Clinical and Magnetic Resonance Image Changes of Platelet-Rich Plasma Therapy in Combination with Human Mesenchymal Stem Cells from Autologous Adipose Tissue for Knee Osteoarthritis Treatment
Objective: To evaluate the efficacy based on clinical symptom and on magnetic resonance image of platelet-rich plasma therapy in combination with mesenchymal stem cells from autologous adipose tissue for knee osteoarthritis treatment. Patients and Method: 30 patients including 26 females and 4 males; correspondingly, 60 knee joints were diagnosed with osteoarthritis with stages II - III of Kellgren and Lawrence, their mean age was 58.63 ± 11.11. All were injected with autologous platelet-rich plasma that was extracted by PRP set, APC 30 PRP PRCEDURE PRAK and autologously extracted mesenchymal stem cells from abdominal adipose tissue using the ADI-25-01 ADIPOSEPRCEDURE PRAK of USA. Results: After 12 months: the pain level according to VAS score at the right knee joint was decreased from 6.0 ± 1.28 before treatment to 1.9 ± 0.3; VAS score at the left knee joint was decreased from 6.43 ± 1.19 to 2.25 ± 0.43. Total Lequene score at right knee joint was decreased from 16.04 ± 1.57 before treatment to 4.31 ± 1.04, at left knee joint was decreased from 17.52 ± 1.74 before treatment to 5.15 ± 1.48. Total WOMAC score at right knee joint was decreased from 55.93 ± 5.56 to 10.37 ± 1.56; at left knee joint was decreased from 53.97 ± 5.57 to 10.07 ± 1.59. There were 86.77% joints with cartilage thickness change and the patellar cartilage thickness was increased from 1.56 ± 0.09 mm before treatment to 1.65 ± 0.09 mm. Conclusion: The treatment of knee osteoarthritis by platelet-rich plasma therapyin combination with mesenchymal stem cells from autologous adipose tissue is effective in reducing pain, improving patient's mobility and walking function, reforming articular cartilage thickness on magnetic resonance image.
References
[1]
Koh, Y.G. and Choi, Y.J. (2012) Infrapatellar Adipose Pad-Derived Mesenchymal Stem Cell Therapy for Knee Osteoarthritis. The Knee, 19, 902-907. https://doi.org/10.1016/j.knee.2012.04.001
[2]
Freitag, J., Bates, D., Boyd, R., Shah, K., Barnard, A., Huguenin, L., et al. (2016) Mesenchymal Stem Cell Therapy in the Treatment of Osteoarthritis: Reparative Pathways, Safety and Efficacy—A Review. BMC Musculoskeletal Disorders, 17, Article No. 230. https://doi.org/10.1186/s12891-016-1085-9
[3]
Jones, I.A., Togashi, R., Wilson, M.L., Heckmann, N. and Vangsness, C.T. (2019) Intra-Articular Treatment Options for Knee Osteoarthritis. Nature Reviews Rheumatology, 15, 77-90. https://doi.org/10.1038/s41584-018-0123-4
[4]
El-Sharkawy, H., Kantarci, A., Deady, J., Hasturk, H., et al. (2007) Platelet-Rich Plasma: Growth Factors and Pro- and Anti-Iflammatory Properties. Journal of Periodontology, 78, 661-669. https://doi.org/10.1902/jop.2007.060302
[5]
Sampson, S., Reed, M., Silvers, H., Meng, M. and Mandelbaum, B. (2010) Injection of Platelet-Rich Plasma in Patients with Primary and Secondary Knee Osteoarthritis: A Pilot Study. American Journal of Physical Medicine & Rehabilitation, 89, 961-969. https://doi.org/10.1097/PHM.0b013e3181fc7edf
[6]
Coulson-Thomas, V.J., Coulson-Thomas, Y.M., Gesteira, T.F. and Kao, W.Y. (2016) Extrinsic and Intrinsic Mechanisms by Which Mesenchymal Stem Cells Suppress the Immune System. The Ocular Surface, 14, 121-134. https://doi.org/10.1016/j.jtos.2015.11.004
