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Dey D, Fischer NG, Dragon AH, Ronzier E, Mutreja I, Danielson DT, Homer CJ, Forsberg JA, Bechtold JE, Aparicio C, Davis TA. Culture and characterization of various porcine integumentary-connective tissue-derived mesenchymal stromal cells to facilitate tissue adhesion to percutaneous metal implants. Stem Cell Res Ther 2021; 12:604. [PMID: 34922628 PMCID: PMC8684200 DOI: 10.1186/s13287-021-02666-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/19/2021] [Indexed: 02/08/2023] Open
Abstract
Background Transdermal osseointegrated prosthesis have relatively high infection rates leading to implant revision or failure. A principle cause for this complication is the absence of a durable impervious biomechanical seal at the interface of the hard structure (implant) and adjacent soft tissues. This study explores the possibility of recapitulating an analogous cellular musculoskeletal-connective tissue interface, which is present at naturally occurring integumentary tissues where a hard structure exits the skin, such as the nail bed, hoof, and tooth. Methods Porcine mesenchymal stromal cells (pMSCs) were derived from nine different porcine integumentary and connective tissues: hoof-associated superficial flexor tendon, molar-associated periodontal ligament, Achilles tendon, adipose tissue and skin dermis from the hind limb and abdominal regions, bone marrow and muscle. For all nine pMSCs, the phenotype, multi-lineage differentiation potential and their adhesiveness to clinical grade titanium was characterized. Transcriptomic analysis of 11 common genes encoding cytoskeletal proteins VIM (Vimentin), cell–cell and cell–matrix adhesion genes (Vinculin, Integrin β1, Integrin β2, CD9, CD151), and for ECM genes (Collagen-1a1, Collagen-4a1, Fibronectin, Laminin-α5, Contactin-3) in early passaged cells was performed using qRT-PCR. Results All tissue-derived pMSCs were characterized as mesenchymal origin by adherence to plastic, expression of cell surface markers including CD29, CD44, CD90, and CD105, and lack of hematopoietic (CD11b) and endothelial (CD31) markers. All pMSCs differentiated into osteoblasts, adipocytes and chondrocytes, albeit at varying degrees, under specific culture conditions. Among the eleven adhesion genes evaluated, the cytoskeletal intermediate filament vimentin was found highly expressed in pMSC isolated from all tissues, followed by genes for the extracellular matrix proteins Fibronectin and Collagen-1a1. Expression of Vimentin was the highest in Achilles tendon, while Fibronectin and Col1agen-1a1 were highest in molar and hoof-associated superficial flexor tendon bone marrow, respectively. Achilles tendon ranked the highest in both multilineage differentiation and adhesion assessments to titanium metal. Conclusions These findings support further preclinical research of these tissue specific-derived MSCs in vivo in a transdermal osseointegration implant model. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02666-2.
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Affiliation(s)
- Devaveena Dey
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Henry M Jackson Foundation for Advancement of Military Medicine, Bethesda, USA
| | - Nicholas G Fischer
- Department of Restorative Sciences and MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - Andrea H Dragon
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Henry M Jackson Foundation for Advancement of Military Medicine, Bethesda, USA
| | - Elsa Ronzier
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.,Henry M Jackson Foundation for Advancement of Military Medicine, Bethesda, USA
| | - Isha Mutreja
- Department of Restorative Sciences and MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - David T Danielson
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Cole J Homer
- Department of Restorative Sciences and MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA.,Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jonathan A Forsberg
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Joan E Bechtold
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA.,Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.,Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Conrado Aparicio
- Department of Restorative Sciences and MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, USA
| | - Thomas A Davis
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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Does Needle Design Affect the Regenerative Potential of Bone Marrow Aspirate? An In Vitro Study. Life (Basel) 2021; 11:life11080748. [PMID: 34440491 PMCID: PMC8401947 DOI: 10.3390/life11080748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
Abstract
While autologous bone is still the gold standard for treatment of bone defects, its availability is limited. Sufficient numbers of mesenchymal stroma cells (MSC) may be an alternative. Small volumes of bone marrow aspirate (BMA) were harvested with two different needle systems comparing the yield and regenerative potency of the MSCs. BMA (10 mL) was aspirated from the posterior iliac crest of 12 patients with degenerative spinal disc disease using both needle systems in each patient: the Jamshidi needle (JAM) and on the contralateral side the Marrow Cellution® Needle (AMC). Number of mononuclear cells (MNCs) and regeneration capacity (colony-forming unit/CFU) were determined. MSCs were characterized for surface markers and their differentiation into trilineages. There was no significant difference between the two harvesting needles regarding the quantity of MNCs in BMA: 5.2 ± 1.8 × 109 MNC/mL for AMC vs. 4.8 ± 2.5 × 109 MNC/mL for JAM, p = 0.182. The quantity of CFUs per ml BMA was similar for both groups: 3717 ± 5556 for AMC and 4305 ± 5507 for JAM (p = 0.695). The potency of MSCs expressed as colony-forming potential per 106 MNC resulted in 0.98 ± 1.51 for AMC and 1.00 ± 0.96 for JAM (p = 0.666). Regardless of the needle design, 10 mL bone marrow aspirate contains a sufficient number of about 40,000 MSCs that can be used to enhance bone healing.
