Stem cells for regenerative medicine purposes offer therapeutic benefits, but disadvantages are still ill defined. The benefit of stem cells may be attributed to their secretion of growth factors (GFs), cytokines (CKs), and extracellular vesicles (EVs), including exosomes. We present a novel cell-free stem cell-derived extract (CCM), formulated from human progenitor endothelial stem cells (hPESCs), characterized for biologically active factors using ELISA, nanoparticle tracking analysis and single particle interferometric reflectance imaging sensing. The effect on fibroblast proliferation and ability to induce stem cell migration was analyzed using Alamar Blue proliferation and Transwell migration assays, respectively. GFs including IGFBP 1, 2, 3, and 6, insulin, growth hormone, PDGF-AA, TGF-α, TGF-β1, VEGF, and the anti-inflammatory cytokine, IL-1RA were detected. Membrane enclosed particles within exosome size range and expressing exosome tetraspanins CD81 and CD9 were identified. CCM significantly increased cell proliferation and induced stem cell migration. Analysis of CCM revealed presence of GFs, CKs, and EVs, including exosomes. The presence of multiple factors including exosomes within one formulation, the ability to promote cell proliferation and induce stem cell migration may reduce inflammation and pain, and augment tissue repair.
Background Musculoskeletal conditions are highly prevalent, and knee OA is most common. Current treatment modalities have limitations and either fail to solve the underlying pathophysiology or are highly invasive. To address these limitations, attention has focused on the use of biologics. The efficacy of these devices is attributed to presence of growth factors (GFs), cytokines (CKs), and extracellular vesicles (EVs). With this in mind, we formulated a novel cell-free stem cell-derived extract (CCM) from human progenitor endothelial stem cells (hPESCs). A preliminary study demonstrated the presence of essential components of regenerative medicine, namely GFs, CKs, and EVs, including exosomes, in CCM. The proposed study aims to evaluate the safety and efficacy of intraarticular injection of the novel cell-free stem cell-derived extract (CCM) for the treatment of knee OA. Methods and analysis This is a non-randomized, open-label, multi-center, prospective study in which the safety and efficacy of intraarticular CCM in patients suffering from grade II/III knee OA will be evaluated. Up to 20 patients with grade II/III OA who meet the inclusion and exclusion criteria will be consented and screened to recruit 12 patients to receive treatment. The study will be conducted at up to 2 sites within the USA, and the 12 participants will be followed for 24 months. The study participants will be monitored for adverse reactions and assessed using Numeric Pain Rating Scale (NPRS), Patient-Reported Outcomes Measurement Information System (PROMIS) Score, Knee Injury and Osteoarthritis Outcome Score Jr. (KOOS Jr.), 36-ietm short form survey (SF-36), Single Assessment Numeric Evaluation (SANE), physical exams, plain radiography, and magnetic resonance imaging (MRI) with Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score for improvements in pain, function, satisfaction, and cartilage regeneration. Discussion This prospective study will provide valuable information into the safety and efficacy of intraarticular administration of cell-free stem cell-derived extract (CCM) in patients suffering with grade II/III knee OA. The outcomes from this initial study of novel CCM will lay the foundation for a larger randomized, placebo-controlled, multi-center clinical trial of intraarticular CCM for symptomatic knee OA. Trial registration Registered on July 21, 2021. ClinicalTrials.gov NCT04971798
METHODS: Fifty-four adults with SIS were randomly assigned into either YJB training (n = 18), a usual exercise therapy (UET) training involving resistance exercise using elastic band and stretching (n = 18), or a control group (n= 18). The exercise intervention for both the YJB and UET groups last for 10 weeks, with four sessions per week, and about 30 minutes per session. Participants in the control group did not receive any treatment. Pre-Post-outcome measures were range of motions (ROMs) of shoulder flexion and abduction, the back scratch test, and the shoulder lateral raise muscular endurance test by use of a resistive elastic band. These outcome measures were assessed before and after the first training session (acute effect), as well as after the 10-week training (chronic effect). RESULTS: For acute effect, two-way repeated measure ANOVA found significant group x time (pre-post) interaction (p< .05) in ROMs of shoulder flexion, abduction, and back-scratch test. Both YJB and UET groups demonstrated better improvement than the control group, with no different between YJB and UET. Both YJB and UET groups produced 10o-13o improvement in shoulder ROM after just one training session. No acute effect was found for shoulder endurance. For chronic effect, significant interaction was found for back scratch test (p< .05) and shoulder endurance (p< .06). Both YJB and UET improved shoulder mobility (+3.4 to 4.3 cm) more than the control (+0.9 cm). For shoulder endurance the UET demonstrated greater improvement than the YJB and control. CONCLUSIONS: The innovated YJB exercise is a promising mind-body exercise that help to improve immediate and long-term shoulder mobility and flexibility, and may be recommended as one of the supportive exercise therapies for patients with shoulder impingement syndrome.
In this editorial, we focused on the article, “MicroRNA-132 in the Adult Dentate Gyrus is Involved in Opioid Addiction Via Modifying the Differentiation of Neural Stem Cells” by Jia and colleagues [...]
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