Article Sidebar
Views PDF: 287
EFFECTS AND SAFETY OF PLATELET-RICH PLASMA IN COMBINATION WITH HUMAN MESENCHYMAL STEM CELLS FROM AUTOLOGOUS ADIPOSE TISSUE FOR KNEE OSTEOARTHRITIS
Main Article Content
Abstract
Objective: To evaluate the efficacy of platelet-rich plasma in combination with human mesenchymal stem cells from autologous adipose tissue for knee osteoarthritis treatment. Research object and method: In the study, there are 30 patients including 26 females and 4 males; correspondingly, 60 knee joints were diagnosed with osteoarthritis according to the American College of Rheumatology (ACR) who are at the mean age of 58,63 ± 11.11, disease duration is from 5,3± 4,6 years which is respectively of stages II - III according to Kellgren and Lawrence. All were injected with autologous platelet-rich plasma that was extracted by PRP set, APC 30 PRP PRCEDURE PRAK and autologously extracted mesenchymal stem cells from abdominal adipose tissue using the ADI-25-01 ADIPOSEPRCEDURE PRAK set with the Harvest smart stem cell separator of TERUMO BCT- USA. Results: After 12 months of treatment: the pain level according to VAS score at the right knee joint was decreased from 6.0 ± 1.28 before treatment to 1.9 ± 0.3; VAS score at the left knee joint was decreased from 6.43±1.19 to 2.25±0.43. Total Liquesce score at right knee joint was decreased from 16.04±1.57 before treatment to 4.31±1.04, at left knee joint was decreased from 17.52±1.74 before treatment to 5.15. ±1.48. Total WOMAC score at right knee joint was decreased from 55.93±5.56 to 10.37±1.56; at left knee joint was decreased from 53.97±5.57 to 10.07±1.59. There were 52/60 (86.77%) joints with cartilage thickness change and the patellar cartilage thickness was increased from 1.56 ± 0.09 mm before treatment to 1.65 ± 0.09 mm. The rate of complications at injection site, abdominal adipose removal is low, there are no complications of local infection and systemic reactions. Conclusion: The treatment of knee osteoarthritis with platelet-rich plasma in combination with mesenchymal stem cells from autologous adipose tissue is effective in reducing pain, improving patient's mobility and walking function comparing with before treatment; reforming articular cartilage thickness on magnetic resonance image which therefore improves the mobility function of the knee joint. This therapy is safe.
Article Details
References
2. Ghosh P, Smith M (2002), Osteoarthritis, genetic and molecular mechanisms, Biogerontology 2002;3(1-2):85-8.
3. Vega Aurelio, Martín-Ferrero Miguel Angel, Canto Francisco Del, Alberca Mercedes, García Veronica, Munar Anna, et al (2015), Treatment of knee osteoarthritis with allogeneic bone marrow mesenchymal stem cells. Transplantation 2015;99(8): 1681-90.
4. Pers YM, Rackwitz L, Ferreira R, Pullig O, Delfour C, Barry F, et al (2016), Adipose mesenchymal stromal cell-based therapy for severe osteoarthritis of the knee: a phase I dose-escalation trial, Stem Cells Transl Med 2016;5:847-56. sctm.2015- 0245.
5. Wang YL, Jin WX, Liu HY, Cui YH, Mao QC, Fei ZY, et al (2016), Curative effect of human umbilical cord mesenchymal stem cells by intra-articular injection for degenerative knee osteoarthritis. Zhongguo xiu fu chong jian wai ke za zhi Zhongguo xiufu chongjian waike zazhi Chinese journal of reparative and reconstructive surgery 2016;30(12):1472.
6. Espinoza F, Matas J, Orrego M, Tapia R, Infante C, Khoury M, et al (2017), Allogeneic mesenchymal stromal cell (MSC) therapy for knee osteoarthritis (OA): a phase I/II randomized controlled trial, Cytotherapy 2017;19(5):24.
7. Hootman Jennifer M, Helmick Charles G, Barbour Kamil E, Theis Kristina A, Boring Michael A(2016) Updated projected prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation among US adults, 2015-2040, Arthritis Rheum 2016;68(7):1582-7.
8. Bastos Ricardo, Mathias Marcelo, Andrade Renato, Bastos Raquel, Balduino Alex, Schott Vinicius, et al (2018), Intra-articular injections of expanded mesenchymal stem cells with and without addition of platelet-rich plasma are safe and effective for knee osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy; 2018.
9. Qingyun X, Kunzheng W, Fuxing P, Hanmin Z, Dadi J, Tianzun T, et al (2015), The survey of the prevalence of primary osteoarthritis in the population aged 40 years and over in China. Chin J Orthop 2015;35(12):1206-12.
