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Alharbi AH, Seyam MK, Alanazi A, Almansour A, Hasan S. Influence of Pain, Risk Factors, and Functional Ability on Physical Activity Levels in Women with Anterior Knee Pain: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1467. [PMID: 39336508 PMCID: PMC11433932 DOI: 10.3390/medicina60091467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 08/21/2024] [Accepted: 09/02/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: Anterior knee pain (AKP) refers to chronic prepatellar pain and is one of the most common knee complaints in physically active women. This condition can significantly affect daily activities and overall quality of life. This study aims to assess the impact of pain, risk factors, and functional ability on different levels of physical activity (comparing low versus moderate activity) in women with AKP. Materials and Methods: This cross-sectional study involved fifty-six women diagnosed with AKP (aged 20-45 years) who were equally allocated into low and moderate physical activity groups. Their AKP and functional ability were assessed using the visual analog scale (VAS) and double squats and step-down tests, respectively. Possible risk factors were assessed using the Q-angle, modified Thomas test, sit and reach test, and patellar glide test. A person's correlation coefficient and independent t-tests were used to determine the relationship and the differences between these variables while keeping the confidence interval level at 95%. Result: Women with moderate activity levels showed significantly higher scores on the VAS than those with low activity levels (p = 0.040). However, both groups had no significant difference in their functional ability or potential risk factors (p > 0.05). Additionally, their functional ability (double squat) showed a positive association with hamstring flexibility (Pearson correlation coefficient [r]:0.3; p = 0.006). Conclusions: Women with AKP who were engaged in moderate physical activity experienced higher levels of pain compared to those with low activity levels. These findings underscore the urgent need for further investigation into different levels of physical activity to develop appropriate prevention and treatment strategies for women with AKP.
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Affiliation(s)
- Amjad Hajaj Alharbi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Mohamed K Seyam
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Ahmad Alanazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Ahmed Almansour
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Shahnaz Hasan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
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Liao CD, Chen HC, Huang MH, Liou TH, Lin CL, Huang SW. Comparative Efficacy of Intra-Articular Injection, Physical Therapy, and Combined Treatments on Pain, Function, and Sarcopenia Indices in Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Int J Mol Sci 2023; 24:ijms24076078. [PMID: 37047058 PMCID: PMC10094194 DOI: 10.3390/ijms24076078] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 04/14/2023] Open
Abstract
Knee osteoarthritis (KOA) is associated with a high risk of sarcopenia. Both intra-articular injections (IAIs) and physical therapy (PT) exert benefits in KOA. This network meta-analysis (NMA) study aimed to identify comparative efficacy among the combined treatments (IAI+PT) in patients with KOA. Seven electronic databases were systematically searched from inception until January 2023 for randomized controlled trials (RCTs) reporting the effects of IAI+PT vs. IAI or PT alone in patients with KOA. All RCTs which had treatment arms of IAI agents (autologous conditioned serum, botulinum neurotoxin type A, corticosteroids, dextrose prolotherapy (DxTP), hyaluronic acid, mesenchymal stem cells (MSC), ozone, platelet-rich plasma, plasma rich in growth factor, and stromal vascular fraction of adipose tissue) in combination with PT (exercise therapy, physical agent modalities (electrotherapy, shockwave therapy, thermal therapy), and physical activity training) were included in this NMA. A control arm receiving placebo IAI or usual care, without any other IAI or PT, was used as the reference group. The selected RCTs were analyzed through a frequentist method of NMA. The main outcomes included pain, global function (GF), and walking capability (WC). Meta-regression analyses were performed to explore potential moderators of the treatment efficacy. We included 80 RCTs (6934 patients) for analyses. Among the ten identified IAI+PT regimens, DxTP plus PT was the most optimal treatment for pain reduction (standard mean difference (SMD) = -2.54) and global function restoration (SMD = 2.28), whereas MSC plus PT was the most effective for enhancing WC recovery (SMD = 2.54). More severe KOA was associated with greater changes in pain (β = -2.52) and WC (β = 2.16) scores. Combined IAI+PT treatments afford more benefits than do their corresponding monotherapies in patients with KOA; however, treatment efficacy is moderated by disease severity.
