Assessment of clinical, biochemical, and radiological outcomes following intra-articular injection of Wharton jelly-derived mesenchymal stromal cells in patients with knee osteoarthritis: A prospective clinical study

Abstract

The aim of the present study was to perform clinical, biochemical, and radiological evaluation of the efficacy of mesenchymal stem cells derived from Wharton jelly (WJ) present within the human umbilical cord in the treatment of knee osteoarthritis. Between 2018 and 2019, 10 patients with knee osteoarthritis for whom the conservative treatment was not beneficial were included in the study. Patients were clinically, radiologically, and biochemically evaluated before treatment initiation. Thereafter, the patients were intra-articularly injected using a solution containing 1 × 10 8 WJ-derived MSCs. Evaluations were performed on day 21 (V1) and 42 (V2) and month 3 (V3), 6 (V4), and 12 (V5) after the procedure. At 1-year post-injection, visual analogue scale, Western Ontario and McMaster Universities Osteoarthritis Index, and Lequesne scores of patients were lower than those observed during the initial evaluation, whereas the mean 36-Item Short Form Health Survey score was higher. Cartilage thicknesses were found to be increased in all regions except in the medial femur, medial posterior femur, lateral posterior femur, and lateral posterior tibia regions in magnetic resonance imaging. A significant increase was observed in tumor necrosis factor-alpha, interleukin-1β, adiponectin, resistin, and interleukin-6 levels compared with pre-injection values. The leptin levels at 6-month and 1-year controls were lower than the pre-injection levels, and the decrease observed at 6 months was significant. In patients with knee osteoarthritis, intra-articular WJ-derived MSC injection causes significant pain reduction, satisfactory functional improvement, and increased patient satisfaction following a 1-year follow-up. These clinical improvements were supported by magnetic resonance images, along with changes in adiponectin and leptin levels in synovial fluid. Level of evidence: IV.

Naturally derived injectable hydrogels with ROS-scavenging property to protect transplanted stem cell bioactivity for osteoarthritic cartilage repair

“…Among them, MSCs are considered as a kind of alternative seed cells to treat OA because of their extensive sources, easy access, great potential for self-proliferation and multi-differentiation, and ability to regulate inflammation ( Barry and Murphy, 2013 ; Bertoni et al, 2021 ; Hwang et al, 2021 ). Numerous previous clinical studies have systematically demonstrated that intra-articular injection of MSCs can improve cartilage damage and relieve pain in patients with OA ( Aletto et al, 2022 ; Carvalho Schweich-Adami et al, 2022 ; Gunay et al, 2022 ). Specifically, ADSCs significantly reduced OA cartilage damage in rats, which can be achieved by down-regulating MMP-13 and COL-X and up-regulating COL-2.…”

A systematic review, umbrella review, and quality assessment on clinical translation of stem cell therapy for knee osteoarthritis: Are we there yet?

“…Included in the 50 studies were 16 RCTs [ 42 – 57 ], 10 controlled trials [ 58 – 67 ], and 24 single-arm studies [ 68 – 91 ]. There were 1223 patients, including 565 men and 807 women (sexes ratio was missed in four studies).…”

Wharton’s jelly and osteoarthritis of the knee

“…The study was limited by its small sample size, short follow-up period, absence of a control group and lack of histopathological analysis, suggesting the need for further research with larger patient cohorts, histopathological analyses, extended observation periods and comparison to control groups. 44 …”