell sourcing in any tissue may require separation of CTPs with preferred attributes from those with less desirable attributes. The heterogeneity manifest in the early stage of colony formation represents an opportunity for performance-based clone selection for clinical cell processing and manufacturing.
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Affiliation(s)
- Venkata P Mantripragada
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Wes A Bova
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Nicolas S Piuzzi
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Cynthia Boehm
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Nancy A Obuchowski
- Department of Quantitative Health Science, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ronald J Midura
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - George F Muschler
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA
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Mantripragada VP, Piuzzi NS, Bova WA, Boehm C, Obuchowski NA, Lefebvre V, Midura RJ, Muschler GF. Donor-matched comparison of chondrogenic progenitors resident in human infrapatellar fat pad, synovium, and periosteum - implications for cartilage repair. Connect Tissue Res 2019; 60:597-610. [PMID: 31020864 DOI: 10.1080/03008207.2019.1611795] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose: There is a clinical need to better characterize tissue sources being used for stem cell therapies. This study focuses on comparison of cells and connective tissue progenitors (CTPs) derived from native human infrapatellar fatpad (IPFP), synovium (SYN), and periosteum (PERI). Materials and Methods: IPFP, SYN, PERI were harvested from twenty-eight patients undergoing arthroplasty. CTPs were quantitatively characterized using automated colony-forming-unit assay to compare total nucleated cell concentration-[Cell], cells/mg; prevalence-(PCTP), CTPs/million nucleated cells; CTP concentration-[CTP], CTPs/mg; proliferation and differentiation potential; and correlate outcomes with patient's age and gender. Results: [Cell] did not differ between IPFP, SYN, and PERI. PCTP was influenced by age and gender: patients >60 years, IPFP and SYN had higher PCTP than PERI (p < 0.001) and females had higher PCTP in IPFP (p < 0.001) and SYN (p = 0.001) than PERI. [CTP] was influenced by age: patients <50 years, SYN (p = 0.0165) and PERI (p < 0.001) had higher [CTP] than IPFP; patients between 60 and 69 years, SYN (p < 0.001) had higher [CTP] than PERI; patients >70 years, IPFP (p = 0.006) had higher [CTP] than PERI. In patients >60 years, proliferation potential of CTPs differed significantly (SYN>IPFP>PERI); however, differentiation potentials were comparable between all three tissue sources. Conclusion: SYN and IPFP may serve as a preferred tissue source for patients >60 years, and PERI along with SYN and IPFP may serve as a preferred tissue source for patients <60 years for cartilage repair. However, the heterogeneity among the CTPs in any given tissue source suggests performance-based selection might be useful to optimize cell-sourcing strategies to improve efficacy of cellular therapies for cartilage repair.
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Affiliation(s)
- V P Mantripragada
- Department of Biomedical Engineering, Lerner Research Institute , Cleveland , OH , USA
| | - N S Piuzzi
- Department of Biomedical Engineering, Lerner Research Institute , Cleveland , OH , USA.,Department of Orthopedic Surgery, Cleveland Clinic , Cleveland , OH , USA.,Department of Orthopaedic Surgery, Instituto Universitario del Hospital Italiano de Buenos Aires , Buenos Aires , Argentina
| | - W A Bova
- Department of Biomedical Engineering, Lerner Research Institute , Cleveland , OH , USA
| | - C Boehm
- Department of Biomedical Engineering, Lerner Research Institute , Cleveland , OH , USA
| | - N A Obuchowski
- Department of Quantitative Health Science, Cleveland Clinic , Cleveland , OH , USA
| | - V Lefebvre
- Department of Cellular and Molecular Medicine, Cleveland Clinic , Cleveland , OH , USA
| | - R J Midura
- Department of Biomedical Engineering, Lerner Research Institute , Cleveland , OH , USA
| | - G F Muschler
- Department of Biomedical Engineering, Lerner Research Institute , Cleveland , OH , USA.,Department of Orthopedic Surgery, Cleveland Clinic , Cleveland , OH , USA
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14