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Affiliation(s)
- Chun-De Liao
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110301, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Mao-Hua Huang
- Department of Biochemistry, University of Washington, Seattle, WA 98015, USA
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Che-Li Lin
- Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
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Migliorini F, Eschweiler J, Götze C, Driessen A, Tingart M, Maffulli N. Matrix-induced autologous chondrocyte implantation (mACI) versus autologous matrix-induced chondrogenesis (AMIC) for chondral defects of the knee: a systematic review. Br Med Bull 2022; 141:47-59. [PMID: 35175354 PMCID: PMC9351375 DOI: 10.1093/bmb/ldac004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Chondral defects of the knee are common and their treatment is challenging. SOURCE OF DATA PubMed, Google scholar, Embase and Scopus databases. AREAS OF AGREEMENT Both autologous matrix-induced chondrogenesis (AMIC) and membrane-induced autologous chondrocyte implantation (mACI) have been used to manage chondral defects of the knee. AREAS OF CONTROVERSY It is debated whether AMIC and mACI provide equivalent outcomes for the management of chondral defects in the knee at midterm follow-up. Despite the large number of clinical studies, the optimal treatment is still controversial. GROWING POINTS To investigate whether AMIC provide superior outcomes than mACI at midterm follow-up. AREAS TIMELY FOR DEVELOPING RESEARCH AMIC may provide better outcomes than mACI for chondral defects of the knee. Further studies are required to verify these results in a clinical setting.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic and Trauma Surgery, RWTH University Hospital Aachen, Pauwellstr. 31, 52074 Aachen, Germany
| | - Jörg Eschweiler
- Department of Orthopaedic and Trauma Surgery, RWTH University Hospital Aachen, Pauwellstr. 31, 52074 Aachen, Germany
| | - Christian Götze
- Department of Orthopaedic Surgery, Auguste-Viktoria Clinic, Ruhr University Bochum, Am Kokturkanal 2, 32545 Bad Oeynhausen, Germany
| | - Arne Driessen
- Department of Orthopaedic and Trauma Surgery, RWTH University Hospital Aachen, Pauwellstr. 31, 52074 Aachen, Germany
| | - Markus Tingart
- Department of Orthopaedic and Trauma Surgery, RWTH University Hospital Aachen, Pauwellstr. 31, 52074 Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy.,Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK.,School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, Stoke on Trent, ST5 5BG, UK
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Delgado-Enciso I, Paz-Garcia J, Barajas-Saucedo CE, Mokay-Ramírez KA, Meza-Robles C, Lopez-Flores R, Delgado-Machuca M, Murillo-Zamora E, Toscano-Velazquez JA, Delgado-Enciso J, Melnikov V, Walle-Guillen M, Galvan-Salazar HR, Delgado-Enciso OG, Cabrera-Licona A, Danielewicz-Mata EJ, Mandujano-Diaz PJ, Guzman-Esquivel J, Montes-Galindo DA, Perez-Martinez H, Jimenez-Villegaz JM, Hernandez-Rangel AE, Montes-Diaz P, Rodriguez-Sanchez IP, Martinez-Fierro ML, Garza-Veloz I, Tiburcio-Jimenez D, Zaizar-Fregoso SA, Gonzalez-Alcaraz F, Gutierrez-Gutierrez L, Diaz-Lopez L, Ramirez-Flores M, Guzman-Solorzano HP, Gaytan-Sandoval G, Martinez-Perez CR, Espinoza-Gómez F, Rojas-Larios F, Hirsch-Meillon MJ, Baltazar-Rodriguez LM, Barrios-Navarro E, Oviedo-Rodriguez V, Mendoza-Hernandez MA, Prieto-Diaz-Chavez E, Paz-Michel BA. Safety and efficacy of a COVID-19 treatment with nebulized and/or intravenous neutral electrolyzed saline combined with usual medical care vs. usual medical care alone: A randomized, open-label, controlled trial. Exp Ther Med 2021; 22:915. [PMID: 34306189 PMCID: PMC8281484 DOI: 10.3892/etm.2021.10347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/11/2021] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is currently the major public health problem worldwide. Neutral electrolyzed saline solution that contains reactive chlorine and oxygen species may be an effective therapeutic. In the present study, the treatment efficacy of intravenous and/or nebulized neutral electrolyzed saline combined with usual medical care vs. usual medical care alone was evaluated in ambulatory patients with COVID-19. A prospective, 2-arm, parallel-group, randomized, open-label, multi-center, phase I-II clinical trial including 214 patients was performed. The following two outcomes were evaluated during the 20-day follow-up: i) The number of patients with disease progression; and ii) the patient acceptable symptom state. Serial severe acute respiratory syndrome coronavirus 2 naso/oro-pharyngeal detection by reverse transcription-quantitative (RT-q) PCR was performed in certain patients of the experimental group. Biochemical and hematologic parameters, as well as adverse effects, were also evaluated in the experimental group. The experimental treatment decreased the risk of hospitalization by 89% [adjusted relative risk (RR)=0.11, 95% confidence interval (CI): 0.03-0.37, P<0.001] and the risk of death by 96% (adjusted RR=0.04, 95% CI: 0.01-0.42, P=0.007) and also resulted in an 18-fold higher probability of achieving an acceptable symptom state on day 5 (adjusted RR=18.14, 95% CI: 7.29-45.09, P<0.001), compared with usual medical care alone. Overall, neutral electrolyzed saline solution was better than usual medical care alone. Of the patients analyzed, >50% were negative for the virus as detected by RT-qPCR in naso/oro-pharyngeal samples on day 4, with only a small number of positive patients on day 6. Clinical improvement correlated with a decrease in C-reactive protein, aberrant monocytes and increased lymphocytes and platelets. Cortisol and testosterone levels were also evaluated and a decrease in cortisol levels and an increase in the testosterone-cortisol ratio were observed on days 2 and 4. The experimental treatment produced no serious adverse effects. In conclusion, neutral electrolyzed saline solution markedly reduced the symptomatology and risk of progression in ambulatory patients with COVID-19. The present clinical trial was registered in the Cuban public registry of clinical trials (RPCEC) database (May 5, 2020; no. TX-COVID19: RPCEC00000309).
