Safety and efficacy of adipose-derived mesenchymal stem cells for knee osteoarthritis: A systematic review and m-analysis

Gadelkarim, Mohamed; Elmegeed, Aya Abd; Hafez, Ahmed A. A.; Awad, Ahmed K.; Shehata, Mostafa; AbouEl-Enein, Asmaa; Alsadek, Mohamed Eid; Deeb, Mohammad Abo; Afifi, Ahmed

doi:10.1016/j.jbspin.2022.105404

Cited by 19 publications

(18 citation statements)

References 47 publications

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“…The studies in 11 of the 13 SRs/MAs were RCTs [ 92 – 102 ], while two included RCTs and Non-RCTs [ 103 , 104 ]. The analysis included patients ranging between 138 [ 100 ] and 1494 [ 102 ].…”

Section: Resultsmentioning

confidence: 99%

“…MSCs included in this analysis were ADMSCs, BMSCs, and UCMSCs. Only eight studies reported stem cell transplantation doses [ 93 , 98 – 104 ], ranging from 1 × 10 6 to 1.5 × 10 8 . Three to 10 electronic databases were searched.…”

Section: Resultsmentioning

confidence: 99%

“…All studies were evaluated for quality. All nine studies that reported ARs after stem cell transplantation [ 92 , 94 , 96 , 97 , 99 , 101 – 104 ] treated ARs as a secondary indicator without calculating the ARs incidence and explored the impact of ARs on patients (Additional file 1 : Table S3 of Appendix 1).…”

Section: Resultsmentioning

confidence: 99%

“…At 3 months, Huang et al [ 97 ] and Long et al [ 105 ] found that stem cell transplantation significantly improved patients VAS scores compared to the opposite results obtained by Qu et al [ 93 ]. At 6 months, four studies concluded that stem cells did not improve the VAS scores of patients [ 92 , 103 , 104 , 106 ]. At 12 months, three studies concluded that stem cells did not improve patients VAS scores [ 92 , 103 , 104 ].…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2023

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Background The success of stem cell therapy for knee osteoarthritis (KOA) in preclinical animal models has accelerated the pace of clinical translation. However, it remains uncertain whether the current scientific evidence supports the clinical application of stem cells in treating KOA. A comprehensive evaluation of the safety and efficacy of stem cell therapies and scientific evidence quality is necessary. Methods Using “stem cells” and “knee osteoarthritis” as the search terms, several databases, including PubMed, Web of Science, Cochrane, Embase, and Clinicaltrials.gov, were searched on August 25, 2022, and updated on February 27, 2023. Clinical studies that reported adverse reactions (ARs) of stem cell therapy in KOA patients were included without limiting the type of studies. Quantitative systematic reviews of stem cell therapy for KOA that conducted meta-analysis were included. Two researchers conducted literature screening and data extraction independently, and the evidence quality was evaluated according to the Institute of Health Economics and AMSTAR 2 criteria. Results Fifty clinical studies and 13 systematic reviews/meta-analyses (SRs/MAs) were included. Nineteen ARs were reported in 50 studies, including five knee-related ARs, seven common ARs, and seven other ARs. Some studies reported over 10% prevalence of knee pain (24.5%; 95% CI [14.7%, 35.7%]), knee effusion (12.5%; 95% CI [4.8%, 22.5%]), and knee swelling (11.9%; 95% CI [3.5%, 23.5%]). Additionally, two studies have reported cases of prostate cancer and breast tumors, respectively. However, these two studies suggest that stem cell therapy does not bring significant ARs to patients. SRs/MAs results revealed that stem cell therapy relieved pain in patients over time but did not improve knee function. However, current clinical studies have limited evidence regarding study objectives, test designs, and patient populations. Similarly, SRs/MAs have inadequate evidence regarding study design, risk of bias assessment, outcome description, comprehensive discussion, and potential conflicts of interest. Conclusions The inefficacy of stem cells, the risk of potential complications, and the limited quality of evidence from current studies precluded any recommendation for using stem cell products in patients with KOA. Clinical translation of stem cell therapies remains baseless and should be cautiously approached until more robust evidence is available. PROSPERO registration number: CRD42022355875.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

et al. 2023

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“…Fat grafting has become an essential component of plastic and reconstructive surgery. Adipose tissue research is shifting away from volumisation toward regeneration in wound healing and angiogenesis, as well as rheumatoid diseases, osteoarthritis, 27 and fibrosis. Until now, the regulatory and scaling burdens associated with purification and concentration techniques have limited this translation.…”