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Kovermann NJ, Basoli V, Della Bella E, Alini M, Lischer C, Schmal H, Kubosch EJ, Stoddart MJ. BMP2 and TGF-β Cooperate Differently during Synovial-Derived Stem-Cell Chondrogenesis in a Dexamethasone-Dependent Manner. Cells 2019; 8:cells8060636. [PMID: 31242641 PMCID: PMC6628125 DOI: 10.3390/cells8060636] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 02/07/2023] Open
Abstract
Recent studies highlighting mesenchymal stem cell (MSC) epigenetic memory suggest that a different differentiation medium may be required depending on the tissue of origin. As synovial-derived stem cells (SDSCs) attract interest we aimed to investigate the influence of TGF-β1, BMP-2 and dexamethasone on SDSC chondrogenesis in vitro. We demonstrate that dexamethasone-free medium led to enhanced chondrogenic differentiation at both the mRNA and matrix level. The greatest COL2A1/COL10A1 ratio was detected in cells exposed to a combination medium containing 10 ng/mL BMP-2 and 1 ng/mL TGF-β1 in the absence of dexamethasone, and this was reflected in the total amount of glycosaminoglycans produced. In summary, dexamethasone-free medium containing BMP-2 and TGF-β1 may be the most suitable when using SDSCs for cartilage tissue regeneration.
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Affiliation(s)
- Nikolas J Kovermann
- AO Research Institute, AO Foundation, 7270 Davos, Switzerland.
- Equine Clinic, Free University of Berlin, 14163 Berlin, Germany.
| | | | | | - Mauro Alini
- AO Research Institute, AO Foundation, 7270 Davos, Switzerland.
| | | | - Hagen Schmal
- Department of Orthopaedics and Traumatology, Odense University Hospital, 5000 Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark.
| | - Eva Johanna Kubosch
- Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, 79085 Freiburg, Germany.
| | - Martin J Stoddart
- AO Research Institute, AO Foundation, 7270 Davos, Switzerland.
- Department of Orthopedics and Trauma Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, 79085 Freiburg, Germany.
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15
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Niemeyer P, Hirschmann MT. Zukunftsperspektive „Stammzelltherapie“ in Deutschland. ARTHROSKOPIE 2019. [DOI: 10.1007/s00142-019-0279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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16
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Delanois RE, Etcheson JI, Sodhi N, Henn RF, Gwam CU, George NE, Mont MA. Biologic Therapies for the Treatment of Knee Osteoarthritis. J Arthroplasty 2019; 34:801-813. [PMID: 30612835 DOI: 10.1016/j.arth.2018.12.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/14/2018] [Accepted: 12/03/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The use of biologic therapies for the management of knee osteoarthritis has increased, despite insufficient evidence of efficacy. Our aim was to complete a systematic review and analysis of reports utilizing the highest level-of-evidence evaluating: (1) platelet-rich plasma injections (PRPs); (2) bone marrow-derived mesenchymal stem cells (BMSCs); (3) adipose-derived mesenchymal stem cells (ADSCs); and (4) amnion-derived mesenchymal stem cells (AMSCs). METHODS PubMed, Embase, and Cochrane Library databases were queried for studies evaluating PRP injections, BMSCs, ADSCs, and AMSCs in patients with knee osteoarthritis. Of 1009 studies identified within the last 5 years, 123 met inclusion criteria. A comprehensive analysis of all levels-of-evidence was performed, as well as separate analysis on level-of-evidence I studies. Level-of-evidence was determined by the American Academy of Orthopedic Surgeons classification system. RESULTS Although the majority of PRP reports demonstrated improvements in pain and/or function, others revealed no substantial improvements. Similar findings were noted for BMSCs, ADSCs, and AMSCs. Assessments of BMSC studies yielded majority with positive clinical results, although short-lived. Studies on ADSCs revealed improved clinical outcomes, but equivocal radiographic outcomes. Studies evaluating AMSCs demonstrated improvements in pain and function, and decreased radiographic evidence of osteoarthritis. CONCLUSION Despite some promising early results for PRP, BMSC, ADSC, and AMSC therapies, the majority of level-of-evidence I studies have multiple problems: small sample sizes, potentially inappropriate control cohorts, short-term follow-up, and so on. Despite the limitations, there still appears to be evidence justifying their use for knee osteoarthritis management. More high-level, larger human studies utilizing standardized protocols are needed.