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Affiliation(s)
- Ivan Delgado-Enciso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Juan Paz-Garcia
- Department of Internal Medicine and Surgery, Union Hospital Center, Villa de Álvarez, Colima 28970, México
| | | | - Karen A. Mokay-Ramírez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Carmen Meza-Robles
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Rodrigo Lopez-Flores
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Marina Delgado-Machuca
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Efren Murillo-Zamora
- Department of Research, General Hospital of Zone No. 1 and Family Medicine Unit No. 19 IMSS, Villa de Alvarez, Colima 28984, México
| | | | - Josuel Delgado-Enciso
- Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima 28085, México
| | - Valery Melnikov
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Mireya Walle-Guillen
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Hector R. Galvan-Salazar
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Osiris G. Delgado-Enciso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
- Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima 28085, México
| | | | | | | | - José Guzman-Esquivel
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
- Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima 28085, México
| | - Daniel A. Montes-Galindo
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Henry Perez-Martinez
- COVID-19 Respiratory Care Clinic INSABI Poliforum, Tuxtla Gutierrez, Chiapas 29040, México
| | | | | | | | - Iram P. Rodriguez-Sanchez
- Laboratory of Molecular and Structural Physiology, School of Biological Sciences, Universidad Autónoma de Nuevo León, San Nicolas de los Garza, Nuevo León 66455, México
| | - Margarita L. Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, México
| | - Idalia Garza-Veloz
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, México
| | - Daniel Tiburcio-Jimenez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Sergio A. Zaizar-Fregoso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | | | | | - Luciano Diaz-Lopez
- COVID-19 Respiratory Care Clinic INSABI Poliforum, Tuxtla Gutierrez, Chiapas 29040, México
| | - Mario Ramirez-Flores
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | | | - Gustavo Gaytan-Sandoval
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Carlos R. Martinez-Perez
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | - Francisco Espinoza-Gómez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Fabián Rojas-Larios
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Michael J. Hirsch-Meillon
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | | | - Enrique Barrios-Navarro
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
| | - Vladimir Oviedo-Rodriguez
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, México
| | | | | | - Brenda A. Paz-Michel
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, México
- Department of Research, Esteripharma S.A. de C.V., Ciudad de México 03100, México
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Zhang X, He J, Wang W. Progress in the use of mesenchymal stromal cells for osteoarthritis treatment. Cytotherapy 2021; 23:459-470. [PMID: 33736933 DOI: 10.1016/j.jcyt.2021.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/20/2020] [Accepted: 01/29/2021] [Indexed: 12/26/2022]
Abstract
LITERATURE REVIEW OF MSCS IN THE TREATMENT OF OSTEOARTHRITIS IN THE PAST FIVE YEARS: Osteoarthritis (OA) is one of the most common chronic joint diseases, with prominent symptoms caused by many factors. However, current medical interventions for OA have resulted in poor clinical outcomes, demonstrating that there are huge unmet medical needs in this area. Cell therapy has opened new avenues of OA treatment. Different sources of mesenchymal stromal cells (MSCs) may have different phenotypes and cellular functions. Pre-clinical and clinical studies have demonstrated the feasibility, safety and efficacy of MSC therapy. Mitogen-activated protein kinase, Wnt and Notch signaling pathways are involved in the chondrogenesis of MSC-mediated treatments. MSCs may also exert effective immunoregulatory and paracrine effects to stimulate tissue repair. Therapy with extracellular vesicles containing cytokines, which are secreted by MSCs, might be a potential treatment for OA.
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Affiliation(s)
- Xiaotian Zhang
- Department of Orthopedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jiyin He
- Department of Orthopedics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wen Wang
- Clinical Development, IASO Biotherapeutics Co., Ltd., Shanghai, China.
