Repair of Torn Avascular Meniscal Cartilage Using Undifferentiated Autologous Mesenchymal Stem Cells: From In Vitro Optimization to a First-in-Human Study
| Autor: | Allen E. Goodship, Eric Austin, Kyla Brady, Ashley W Blom, Michael Parry, Anthony P. Hollander, Michael R Whitehouse, Jonathan Eldridge, Wael Kafienah, N. R. Howells |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Cell- and Tissue-Based Therapy Osteoarthritis Meniscus (anatomy) In Vitro Techniques Menisci Tibial Cell therapy 03 medical and health sciences 0302 clinical medicine Tissue engineering Translational Research Articles and Reviews Tissue Engineering and Regenerative Medicine medicine Animals Humans Cells Cultured 030222 orthopedics Wound Healing Sheep Tissue Engineering Tissue Scaffolds business.industry Cartilage Mesenchymal stem cell Mesenchymal Stem Cells Cell Biology General Medicine medicine.disease Torn meniscus Surgery Tibial Meniscus Injuries 030104 developmental biology medicine.anatomical_structure Centre for Surgical Research Mesenchymal stem cells Female Stem cell Wound healing business Meniscal cartilage Cartilage Diseases Developmental Biology |
| Zdroj: | Stem Cells Translational Medicine Whitehouse, M, Howells, N, Parry, M, Austin, E, Kafienah, W, Brady, K, Goodship, A, Eldridge, J, Blom, A & Hollander, A 2017, ' Repair of Torn Avascular Meniscal Cartilage Using Undifferentiated Autologous Mesenchymal Stem Cells : From In Vitro Optimization to a First-in-Human Study ', Stem Cells Translational Medicine, vol. 6, no. 4, pp. 1237-1248 . https://doi.org/10.1002/sctm.16-0199 |
| DOI: | 10.1002/sctm.16-0199 |
| Popis: | Meniscal cartilage tears are common and predispose to osteoarthritis (OA). Most occur in the avascular portion of the meniscus where current repair techniques usually fail. We described previously the use of undifferentiated autologous mesenchymal stem cells (MSCs) seeded onto a collagen scaffold (MSC/collagen-scaffold) to integrate meniscal tissues in vitro. Our objective was to translate this method into a cell therapy for patients with torn meniscus, with the long-term goal of delaying or preventing the onset of OA. After in vitro optimization, we tested an ovine-MSC/collagen-scaffold in a sheep meniscal cartilage tear model with promising results after 13 weeks, although repair was not sustained over 6 months. We then conducted a single center, prospective, open-label first-in-human safety study of patients with an avascular meniscal tear. Autologous MSCs were isolated from an iliac crest bone marrow biopsy, expanded and seeded into the collagen scaffold. The resulting human-MSC/collagen-scaffold implant was placed into the meniscal tear prior to repair with vertical mattress sutures and the patients were followed for 2 years. Five patients were treated and there was significant clinical improvement on repeated measures analysis. Three were asymptomatic at 24 months with no magnetic resonance imaging evidence of recurrent tear and clinical improvement in knee function scores. Two required subsequent meniscectomy due to retear or nonhealing of the meniscal tear at approximately 15 months after implantation. No other adverse events occurred. We conclude that undifferentiated MSCs could provide a safe way to augment avascular meniscal repair in some patients. Registration: EU Clinical Trials Register, 2010-024162-22. |
| Databáze: | OpenAIRE |
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