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Hasannejad F, Montazeri L, Mano JF, Bonakdar S, Fazilat A. Regulation of cell fate by cell imprinting approach in vitro. BIOIMPACTS : BI 2023; 14:29945. [PMID: 38938752 PMCID: PMC11199935 DOI: 10.34172/bi.2023.29945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 06/29/2024]
Abstract
Cell culture-based technologies are widely utilized in various domains such as drug evaluation, toxicity assessment, vaccine and biopharmaceutical development, reproductive technology, and regenerative medicine. It has been demonstrated that pre-adsorption of extracellular matrix (ECM) proteins including collagen, laminin and fibronectin provide more degrees of support for cell adhesion. The purpose of cell imprinting is to imitate the natural topography of cell membranes by gels or polymers to create a reliable environment for the regulation of cell function. The results of recent studies show that cell imprinting is a tool to guide the behavior of cultured cells by controlling their adhesive interactions with surfaces. Therefore, in this review we aim to compare different cell cultures with the imprinting method and discuss different cell imprinting applications in regenerative medicine, personalized medicine, disease modeling, and cell therapy.
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Affiliation(s)
- Farkhonde Hasannejad
- Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Semnan University of Medical Science, Semnan, Iran
- Genetic Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Leila Montazeri
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - João F Mano
- Department of Chemistry, CICECO - Aveiro Institute of Materials, University of Aveiro, Portugal
| | - Shahin Bonakdar
- National Cell Bank Department, Pasteur Institute of Iran, Tehran, Iran
| | - Ahmad Fazilat
- Genetic Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
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2
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Pérez-Castrillo S, González-Fernández ML, Gutiérrez-Velasco L, Villar-Suárez V. Isolation and morphological characterization of equine mesenchymal stem cells from harvested adipose tissue and bone marrow and stably transfected with green fluorescent protein. Am J Vet Res 2021; 82:770-776. [PMID: 34432512 DOI: 10.2460/ajvr.82.9.770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize the ultrastructure of mesenchymal stem cells (MSCs) that were harvested from the adipose tissue (AT-MSCs) and bone marrow (BM-MSCs) of horses and transfected with green fluorescent protein. SAMPLE MSCs from adipose tissue and bone marrow of 6 adult female Hispano-Bretón horses. PROCEDURES Harvested equine MSCs were cultivated and transfected with green fluorescent protein, and the immunophenotypes of the MSCs were characterized by use of anti-CD90 and anti-CD105 monoclonal antibodies. When stable transfection of MSCs was achieved, the morphological and ultrastructural characteristics of transfected and nontransfected AT-MSCs and BM-MSCs were compared with electron microscopy. RESULTS The protocols for transfection and subsequent isolation of transfected cells with use of G418 were suitable for obtaining transfected MSCs. Transfection efficiency was 5% in AT-MSCs and 4% in BM-MSCs. Characterization of transfected and nontransfected MSCs revealed that they share immunocytochemical and morphological profiles. Expression of CD90 was significantly higher for transfected versus nontransfected AT-MSCs (97% vs 92%). Expression of CD105 was significantly lower for transfected versus nontransfected BM-MSCs (85% vs 94%). Transfected BM-MSCs had differences in organelles, compared with the other cell types, specifically including most commonly the rough endoplasmic reticulum with dilated cisternae and mitochondria. CONCLUSION AND CLINICAL RELEVANCE These findings contribute to the knowledge base of the characteristics of equine AT-MSCs and BM-MSCs and of transfected versus nontransfected equine MSCs. The data provided a valuable starting point for researchers wishing to further study the morphological characteristics of equine MSCs.