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Delgado-Enciso I, Paz-Garcia J, Valtierra-Alvarez J, Preciado-Ramirez J, Olmedo-Buenrostro BA, Delgado-Enciso J, Guzman-Esquivel J, Barajas-Saucedo CE, Ceja-Espiritu G, Rodriguez-Sanchez IP, Martinez-Fierro ML, Zaizar-Fregoso SA, Tiburcio-Jimenez D, Plata-Florenzano JE, Paz-Michel B. A novel cell-free formulation for the treatment of knee osteoarthritis generates better patient-reported health outcomes in more severe cases. J Orthop Surg (Hong Kong) 2021; 28:2309499020938121. [PMID: 32691672 DOI: 10.1177/2309499020938121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The bioactive cell-free formulation (BIOF2) for cartilage regeneration has shown a major therapeutic response in severe knee osteoarthritis. However, its effect on patients with mild or moderate stages of the disease has not been studied. OBJECTIVE To evaluate the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, minimal clinically important improvement (MCII) and sleep disturbances in mild, moderate, and severe stages of knee osteoarthritis (OA) with the novel cell-free formulation treatment (BIOF2). METHODS An open-label, nonrandomized, baseline-controlled, parallel group study on patients with mild, moderate, and severe knee OA was conducted to evaluate the effect of intra-articular administration of BIOF2. Clinical improvement was determined through the WOMAC score and MCII, whereas sleep disturbances were measured through a Likert scale questionnaire. RESULTS At 6 months post-treatment, the mean decrease in the total WOMAC score was 16.4 +/- 4.7%, 49.9 +/- 6.4%, and 62.7 +/- 4.5% in the patients with mild, moderate, and severe disease, respectively (p < 0.001, analysis of variance test). MCII at 6 months was 18%, 78%, and 100% for mild, moderate, and severe disease, respectively (p < 0.001, likelihood-ratio χ2 test). Concerning sleep disturbances, 60% of the patients with severe OA had important sleep problems before beginning treatment, and those difficulties were overcome 6 months after treatment. Only 18% of the patients with mild disease and 16% with moderate disease had serious sleep disturbances at the beginning of the study, and there was slight improvement after treatment. No adverse events were recorded during follow-up. CONCLUSION BIOF2 generates better patient-reported health outcomes (on pain, stiffness, function, and sleep) in the more severe cases of knee OA.
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Affiliation(s)
- Ivan Delgado-Enciso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima, Mexico
| | - Juan Paz-Garcia
- Department of Traumatology, Union Hospital Center, Villa de Alvarez, Colima, Mexico
| | - Jose Valtierra-Alvarez
- Department of Traumatology, University Regional Hospital, Colima State Health Services, Colima, Mexico
| | - Jorge Preciado-Ramirez
- Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima, Mexico
| | - Bertha A Olmedo-Buenrostro
- Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima, Mexico
| | - Josuel Delgado-Enciso
- Department of Research, Foundation for Cancer Ethics, Education and Research of the Cancerology State Institute, Colima, Mexico
| | | | - Carlos E Barajas-Saucedo
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima, Mexico
| | - Gabriel Ceja-Espiritu
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima, Mexico
| | - Iram P Rodriguez-Sanchez
- Department of Cellular Biology, School of Biological Sciences, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Margarita L Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas, Mexico
| | - Sergio A Zaizar-Fregoso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima, Mexico
| | - Daniel Tiburcio-Jimenez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima, Mexico
| | - Jorge E Plata-Florenzano
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima, Mexico
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7
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Muthu S, Jeyaraman M, Jain R, Gulati A, Jeyaraman N, Prajwal GS, Mishra PC. Accentuating the sources of mesenchymal stem cells as cellular therapy for osteoarthritis knees-a panoramic review. Stem Cell Investig 2021; 8:13. [PMID: 34386542 PMCID: PMC8327191 DOI: 10.21037/sci-2020-055] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/25/2021] [Indexed: 02/05/2023]
Abstract
The large economic burden on the global health care systems is due to the increasing number of symptomatic osteoarthritis (OA) knee patients whereby accounting for greater morbidity and impaired functional quality of life. The recent developments and impulses in molecular and regenerative medicine have paved the way for inducing the biological active cells such as stem cells, bioactive materials, and growth factors towards the healing and tissue regenerative process. Mesenchymal stem cells (MSCs) act as a minimally invasive procedure that bridges the gap between pharmacological treatment and surgical treatment for OA. MSCs are the ideal cell-based therapy for treating disorders under a minimally invasive environment in conjunction with cartilage regeneration. Due to the worldwide recognized animal model for such cell-based therapies, global researchers have started using the various sources of MSCs towards cartilage regeneration. However, there is a lacuna in literature on the comparative efficacy and safety of various sources of MSCs in OA of the knee. Hence, the identification of a potential source for therapeutic use in this clinical scenario remains unclear. In this article, we compared the therapeutic effects of various sources of MSCs in terms of efficacy, safety, differentiation potential, durability, accessibility, allogenic preparation and culture expandability to decide the optimal source of MSCs for OA knee.
