The Role of Immunologic Response in Fresh Osteochondral Allografting of the Knee

Hunt, Harold E.; Sadr, Kamran N.; DeYoung, Allison J.; Görtz, Simon; Bugbee, William D.

doi:10.1177/0363546513518733

Cited by 60 publications

(72 citation statements)

References 29 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We have demonstrated the efficacy of chondrocyte sheet transplantation in allogeneic settings in rats, rabbits, and minipigs without immunosuppression [5][6][7][8]. Additionally, many allogeneic osteochondral transplantations in histoincompatibile patients have been conducted safely [10,45,46]. However, the influence of histoincompatiblility on efficacy of PD sheet transplantation is still unknown, as we are currently evaluating the immune response in the PD sheet transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

Transcriptomic and Proteomic Analyses Reveal the Potential Mode of Action of Chondrocyte Sheets in Hyaline Cartilage Regeneration

Toyoda

Sato

Takahashi

et al. 2019

IJMS

View full text Add to dashboard Cite

Chondrocyte sheet transplantation is a novel and promising approach to treating patients who have cartilage defects associated with osteoarthritis. Hyaline cartilage regeneration by autologous chondrocyte sheets has already been demonstrated in clinical research. In this study, the efficacy of polydactyly-derived chondrocyte sheets (PD sheets) as an allogeneic alternative to standard chondrocyte sheets was examined using an orthotopic xenogeneic transplantation model. In addition, the expression of genes and the secreted proteins in the PD sheets was analyzed using a microarray and a DNA aptamer array. The efficacy of PD sheets with respect to cartilage defects was assessed using histological scores, after which the expressions of genes and proteins exhibiting a correlation to efficacy were identified. Enrichment analysis of efficacy-correlated genes and proteins showed that they were associated with extracellular matrices, skeletal development, and angiogenesis. Eight genes (ESM1, GREM1, SERPINA3, DKK1, MIA, NTN4, FABP3, and PDGFA) exhibited a positive correlation with the efficacy of PD sheets, and three genes (RARRES2, APOE, and PGF) showed a negative correlation for both transcriptomic and proteomic analyses. Among these, MIA, DKK1, and GREM1 involved in skeletal development pathways and ESM1 involved in the angiogenesis pathway exhibited a correlation between the amount of secretion and efficacy. These results suggest that these secreted factors may prove useful for predicting PD sheet efficacy and may therefore contribute to hyaline cartilage regeneration via PD sheets.

show abstract

Section: Discussionmentioning

confidence: 99%

Transcriptomic and Proteomic Analyses Reveal the Potential Mode of Action of Chondrocyte Sheets in Hyaline Cartilage Regeneration

Toyoda

Sato

Takahashi

et al. 2019

IJMS

View full text Add to dashboard Cite

show abstract

“…The immunologic ramifications of this procedure remain an important consideration and might allow its use to further improve the treatment and prevent graft failures secondary to host rejection. In a study examining the relationship between development of anti‐HLA antibodies after OCA with graft size and clinical outcome, positive HLA‐antibody screens were found in 70% of patients with large (19/27), 54% of patients with medium (20/37), and 6% of patients with small (1/16) OCA post‐operative, but graft survivorship was similar in positive anti‐HLA antibody (64%) and negative anti‐HLA antibody (79%) patients ( p = 0.15), as were Knee Society function scores (88.3 vs. 84.6, p = 0.5) …”

Section: Defining the Clinical Algorithm To Treat Chondral And Osteochomentioning

confidence: 99%

Osteochondral allograft transplantation in cartilage repair: Graft storage paradigm, translational models, and clinical applications

