Knee osteoarthritis is a degenerative condition with a significant disease burden and no disease-modifying therapy.Definitive treatment ultimately requires joint replacement.Therapies capable of regenerating cartilage...Knee osteoarthritis is a degenerative condition with a significant disease burden and no disease-modifying therapy.Definitive treatment ultimately requires joint replacement.Therapies capable of regenerating cartilage could significantly reduce financial and clinical costs.The regenerative potential of mesenchymal stromal cells(MSCs)has been extensively studied in the context of knee osteoarthritis.This has yielded promising results in human studies,and is likely a product of immunomodulatory and chondroprotective biomolecules produced by MSCs in response to inflammation.Adipose-derived MSCs(ASCs)are becoming increasingly popular owing to their relative ease of isolation and high proliferative capacity.Stromal vascular fraction(SVF)and micro-fragmented adipose tissue(MFAT)are produced by the enzymatic and mechanical disruption of adipose tissue,respectively.This avoids expansion of isolated ASCs ex vivo and their composition of heterogeneous cell populations,including immune cells,may potentiate the reparative function of ASCs.In this editorial,we comment on a multicenter randomized trial regarding the efficacy of MFAT in treating knee osteoarthritis.We discuss the study’s findings in the context of emerging evidence regarding adipose-derived regenerative therapies.An underlying mechanism of action of ASCs is proposed while drawing important distinctions between the properties of isolated ASCs,SVF,and MFAT.展开更多
BACKGROUND Peripheral nerve injury can occur as a result of trauma or disease and carries significant morbidity including sensory and motor loss.The body has limited ability for nerve regeneration and functional recov...BACKGROUND Peripheral nerve injury can occur as a result of trauma or disease and carries significant morbidity including sensory and motor loss.The body has limited ability for nerve regeneration and functional recovery.Left untreated,nerve lesions can cause lifelong disability.Traditional treatment options such as neurorrhaphy and neurolysis have high failure rates.Surgical reconstruction with autograft carries donor site morbidity and often provide suboptimal results.Mesenchymal stem cells(MSCs)are known to have promising regenerative potential and have gained attention as a treatment option for nerve lesions.It is however,unclear whether it can be effectively used for nerve regeneration.AIM To evaluate the evidence for the use of human umbilical cord derived MSCs(UCMSCs)in peripheral nerve regeneration.METHODS We carried out a systematic literature review in accordance with the PRISMA protocol.A literature search was performed from conception to September 2019 using PubMed,EMBASE and Web of Science.The results of eligible studies were appraised.A risk of bias analysis was carried out using Cochrane’s RoB 2.0 tool.RESULTS Fourteen studies were included in this review.A total of 279 subjects,including both human and animal were treated with UCMSCs.Four studies obtained UCMSCs from a third-party source and the remainder were harvested by the investigators.Out of the 14 studies,thirteen conducted xenogenic transplantation into nerve injury models.All studies reported significant improvement in nerve regeneration in the UCMSC treated groups compared with the various different controls and untreated groups.CONCLUSION The evidence summarised in this PRISMA systematic review of in vivo studies supports the notion that human UCMSC transplantation is an effective treatment option for peripheral nerve injury.展开更多
文摘Knee osteoarthritis is a degenerative condition with a significant disease burden and no disease-modifying therapy.Definitive treatment ultimately requires joint replacement.Therapies capable of regenerating cartilage could significantly reduce financial and clinical costs.The regenerative potential of mesenchymal stromal cells(MSCs)has been extensively studied in the context of knee osteoarthritis.This has yielded promising results in human studies,and is likely a product of immunomodulatory and chondroprotective biomolecules produced by MSCs in response to inflammation.Adipose-derived MSCs(ASCs)are becoming increasingly popular owing to their relative ease of isolation and high proliferative capacity.Stromal vascular fraction(SVF)and micro-fragmented adipose tissue(MFAT)are produced by the enzymatic and mechanical disruption of adipose tissue,respectively.This avoids expansion of isolated ASCs ex vivo and their composition of heterogeneous cell populations,including immune cells,may potentiate the reparative function of ASCs.In this editorial,we comment on a multicenter randomized trial regarding the efficacy of MFAT in treating knee osteoarthritis.We discuss the study’s findings in the context of emerging evidence regarding adipose-derived regenerative therapies.An underlying mechanism of action of ASCs is proposed while drawing important distinctions between the properties of isolated ASCs,SVF,and MFAT.
文摘BACKGROUND Peripheral nerve injury can occur as a result of trauma or disease and carries significant morbidity including sensory and motor loss.The body has limited ability for nerve regeneration and functional recovery.Left untreated,nerve lesions can cause lifelong disability.Traditional treatment options such as neurorrhaphy and neurolysis have high failure rates.Surgical reconstruction with autograft carries donor site morbidity and often provide suboptimal results.Mesenchymal stem cells(MSCs)are known to have promising regenerative potential and have gained attention as a treatment option for nerve lesions.It is however,unclear whether it can be effectively used for nerve regeneration.AIM To evaluate the evidence for the use of human umbilical cord derived MSCs(UCMSCs)in peripheral nerve regeneration.METHODS We carried out a systematic literature review in accordance with the PRISMA protocol.A literature search was performed from conception to September 2019 using PubMed,EMBASE and Web of Science.The results of eligible studies were appraised.A risk of bias analysis was carried out using Cochrane’s RoB 2.0 tool.RESULTS Fourteen studies were included in this review.A total of 279 subjects,including both human and animal were treated with UCMSCs.Four studies obtained UCMSCs from a third-party source and the remainder were harvested by the investigators.Out of the 14 studies,thirteen conducted xenogenic transplantation into nerve injury models.All studies reported significant improvement in nerve regeneration in the UCMSC treated groups compared with the various different controls and untreated groups.CONCLUSION The evidence summarised in this PRISMA systematic review of in vivo studies supports the notion that human UCMSC transplantation is an effective treatment option for peripheral nerve injury.