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Busch A, Herten M, Haversath M, Kaiser C, Brandau S, Jäger M. Ceramic Scaffolds in a Vacuum Suction Handle for Intraoperative Stromal Cell Enrichment. Int J Mol Sci 2020; 21:ijms21176393. [PMID: 32887518 PMCID: PMC7504718 DOI: 10.3390/ijms21176393] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 12/11/2022] Open
Abstract
During total joint replacement, high concentrations of mesenchymal stromal cells (MSCs) are released at the implantation site. They can be found in cell–tissue composites (CTC) that are regularly removed by surgical suction. A surgical vacuum suction handle was filled with bone substitute granules, acting as a filter allowing us to harvest CTC. The purpose of this study was to investigate the osteopromotive potential of CTC trapped in the bone substitute filter material during surgical suction. In the course of 10 elective total hip and knee replacement surgeries, β-tricalcium-phosphate (TCP) and cancellous allograft (Allo) were enriched with CTC by vacuum suction. Mononuclear cells (MNC) were isolated from the CTC and investigated towards cell proliferation and colony forming unit (CFU) formation. Furthermore, MSC surface markers, trilineage differentiation potential and the presence of defined cytokines were examined. Comparable amounts of MNC and CFUs were detected in both CTCs and characterized as MSC‰ of MNC with 9.8 ± 10.7‰ for the TCP and 12.8 ± 10.2‰ for the Allo (p = 0.550). CTCs in both filter materials contain cytokines for stimulation of cell proliferation and differentiation (EGF, PDGF-AA, angiogenin, osteopontin). CTC trapped in synthetic (TCP) and natural (Allo) bone substitute filters during surgical suction in the course of a joint replacement procedure include relevant numbers of MSCs and cytokines qualified for bone regeneration.
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Affiliation(s)
- André Busch
- Department of Orthopedics, Trauma and Reconstructive Surgery, St. Marien Hospital Mülheim an der Ruhr, D-45468 Mülheim/Ruhr, Germany;
| | - Monika Herten
- Department of Orthopedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany;
- Correspondence: (M.H.); (M.J.); Tel.: +49-201-723-2475 (M.H.)
| | - Marcel Haversath
- Department of Orthopedics, St. Vinzenz Hospital Düsseldorf, 40477 Düsseldorf, Germany;
| | - Christel Kaiser
- Department of Orthopedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany;
| | - Sven Brandau
- Department of Otorhinolaryngology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany;
| | - Marcus Jäger
- Department of Orthopedics, Trauma and Reconstructive Surgery, St. Marien Hospital Mülheim an der Ruhr, D-45468 Mülheim/Ruhr, Germany;
- Chair of Orthopedics and Trauma Surgery, University of Duisburg Essen, D-45147 Essen, Germany
- Correspondence: (M.H.); (M.J.); Tel.: +49-201-723-2475 (M.H.)