Bugbee

Pallante-Kichura

Görtz

et al. 2015

Journal Orthopaedic Research

Self Cite

109

117

View full text Add to dashboard Cite

The treatment of articular cartilage injury and disease has become an increasingly relevant part of orthopaedic care. Articular cartilage transplantation, in the form of osteochondral allografting, is one of the most established techniques for restoration of articular cartilage. Our research efforts over the last two decades have supported the transformation of this procedure from experimental “niche” status to a cornerstone of orthopaedic practice. In this Kappa Delta paper, we describe our translational and clinical science contributions to this transformation: (1) to enhance the ability of tissue banks to process and deliver viable tissue to surgeons and patients, (2) to improve the biological understanding of in vivo cartilage and bone remodeling following osteochondral allograft (OCA) transplantation in an animal model system, (3) to define effective surgical techniques and pitfalls, and (4) to identify and clarify clinical indications and outcomes. The combination of coordinated basic and clinical studies is part of our continuing comprehensive academic OCA transplant program. Taken together, the results have led to the current standards for OCA processing and storage prior to implantation and also novel observations and mechanisms of the biological and clinical behavior of OCA transplants in vivo. Thus, OCA transplantation is now a successful and increasingly available treatment for patients with disabling osteoarticular cartilage pathology.

show abstract

“…For years it is stated that intact hyaline cartilage is immuneprivileged" [17,18], and so no AB0 blood group or HLA matching is performed during allograft transplantation. Current publications [8,[19][20][21] show that donor chondrocytes in the allograft are replaced by patient's chondrocytes over the time and HLAresponse could have an impact on outcome after allograft transplantation. Interactions takes place between recipient joint and the donor allograft, which are not yet entirely understood.…”

Section: Discussionmentioning

confidence: 99%

“…Vascularization and osteo-integration are fast (6-12 weeks) [7]. According to the literature, there is no need for HLA matching or immunosuppression due to protection of the donor cartilage cells from host cell response by their matrix [8].…”

Section: Introductionmentioning

confidence: 99%

Two-stage late reconstruction with a fresh large osteochondral shell allograft transplantation (FLOCSAT) for a large ostechondral defect in a non-union after a lateral tibia plateau fracture 2-year follow up

Krettek

Clausen

Omar

et al. 2017

Injury

View full text Add to dashboard Cite

This is the description of a 58-year-old female patient presenting 8 months after a horse riding accident with significant pain and inability to walk independently. Imaging revealed a large osseous defect of the lateral tibia plateau which was not united posteriorly. The patient refused knee replacement and we developed a patient specific two-step procedure for her. Step 1: Filling of the defect with a large cortico-cancellous autograft from the posterior iliac crest; step 2: Transplantation of a fresh large osteochondral shell allograft (FLOCSAT). The postoperative protocol included continuous passive motion (CPM), partial weight bearing for three months, and physiotherapy. Based on the concept of immuno-privileged cartilage tissue, the patient did not get any immuno-suppressive therapy. Pain-, activity of daily living, Lysholm and Tegner scores were evaluated before defect filling surgery with autograft, before allograft transplantation, and at 12 and 24 months after allograft transplantation. There were no complications. Radiographic analyses with plain films and CT scans revealed solid osseous integration within 3 month. The patient regained excellent functionality in both, activities of daily living and sports (back to horse riding, trampolin jumping). Knee arthroscopy after 1year showed excellent condition of the lateral meniscus and the cartilage of the lateral tibia plateau. Chimerism/DNA analysis of a cartilage biopsy showed, that at 1year 32% of the donor cells have been already replaced by the patient's own cells. To our knowledge, this is the first case of a patient who sustained such a large defect during a tibia plateau fracture, and got successfully treated with a fresh large osteochondral shell allograft transplantation in a two-step procedure.

show abstract

The Role of Immunologic Response in Fresh Osteochondral Allografting of the Knee

Cited by 60 publications

References 29 publications

Transcriptomic and Proteomic Analyses Reveal the Potential Mode of Action of Chondrocyte Sheets in Hyaline Cartilage Regeneration

Transcriptomic and Proteomic Analyses Reveal the Potential Mode of Action of Chondrocyte Sheets in Hyaline Cartilage Regeneration

Osteochondral allograft transplantation in cartilage repair: Graft storage paradigm, translational models, and clinical applications

Two-stage late reconstruction with a fresh large osteochondral shell allograft transplantation (FLOCSAT) for a large ostechondral defect in a non-union after a lateral tibia plateau fracture 2-year follow up

Contact Info

Product

Resources

About