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Affiliation(s)
- Sathish Muthu
- Assistant Orthopaedic Surgeon, Government Hospital, Velayuthampalayam, Karur, Tamil Nadu, India
- International Association of Stemcell and Regenerative Medicine (IASRM), New Delhi, India
| | - Madhan Jeyaraman
- International Association of Stemcell and Regenerative Medicine (IASRM), New Delhi, India
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Rashmi Jain
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Arun Gulati
- Department of Orthopaedics, Kalpana Chawla Government Medical College & Hospital, Karnal, Haryana, 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
| | | | - Prabhu Chandra Mishra
- International Association of Stemcell and Regenerative Medicine (IASRM), New Delhi, India
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8
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Ip HL, Nath DK, Sawleh SH, Kabir MH, Jahan N. Regenerative Medicine for Knee Osteoarthritis - The Efficacy and Safety of Intra-Articular Platelet-Rich Plasma and Mesenchymal Stem Cells Injections: A Literature Review. Cureus 2020; 12:e10575. [PMID: 33101819 PMCID: PMC7577352 DOI: 10.7759/cureus.10575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The prevalence of osteoarthritis (OA) has been rising exponentially in recent years. As the disease progresses, patients may eventually require surgical intervention to restore the functionality of the affected knees. The current literature review aims to explore two treatment options in regenerative medicine for OA by analyzing the efficacy and safety of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) use, as well as determining which population will benefit from these treatments. A total of 1093 patients who were diagnosed with unilateral or bilateral knee osteoarthritis (KOA) were recruited in 23 studies. The experimental groups received either PRP or MSCs injections in comparison to the control groups receiving either hyaluronic acid (HA) or placebo (saline or dextrose) injections. Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used to evaluate all participants at different time intervals of the studies. Medical imaging evaluations (X-ray or MRI) were used to look for structural improvements. In conclusion, both PRP and MSCs treatments were well tolerated, effective and safe to use. Repeated administrations and higher concentrations resulted in superior clinical improvements. A decrease in cartilage loss was observed in some MSCs trials. No severe adverse effects were documented. PRP treatment proved to be more efficacious among patients with KOA Kellgren-Lawrence (KL) grade I-II, while MSCs treatment proved to be more beneficial among the KOA KL grade II-III group.
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Affiliation(s)
- Hoi Leng Ip
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Debashis Kumar Nath
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safia H Sawleh
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Md Humayun Kabir
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nusrat Jahan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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9
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Kim SH, Djaja YP, Park YB, Park JG, Ko YB, Ha CW. Intra-articular Injection of Culture-Expanded Mesenchymal Stem Cells Without Adjuvant Surgery in Knee Osteoarthritis: A Systematic Review and Meta-analysis. Am J Sports Med 2020; 48:2839-2849. [PMID: 31874044 DOI: 10.1177/0363546519892278] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although many clinical studies have assessed the efficacy of mesenchymal stem cells (MSCs) in knee osteoarthritis, evidence on their efficacy remains unclear owing to heterogeneity of cell entity and concomitant procedures. PURPOSE To determine the efficacy of culture-expanded MSCs in knee osteoarthritis in terms of clinical outcome and cartilage repair via meta-analysis of randomized controlled trials (RCTs) without adjuvant surgery. STUDY DESIGN Meta-analysis. METHODS PubMed, Embase, the Cochrane Library, CINAHL, and Scopus were searched from inception to December 31, 2018. RCTs with culture-expanded MSCs for treating knee osteoarthritis were included. Studies with adjuvant surgery or cell concentrate were excluded. Quality was assessed by the Cochrane Collaboration risk-of-bias tool. For meta-analysis, data on clinical outcomes were measured using a visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and data on cartilage repair were measured using the Whole-Organ Magnetic Resonance Imaging Score (WORMS); categorization related to improvement was extracted. RESULTS Six RCTs (203 patients) were included. Two studies were deemed to have a low risk of bias. In pooled analysis, the only significant difference was in the VAS score (mean difference, -13.55; 95% CI, -22.19 to -4.9). In cumulative pain analysis with VAS and WOMAC pain scores, there was significant improvement after treatment (standardized mean difference, -0.54; 95% CI, -0.85 to -0.23). There was no significant difference in cartilage repair assessed by magnetic resonance imaging (standardized mean difference, 0.11; 95% CI, -0.51 to 0.73), WORMS (standardized mean difference, 1.68; 95% CI -14.84 to 18.21), or categorical results (odds ratio, 1.56; 95% CI, 0.32-7.59). CONCLUSION Intra-articular injection of culture-expanded MSCs without adjuvant surgery can improve pain for patients experiencing knee osteoarthritis at short-term follow-up (6-12 months). However, evidence regarding function and cartilage repair remains limited.