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Henze K, Herten M, Haversath M, Busch A, Brandau S, Hackel A, Flohé SB, Jäger M. Surgical vacuum filter-derived stromal cells are superior in proliferation to human bone marrow aspirate. Stem Cell Res Ther 2019; 10:338. [PMID: 31753037 PMCID: PMC6868799 DOI: 10.1186/s13287-019-1461-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/16/2019] [Accepted: 10/18/2019] [Indexed: 01/11/2023] Open
Abstract
Background During joint replacement, surgical vacuum suction guarantees a sufficient overview on the situs. We assume high concentrations of mesenchymal stromal cells (MSCs) on surgical vacuum filters. We compared the in vitro proliferative and differentiation potency of cells from the following: (i) bone marrow (BM), (ii) cancellous bone (CB), (iii) vacuum filter (VF), and (iv) cell saver filtrate reservoir (SF) in 32 patients undergoing elective total hip replacement. Methods Mononuclear cells (MNC) were isolated, and cell proliferation and colony-forming units (CFU) were measured. Adherent cells were characterized by flow cytometry for MSC surface markers. Cells were incubated with osteogenic, adipogenic, and chondrogenic stimuli. Cells were cytochemically stained and osteoblastic expression (RUNX-2, ALP, and BMP-2) investigated via qPCR. Results Dependent on the source, initial MNC amount as well as CFU number was significantly different whereas generation time did not vary significantly. CFU numbers from VF were superior to those from SR, BM, and CB. The resulting amount of MSC from the respective source was highest in the vacuum filter followed by reservoir, aspirate, and cancellous bone. Cells from all groups could be differentiated into the three mesenchymal lines demonstrating their stemness nature. However, gene expression of osteoblastic markers did not differ significantly between the groups. Conclusion We conclude that surgical vacuum filters are able to concentrate tissue with relevant amounts of MSCs. A new potent source of autologous regeneration material with clinical significance is identified. Further clinical studies have to elucidate the regenerative potential of this material in an autologous setting.
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Affiliation(s)
- Katharina Henze
- Department of Orthopaedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Monika Herten
- Department of Orthopaedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Marcel Haversath
- Department of Orthopaedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - André Busch
- Department of Orthopaedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Sven Brandau
- Department of Otorhinolaryngology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Alexander Hackel
- Department of Otorhinolaryngology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Stefanie B Flohé
- Department of Orthopaedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Marcus Jäger
- Department of Orthopaedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. .,Department of Orthopaedics, Trauma and Reconstructive Surgery, University of Duisburg Essen & St. Marien Hospital Mülheim an der Ruhr / Contilia, Kaiserstrasse 50, 45468, Mülheim/Ruhr, Germany.
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Human iPSC-derived iMSCs improve bone regeneration in mini-pigs. Bone Res 2019; 7:32. [PMID: 31667001 PMCID: PMC6813363 DOI: 10.1038/s41413-019-0069-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 06/04/2019] [Accepted: 07/22/2019] [Indexed: 01/15/2023] Open
Abstract
Autologous bone marrow concentrate (BMC) and mesenchymal stem cells (MSCs) have beneficial effects on the healing of bone defects. To address the shortcomings associated with the use of primary MSCs, induced pluripotent stem cell (iPSC)-derived MSCs (iMSCs) have been proposed as an alternative. The aim of this study was to investigate the bone regeneration potential of human iMSCs combined with calcium phosphate granules (CPG) in critical-size defects in the proximal tibias of mini-pigs in the early phase of bone healing compared to that of a previously reported autograft treatment and treatment with a composite made of either a combination of autologous BMC and CPG or CPG alone. iMSCs were derived from iPSCs originating from human fetal foreskin fibroblasts (HFFs). They were able to differentiate into osteoblasts in vitro, express a plethora of bone morphogenic proteins (BMPs) and secrete paracrine signaling-associated cytokines such as PDGF-AA and osteopontin. Radiologically and histomorphometrically, HFF-iMSC + CPG transplantation resulted in significantly better osseous consolidation than the transplantation of CPG alone and produced no significantly different outcomes compared to the transplantation of autologous BMC + CPG after 6 weeks. The results of this translational study imply that iMSCs represent a valuable future treatment option for load-bearing bone defects in humans.