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Affiliation(s)
- Ronald E Delanois
- Department of Orthopaedic Surgery, Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Replacement, Sinai Hospital - Baltimore, Baltimore, MD
| | - Jennifer I Etcheson
- Department of Orthopaedic Surgery, Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Replacement, Sinai Hospital - Baltimore, Baltimore, MD
| | - Nipun Sodhi
- Department of Orthopaedic Surgery, Lenox Hill Hospital, New York City, NY
| | - Ralph F Henn
- Department of Orthopaedic Surgery, University of Maryland School of Medicine, Baltimore, MD
| | - Chukwuweike U Gwam
- Department of Orthopedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Nicole E George
- Department of Orthopaedic Surgery, Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Replacement, Sinai Hospital - Baltimore, Baltimore, MD
| | - Michael A Mont
- Department of Orthopaedic Surgery, Lenox Hill Hospital, New York City, NY
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17
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Roato I, Belisario DC, Compagno M, Lena A, Bistolfi A, Maccari L, Mussano F, Genova T, Godio L, Perale G, Formica M, Cambieri I, Castagnoli C, Robba T, Felli L, Ferracini R. Concentrated adipose tissue infusion for the treatment of knee osteoarthritis: clinical and histological observations. INTERNATIONAL ORTHOPAEDICS 2018; 43:15-23. [PMID: 30311059 DOI: 10.1007/s00264-018-4192-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/27/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Osteoarthritis (OA) is characterized by articular cartilage degeneration and subchondral bone sclerosis. OA can benefit of non-surgical treatments with collagenase-isolated stromal vascular fraction (SVF) or cultured-expanded mesenchymal stem cells (ASCs). To avoid high manipulation of the lipoaspirate needed to obtain ASCs and SVF, we investigated whether articular infusions of autologous concentrated adipose tissue are an effective treatment for knee OA patients. METHODS The knee of 20 OA patients was intra-articularly injected with autologous concentrated adipose tissue, obtained after centrifugation of lipoaspirate. Patients' articular functionality and pain were evaluated by VAS and WOMAC scores at three, six and 18 months from infusion. The osteogenic and chondrogenic ability of ASCs contained in the injected adipose tissue was studied in in vitro primary osteoblast and chondrocyte cell cultures, also plated on 3D-bone scaffold. Knee articular biopsies of patients previously treated with adipose tissue were analyzed. Immunohistochemistry (IHC) and scanning electron microscopy (SEM) were performed to detect cell differentiation and tissue regeneration. RESULTS The treatment resulted safe, and all patients reported an improvement in terms of pain reduction and increase of function. According to the osteogenic or chondrogenic stimulation, ASCs expressed alkaline phosphatase or aggrecan, respectively. The presence of a layer of newly formed tissue was visualized by IHC staining and SEM. The biopsy of previously treated knee joints showed new tissue formation, starting from the bone side of the osteochondral lesion. CONCLUSIONS Overall our data indicate that adipose tissue infusion stimulates tissue regeneration and might be considered a safe treatment for knee OA.
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Affiliation(s)
- Ilaria Roato
- Center for Research and Medical Studies, A.O.U. Città della Salute e della Scienza, Turin, Italy.