[7]
Ryu, J.S., Jung, Y.H., Cho, M.Y., Yeo, J.E., Choi, Y.J., Kim, Y.I. and Koh, Y.G. (2014) Co-Culture with Human Synovium-Derived Mesenchymal Stem Cells Inhibits Inflammatory Activity and Increases Cell Proliferation of Sodium Nitroprusside-Stimulated Chondrocytes. Biochemical and Biophysical Research Communications, 447, 715-720. https://doi.org/10.1016/j.bbrc.2014.04.077
[8]
Barry, F. and Murphy, M. (2013) Mesenchymal Stem Cells in Joint Disease and Repair. Nature Reviews Rheumatology, 9, 584-594. https://doi.org/10.1038/nrrheum.2013.109
[9]
Mamidi, M.K., Das, A.K., Zakaria, Z. and Bhonde, R. (2016) Mesenchymal Stromal Cells for Cartilage Repair in Osteoarthritis. Osteoarthritis and Cartilage, 24, 1307-1316. https://doi.org/10.1016/j.joca.2016.03.003
[10]
Caplan, A.I. (2013) Adult Mesenchymal Stem Cells for Tissue Engineering Versus Regenerative Medicine. Journal of Cellular Physiology, 213, 341-347. https://doi.org/10.1002/jcp.21200
[11]
Grässel, S. and Lorenz, J. (2014) Tissue-Engineering Strategies to Repair Chondral and Osteochondral Tissue in Osteoarthritis: Use of Mesenchymal Stem Cells. Current Rheumatology Reports, 16, Article No. 452. https://doi.org/10.1007/s11926-014-0452-5
[12]
Zuk, P.A., Zhu, M., Mizuno, H., Huang, J., Futrell, J.W., Katz, A.J., Benhaim, P., Lorenz, H.P. and Hedrick, M.H. (2001) Multilineage Cells from Human Adipose Tissue: Implications for Cell-Based Therapies. Tissue Engineering, 7, 211-228. https://doi.org/10.1089/107632701300062859
[13]
Song, Y., Zhang, J., Xu, H., Lin, Z., Chang, H., Liu, W. and Kong, L. (2020) Mesenchymal Stem Cell in Knee Osteoarthritis Treatment: A Sytematic Review and Meta-Analysis. Journal of Orthopaedic Translation, 24, 121-130. https://doi.org/10.1016/j.jot.2020.03.015
[14]
Srikulmontree, T. (2012) Osteoarthritis. The American College of Rheumatology, Georgia (U.S. State).
[15]
Van Pham, P., Bui, K.H.T., Duong, T.D., Nguyen, N.T., Nguyen, T.D., Mai, V.T., et al. (2014) Symptomatic Knee Osteoarthritis Treatment Using Autologous Adipose Derived Stem Cells and Platelet-Rich Plasma: A Clinical Study. Biomedical Research and Therapy, 1, Article No. 2. https://doi.org/10.7603/s40730-014-0002-9
[16]
Hoai, T.P. (2017) Study on Treatment Results of Primary Knee Osteoarthritis with Autologous Adipose Tissue Stem Cell Therapy. Doctoral Thesis in Medicine, Hanoi Medical University, Hanoi.
[17]
Viet, T.T., et al. (2015) Research on the Application of Autologous Stem Cells in the Treatment of Osteoarthritis. State-Level Independent Project, Military Medical Academy.
[18]
Koh, Y.-G., Jo, S.-B., Kwon, O.-R., et al. (2012) Mesenchymal Stem Cell Injections Improve Symptoms of Knee Osteoarthritis. The Journal of Arthroscopic and Related Surgery, 29, 748-755. https://doi.org/10.1016/j.arthro.2012.11.017
[19]
Koh, Y.-G., Choi, Y.-J., Kwon, S.-K., Kim, Y.-S. and Yeo, J.-E. (2013) Clinical Results and Second-Look Arthroscopic Findings after Treatment with Adipose-Derived Stem Cells for Knee Osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy, 23, 1308-1316. https://doi.org/10.1007/s00167-013-2807-2
[20]
Lu, L.-J., et al. (2016) Treatment with Human Adipose-Derived Mesenchymal Stem Cells for Knee Osteoarthritis. NCT 021626693. The 18th Congress of Asia Pacific League of Association for Rheuatology (APLAR 2016), Shanghai, 26-29 September, 2016.