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Affiliation(s)
- Saúl Pérez-Castrillo
- 1From the Department of Anatomy, Faculty of Veterinary Sciences, University of León, Campus de Vega-zana s/n, 24071, León, Spain
| | - María Luisa González-Fernández
- 1From the Department of Anatomy, Faculty of Veterinary Sciences, University of León, Campus de Vega-zana s/n, 24071, León, Spain
| | - Laura Gutiérrez-Velasco
- 1From the Department of Anatomy, Faculty of Veterinary Sciences, University of León, Campus de Vega-zana s/n, 24071, León, Spain
| | - Vega Villar-Suárez
- 2From the Institute of Biomedicine, University of León, Campus de Vega-zana s/n, 24071, León, Spain
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3
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Pérez-Castrillo S, González-Fernández ML, Álvarez-Suárez J, Sánchez-Lázaro J, Esteban-Blanco M, Gutiérrez-Velasco L, González-Cubero E, Villar-Suárez V. Effect of mesenchymal stem cells combined with chondroitin sulfate in an in vitro model of osteoarthritis. Am J Transl Res 2021; 13:5928-5942. [PMID: 34306335 PMCID: PMC8290715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/25/2021] [Indexed: 06/13/2023]
Abstract
Osteoarthritis (OA) is a degenerative joint disease affecting the whole joint structure. The specific molecules responsible for the inflammatory processes involved in the development of OA have been the focus of many studies. Adipose tissue-derived mesenchymal stem cells (ASCs) constitute a promising cell-based therapy which could be used as an alternative to or in combination with drug therapies. Chondroitin sulfate (CS) plays a protective role in the joint by decreasing concentrations of pro-inflammatory cytokines and therefore has an important part in moderating chondrocyte metabolism. The aim of this study is to use an in vitro model of OA to evaluate the combined effectiveness of CS and ASCs as a treatment. We give a detailed discussion of the roles of cytokines and other key molecules involved in OA. In addition, we report the effects of treating inflamed chondrocytes with ASCs and CS on the expression of specific cartilage genes. Findings show that both treatments reduced expression of all genes associated with the pro-inflammatory cytokines we analyzed. However, we saw no increase in the expression of the specific genes encoding for cartilage matrix proteins, such as collagen type II and aggrecan. This study shows the effectiveness of combining ASCs and CS in the treatment of OA.
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Affiliation(s)
- Saúl Pérez-Castrillo
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana, University of Léon-Universidad de LeónLeón 24071, Spain
| | - Maria Luisa González-Fernández
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana, University of Léon-Universidad de LeónLeón 24071, Spain
| | - Jessica Álvarez-Suárez
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana, University of Léon-Universidad de LeónLeón 24071, Spain
| | - Jaime Sánchez-Lázaro
- Institute of Biomedicine (IBIOMED), Faculty of Veterinary Sciences, Campus de Vegazana, University of León-Universidad de LeónLeón 24071, Spain
| | - Marta Esteban-Blanco
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana, University of Léon-Universidad de LeónLeón 24071, Spain
| | - Laura Gutiérrez-Velasco
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana, University of Léon-Universidad de LeónLeón 24071, Spain
| | - Elsa González-Cubero
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana, University of Léon-Universidad de LeónLeón 24071, Spain
| | - Vega Villar-Suárez
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana, University of Léon-Universidad de LeónLeón 24071, Spain
- Institute of Biomedicine (IBIOMED), Faculty of Veterinary Sciences, Campus de Vegazana, University of León-Universidad de LeónLeón 24071, Spain
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4
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Kenihan L, McTier L, Phillips NM. Patients' expectations and experiences of stem cell therapy for the treatment of knee osteoarthritis. Health Expect 2020; 23:1300-1309. [PMID: 32794633 PMCID: PMC7696136 DOI: 10.1111/hex.13113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/17/2020] [Accepted: 07/09/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Stem cell therapy is a novel treatment option for people living with osteoarthritis. Research investigating stem cell therapy for this debilitating condition has predominantly involved the pathogenesis of the cells and efficacy of the treatment. There is little understanding of patients' expectations and experiences of stem cell therapy treatment. OBJECTIVE To explore the expectations and experiences of people undergoing stem cell therapy for the treatment of knee osteoarthritis. DESIGN An exploratory, descriptive, qualitative study using semi-structured interviews was conducted. SETTING AND PARTICIPANTS Participants were recruited into two groups: (a) Expectations Group (n = 15); the expectations of stem cell treatment were explored with participants that were yet to commence stem cell therapy. (b) Experiences Group (n = 15); the experiences of stem cell therapy were explored with participants 12 months after their initial stem cell treatment. Transcripts were analysed using thematic analysis to identify themes in both groups. RESULTS Themes for the Expectations Group were active involvement in the treatment; treatment will improve symptoms; and benefits of treatment outweigh the risks. Themes for the Experiences Group were symptoms of treatment; satisfaction with treatment; and anticipation of further improvement. DISCUSSION AND CONCLUSIONS The findings are the first qualitative study to represent patients' perspective on expectations and experiences of stem cell therapy for knee osteoarthritis. They provide insight into the potential areas for improvement within this field to aid patients' preparation and approach to the treatment, promoting patient-centred care.