| | - Dimas Carolina Belisario
- Center for Research and Medical Studies, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Mara Compagno
- Center for Research and Medical Studies, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Aurora Lena
- Department of Traumatology and Rehabilitation, C.T.O. Hospital-A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Alessandro Bistolfi
- Department of Traumatology and Rehabilitation, C.T.O. Hospital-A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Luca Maccari
- Department of Surgical Sciences (DISC), Orthopaedic Clinic-IRCCS A.O.U, San Martino, Genoa, Italy
| | - Federico Mussano
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Tullio Genova
- Department of Life Sciences & Systems Biology, University of Turin, Turin, Italy
| | - Laura Godio
- Pathology Unit, A.O.U. Città della Salute e della Scienza of Turin, Turin, Italy
| | - Giuseppe Perale
- Industrie Biomediche Insubri SA, Mezzovico-Vira, Switzerland
- University of Applied Sciences and Arts of Southern Switzerland - SUPSI, Manno, Switzerland
| | - Matteo Formica
- Department of Surgical Sciences (DISC), Orthopaedic Clinic-IRCCS A.O.U, San Martino, Genoa, Italy
| | - Irene Cambieri
- Skin Bank, Department of General and Specialized Surgery, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Carlotta Castagnoli
- Skin Bank, Department of General and Specialized Surgery, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Tiziana Robba
- Department of Imaging and Radio-diagnostic, C.T.O. Hospital-A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Lamberto Felli
- Department of Surgical Sciences (DISC), Orthopaedic Clinic-IRCCS A.O.U, San Martino, Genoa, Italy
| | - Riccardo Ferracini
- Department of Surgical Sciences (DISC), Orthopaedic Clinic-IRCCS A.O.U, San Martino, Genoa, Italy
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18
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Hong Z, Chen J, Zhang S, Zhao C, Bi M, Chen X, Bi Q. Intra-articular injection of autologous adipose-derived stromal vascular fractions for knee osteoarthritis: a double-blind randomized self-controlled trial. INTERNATIONAL ORTHOPAEDICS 2018; 43:1123-1134. [PMID: 30109404 DOI: 10.1007/s00264-018-4099-0] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 08/06/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the clinical and radiological efficacy of autologous adipose-derived stromal vascular fraction (SVF) versus hyaluronic acid in patients with bilateral knee osteoarthritis. METHODS Sixteen patients with bilateral symptomatic knee osteoarthritis (K-L grade II to III; initial pain evaluated at four or greater on a ten-point VAS score) were enrolled in this study, which were randomized into two groups. Each patient received 4-ml autologous adipose-derived SVF treatment (group test, n = 16) in one side of knee joints and a single dose of 4-ml hyaluronic acid treatment (group control, n = 16) in the other side. The clinical evaluations were performed pre-operatively and post-operatively at one month, three months, six months, and 12-months follow-up visit, using the ten-point visual analog scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the knee range of motion (ROM). The whole-organ assessment of the knees was performed with whole-organ magnetic resonance imaging score (WORMS) based on MRI at baseline, six months and 12-months follow-up. The articular repair tissue was assessed quantitatively and qualitatively by magnetic resonance observation of cartilage repair tissue (MOCART) score based on follow-up MRI at six months and 12 months. RESULTS No significant baseline differences were found between two groups. Safety was confirmed with no severe adverse events observed during 12-months follow-up. The SVF-treated knees showed significantly improvement in the mean VAS, WOMAC scores, and ROM at 12-months follow-up visit compared with the baseline. In contrast, the mean VAS, WOMAC scores, and ROM of the control group became even worse but not significant from baseline to the last follow-up visit. WORMS and MOCART measurements revealed a significant improvement of articular cartilage repair in SVF-treated knees compared with hyaluronic acid-treated knees. CONCLUSION The results of this study suggest that autologous adipose-derived SVF treatment is safe and can effectively relief pain, improve function, and repair cartilage defects in patients with knee osteoarthritis.
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Affiliation(s)
- Zheping Hong
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jihang Chen
- Department of Orthopedic Surgery, Zhejiang Provincial People's Hospital and People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China
| | - Shuijun Zhang
- Department of Orthopedic Surgery, Zhejiang Provincial People's Hospital and People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China
| | - Chen Zhao
- Department of Orthopedic Surgery, Zhejiang Provincial People's Hospital and People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China
| | - Mingguang Bi
- Department of Orthopedic Surgery, Zhejiang Provincial People's Hospital and People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China
| | - Xinji Chen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qing Bi
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. .,Department of Orthopedic Surgery, Zhejiang Provincial People's Hospital and People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.