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Affiliation(s)
- Seong Hwan Kim
- Department of Orthopedic Surgery, Hyundae General Hospital, Chung-Ang University, Namyangju-Si, Kyunggi-Do, Republic of Korea
| | - Yoshi Pratama Djaja
- Department of Orthopedic and Traumatology, Fatmawati General Hospital, South Jakarta, Indonesia
| | - Yong-Beom Park
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Jung-Gwan Park
- Department of Orthopedic Surgery, Madisesang Hospital, Seoul, Republic of Korea
| | - Young-Bong Ko
- Department of Orthopedic Surgery, Jounachim Hospital, Gyeonggi-do, Republic of Korea
| | - Chul-Won Ha
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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10
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Song Y, Zhang J, Xu H, Lin Z, Chang H, Liu W, Kong L. Mesenchymal stem cells in knee osteoarthritis treatment: A systematic review and meta-analysis. J Orthop Translat 2020; 24:121-130. [PMID: 32913710 PMCID: PMC7452318 DOI: 10.1016/j.jot.2020.03.015] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED Stem cells are considered to be one of the greatest potential treatments to cure degenerative diseases. Stem cells injection for knee osteoarthritis (OA) is still a relatively new treatment and has not yet gained popularity. So, the effectiveness, safety and potential of mesenchymal stem cells (MSCs) for knee OA treatment is worthy to be explored. Explore the effectiveness and safety of mesenchymal stem cells (MSCs) in the treatment of knee osteoarthritis. We collected clinical trials using MSCs as treatment for knee OA (before April 2019), including randomized controlled trials (RCTs), retrospective studies and cohort studies. We searched PubMed, EMBASE, Cochrane Library, Web of Science and the ClinicalTrials.gov with keywords (Mesenchymal stem cells [MSCs], Knee osteoarthritis, Effectiveness and Safety), and then performed a systematic review and cumulative metaanalysis of all RCTs and retrospective comparative studies. To evaluate the effectiveness and safety of MSC in knee OA treatment, we applied visual analog scale score, Western Ontario and McMaster Universities Osteo-arthritis Index and adverse events. We included 15 RCTs, two retrospective studies and two cohort studies including a total of 584 knee OA patients in this study. We demonstrated that MSC treatment could significantly decrease visual analog scale in a 12-month follow-up study compared with controls (p < 0.001). MSC therapy also showed significant decreases in Western Ontario and McMaster Universities Osteoarthritis Index scores after the 6-month follow-up (p < 0.001). MSC therapy showed no difference compared with controls (p > 0.05) in adverse events. We suggest that MSC therapy could serve as an effective and safe therapy for clinical application in OA treatment. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE This study provided the best available evidence and a wider perspective to MSCs application in the management of knee OA. MSCs therapy will have great translational potential in the clinical treatment of various degenerative diseases once optimum formula and explicit target population are identified.
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Affiliation(s)
- Yancheng Song
- Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Corresponding author. Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, 19 Nonglinxia Rd., Yuexiu District, 510000, Guangzhou, China.
| | - Junhui Zhang
- Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Hualiang Xu
- Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhujian Lin
- Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Hong Chang
- Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Wei Liu
- Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Ling Kong
- Department of Basic Research & International Cooperation, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
- Corresponding author. Department of Basic Research & International Cooperation, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, 510005 Guangzhou, China.
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11
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Saltzman BM, Frank RM, Davey A, Cotter EJ, Redondo ML, Naveen N, Wang KC, Cole BJ. Lack of standardization among clinical trials of injection therapies for knee osteoarthritis: a systematic review. PHYSICIAN SPORTSMED 2020; 48:266-289. [PMID: 32027200 DOI: 10.1080/00913847.2020.1726716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose: Osteoarthritis (OA) of the knee is a debilitating, expensive, and prevalent disease, and interest in the non-surgical management of knee OA has grown recently. Our objective was to systematically assess the level of heterogeneity among all clinical trials and published studies regarding injections for knee osteoarthritis, in terms of treatment of interest, outcomes evaluated, and time points of outcome assessment. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized to review all published studies and publically available clinical trials from 1 January 2013 to 3 May 2019evaluating intra-articular injections to treat knee OA. Their treatment group and specifics of methodology were scrutinized and compared. Results: 84 published studies and 114 clinical trials were included. Within the 84 published studies, the most common injection treatment studied was hyaluronic acid [N = 22; 26.2%]. In total, 29 different injection treatment groups were utilized. The most common time point for patient evaluation post-injection was 6 months (N = 33 studies; 50.0%), and ranged from 1 week (N = 9 studies; 13.6%) to 7 years (N = 1 study; 1.5%). The most common patient-reported outcome (PRO) measure assessed in the included studies was Western Ontario and McMaster's University Osteoarthritis Index (WOMAC) [N = 44 studies; 66.7%]. For the 114 clinical trials identified, the most common injection treatment studied is platelet-rich plasma in isolation (N = 19; 16.7%). Forty-two different injection treatment types/groups are utilized. The most common PRO measure assessed was WOMAC (N = 77 trials; 67.5%). Overall there were 34 different patient-reported outcome measures used. Conclusions: Research efforts to find the most effective injection therapy for knee OA continue with a tremendous number of injection therapies still being evaluated. Substantial heterogeneity exists in these completed and ongoing trials in terms of patient demographics, OA grades, outcome scores and relatively short-term timing of assessments, with no clear standardization of testing protocol despite proposing to answer the same clinical question. We recommend that studies of this genre going forward be standardized in terms of outcome measures and longer-term follow-up time points, and should incorporate functional assessment evaluations and imaging studies.