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Affiliation(s)
| | - Lauren McTier
- Centre for Quality and Patient Safety ResearchSchool of Nursing and MidwiferyDeakin UniversityGeelongVIC.Australia
| | - Nicole M. Phillips
- Centre for Quality and Patient Safety ResearchSchool of Nursing and MidwiferyDeakin UniversityGeelongVIC.Australia
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Nour-Eldeen G, Abdel-Rasheed M, El-Rafei AM, Azmy O, El-Bassyouni GT. Adipose tissue-derived mesenchymal stem cells and chitosan/poly (vinyl alcohol) nanofibrous scaffolds for cartilage tissue engineering. CELL REGENERATION (LONDON, ENGLAND) 2020; 9:7. [PMID: 32588202 PMCID: PMC7306832 DOI: 10.1186/s13619-020-00045-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/27/2020] [Indexed: 12/12/2022]
Abstract
Osteoarthritis (OA) has been defined as a chronic inflammatory joint disease characterized by progressive articular cartilage degeneration. Recently growing interest in regenerative medicine, using cell therapy and tissue engineering, where cellular components in combination with engineered scaffolds and bioactive materials were used to induce functional tissue regeneration. In the present study, nanofibrous scaffold based on chitosan (CS)/poly (vinyl alcohol) (PVA) were used to develop biologically functionalized biomaterial to mimic the extracellular matrix, allowing the human adipose tissue derived mesenchymal stem cells (ADSCs) to proliferate and differentiate to chondrogenic cells. The morphology of the nanofibrous mat was examined using field emission scanning electron microscope (FE/SEM). The characteristic functional groups and the nature of the chemical bonds between atoms were evaluated using Fourier transform infrared spectroscopy (FTIR) spectrum. Characterization of the seeded cells was morphologically evaluated by scanning electron microscopy and by flow cytometry for the expression of the stem cell surface markers. The differentiation potential was verified after chondrogenic induction by analyzing the expression of chondrogenic marker genes using real-time (RT PCR). Current study suggest significant potential for the use of ADSCs with the nanofibrous scaffolds in improving the osteoarthritis pathology.
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Affiliation(s)
- Ghada Nour-Eldeen
- Molecular Genetics and Enzymology Department, National Research Centre, Dokki, Cairo, 12622, Egypt.,Stem Cell Research group, Medical Research Centre of Excellence, National Research Centre, Cairo, 12622, Egypt
| | - Mazen Abdel-Rasheed
- Stem Cell Research group, Medical Research Centre of Excellence, National Research Centre, Cairo, 12622, Egypt. .,Reproductive Health Research Department, National Research Centre, 33 El-Buhouth St, Dokki, Cairo, 12622, Egypt.
| | - Amira M El-Rafei
- Refractories, Ceramics and Building Materials Department, National Research Centre, Dokki, Cairo, 12622, Egypt
| | - Osama Azmy
- Stem Cell Research group, Medical Research Centre of Excellence, National Research Centre, Cairo, 12622, Egypt.,Reproductive Health Research Department, National Research Centre, 33 El-Buhouth St, Dokki, Cairo, 12622, Egypt
| | - Gehan T El-Bassyouni
- Refractories, Ceramics and Building Materials Department, National Research Centre, Dokki, Cairo, 12622, Egypt
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6
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Extracellular vesicles: A new therapeutic strategy for joint conditions. Biochem Pharmacol 2018; 153:134-146. [PMID: 29427625 DOI: 10.1016/j.bcp.2018.02.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/05/2018] [Indexed: 02/07/2023]
Abstract
Extracellular vesicles (EVs) are attracting increasing interest since they might represent a more convenient therapeutic tool with respect to their cells of origin. In the last years much time and effort have been expended to determine the biological properties of EVs from mesenchymal stem cells (MSCs) and other sources. The immunoregulatory, anti-inflammatory and regenerative properties of MSC EVs have been demonstrated in in vitro studies and animal models of rheumatoid arthritis or osteoarthritis. This cell-free approach has been proposed as a possible better alternative to MSC therapy in autoimmune conditions and tissue regeneration. In addition, EVs show great potential as biomarkers of disease or delivery systems for active molecules. The standardization of isolation and characterization methods is a key step for the development of EV research. A better understanding of EV mechanisms of action and efficacy is required to establish the potential therapeutic applications of this new approach in joint conditions.
