同种异体间充质干细胞是一种安全有效的治疗膝关节骨关节炎的方法:随机对照试验的系统回顾

IF 2.7 Q2 ORTHOPEDICS
Randy Y. J. Loke, Zachary Chu, Jonathan Liang, Don Koh, Junwei Soong, Kong Hwee Lee, Hamid Rahmatullah Bin Abd Razak
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引用次数: 0

摘要

目的间充质干细胞(MSCs)移植是一种潜在的非手术修复软骨的方法。目前,其临床应用主要集中在膝关节骨关节炎(OA)的局灶性软骨缺损修复和关节内注射。大多数研究关注的是自体骨髓间充质干细胞的疗效,这可能受到年龄、疾病、部位和采集方法等患者间差异的限制。本系统综述旨在评估异体间充质干细胞植入与安慰剂在膝关节OA患者中的研究,总结异体间充质干细胞治疗膝关节OA的疗效和安全性。方法按照PRISMA指南在PubMed、Scopus和EMBASE中进行系统检索。原始研究调查同种异体间充质干细胞植入膝关节OA患者的结果。提取临床结果的数据,如主观评分如VAS和WOMAC,放射学结果如软骨厚度,组织学结果如ICRSII评分。结果本综述纳入了7项研究。12个月时,视觉模拟量表得分提高30.4分,西安大略省和麦克马斯特大学骨关节炎指数得分提高40.0分。通过T2松弛测量,改善软骨厚度,减少不良软骨质量。在三个研究中观察到病变部位的测量,并通过术后磁共振成像进行评估,这与临床相关。一项研究也显示组织学改善,总体ICRSII评分从基线时的32.0±21.6显著改善至6个月时的55.9±23.2 (p < 0.05)。无重大并发症或肿瘤发生。结论同种异体间充质干细胞植入术治疗膝关节骨性关节炎可获得持续的临床改善和满意的软骨修复,随访时间长达12个月。这些结果得到了影像学和组织学研究的支持。同种异体间充质干细胞的安全性非常好,其不良事件主要局限于局部注射反应,无长期不良反应。证据等级二级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Allogenic MSCs are a safe and efficacious treatment for knee osteoarthritis: A systematic review of randomised controlled trials

Allogenic MSCs are a safe and efficacious treatment for knee osteoarthritis: A systematic review of randomised controlled trials

Allogenic MSCs are a safe and efficacious treatment for knee osteoarthritis: A systematic review of randomised controlled trials

Allogenic MSCs are a safe and efficacious treatment for knee osteoarthritis: A systematic review of randomised controlled trials

Allogenic MSCs are a safe and efficacious treatment for knee osteoarthritis: A systematic review of randomised controlled trials

Purpose

Implantation of mesenchymal stem cells (MSCs) is a potential non-surgical option for cartilage repair. Currently, its clinical use largely focuses on focal cartilage defect repair and intra-articular injections in knee osteoarthritis (OA). Most studies have looked at the efficacy of MSCs from autologous sources, which can be limited by inter-patient variability of age, diseases, sites and methods of harvest. This systematic review aims to evaluate studies that focus on allogeneic MSCs implantation versus placebo in patients with knee OA to summarise the efficacy and safety of allogeneic MSCs in knee OA.

Methods

A systematic search following PRISMA guidelines was performed in PubMed, Scopus and EMBASE. Original studies investigating the outcomes of allogeneic MSC implantations in patients with knee OA were included. Data on clinical outcomes, such as subjective scores such as VAS and WOMAC, radiological outcomes, such as cartilage thickness, and histological outcomes, such as ICRSII score, were extracted.

Results

Seven studies were included in this review. There was 30.4 points improvement in Visual Analogue Scale scores and 40.0 points of improvement in Western Ontario and McMaster Universities Osteoarthritis Index scores at 12 months. Improved cartilage thickness and decreased poor cartilage quality as measured by T2 relaxation. Measurements at the lesion site were observed in three studies as assessed by postoperative magnetic resonance imaging and this was correlated clinically. One study also showed histological improvement with overall ICRSII scores significantly improving from 32.0 ± 21.6 at baseline to 55.9 ± 23.2 at 6 months (p < 0.05). No major complications or tumorigenesis occurred.

Conclusion

Allogeneic MSC implantation in patients with knee osteoarthritis provides sustained clinical improvement and satisfactory cartilage restoration, up to 12 months follow-up. These results are supported by both imaging and histological studies. The safety profile of allogeneic MSCs is excellent, with minimal adverse events mainly limited to local reaction to injection and no long-term adverse effects.

Level of Evidence

Level II.

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来源期刊
Journal of Experimental Orthopaedics
Journal of Experimental Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
3.20
自引率
5.60%
发文量
114
审稿时长
13 weeks
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