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Affiliation(s)
- Bryan M Saltzman
- Orthopaedic Surgery, Rush University Medical Center , Chicago, IL, USA
| | - Rachel M Frank
- Orthopaedic Surgery, Rush University Medical Center , Chicago, IL, USA
| | - Annabelle Davey
- Orthopaedic Surgery, Rush University Medical Center , Chicago, IL, USA
| | - Eric J Cotter
- Orthopaedic Surgery, Rush University Medical Center , Chicago, IL, USA
| | - Michael L Redondo
- Orthopaedic Surgery, Rush University Medical Center , Chicago, IL, USA
| | - Neal Naveen
- Orthopaedic Surgery, Rush University Medical Center , Chicago, IL, USA
| | - Kevin C Wang
- Orthopaedic Surgery, Rush University Medical Center , Chicago, IL, USA
| | - Brian J Cole
- Orthopaedic Surgery, Rush University Medical Center , Chicago, IL, USA
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12
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Effects of rAAV-Mediated sox9 Overexpression on the Biological Activities of Human Osteoarthritic Articular Chondrocytes in Their Intrinsic Three-Dimensional Environment. J Clin Med 2019; 8:jcm8101637. [PMID: 31591319 PMCID: PMC6832991 DOI: 10.3390/jcm8101637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 12/11/2022] Open
Abstract
Gene therapy for osteoarthritis offers powerful, long-lasting tools that are well adapted to treat such a slow, progressive disorder, especially those therapies based on the clinically adapted recombinant adeno-associated viral (rAAV) vectors. Here, we examined the ability of an rAAV construct carrying a therapeutic sequence for the cartilage-specific SOX9 transcription factor to modulate the phenotype of human osteoarthritic articular chondrocytes compared with normal chondrocytes in a three-dimensional environment where the cells are embedded in their extracellular matrix. Successful sox9 overexpression via rAAV was noted for at least 21 days, leading to the significant production of major matrix components (proteoglycans, type-II collagen) without affecting the proliferation of the cells, while the cells contained premature hypertrophic processes relative to control conditions (reporter rAAV-lacZ application, absence of vector treatment). These findings show the value of using rAAV to adjust the osteoarthritic phenotype when the chondrocytes are confined in their inherently altered environment and the possibility of impacting key cellular processes via gene therapy to remodel human osteoarthritic cartilage lesions.
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13
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Delgado-Enciso I, Valtierra-Alvarez J, Paz-Garcia J, Preciado-Ramirez J, Soriano-Hernandez AD, Mendoza-Hernandez MA, Guzman-Esquivel J, Cabrera-Licona A, Delgado-Enciso J, Cortes-Bazan JL, Rodriguez-Sanchez IP, Martinez-Fierro ML, Cabrera-Medina AO, Barajas-Saucedo CE, Paz-Michel B. Patient-reported health outcomes for severe knee osteoarthritis after conservative treatment with an intra-articular cell-free formulation for articular cartilage regeneration combined with usual medical care vs. usual medical care alone: A randomized controlled trial. Exp Ther Med 2019; 17:3351-3360. [PMID: 30988711 PMCID: PMC6447772 DOI: 10.3892/etm.2019.7384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/16/2019] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA) is a major public health problem characterized by joint pain, fatigue, functional limitation and decreased quality of life of the patient, which results in increased use of healthcare services and high economical costs. A promising novel bioactive cell-free formulation (BIOF2) for cartilage regeneration has recently been tested in pre-clinical and clinical trials, and has demonstrated a success rate similar to that of total joint arthroplasty for the treatment of severe knee OA. The present study evaluated the efficacy of treatment with BIOF2, by including it within a conservative regimen of 'usual medical care' of knee OA, and whether its efficacy was affected in subgroups of patients presenting with comorbidities that exacerbate OA. A prospective, randomized, 2-arm parallel group phase III clinical trial was conducted, which included 105 patients in the 'usual medical care' group (paracetamol/NSAIDs and general care provided by the family physician) and 107 patients in the BIOF2 group (usual medical care + intra-articular BIOF2 application at 0, 1 and 2 months). Two aspects were evaluated at 0, 6 and 12 months: i) Minimal clinically important improvement (MCII), based on 30% improvement of pain from the baseline; and ii) the Patient Acceptable Symptom State (PASS), a questionnaire that determines patient well-being thresholds for articular pain and function. Adverse effects and regular NSAID use were registered. At 12 months, BIOF-2 treatment produced MCII in 70% of the patients and >50% achieved PASS. Excluding the patients with class 2 obesity or malalignment conditions (genu varum or genu valgum >20 degrees), the experimental treatment produced MCII and PASS in 100 and 92% of patients, respectively, compared with 25 and 8% in the group of usual medical care (P<0.001). No patient with malalignment and treatment with BIOF2 achieved PASS. Notably, there were no serious adverse effects. To conclude, BIOF2 is a safe therapeutic alternative that is easy to implement together with usual medical care for knee OA. Trial registration: Cuban Public Registry of Clinical Trials (RPCEC) Database RPCEC00000277. Retrospectively registered June, 2018.