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7
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Ramkumar PN, Navarro SM, Haeberle HS, Chughtai M, Demetriades C, Piuzzi NS, Mont MA, Bauer TW, Muschler GF. Cellular therapy injections in today's orthopedic market: A social media analysis. Cytotherapy 2017; 19:1392-1399. [PMID: 28916228 DOI: 10.1016/j.jcyt.2017.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/02/2017] [Accepted: 08/09/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND The current state of cellular therapy for musculoskeletal conditions is at a crossroads. Marketing efforts are often outpacing clinical evidence and regulatory control. QUESTIONS/PURPOSES This study was an effort to describe the marketing of cellular therapy in musculoskeletal medicine by evaluating the content in popular social media channels. Specifically, media posts were evaluated for the following: (1) perspective, (2) tone, (3) content and (4) visibility. PATIENT AND METHODS Social media content related to cell therapy for musculoskeletal conditions was assessed in a search using 28 hashtags on the public domains of Instagram and Twitter over a 2-year period (2014-2016) that resulted in analysis of 698 posts. Supplemental analyses of LinkedIn and Facebook domains were also conducted. A categorical scoring system was used to analyze perspective (patient, family or friend, business or organization), tone (positive, negative), content (education, advertisement, research, media coverage or patient experience) and visibility (number of hashtags per post). Sub-analyses of the advertisement content from various perspectives (patients, physicians and businesses) were performed. RESULTS The media perspective was most frequently from a business or organization (83%; n = 575). A total of 94% of the posts had a positive tone and only 6% had a negative tone, and the only negative posts came from patients (60% positive and 40% negative). The most common content of social media posts were advertisements, representing 68% (n = 477) of all posts; this was confirmed in the Facebook analysis. The mean number of hashtags was five per post. Sub-analyses revealed approximately half of the advertising posts originated from a single business that recruited physicians to market their cell-based therapies on social media, which was confirmed in the LinkedIn analysis. CONCLUSION The market messages related to cell-based therapies for musculoskeletal conditions available on social media are dominated by businesses that seem to use a network of physicians, apply several hashtags to enhance visibility and advertise these largely unproven modalities. The posts portray an almost exclusively positive tone, without providing a "fair balance" on the risks, benefits and limitations.
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Affiliation(s)
- Prem N Ramkumar
- Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA.