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McLaren JS, Macri-Pellizzeri L, Hossain KMZ, Patel U, Grant DM, Scammell BE, Ahmed I, Sottile V. Porous Phosphate-Based Glass Microspheres Show Biocompatibility, Tissue Infiltration, and Osteogenic Onset in an Ovine Bone Defect Model. ACS APPLIED MATERIALS & INTERFACES 2019; 11:15436-15446. [PMID: 30990301 DOI: 10.1021/acsami.9b04603] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Phosphate-based glasses (PBGs) are bioactive and fully degradable materials with tailorable degradation rates. PBGs can be produced as porous microspheres through a single-step process, using changes in their formulation and geometry to produce varying pore sizes and interconnectivity for use in a range of applications, including biomedical use. Calcium phosphate PBGs have recently been proposed as orthobiologics, based on their in vitro cytocompatibility and ion release profile. In this study, porous microspheres made of two PBG formulations either containing TiO2 (P40Ti) or without (P40) were implanted in vivo in a large animal model of bone defect. The biocompatibility and osteogenic potential of these porous materials were assessed 13 weeks postimplantation in sheep and compared to empty defects and autologous bone grafts used as negative and positive controls. Histological analysis showed marked differences between the two formulations, as lower trabeculae-like interconnection and higher fatty bone marrow content were observed in the faster degrading P40-implanted defects, while the slower degrading P40Ti material promoted dense interconnected tissue. Autologous bone marrow concentrate (BMC) was also incorporated within the P40 and P40Ti microspheres in some defects; however, no significant differences were observed in comparison to microspheres implanted alone. Both formulations induced the formation of a collagen-enriched matrix, from 20 to 40% for P40 and P40Ti2.5 groups, suggesting commitment toward the bone lineage. With the faster degrading P40 formulation, mineralization of the tissue matrix was observed both with and without BMC. Some lymphocyte-like cells and foreign body multinucleated giant cells were observed with P40Ti2.5, suggesting that this more durable formulation might be linked to an inflammatory response. In conclusion, these first in vivo results indicate that PBG microspheres could be useful candidates for bone repair and regenerative medicine strategies and highlight the role of material degradation in the process of tissue formation and maturation.
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Herten M, Zilkens C, Thorey F, Tassemeier T, Lensing-Höhn S, Fischer JC, Sager M, Krauspe R, Jäger M. Biomechanical Stability and Osteogenesis in a Tibial Bone Defect Treated by Autologous Ovine Cord Blood Cells-A Pilot Study. Molecules 2019; 24:molecules24020295. [PMID: 30650584 PMCID: PMC6358876 DOI: 10.3390/molecules24020295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to elucidate the impact of autologous umbilical cord blood cells (USSC) on bone regeneration and biomechanical stability in an ovine tibial bone defect. Ovine USSC were harvested and characterized. After 12 months, full-size 2.0 cm mid-diaphyseal bone defects were created and stabilized by an external fixateur containing a rigidity measuring device. Defects were filled with (i) autologous USSC on hydroxyapatite (HA) scaffold (test group), (ii) HA scaffold without cells (HA group), or (iii) left empty (control group). Biomechanical measures, standardized X-rays, and systemic response controls were performed regularly. After six months, bone regeneration was evaluated histomorphometrically and labeled USSC were tracked. In all groups, the torsion distance decreased over time, and radiographies showed comparable bone regeneration. The area of newly formed bone was 82.5 ± 5.5% in the control compared to 59.2 ± 13.0% in the test and 48.6 ± 2.9% in the HA group. Labeled cells could be detected in lymph nodes, liver and pancreas without any signs of tumor formation. Although biomechanical stability was reached earliest in the test group with autologous USSC on HA scaffold, the density of newly formed bone was superior in the control group without any bovine HA.
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Affiliation(s)
- Monika Herten
- Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, 45147 Essen, Germany.
| | - Christoph Zilkens
- Orthopedic Department, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany.
| | - Fritz Thorey
- Center for Hip, Knee and Foot Surgery, Sports Traumatology Department, ATOS Hospital, 69115 Heidelberg, Germany.
| | - Tjark Tassemeier
- Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, 45147 Essen, Germany.
| | - Sabine Lensing-Höhn
- Orthopedic Department, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany.
| | - Johannes C Fischer
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany.
| | - Martin Sager
- Animal Research Institute, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany.
| | - Rüdiger Krauspe
- Orthopedic Department, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany.
| | - Marcus Jäger
- Department of Orthopedics and Trauma Surgery, University of Duisburg-Essen, 45147 Essen, Germany.