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Affiliation(s)
- Ivan Delgado-Enciso
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28000, Mexico
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Jose Valtierra-Alvarez
- Department of Traumatology, University Regional Hospital, Colima State Health Services, Colima 28019, Mexico
| | - Juan Paz-Garcia
- Department of Traumatology, Union Hospital Center, Villa de Alvarez, Colima 28970, Mexico
| | - Jorge Preciado-Ramirez
- Department of Traumatology, University Regional Hospital, Colima State Health Services, Colima 28019, Mexico
| | - Alejandro D. Soriano-Hernandez
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28000, Mexico
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | | | - Jose Guzman-Esquivel
- Department of Research, General Hospital of Zone No. 1 IMSS, Villa de Alvarez, Colima 28983, Mexico
| | - Ariana Cabrera-Licona
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28000, Mexico
| | - Josuel Delgado-Enciso
- Department of Research, Foundation for Cancer Ethics, Education and Research of The Cancerology State Institute, Colima 28085, Mexico
| | - Jose L. Cortes-Bazan
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28000, Mexico
| | - Iram P. Rodriguez-Sanchez
- Department of Cellular Biology, School of Biological Sciences, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon 64460, Mexico
| | - Margarita L. Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, Mexico
| | - Ana O. Cabrera-Medina
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28000, Mexico
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Carlos E. Barajas-Saucedo
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28000, Mexico
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Brenda Paz-Michel
- Department of Research, Esteripharma Mexico, Mexico City 03100, Mexico
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Synovium-Derived Mesenchymal Stem/Stromal Cells and their Promise for Cartilage Regeneration. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1212:87-106. [PMID: 31069722 DOI: 10.1007/5584_2019_381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Adult tissues are reservoirs of rare populations of cells known as mesenchymal stem/stromal cells (MSCs) that have tissue-regenerating features retained from embryonic development. As well as building up the musculoskeletal system in early life, MSCs also replenish and repair tissues in adult life, such as bone, cartilage, muscle, and adipose tissue. Cells that show regenerative features at least in vitro have been identified from several connective tissues. Bone marrow and adipose tissue are the most well recognized sources of MSCs that are already used widely in clinical practice. Regenerative medicine aims to exploit MSCs and their tissue regeneration even though the underlying mechanisms for their beneficial effects are largely unknown. Despite many studies that have used various tissue-derived MSCs, the most effective tissue source for orthopedic procedures still remains to be identified. Another question that needs to be addressed is how to evaluate autologous MSCs (i.e., patient derived). Previous studies have suggested the features of bone-marrow-derived MSCs can differ widely between individuals, and can be changed in particular in patients suffering from some forms of degenerative disorder, such as osteoarthritis. The synovium is a thin membrane that protects the synovial joints, and it is a rich source of MSCs that show great potential for regenerative medicine. Here, we review synovium-derived MSCs from reports on basic and clinical studies. We discuss their potential to treat cartilage defects caused by either degeneration or trauma, and what needs to be done in further research toward their better exploitation for joint regeneration.
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15
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Mesenchymal stem cell-based therapy of osteoarthritis: Current knowledge and future perspectives. Biomed Pharmacother 2018; 109:2318-2326. [PMID: 30551490 DOI: 10.1016/j.biopha.2018.11.099] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/30/2018] [Accepted: 11/25/2018] [Indexed: 02/07/2023] Open
Abstract
Osteoarthritis (OA) is a chronic, prevalent, debilitating joint disease characterized by progressive cartilage degradation, subchondral bone remodeling, bone marrow lesions, meniscal damage, and synovitis. Innate immune cells (natural killer cells, macrophages, and mast cells) play the most important pathogenic role in the early inflammatory response, while cells of adaptive immunity (CD4 + Th1 lymphocytes and antibody producing B cells) significantly contribute to the development of chronic, relapsing course of inflammation in OA patients. Conventional therapy for OA is directed toward symptomatic treatment, mainly pain management, and is not able to promote regeneration of degenerated cartilage or to attenuate joint inflammation. Since articular cartilage, intra-articular ligaments, and menisci have no ability to heal, regeneration of these tissues remains one of the most important goals of new therapeutic approaches used for OA treatment. Due to their capacity for differentiation into chondrocytes and due to their immunomodulatory properties, mesenchymal stem cells (MSCs) have been the most extensively explored as new therapeutic agents in the cell-based therapy of OA. Simple acquisition, rapid proliferation, maintenance of differentiation potential after repeated passages in vitro, minor immunological rejection due to the low surface expression of major histocompatibility complex antigens, efficient engraftment and long-term coexistence in the host are the main characteristics of MSCs that enable their therapeutic use in OA. In this review article, we emphasized current knowledge and future perspectives regarding molecular and cellular mechanisms responsible for beneficial effects of autologous and allogeneic MSCs in the treatment of OA.
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