Adipose-derived stem cells and knee osteoarthritis:New perspectives,old concerns

In this editorial,we comment on the paper by Muthu et al published in the recent issue of the journal.This editorial review focusses on the use of adipose-derived stem cells(ADSCs)in knee osteoarthritis treatment.We discuss the differences between the stromal vascular fraction and microfragmented adipose tissue and highlight the results of clinical studies comparing both treatments and the use of hyaluronic acid,platelet-rich plasma,and bone marrow aspirate concentrate.The use of expanded ADSCs is also discussed;moreover,concerns regarding treatment with ADSCs,particularly the heterogeneity of published studies and the need to standardize protocols to explore clinical potential is explored.

Mid-term outcomes of microfragmented adipose tissue plus arthroscopic surgery for knee osteoarthritis:A randomized,activecontrol,multicenter clinical trial

BACKGROUND Osteoarthritis(OA)is the most prevalent form of degenerative whole-joint disease.Before the final option of knee replacement,arthroscopic surgery was the most widely used joint-preserving surgical treatment.Emerging regenerative therapies,such as those involving platelet-rich plasma,mesenchymal stem cells,and microfragmented adipose tissue(MFAT),have been pushed to the forefront of treatment to prevent the progression of OA.Currently,MFAT has been successfully applied to treat different types of orthopedic diseases.AIM To assess the efficacy and safety of MFAT with arthroscopic surgery in patients with knee OA(KOA).METHODS A randomized,multicenter study was conducted between June 2017 and November 2022 in 10 hospitals in Zhejiang,China.Overall,302 patients diagnosed with KOA(Kellgren-Lawrence grades 2-3)were randomized to the MFAT group(n=151,were administered MFAT following arthroscopic surgery),or the control group(n=151,were administered hyaluronic acid following arthroscopic surgery).The study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,the visual analog scale(VAS)score,the Lequesne index score,the Whole-Organ Magnetic Resonance Imaging Score(WORMS),and safety over a 24-mo period from baseline.RESULTS The changes in the WOMAC score(including the three subscale scores),VAS pain score,and Lequesne index score at the 24-mo mark were significantly different in the MFAT and control groups,as well as when comparing values at the posttreatment visit and those at baseline(P<0.001).The MFAT group consistently demonstrated significant decreases in the WOMAC pain scores and VAS scores at all follow-ups compared to the control group(P<0.05).Furthermore,the WOMAC stiffness score,WOMAC function score,and Lequesne index score differed significantly between the groups at 12 and 24 mo(P<0.05).However,no signicant between-group differences were observed in the WORMS at 24 mo(P=0.367).No serious adverse events occurred in both groups.CONCLUSION The MFAT injection combined with arthroscopic surgery treatment group showed better mid-term clinical outcomes compared to the control group,suggesting its efficacy as a therapeutic approach for patients with KOA.

Detection and Identification of Microplastics from Locally Sold Fishes in Borongan City, Samar Island, Philippines

Microplastics, a prevailing modern contaminant, were detected on fish caught in Brgy. Mayangdan and Brgy. Tabunan, Borongan City, Eastern Samar. Fish samples were collected from markets and barangays, with 1 representative species per species, irrespective of location. The digestive channel, including the gills, was utilized as an anatomy of concern in fishes as the digestive systems are used in the feeding process while gills are primarily exposed to the water around them. Results found a few microplastics, mostly micro fragments that are irregularly shaped and colored either red or transparent/white. This concludes the presence of microplastics in the area of the two barangays in Borongan City. Therefore, it is highly recommended that the presence of microplastics in the water and mangrove areas of the said barangay be assessed to lessen the contamination of water systems with different plastic garbage.

Microfragmented adipose tissue and its initial application in articular disease

Osteoarthritis(OA)is a degenerative disease of articular cartilage whose main clinical manifestation is joint pain.The database from the China Health and Retirement Longitudinal Study showed that the morbidity of symptomatic OA(knee Kellgren and Lawrence score≥2,with knee pain)was 8.1%in China.With the development of aging in China,the incidence of OA is rising.As there are no blood vessels,nerves,or lymph in articular cartilage,its self-healing ability is poor.There are many types of nonsurgical treatments,such as medications including non-steroidal anti-inflammatory drugs,glucocorticoid,or opioids,[1,2]as well as physiotherapy treatments including injecting hyaluronic acid(HA)or platelet-rich plasma(PRP),[3,4]to prevent pain and improve joint function.All of these methods can prevent pain temporarily but are unable to interrupt the degeneration of articular cartilage.