Stromal vascular fraction cell therapy for osteoarthritis in elderly: Multicenter case-control study

Michálek, Jaroslav; Vrablikova, Alena; Darinskas, Adas; Lukác, L; Průcha, Jaroslav; Skopalík, Josef; Travnik, Jan; Cibulka, Marek; Dudasova, Zuzana

doi:10.1016/j.jcot.2018.11.010

Cited by 23 publications

(21 citation statements)

References 38 publications

(46 reference statements)

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“…Adverse reactions observed were mild and transient, mostly abdominal discomfort related with liposuction procedure. As in other studies, we have not found severe complications in elderly patients [27]. Regarding the infiltration of SVF, the most frequent adverse effect was a mild and transient synovitis, probably caused by the volume injected, as described by other authors [28].…”

Section: Svf Characterizationsupporting

confidence: 85%

Intra-articular infiltration of adipose-derived stromal vascular fraction cells slows the clinical progression of moderate-severe knee osteoarthritis: hypothesis on the regulatory role of intra-articular adipose tissue

2020

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Background: The infiltration of the stromal vascular fraction (SVF) of autologous adipose tissue to treat osteoarthritis has been used for several years demonstrating its safety and noticeable efficacy. This article presents clinical data from patients afftected by moderate and severe knee osteoarthritis demonstrating safety and clinical efficacy of the treatment when this autologous cell product is injected in the knee joint and patients evaluated post-operatively after 1 year. However, what do we know about the mechanism that underlies this clinical improvement? This article proposes, for the first time in our opinion, a hypothesis of the mode of action that involves structural and molecular interactions between SVF and infrapatellar fat pad (IFP). As consequence, there would be a re-education of intra-articular adipose tissue, which we consider a key player for the clinical effect observed in the mid and long term mainly due to immuno-regulatory mechanisms. Methods: This is a retrospective and not controlled study that evaluated 50 patients (100 joints) ranging from 50 to 89 years old, separated by age cohorts. Clinical efficacy was assessed using the Lequesne, WOMAC, and VAS scales, by ultrasound control and quantification of the biochemical profiles of synovial fluid. Results: There were no serious adverse effects. All the indexes studied showed a significant clinical improvement after 1-year follow-up for all ages and OA degree groups. This finding was correlated with the ultrasound observations and biochemical data, which show a marked decrease in catabolic and pro-inflammatory molecules (MMP-2, IL-1B, IL-6, and IL-8) and significant increase for anabolic and anti-inflammatory molecules (IGF-1 and IL-10). Conclusions: We conclude that intra-articular SVF infiltration for knee OA treatment is safe and effective during 1 year. We propose that applied SVF cells cause a cascade of molecular and structural events that, through complex interactions between IFP and SVF, re-educating the intra-articular fatty tissue towards a homeostatic, protective, and anti-inflammatory function, which will ultimately promote the restructuring and regeneration of damaged tissues.

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Section: Svf Characterizationsupporting

confidence: 85%

Intra-articular infiltration of adipose-derived stromal vascular fraction cells slows the clinical progression of moderate-severe knee osteoarthritis: hypothesis on the regulatory role of intra-articular adipose tissue

2020

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“…Included articles were grouped according to the characteristics of the injected products, in particular cell source and degree of manipulation, autologous or homologous products: SVF was prepared from lipoaspirate, most commonly abdominal in a total of 13 studies; 41 – 53 from these, eight studies used cSVF, 41 – 48 and five studies used microfragmented adipose tissue ( Table 1 ). 49 – 53 In the eight cSVF studies, five studies were case series, 41 , 42 , 44 , 46 , 47 another involved bilateral patients receiving HA in one knee and SVF in the other. 45 Garza et al 43 analysed two different doses of SVF (volumes), with better results in the lower dose.…”

Section: Resultsmentioning

confidence: 99%

Mesenchymal stromal cell products for intra-articular knee injections for conservative management of osteoarthritis

