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Gupta A, Aratikatla A. Hyperacute Serum and Knee Osteoarthritis. Cureus 2024; 16:e53118. [PMID: 38420081 PMCID: PMC10899007 DOI: 10.7759/cureus.53118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
The knees are the most frequently affected weight-bearing joints in osteoarthritis (OA), impacting millions of people globally. With increasing life spans and obesity rates, the prevalence of knee OA will further mount, leading to a significant increase in the economic burden. The usual treatment modalities utilized to manage knee OA have shortcomings. Over the last decade, the field of regenerative medicine involving the use of biologics, such as autologous peripheral blood-derived orthobiologics, including hyperacute serum (HS), has evolved and shown potential for managing knee OA. In this manuscript, we qualitatively present the in vitro, pre-clinical, clinical, and ongoing studies investigating the applications of HS in the context of knee OA. Seven in vitro studies and one clinical study fit the scope of our manuscript. The results demonstrated that the administration of HS is potentially safe and efficacious in terms of increasing the viability of osteoarthritic chondrocytes, reducing pain and inflammation, and improving function in patients with knee OA. However, due to insufficient literature, pre-clinical studies to better understand the mechanism of action are required. In addition, adequately powered, multi-center, non-randomized, and randomized controlled trials with longer follow-up are warranted to establish the safety and efficacy of HS for the management of knee OA and to justify its clinical use.
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Affiliation(s)
- Ashim Gupta
- Orthopaedics and Regenerative Medicine, Regenerative Orthopaedics, Noida, IND
- Regenerative Medicine, Future Biologics, Lawrenceville, USA
- Regenerative Medicine, BioIntegrate, Lawrenceville, USA
- Orthopaedics, South Texas Orthopaedic Research Institute, Laredo, USA
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Neubauer M, Otahal A, Kuten O, Sherman SL, Moser L, Kramer K, DeLuna A, Neugebauer J, Dammerer D, Muellner T, Nehrer S. Infra-patellar fat pad-derived mesenchymal stem cells maintain their chondrogenic differentiation potential after arthroscopic harvest with blood-product supplementation. INTERNATIONAL ORTHOPAEDICS 2024; 48:279-290. [PMID: 37646823 PMCID: PMC10766657 DOI: 10.1007/s00264-023-05930-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 08/06/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Mesenchymal stem cells/medicinal signaling cells (MSCs) possess therapeutic potential and are used in regenerative orthopaedics. The infra-patellar fat pad (IFP) is partially resected during knee arthroscopy (KASC) and contains MSCs. Heat, irrigation, and mechanical stress during KASC may decrease MSC's therapeutic potential. This study assessed MSCs' regenerative potential after arthroscopic IFP harvest and potential effects of two blood products (BP) (platelet-rich plasma (PRP), hyperacute serum (HAS)) on MSCs' viability and chondrogenic differentiation capacity. METHODS IFP was arthroscopically harvested, isolated, and counted (n = 5). Flow cytometry was used to assess cell viability via staining with annexin V/7-AAD and stemness markers via staining for CD90, CD73, and CD105. MSCs were incubated with blood products, and metabolic activity was determined via an XTT assay. Deposition of cartilage extracellular matrix was determined in histologic sections of chondrogenically differentiated 3D pellet cultures via staining with Alcian Blue. Expression of cartilage-specific genes (SOX9, MMP3/13, ACAN, COL1/2) was analyzed via quantitative PCR. RESULTS MSC isolation from IFP yielded 2.66*106 ± 1.49*106 viable cells from 2.7 (0.748) g of tissue. MSC markers (CD 90/105/73) were successfully detected and annexin V staining showed 81.5% viable cells. XTT showed increased metabolic activity. Within the BP groups, this increase was significant (days 0-14, p < 0.05). PCR showed expression of cartilage-specific genes in each group. COL2 (p < 0.01) as well as ACAN (p < 0.001) expression levels were significantly higher in the HAS group. Histology showed successful differentiation. CONCLUSION Arthroscopic harvest of IFP-MSCs yields sufficient cells with maintained regenerative potential and viability. Blood products further enhance MSCs' viability.
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Affiliation(s)
- Markus Neubauer
- Center for Regenerative Medicine and Orthopaedics, Danube University Krems, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria
- Division of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Alexander Otahal
- Center for Regenerative Medicine and Orthopaedics, Danube University Krems, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria
| | - Olga Kuten
- Ortho Sera GmbH, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria
| | | | - Lukas Moser
- Center for Regenerative Medicine and Orthopaedics, Danube University Krems, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria
- Division of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Karina Kramer
- Center for Regenerative Medicine and Orthopaedics, Danube University Krems, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria
| | - Andrea DeLuna
- Center for Regenerative Medicine and Orthopaedics, Danube University Krems, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria
| | - Johannes Neugebauer
- Division of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Dietmar Dammerer
- Center for Regenerative Medicine and Orthopaedics, Danube University Krems, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria
- Division of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Thomas Muellner
- Center for Regenerative Medicine and Orthopaedics, Danube University Krems, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria
- Department of Orthopaedics and Traumatology, Evangelic Hospital Vienna, Hans-Sachs-Gasse 10-12, 1180, Vienna, Austria
| | - Stefan Nehrer
- Center for Regenerative Medicine and Orthopaedics, Danube University Krems, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Austria.
- Division of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria.
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Albumin as a Biomaterial and Therapeutic Agent in Regenerative Medicine. Int J Mol Sci 2022; 23:ijms231810557. [PMID: 36142472 PMCID: PMC9502107 DOI: 10.3390/ijms231810557] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 02/07/2023] Open
Abstract
Albumin is a constitutional plasma protein, with well-known biological functions, e.g., a nutrient for stem cells in culture. However, albumin is underutilized as a biomaterial in regenerative medicine. This review summarizes the advanced therapeutic uses of albumin, focusing on novel compositions that take advantage of the excellent regenerative potential of this protein. Albumin coating can be used for enhancing the biocompatibility of various types of implants, such as bone grafts or sutures. Albumin is mainly known as an anti-attachment protein; however, using it on implantable surfaces is just the opposite: it enhances stem cell adhesion and proliferation. The anticoagulant, antimicrobial and anti-inflammatory properties of albumin allow fine-tuning of the biological reaction to implantable tissue-engineering constructs. Another potential use is combining albumin with natural or synthetic materials that results in novel composites suitable for cardiac, neural, hard and soft tissue engineering. Recent advances in materials have made it possible to electrospin the globular albumin protein, opening up new possibilities for albumin-based scaffolds for cell therapy. Several described technologies have already entered the clinical phase, making good use of the excellent biological, but also regulatory, manufacturing and clinical features of serum albumin.
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