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成人人间充质干细胞疗法在膝关节骨关节炎治疗中的临床适用性

Clinical Applicability of Adult Human Mesenchymal Stem Cell Therapy in the Treatment of Knee Osteoarthritis.

作者信息

Buzaboon Noor, Alshammary Sfoug

机构信息

Department of Molecular Medicine, College of Medicine and Medical Sciences, Princess Al-Jawhara Center for Molecular Medicine and Inherited Disorders, Arabian Gulf University, Manama, Bahrain.

出版信息

Stem Cells Cloning. 2020 Dec 17;13:117-136. doi: 10.2147/SCCAA.S268940. eCollection 2020.

Abstract

INTRODUCTION

Osteoarthritis causes a progressive deterioration to the protective cartilage between the joints leading to chronic pain and disability. This review focuses on the intrinsic potential of MSCs to stabilize and repair the cartilage tissue of the knee joint in knee osteoarthritis (KOA) patients.

METHODS

An online search through the PubMed database was conducted, limiting the search to the English language and human clinical trials within the past 5 years. Twenty-one clinical trials passed the inclusion criteria. Combined, those trials involved the participation of 589 patients where the progress of the treatments was monitored between a 4-month to 7-years period. The cartilage volume and defects were observed through an MRI to provide an objective assessment. While the pain and knee function were monitored using KOOS, VAS, and WOMAC scoring scales providing a subjective assessment.

RESULTS

MRI scans obtained from clinical trials demonstrate a slowed progression of cartilage degeneration and early signs of cartilage regeneration in KOA patients at the 12-month follow-up period. No major adverse effects were observed post-intervention. The overall KOOS, WOMAC, and VAS scores in patients receiving MSC treatment were reduced, suggesting subjective improvements in knee function and pain reduction when compared to patients in the placebo group.

CONCLUSION

The use of MSC therapy is a valid form of treatment for KOA as it targets the disease itself rather than the symptoms. We found MSC therapy in KOA patients to be safe, effective, and feasible in its execution.

摘要

引言

骨关节炎会导致关节间起保护作用的软骨逐渐退化,进而引发慢性疼痛和功能障碍。本综述聚焦于间充质干细胞(MSCs)在稳定和修复膝关节骨关节炎(KOA)患者膝关节软骨组织方面的内在潜力。

方法

通过PubMed数据库进行在线搜索,将搜索范围限制在过去5年内的英文人类临床试验。21项临床试验通过了纳入标准。这些试验总共涉及589名患者,在4个月至7年的时间内对治疗进展进行监测。通过磁共振成像(MRI)观察软骨体积和缺损情况,以提供客观评估。同时,使用膝关节损伤和骨关节炎疗效评分(KOOS)、视觉模拟评分法(VAS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分量表监测疼痛和膝关节功能,以提供主观评估。

结果

从临床试验获得的MRI扫描显示,在12个月的随访期内,KOA患者软骨退变进展减缓,出现了软骨再生的早期迹象。干预后未观察到重大不良反应。接受间充质干细胞治疗的患者的总体KOOS、WOMAC和VAS评分降低,这表明与安慰剂组患者相比,膝关节功能和疼痛减轻方面有主观改善。

结论

使用间充质干细胞疗法是治疗KOA的一种有效治疗方式,因为它针对的是疾病本身而非症状。我们发现间充质干细胞疗法在KOA患者中执行起来安全、有效且可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4b1/7751722/236ca1406844/SCCAA-13-117-g0001.jpg

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