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Grassmann JP, Schneppendahl J, Sager M, Hakimi AR, Herten M, Loegters TT, Wild M, Hakimi M, Windolf J, Jungbluth P. The effect of bone marrow concentrate and hyperbaric oxygen therapy on bone repair. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:5331. [PMID: 25577213 DOI: 10.1007/s10856-014-5331-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 07/27/2014] [Indexed: 06/04/2023]
Abstract
Neoangiogenesis represents an essential part of bone regeneration. Therefore the improvement of neovascularization is the subject of various research approaches. In addition autologous mesenchymal stem cells concentrate in combination with bone substitute materials have been shown to support bone regeneration. In a rabbit model we examined the proposed synergistic effect of hyperbaric oxygen therapy (HBOT) and bone marrow concentrate (BMC) with porous calcium phosphate granules (CPG) on neoangiogenesis and osseous consolidation of a critical- size defect. The animal groups treated with HBOT showed a significantly higher microvessel density (MVD) by immunhistochemistry. Furthermore HBOT groups presented a significantly larger amount of new bone formation histomorphometrically as well as radiologically. We conclude that the increase in perfusion as a result of increased angiogenesis may play a key role in the effects of HBOT and consequently promotes bone healing.
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Affiliation(s)
- J P Grassmann
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
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Hakimi M, Grassmann JP, Betsch M, Schneppendahl J, Gehrmann S, Hakimi AR, Kröpil P, Sager M, Herten M, Wild M, Windolf J, Jungbluth P. The composite of bone marrow concentrate and PRP as an alternative to autologous bone grafting. PLoS One 2014; 9:e100143. [PMID: 24950251 PMCID: PMC4064995 DOI: 10.1371/journal.pone.0100143] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 05/22/2014] [Indexed: 11/18/2022] Open
Abstract
One possible alternative to the application of autologous bone grafts represents the use of autologous bone marrow concentrate (BMC). The purpose of our study was to evaluate the potency of autologous platelet-rich plasma (PRP) in combination with BMC. In 32 mini-pigs a metaphyseal critical-size defect was surgically created at the proximal tibia. The animals were allocated to four treatment groups of eight animals each (1. BMC+CPG group, 2. BMC+CPG+PRP group, 3. autograft group, 4. CPG group). In the BMC+CPG group the defect was filled with autologous BMC in combination with calcium phosphate granules (CPG), whereas in the BMC+CPG+PRP group the defect was filled with the composite of autologous BMC, CPG and autologous PRP. In the autograft group the defect was filled with autologous cancellous graft, whereas in the CPG group the defect was filled with CPG solely. After 6 weeks radiological and histomorphometrical analysis showed significantly more new bone formation in the BMC+CPG+PRP group compared to the BMC+CPG group and the CPG group. There were no significant differences between the BMC+CPG+PRP group and the autograft group. In the PRP platelets were enriched significantly about 4.7-fold compared to native blood. In BMC the count of mononuclear cells increased significantly (3.5-fold) compared to the bone marrow aspirate. This study demonstrates that the composite of BMC+CPG+PRP leads to a significantly higher bone regeneration of critical-size defects at the proximal tibia in mini-pigs than the use of BMC+CPG without PRP. Furthermore, within the limits of the present study the composite BMC+CPG+PRP represents a comparable alternative to autologous bone grafting.