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Stem Cells in Cartilage Diseases and Repair 2018. Stem Cells Int 2018; 2018:3672890. [PMID: 30140290 PMCID: PMC6081581 DOI: 10.1155/2018/3672890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 07/05/2018] [Indexed: 11/17/2022] Open
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20
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Comparison of Regenerative Tissue Quality following Matrix-Associated Cell Implantation Using Amplified Chondrocytes Compared to Synovium-Derived Stem Cells in a Rabbit Model for Cartilage Lesions. Stem Cells Int 2018; 2018:4142031. [PMID: 29765410 PMCID: PMC5933044 DOI: 10.1155/2018/4142031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/05/2018] [Indexed: 11/30/2022] Open
Abstract
Known problems of the autologous chondrocyte implantation motivate the search for cellular alternatives. The aim of the study was to test the potential of synovium-derived stem cells (SMSC) to regenerate cartilage using a matrix-associated implantation. In an osteochondral defect model of the medial femoral condyle in a rabbit, a collagen membrane was seeded with either culture-expanded allogenic chondrocytes or SMSC and then transplanted into the lesion. A tailored piece synovium served as a control. Rabbit SMSC formed typical cartilage in vitro. Macroscopic evaluation of defect healing and the thickness of the regenerated tissue did not reveal a significant difference between the intervention groups. However, instantaneous and shear modulus, reflecting the biomechanical strength of the repair tissue, was superior in the implantation group using allogenic chondrocytes (p < 0.05). This correlated with a more chondrogenic structure and higher proteoglycan expression, resulting in a lower OARSI score (p < 0.05). The repair tissue of all groups expressed comparable amounts of the collagen types I, II, and X. Cartilage regeneration following matrix-associated implantation using allogenic undifferentiated synovium-derived stem cells in a defect model in rabbits showed similar macroscopic results and collagen composition compared to amplified chondrocytes; however, biomechanical characteristics and histological scoring were inferior.
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Production of Adult Human Synovial Fluid-Derived Mesenchymal Stem Cells in Stirred-Suspension Culture. Stem Cells Int 2018; 2018:8431053. [PMID: 29765425 PMCID: PMC5892216 DOI: 10.1155/2018/8431053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/18/2017] [Accepted: 10/24/2017] [Indexed: 12/28/2022] Open
Abstract
The chondrogenic potential of synovial fluid-derived mesenchymal stem cells (SF-MSCs) supports their use in cartilage regeneration strategies. However, their paucity in synovial fluid necessitates their proliferation in culture to generate clinically relevant quantities. Here it was determined that 125 mL stirred suspension bioreactors utilizing Cytodex-3 microcarrier beads represent a viable platform for the proliferation of these cells. During the inoculation phase, a bead loading of 2 g/L, an inoculation ratio of 4.5 cells/bead, and continuous agitation at 40 rpm in a medium with 5% serum resulted in high cell attachment efficiencies and a subsequent overall cell fold expansion of 5.7 over 8 days. During the subsequent growth phase, periodic addition of new microcarriers and fresh medium increased culture longevity, resulting in a 21.3 cell fold increase over 18 days in the same vessel without compromising the defining characteristics of the cells. Compared to static tissue culture flasks, a bioreactor-based bioprocess requires fewer handling steps, is more readily scalable, and for the same cell production level, has a lower operating cost as it uses approximately half the medium. Therefore, stirred suspension bioreactors incorporating microcarrier technology represent a viable and more efficient platform than tissue culture flasks for the generation of SF-MSCs in culture.
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Kim TW, Lee MC, Bae HC, Han HS. Direct Coculture of Human Chondrocytes and Synovium-Derived Stem Cells Enhances In Vitro Chondrogenesis. CELL JOURNAL 2017; 20:53-60. [PMID: 29308619 PMCID: PMC5759681 DOI: 10.22074/cellj.2018.5025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/13/2017] [Indexed: 01/02/2023]
Abstract
Objective Coculture of chondrocytes and mesenchymal stem cells (MSCs) has been developed as a strategy to
overcome the dedifferentiation of chondrocytes during in vitro expansion in autologous chondrocyte transplantation.