| | - Sergio M Navarro
- Baylor College of Medicine, Department of Orthopaedic Surgery, Houston, Texas, USA
| | - Heather S Haeberle
- Baylor College of Medicine, Department of Orthopaedic Surgery, Houston, Texas, USA
| | - Morad Chughtai
- Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA
| | | | - Nicolas S Piuzzi
- Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA
| | - Michael A Mont
- Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA
| | - Thomas W Bauer
- Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA
| | - George F Muschler
- Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio, USA
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8
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Taroni M, Cabon Q, Fèbre M, Cachon T, Saulnier N, Carozzo C, Maddens S, Labadie F, Robert C, Viguier E. Evaluation of the Effect of a Single Intra-articular Injection of Allogeneic Neonatal Mesenchymal Stromal Cells Compared to Oral Non-Steroidal Anti-inflammatory Treatment on the Postoperative Musculoskeletal Status and Gait of Dogs over a 6-Month Period after Tibial Plateau Leveling Osteotomy: A Pilot Study. Front Vet Sci 2017. [PMID: 28642867 PMCID: PMC5463535 DOI: 10.3389/fvets.2017.00083] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Compare the clinical and pressure walkway gait evolution of dogs after a tibial plateau leveling osteotomy (TPLO) for a cranial cruciate ligament rupture (CrCLR) and treatment with either a 1-month course of non-steroidal anti-inflammatory drugs (NSAIDs) or a single postoperative intra-articular (IA) injection of allogeneic neonatal mesenchymal stromal cells (MSCs). STUDY DESIGN Prospective, double-blinded, randomized, controlled, monocentric clinical study. ANIMALS Sixteen client-owned dogs. MATERIALS AND METHODS Dogs with unilateral CrCLR confirmed by arthroscopy were included. Allogeneic neonatal canine MSCs were obtained from fetal adnexa retrieved after C-section performed on healthy pregnant bitches. The dogs were randomly allocated to either the "MSCs group," receiving an IA injection of MSCs after TPLO, followed by placebo for 1 month, or the "NSAIDs group," receiving IA equivalent volume of MSCs vehicle after TPLO, followed by oral NSAID for 1 month. One of the three blinded evaluators assessed the dogs in each group before and after surgery (1, 3, and 6 months). Clinical score and gait and bone healing process were assessed. The data were statistically compared between the two groups for pre- and postoperative evaluations. RESULTS Fourteen dogs (nine in the MSCs group, five in the NSAIDs group) completed the present study. No significant difference was observed between the groups preoperatively. No local or systemic adverse effect was observed after MSCs injection at any time point considered. At 1 month after surgery, bone healing scores were significantly higher in the MSCs group. At 1, 3, and 6 months after surgery, no significant difference was observed between the two groups for clinical scores and gait evaluation. CONCLUSION A single IA injection of allogeneic neonatal MSCs could be a safe and valuable postoperative alternative to NSAIDs for dogs requiring TPLO surgery, particularly for dogs intolerant to this class of drugs.
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Affiliation(s)
- Mathieu Taroni
- Small Animal Surgery Department, VetAgro Sup, Marcy L'Etoile, France
| | - Quentin Cabon
- Small Animal Surgery Department, VetAgro Sup, Marcy L'Etoile, France.,UPSP 2016A104, ICE, Interaction Cells Environment, Campus Veterinaire VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | | | - Thibaut Cachon
- Small Animal Surgery Department, VetAgro Sup, Marcy L'Etoile, France.,UPSP 2016A104, ICE, Interaction Cells Environment, Campus Veterinaire VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | | | - Claude Carozzo
- Small Animal Surgery Department, VetAgro Sup, Marcy L'Etoile, France.,UPSP 2016A104, ICE, Interaction Cells Environment, Campus Veterinaire VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | | | | | | | - Eric Viguier
- Small Animal Surgery Department, VetAgro Sup, Marcy L'Etoile, France.,UPSP 2016A104, ICE, Interaction Cells Environment, Campus Veterinaire VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
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Juneau C, Paine R, Chicas E, Gardner E, Bailey L, McDermott J. Current Concepts in Treatment of Patellofemoral Osteochondritis Dissecans. Int J Sports Phys Ther 2016; 11:903-925. [PMID: 27904793 PMCID: PMC5095943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Identification, protection, and management of patellofemoral articular cartilage lesions continue to remain on the forefront of sports medicine rehabilitation. Due to high-level compression forces that are applied through the patellofemoral (PF) joint, managing articular cartilage lesions is challenging for sports medicine specialists. Articular cartilage damage may exist in a wide spectrum of injuries ranging from small, single areas of focal damage to wide spread osteoarthritis involving large chondral regions. Management of these conditions has evolved over the last two centuries, most recently using biogenetic materials and cartilage replacement modalities. The purpose of this clinical commentary is to discuss PF articular cartilage injuries, etiological variables, and investigate the evolution in management of articular cartilage lesions. Rehabilitation of these lesions will also be discussed with a focus on current trends and return to function criteria. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Chris Juneau
- Memorial Hermann's Ironman Sports Medicine Institute, Houston, TX, USA
| | - Russ Paine
- Memorial Hermann's Ironman Sports Medicine Institute, Houston, TX, USA
| | - Eric Chicas
- Memorial Hermann's Ironman Sports Medicine Institute, Houston, TX, USA
| | - Emily Gardner
- Memorial Hermann's Ironman Sports Medicine Institute, Houston, TX, USA
| | - Lane Bailey