10. Zhu Yu, Yuchen Wang, Bizeng Zhao, Xin Niu, Bin Hu, Qing Li, et al (2017), Comparison of exosomes secreted by induced pluripotent stem cell-derived mesenchymal stem cells and synovial membrane-derived mesenchymal stem cells for the treatment of osteoarthritis. Stem Cell Res Ther 2017;8(1):64.
11. Freitag J, Bates D, Boyd R, Shah K, Barnard A, Huguenin L, et al (2016), Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways, safety and efficacy -a review. BMC Muscoskel Disord 2016;17(1):230.
12. Jones IA, Togashi R, Wilson ML, Heckmann N, Vangsness CT (2019), Intra-articular treatment options for knee osteoarthritis. Nat Rev Rheumatol 2019;15(2):77-90.
13. El-Sharkawy H, Kantarci A, Deady J. et al (2007). Platelet-rich plasma: growth factors and pro-and anti-inflammatory properties. J Periodontol, 78 (4), 661-669.
14. Sampson S, Reed M, Silvers H. et al (2010), Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study. Am J Phys Med Rehabil, 89 (12), 961-969.
15. Coulson-Thomas VJ, Coulson-Thomas YM, Gesteira TF, Kao WY (2016), Extrinsic and intrinsic mechanisms by which mesenchymal stem cells suppress the immune system, Ocul Surf 2016;14(2):121-34.
16. Ryu Jae-Sung, Jung Yeon-Hwa, Cho Mi-Young, Yeo Jee Eun, Choi Yun-Jin, Kim Yong Il, et al (2014), Co-culture with human synovium-derived mesenchymal stem cells inhibits inflammatory activity and increases cell proliferation of sodium nitroprusside-stimulated chondrocytes, Biochem Biophys Res Commun 2014; 447(4):715-20.
17. Barry F, Murphy M (2013), Mesenchymal stem cells in joint disease and repair, Nat Rev Rheumatol 2013;9(10):584-94.
18. Mamidi MK, Das AK, Zakaria Z, Bhonde R (2016), Mesenchymal stromal cells for cartilage repair in osteoarthritis, Osteoarthritis Cartilage 2016;24(8):1307-16.
19. Caplan AI (2010), Adult mesenchymal stem cells for tissue engineering versus regenerative medicine, J Cell Physiol 2010;213(2):341-7.
20. Susanne G, Julia L (2014), Tissue-engineering strategies to repair chondral and osteochondral tissue in osteoarthritis: use of mesenchymal stem cells, Curr Rheumatol Rep 2014;16(10):452.
21. Patricia A. Zuk et al (2001), Multilineage Cells from Human Adipose Tissue: Implications for Cell-Based Therapies. 2001 Apr;7(2):211-28
22. Yancheng Song et al (2020), Mesenchymal stem cell in knee osteoarthritis treatment: A systematic review and meta-analysis, Journal of Orthopaedic Translation 24 (2020)121-130.
23. Thitinan Srikulmontree (2012). Osteoarthritis. The American College of Rheumatology.
24. Khanh Hong-Thien Bui, Triet Dinh Duong, Nhan Thanh Nguyen et al (2014), Symptomatic knee osteoarthritis treatment using autologous adipose derived stem cells and platelet-rich plasma: a clinical study, Biomedical Research and Therapy, 1, 02-08.
25. Phạm Hoài Thu (2017) “Nghiên cứu kết quả điều trị bệnh thoái hóa khớp gối nguyên phát bằng liệu pháp tế bào gốc mô mỡ tự thân”. Luận án tiến sỹ Y học, Trường đại học Y Hà Nội.
26. Trần Viết Tiến và cộng sự (2015). Nghiên cứu ứng dụng tế bào gốc tự thân trong điều trị bệnh thoái hóa khớp. Đề tài độc lập cấp nhà nước, Học viện quân Y.
27. Yong-Gon Koh, Seung-Bae Jo, Oh-Ryong Kwon et al (2012), Mesenchymal Stem Cell Injections Improve Symptoms of Knee Osteoarthritis, The Journal of Arthroscopic and Related Surgery, 29 (4), 748-755.
28. Yong-Gon Koh, Yun-Jin Choi, Sae-Kwang Kwon et al (2013), Clinical results and second-look arthroscopic findings after treatment with adipose- derived stem cells for knee osteoarthritis, Knee Surg Sports Traumatol Arthrosc.
29. Liang-jing Lu et al (2016), Treatment with human adipose- derived mesenchymal stem cells for knee osteoarthritis. NCT 021626693, The 18th Congress of Asia Pacific League of Association for Rheumatology (APLAR 2016). Shanghai, China.
30. Centeno CJ, Schultz J, Cheever M. et al(2010). Safety and complications reporting on the re-implantation of culture-expanded mesenchymal stem cells using autologous platelet lysate technique, Curr Stem cell Res Ther, 5 (1), 81-93.