Synovium-derived stem cells (SDSCs) can be a promising cell source for coculture due to their superior chondrogenic
potential compared to other MSCs and easy accessibility without donor site morbidity. However, studies on coculture of
chondrocytes and SDSCs are very limited. The aim of this study was to investigate whether direct coculture of human
chondrocytes and SDSCs could enhance chondrogenesis compared to monoculture of each cell.
Materials and Methods In this experimental study, passage 2 chondrocytes and SDSCs were directly cocultured
using different ratios of chondrocytes to SDSCs (3:1, 1:1, or 1:3). glycosaminoglycan (GAG) synthetic activity was
assessed using GAG assays and Safranin-O staining. Expression of chondrogenesis-related genes (collagen types I,
II, X, Aggrecan, and Sox-9) were analyzed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR)
and immunohistochemistry staining.
Results GAG/DNA ratios in 1:1 and 1:3 coculture groups were significantly increased compared to those in the
chondrocyte and SDSC monoculture groups. Type II collagen and SOX-9 were significantly upregulated in the 1:1
coculture group compared to those in the chondrocyte and SDSC monoculture groups. On the other hand, osteogenic
marker (type I collagen) and hypertrophic marker (type X collagen) were significantly downregulated in the coculture
groups compared to those in the SDSC monoculture group.
Conclusion Direct coculture of human chondrocytes and SDSCs significantly enhanced chondrogenic potential,
especially at a ratio of 1:1, compared to chondrocyte or SDSC monocultures.
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Affiliation(s)
- Tae Woo Kim
- Department of Orthopaedic Surgery, Hallym University Chuncheon Sacred Heart Hospital 77, Sakju-ro, Chuncheon-si, Gangwon-do, Korea
| | - Myung Chul Lee
- Department of Orthopaedic Surgery, Seoul National University Hospital 101 Daehang-ro, Jongno-gu, Seoul, Korea
| | - Hyun Cheol Bae
- Department of Orthopaedic Surgery, Seoul National University Hospital 101 Daehang-ro, Jongno-gu, Seoul, Korea
| | - Hyuk-Soo Han
- Department of Orthopaedic Surgery, Seoul National University Hospital 101 Daehang-ro, Jongno-gu, Seoul, Korea. Electronic adress:
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Liu SY, He YB, Deng SY, Zhu WT, Xu SY, Ni GX. Exercise affects biological characteristics of mesenchymal stromal cells derived from bone marrow and adipose tissue. INTERNATIONAL ORTHOPAEDICS 2017; 41:1199-1209. [PMID: 28364139 DOI: 10.1007/s00264-017-3441-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/09/2017] [Indexed: 02/05/2023]
Abstract
Both bone marrow mesenchymal stromal cells (BMSCs) and adipose-derived mesenchymal stromal cells (ADSCs) are good sources for tissue engineering. To maximize therapeutic efficacy of MSCs, an appropriate source of MSCs should be selected according to their own inherent characteristics for future clinical application. Hence, this study was conducted to compare proliferative, differential and antiapoptosis abilities of both MSCs derived from exercised and sedentary rats under normal and hypoxia/serum deprivation conditions (H/SD). Our results showed that exercise may enhance proliferative ability and decrease adipogenic ability of BMSCs and ADSCs. However, positive effect of exercise on osteogenesis was only observed for BMSCs in either environment. Little effect was observed on the antiapoptotic ability of both MSC types. It was also suggested that biological characteristics of both types were partly changed. It is therefore believed that BMSCs derived from exercised rat on early passage may be a good cell source for bone tissue engineering.
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Affiliation(s)
- Sheng-Yao Liu
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou, 510515, China
| | - Yong-Bin He
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou, 510515, China
| | - Song-Yun Deng
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou, 510515, China
| | - Wen-Ting Zhu
- Biomaterial Research Center, School of pharmaceutical sciences, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou, 510515, China
| | - Shao-Yong Xu
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou, 510515, China
| | - Guo-Xin Ni
- Department of Orthopeadics and Traumatology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue (N), Guangzhou, 510515, China.
- Department of Rehabilitation Medicine, First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China.
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