- Memorial Hermann's Ironman Sports Medicine Institute, Houston, TX, USA
| | - James McDermott
- University of Texas Health Science Center at Houston/Baylor College of Medicine, Houston, TX, USA
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10
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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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11
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Chahla J, Piuzzi NS, Mitchell JJ, Dean CS, Pascual-Garrido C, LaPrade RF, Muschler GF. Intra-Articular Cellular Therapy for Osteoarthritis and Focal Cartilage Defects of the Knee: A Systematic Review of the Literature and Study Quality Analysis. J Bone Joint Surg Am 2016; 98:1511-21. [PMID: 27655978 DOI: 10.2106/jbjs.15.01495] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Intra-articular cellular therapy injections constitute an appealing strategy that may modify the intra-articular milieu or regenerate cartilage in the settings of osteoarthritis and focal cartilage defects. However, little consensus exists regarding the indications for cellular therapies, optimal cell sources, methods of preparation and delivery, or means by which outcomes should be reported. METHODS We present a systematic review of the current literature regarding the safety and efficacy of cellular therapy delivered by intra-articular injection in the knee that provided a Level of Evidence of III or higher. A total of 420 papers were screened. Methodological quality was assessed using a modified Coleman methodology score. RESULTS Only 6 studies (4 Level II and 2 Level III) met the criteria to be included in this review; 3 studies were on treatment of osteoarthritis and 3 were on treatment of focal cartilage defects. These included 4 randomized controlled studies without blinding, 1 prospective cohort study, and 1 retrospective therapeutic case-control study. The studies varied widely with respect to cell sources, cell characterization, adjuvant therapies, and assessment of outcomes. Outcome was reported in a total of 300 knees (124 in the osteoarthritis studies and 176 in the cartilage defect studies). Mean follow-up was 21.0 months (range, 12 to 36 months). All studies reported improved outcomes with intra-articular cellular therapy and no major adverse events. The mean modified Coleman methodology score was 59.1 ± 16 (range, 32 to 82). CONCLUSIONS The studies of intra-articular cellular therapy injections for osteoarthritis and focal cartilage defects in the human knee suggested positive results with respect to clinical improvement and safety. However, the improvement was modest and a placebo effect cannot be disregarded. The overall quality of the literature was poor, and the methodological quality was fair, even among Level-II and III studies. Effective clinical assessment and optimization of injection therapies will demand greater attention to study methodology, including blinding; standardized quantitative methods for cell harvesting, processing, characterization, and delivery; and standardized reporting of clinical and structural outcomes. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Jorge Chahla
- Steadman Philippon Research lnstitute, Vail, Colorado
| | - Nicolas S Piuzzi
- Institute of Orthopedics, "Carlos E. Ottolenghi" Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | | | - Chase S Dean
- Steadman Philippon Research lnstitute, Vail, Colorado
| | | | - Robert F LaPrade
- Steadman Philippon Research lnstitute, Vail, Colorado The Steadman Clinic, Vail, Colorado
| | - George F Muschler
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
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12
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Hofer HR, Tuan RS. Secreted trophic factors of mesenchymal stem cells support neurovascular and musculoskeletal therapies. Stem Cell Res Ther 2016; 7:131. [PMID: 27612948 PMCID: PMC5016979 DOI: 10.1186/s13287-016-0394-0] [Citation(s) in RCA: 226] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Adult mesenchymal stem cells (MSCs) represent a subject of intense experimental and biomedical interest. Recently, trophic activities of MSCs have become the topic of a number of revealing studies that span both basic and clinical fields. In this review, we focus on recent investigations that have elucidated trophic mechanisms and shed light on MSC clinical efficacy relevant to musculoskeletal applications. Innate differences due to MSC sourcing may play a role in the clinical utility of isolated MSCs. Pain management, osteochondral, nerve, or blood vessel support by MSCs derived from both autologous and allogeneic sources have been examined. Recent mechanistic insights into the trophic activities of these cells point to ultimate regulation by nitric oxide, nuclear factor-kB, and indoleamine, among other signaling pathways. Classic growth factors and cytokines-such as VEGF, CNTF, GDNF, TGF-β, interleukins (IL-1β, IL-6, and IL-8), and C-C ligands (CCL-2, CCL-5, and CCL-23)-serve as paracrine control molecules secreted or packaged into extracellular vesicles, or exosomes, by MSCs. Recent studies have also implicated signaling by microRNAs contained in MSC-derived exosomes. The response of target cells is further regulated by their microenvironment, involving the extracellular matrix, which may be modified by MSC-produced matrix metalloproteinases (MMPs) and tissue inhibitor of MMPs. Trophic activities of MSCs, either resident or introduced exogenously, are thus intricately controlled, and may be further fine-tuned via implant material modifications. MSCs are actively being investigated for the repair and regeneration of both osteochondral and other musculoskeletal tissues, such as tendon/ligament and meniscus. Future rational and effective MSC-based musculoskeletal therapies will benefit from better mechanistic understanding of MSC trophic activities, for example using analytical "-omics" profiling approaches.
