Stem cells and degenerative arthritis

This articles presents research on stem cell treatments to help problems of knee osteoarthritis. In this research doctors from leading medical universities and research centers discuss the various types of stem cells.

POINT: General comments on comparisons between adipose, bone marrow, and other sources of stem cells in the treatment of knee osteoarthritis.

Recent research from the Saarland University Medical Center in Germany says stem cells, no matter where it comes from, or how it is used, regrows cartilage: The highlights of this study:

  • Different stem cell sources have been explored as solutions for cartilage lesions and osteoarthritis treatments such as bone marrow, adipose tissue, synovial tissue, and peripheral blood.
  • A review of recent studies found:
    • Stem cell therapy appears safe: No major adverse events have been reported.
    • Clinical benefits for patients suffering from knee osteoarthritis has been shown in most of the studies regardless of the cell-source processing method and clinical indication, with clinical improvements and also positive MRI and macroscopic findings attesting to patient improvement.
    • Stem cell success can depend on many factors that may influence the outcome. These have been identified, as age, body mass index (BMI), lesion size or degenerative stage, among others. 1

Stem cell therapy regrows cartilage

Supportive independent research on stem cells and cartilage regeneration

Researchers in Malayasia have followed up previously published research with new data that shows stem cell therapy regrows cartilage. In 2014 these same investigators found that Adipose stem cells (ADSC) and bone marrow stem cells (BMSC), regenerated cartilage in sheep who had surgically induced knee osteoarthritis.2

One year later they say that the stem cell therapy tissue engineered cartilages provided evidence of functional recoveries associated to the structural regenerations, and their mechanical properties were comparable with the native cartilage.3 “Good as new.”

Research from August 2015 on knee cartilage in sheep suggest the same, “good as new,” results. Doctors representing the Sweden’s Karolinska Institutet, the University of Oxford, and the University of Tartu in Estonia say: “The tissue engineered cartilages provided evidence of functional recoveries associated to the structural regenerations, and their mechanical properties were comparable with the native cartilage.”4 Stem Cell therapy regenerated the cartilage tissue and knee functionality.

In April 2017, Chinese doctors published research on their systematic review and meta-analysis of randomized controlled trials  to assess the efficacy and safety of MSC-based stem cell therapy in knee osteoarthritis treatment and to provide additional treatment options for patients with knee osteoarthritis.

What they found was mesenchymal stem cell-based stem cell therapy could represent one of the most promising solutions for knee osteoarthritis. Data collected from clinical trials support the following assumptions:

  • Mesenchymal stem cells administered into the knee adhered to and persisted on the surface of a damaged meniscus, differentiated into chondrocytes, and expressed appropriate extracellular matrix proteins resulting in a regeneration of meniscal tissue, which, with an improved meniscus, could ultimately lead to long-term chondroprotection.5

Recapping the studied cited above from the Sweden’s Karolinska Institutet, et al,  the researchers summed  up the challenges and opportunities of treating patients with stem cell therapy.

“The therapeutic potential of mesenchymal stromal cells (MSCs) is evident by the number of new and ongoing trials targeting an impressive variety of conditions. In bone and cartilage repair, MSCs are expected to replace the damaged tissue, whilst in other therapies they modulate a therapeutic response by the secretion of bioactive molecules. “4

Conclusion:

This conclusion comes from an often cited paper in the journal Stem cell research & therapy:

The rush to regenerate cartilage can be seen in the failure of steroid injections and anti-inflammatory medications. Although cortisone shots and anti-inflammatory drugs have been shown to produce short-term pain benefit, both result in long-term loss of function and even more chronic pain by inhibiting the healing process of soft tissues and accelerating cartilage degeneration.

The articular cartilage is especially vulnerable to damage and has poor potential for regeneration because of the absence of vasculature (blood supply) within the tissue. Normal load-bearing capacity and biomechanical properties of thinning cartilage are severely compromised during the course of disease progression.

Although surgical and pharmaceutical interventions are currently available for treating osteoarthritis, restoration of normal cartilage function has been difficult to achieve. . . . ‘mesenchymal stem cells’ or ‘mesenchymal stromal cells’ appear to be ideally suited for therapeutic use in cartilage regeneration.”5

Citations:

1. Cucchiarini M, de Girolamo L, Filardo G, et al. Basic science of osteoarthritis. Journal of Experimental Orthopaedics. 2016;3(1):22. doi:10.1186/s40634-016-0060-6. [Pubmed]

2. Ude CC, et al. Cartilage regeneration by chondrogenic induced adult stem cells in osteoarthritic sheep model. PLoS One. 2014 Jun 9;9(6):e98770. doi: 10.1371/journal.pone.0098770. eCollection 2014. [Pubmed]

3.Ude CC, et al. Improved functional assessment of osteoarthritic knee joint after chondrogenically induced cell treatment. Osteoarthritis Cartilage. 2015 Aug;23(8):1294-306. doi: 10.1016/j.joca.2015.04.003. Epub 2015 Apr 14. [Pubmed]

4. Heldring N, Mäger I, Wood M, Le Blanc K, El Andaloussi S. Therapeutic potential of multipotent mesenchymal stromal cells and their extracellular vesicles. Hum Gene Ther. 2015 Jul 8. [Pubmed]

5. Yubo M, Yanyan L, Li L, Tao S, Bo L, Lin C. Clinical efficacy and safety of mesenchymal stem cell transplantation for osteoarthritis treatment: A meta-analysis. Hills RK, ed. PLoS ONE. 2017;12(4):e0175449. doi:10.1371/journal.pone.0175449. [Pubmed]

6. Gupta PK, Das AK, Chullikana A, Majumdar AS. Mesenchymal stem cells for cartilage repair in osteoarthritis. Stem Cell Res Ther. 2012;3(4):25. [Pubmed]

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