Andı́a

Maffulli

2021

Therapeutic Advances in Musculoskeletal

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Sports injuries and secondary joint problems, mainly of the knee, are common, especially in sports associated with high impact activities and/or torsional loading. The consequences can be career ending in elite athletes and reduce exercise activities in recreational people. Various cell products can be injected intra-articularly. First, fresh cellular mixtures can be prepared and injected in the same day, such as stromal vascular fraction of adipose tissue (SVF) and bone marrow concentrates (BMCs). Second, autologous mesenchymal stromal cells (MSCs) can be isolated from BMCs or SVF and, after several weeks of laboratory expansion, several millions of MSCs can be obtained for intra-articular injection. Finally, allogeneic MSCs from the bone marrow, adipose tissue or perinatal tissues of selected donors constitute an ‘off-the-shelf’ experimental treatment for injection delivery in patients with osteoarthritis of the knee. The perceived efficacy of all these products is based on the hypothesis of a paracrine mechanism of action: when living cells are delivered within the joint, they establish a molecular cross-talk with immune cells and local cell phenotypes, thereby modulating inflammation with subsequent modifications in the catabolic/degenerative milieu. Current clinical research examines whether injection delivery of MSCs translates into actual clinical benefits. Overall, clinical studies lack the quality needed to answer major research questions, including clinical and structural efficacy, optimal cell dose, and number of injections and specific protocol for cell delivery. Poor experimental designs are exacerbated by the diversity of patient phenotypes that hinder comparisons between treatments. Further understanding of disease pathology is paramount to develop potent function assays and understand whether the host tissue, the cell product or both should be primed before MSCs are injected intra-articularly.

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“…MSCs can be easily and safely isolated from adipose tissue in much higher quantities, are more generically stable, and may be easily isolated by standard liposuction of adipose tissue, making them an ideal component of the stromal vascular fraction [2,5]. As we previously demonstrated, SVF cells have a huge tissue regeneration potential in patients with osteoarthritis [3,6]. Additionally, SVFs and adipose tissue-derived stem cells (ADSCs) have been clinically used in the treatment of multiple sclerosis [7], chronic myocardial ischemia [8], acute respiratory distress syndrome [9], Crohn’s disease [10], and other diseases.…”

Section: Discussionmentioning

confidence: 99%

Stromal Vascular Fraction Cell Therapy for a Stroke Patient—Cure without Side Effects

Michálek¹,

Vrablikova²,

Heinrich³

et al. 2019

Brain Sciences

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A 48-year-old male, who suffered from a stroke resulting in cerebellum damage and occlusion of the left vertebral artery, underwent stromal vascular fraction therapy. The clinical status of the patient was monitored by a modified Stroke Specific Quality of Life Scale before therapy and at 3, 9, 12, 18, 24, and 32 months after therapy. Three months after therapy, the patient felt a reduction in pain, vertigo, and fatigue. After 9 months, he was able to walk safely on his own. After 24 months, he was able to ride a bicycle. After 32 months, he felt completely healthy without any limitations or handicaps. Therefore, intravenous application of stromal vascular fraction cells represents a promising strategy for the treatment of patients after a stroke.

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Stromal vascular fraction cell therapy for osteoarthritis in elderly: Multicenter case-control study

Cited by 23 publications

References 38 publications

Intra-articular infiltration of adipose-derived stromal vascular fraction cells slows the clinical progression of moderate-severe knee osteoarthritis: hypothesis on the regulatory role of intra-articular adipose tissue

Intra-articular infiltration of adipose-derived stromal vascular fraction cells slows the clinical progression of moderate-severe knee osteoarthritis: hypothesis on the regulatory role of intra-articular adipose tissue

Mesenchymal stromal cell products for intra-articular knee injections for conservative management of osteoarthritis

Stromal Vascular Fraction Cell Therapy for a Stroke Patient—Cure without Side Effects

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