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Affiliation(s)
- Heidi R Hofer
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA.
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Ham O, Lee CY, Kim R, Lee J, Oh S, Lee MY, Kim J, Hwang KC, Maeng LS, Chang W. Therapeutic Potential of Differentiated Mesenchymal Stem Cells for Treatment of Osteoarthritis. Int J Mol Sci 2015; 16:14961-78. [PMID: 26147426 PMCID: PMC4519882 DOI: 10.3390/ijms160714961] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 06/24/2015] [Accepted: 06/26/2015] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis (OA) is a chronic, progressive, and irreversible degenerative joint disease. Conventional OA treatments often result in complications such as pain and limited activity. However, transplantation of mesenchymal stem cells (MSCs) has several beneficial effects such as paracrine effects, anti-inflammatory activity, and immunomodulatory capacity. In addition, MSCs can be differentiated into several cell types, including chondrocytes, osteocytes, endothelia, and adipocytes. Thus, transplantation of MSCs is a suggested therapeutic tool for treatment of OA. However, transplanted naïve MSCs can cause problems such as heterogeneous populations including differentiated MSCs and undifferentiated cells. To overcome this problem, new strategies for inducing differentiation of MSCs are needed. One possibility is the application of microRNA (miRNA) and small molecules, which regulate multiple molecular pathways and cellular processes such as differentiation. Here, we provide insight into possible strategies for cartilage regeneration by transplantation of differentiated MSCs to treat OA patients.
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Affiliation(s)
- Onju Ham
- Catholic Kwandong University International St. Mary's Hospital, Incheon 404-834, Korea.
| | - Chang Youn Lee
- Department of Integrated Omics for Biomedical Sciences, Yonsei University, 50 Yonsei-ro, Seodamun-gu, Seoul 120-759, Korea.
| | - Ran Kim
- Department of Biology Education, College of Education, Pusan National University, Busan 609-735, Korea.
| | - Jihyun Lee
- Department of Biology Education, College of Education, Pusan National University, Busan 609-735, Korea.
| | - Sekyung Oh
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Min Young Lee
- Department of Molecular Physiology, College of Pharmacy, Kyungpook National University, Daegu 702-701, Korea.
| | - Jongmin Kim
- Department of Life Systems, Sookmyung Women's University, Seoul 140-742, Korea.
| | - Ki-Chul Hwang
- Catholic Kwandong University International St. Mary's Hospital, Incheon 404-834, Korea.
| | - Lee-So Maeng
- Institute of Catholic Integrative Medicine, Incheon St. Mary's Hospital, the Catholic University of Korea, College of Medicine, Incheon 403-720, Korea.
| | - Woochul Chang
- Department of Biology Education, College of Education, Pusan National University, Busan 609-735, Korea.
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Wojtys EM. Happy New Year! Sports Health 2015; 7:17-8. [PMID: 25553208 PMCID: PMC4272698 DOI: 10.1177/1941738114563035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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