Section: Discussionmentioning

confidence: 99%

Hybrid Stromal Vascular Fraction (Hybrid-SVF): A New Paradigm in Mechanical Regenerative Cell Processing

Tiryaki¹,

Cohen

Turkay

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Enzymatic digestion of extracellular matrix (ECM) from lipoaspirate is the conventional form of harvesting stromal vascular fraction (SVF) called enzymatically digested SVF (E-SVF). Mechanical SVF (M-SVF) isolation has emerged as an alternative method, but it has also some limitations in terms of lower cell viability and diminished cell counts. To enhance the SVF qualitatively and quantitatively, we propose a novel concept called "hybrid-SVF,” in which we combine M-SVF with the concentrated parts of adipose tissue after centrifugation, which is called stromal vascular matrix (SVM). Methods: Hybrid-SVF injection was applied as an adjunctive therapy to fat grafting in 88 patients and 11 samples were evaluated in the laboratory for cell count, viability and cell activity. Results: Experimental results determined that SVM part showed higher cellular activity. SVM and M-SVF showed higher cellular potency than E-SVF. Clinically, none of the patients required an additional session for fat grafting since there was no significant graft resorption. However, seven patients asked for further volume augmentation due to their individual preferences. No major complication was encountered. Conclusions: The usage of hybrid-SVF has a very high regenerative potential due to the ECM support and exceptionally high cell yield in addition to preserved cell potency. Although there are ongoing studies focusing on optimizing cell counts and further clinical applications, we believe that our preliminary results might create a paradigm shift in the area of regenerative fat grafting.

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Knee osteoarthritis: A review of animal models and intervention of traditional Chinese medicine

Song,

Liu,

Chen

et al. 2024

Anim Models and Exp Med

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BackgroundKnee osteoarthritis (KOA) characterized by degeneration of knee cartilage and subsequent bone hyperplasia is a prevalent joint condition primarily affecting aging adults. The pathophysiology of KOA remains poorly understood, as it involves complex mechanisms that result in the same outcome. Consequently, researchers are interested in studying KOA and require appropriate animal models for basic research. Chinese herbal compounds, which consist of multiple herbs with diverse pharmacological properties, possess characteristics such as multicomponent, multipathway, and multitarget effects. The potential benefits in the treatment of KOA continue to attract attention.PurposeThis study aims to provide a comprehensive overview of the advantages, limitations, and specific considerations in selecting different species and methods for KOA animal models. This will help researchers make informed decisions when choosing an animal model.MethodsOnline academic databases (e.g., PubMed, Google Scholar, Web of Science, and CNKI) were searched using the search terms “knee osteoarthritis,” “animal models,” “traditional Chinese medicine,” and their combinations, primarily including KOA studies published from 2010 to 2023.ResultsBased on literature retrieval, this review provides a comprehensive overview of the methods of establishing KOA animal models; introduces the current status of advantages and disadvantages of various animal models, including mice, rats, rabbits, dogs, and sheep/goats; and presents the current status of methods used to establish KOA animal models.ConclusionThis study provides a review of the animal models used in recent KOA research, discusses the common modeling methods, and emphasizes the role of traditional Chinese medicine compounds in the treatment of KOA.

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Safety and efficacy of adipose-derived mesenchymal stem cells for knee osteoarthritis: A systematic review and m-analysis

Cited by 19 publications

References 47 publications

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

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

Hybrid Stromal Vascular Fraction (Hybrid-SVF): A New Paradigm in Mechanical Regenerative Cell Processing

Knee osteoarthritis: A review of animal models and intervention of traditional Chinese medicine

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