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Affiliation(s)
- Mohssen Hakimi
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Jan-Peter Grassmann
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
- * E-mail:
| | - Marcel Betsch
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Johannes Schneppendahl
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Sebastian Gehrmann
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Ahmad-Reza Hakimi
- Department of Oral Surgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Patric Kröpil
- Department of Diagnostic and Interventional Radiology, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Martin Sager
- Animal Research Institute, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Monika Herten
- Department of Orthopaedics, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Michael Wild
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Joachim Windolf
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
| | - Pascal Jungbluth
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany
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Inflammatory effects of autologous, genetically modified autologous, allogeneic, and xenogeneic mesenchymal stem cells after intra-articular injection in horses. Vet Comp Orthop Traumatol 2013; 26:453-60. [PMID: 24080668 DOI: 10.3415/vcot-13-01-0008] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Accepted: 07/05/2013] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To compare the clinical and inflammatory joint responses to intra-articular injection of bone marrow-derived mesenchymal stem cells (MSC) including autologous, genetically modified autologous, allogeneic, or xenogeneic cells in horses. METHODS Six five-year-old Thoroughbred mares had one fetlock joint injected with Gey's balanced salt solution as the vehicle control. Each fetlock joint of each horse was subsequently injected with 15 million MSC from the described MSC groups, and were assessed for 28 days for clinical and inflammatory parameters representing synovitis, joint swelling, and pain. RESULTS There were not any significant differences between autologous and genetically modified autologous MSC for synovial fluid total nucleated cell count, total protein, interleukin (IL)-6, IL-10, fetlock circumference, oedema score, pain-free range-of-motion, and soluble gene products that were detected for at least two days. Allogeneic and xenogeneic MSC produced a greater increase in peak of inflammation at 24 hours than either autologous MSC group. CLINICAL SIGNIFICANCE Genetically engineered MSC can act as vehicles to deliver gene products to the joint; further investigation into the therapeutic potential of this cell therapy is warranted. Intra-articular MSC injection resulted in a moderate acute inflammatory joint response that was greater for allogeneic and xenogeneic MSC than autologous MSC. Clinical management of this response may minimize this effect.
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Betsch M, Schneppendahl J, Thuns S, Herten M, Sager M, Jungbluth P, Hakimi M, Wild M. Bone marrow aspiration concentrate and platelet rich plasma for osteochondral repair in a porcine osteochondral defect model. PLoS One 2013; 8:e71602. [PMID: 23951201 PMCID: PMC3741121 DOI: 10.1371/journal.pone.0071602] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 07/08/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Bone marrow aspiration concentrate (BMAC) may possess a high potency for cartilage and osseous defect healing because it contains stem cells and multiple growth factors. Alternatively, platelet rich plasma (PRP), which contains a cocktail of multiple growth factors released from enriched activated thrombocytes may potentially stimulate the mesenchymal stem cells (MSCs) in bone marrow to proliferate and differentiate. METHODS A critical size osteochondral defect (10×6 mm) in both medial femoral condyles was created in 14 Goettinger mini-pigs. All animals were randomized into the following four groups: biphasic scaffold alone (TRUFIT BGS, Smith & Nephew, USA), scaffold with PRP, scaffold with BMAC and scaffold in combination with BMAC and PRP. After 26 weeks all animals were euthanized and histological slides were cut, stained and evaluated using a histological score and immunohistochemistry. RESULTS The thrombocyte number was significantly increased (p = 0.049) in PRP compared to whole blood. In addition the concentration of the measured growth factors in PRP such as BMP-2, BMP-7, VEGF, TGF-β1 and PDGF were significantly increased when compared to whole blood (p<0.05). In the defects of the therapy groups areas of chondrogenic tissue were present, which stained blue with toluidine blue and positively for collagen type II. Adding BMAC or PRP in a biphasic scaffold led to a significant improvement of the histological score compared to the control group, but the combination of BMAC and PRP did not further enhance the histological score. CONCLUSIONS The clinical application of BMAC or PRP in osteochondral defect healing is attractive because of their autologous origin and cost-effectiveness. Adding either PRP or BMAC to a biphasic scaffold led to a significantly better healing of osteochondral defects compared with the control group. However, the combination of both therapies did not further enhance healing.
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Affiliation(s)
- Marcel Betsch
- Department of Trauma and Hand Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Johannes Schneppendahl
- Department of Trauma and Hand Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
- * E-mail:
| | - Simon Thuns
- Department of Trauma and Hand Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Monika Herten
- Clinic for Vascular and Endovascular Surgery, University Hospital Muenster, Muenster, Germany
| | - Martin Sager
- Central Animal Research Facility, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Pascal Jungbluth
- Department of Trauma and Hand Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Mohssen Hakimi
- Department of Trauma and Hand Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Michael Wild
- Department of Trauma and Orthopaedic Surgery, Klinikum Darmstadt, Darmstadt, Germany
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Fracture morphology and fracture management. Vet Comp Orthop Traumatol 2013; 26:V-VI. [PMID: 23358738 DOI: 10.3415/vcot-12-12-0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 12/17/2012] [Indexed: 11/17/2022]
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