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人脐带间充质干细胞促进膝关节软骨生成治疗膝骨关节炎的系统评价。

Human umbilical cord mesenchymal stem cells promoting knee joint chondrogenesis for the treatment of knee osteoarthritis: a systematic review.

机构信息

Xi'an Hong Hui Hospital, Xi'an, Shaanxi, China.

出版信息

J Orthop Surg Res. 2023 Aug 29;18(1):639. doi: 10.1186/s13018-023-04131-7.

Abstract

PURPOSE

The onset of OA is affected by a variety of factors, which eventually lead to the loss of cartilage in the joints, the formation of osteophytes, the loss of normal knee mobility, and pain and discomfort, which seriously affects the quality of life. HUC-MSCs can promote cartilage production and have been widely used in research in the past decade. This article systematically summarizes that it is well used in basic research and clinical studies to promote inflammatory chondrogenesis in the treatment of OA. Provide a theoretical basis for clinical treatment.

PATIENTS AND METHODS

This study collected CNKI, Wanfang, PubMed, and articles related to the treatment of OA with HUC-MSCs since their publication, excluding non-basic and clinical studies such as reviews and meta-analysis. A total of 31 basic experimental studies and 12 clinical studies were included. Systematically analyze the effects of HUC-MSCs on inhibiting inflammatory factors, promoting chondrocyte production, and current clinical treatment.

RESULTS

HUC-MSCs can reduce inflammatory factors such as MMP-13, ADAMTS-5, IL-1β, IL-1, IL-6, TNF-α, induced conversion from M1 to M2 in OA to protect cartilage damage and reduce OA inflammation. Synthesize ColII, SOX9, and aggrecan at the same time to promote cartilage synthesis.

CONCLUSION

HUC-MSCs not only have typical stem cell biological characteristics, but also have rich sources and convenient material extraction. Compared with stem cells from other sources, HUC-MSCs have stronger proliferation, differentiation, and immune regulation abilities. Furthermore, there are no ethical issues associated with their use.

SAFETY

Primarily attributed to pain, the majority of individuals experience recovery within 24 h following injection. HUC-MSCs possess the ability to alleviate pain, enhance knee joint function, and potentially postpone the need for surgical intervention in both non-surgical and other cases, making them highly deserving of clinical promotion and application.

摘要

目的

OA 的发病受多种因素影响,最终导致关节软骨丧失、骨赘形成、正常膝关节活动丧失以及疼痛和不适,严重影响生活质量。HUC-MSCs 可促进软骨生成,在过去十年的研究中得到了广泛应用。本文系统总结了其在促进 OA 炎症性软骨生成的基础研究和临床研究中的应用,为临床治疗提供理论依据。

患者和方法

本研究收集了中国知网、万方、PubMed 以及自发表以来与 HUC-MSCs 治疗 OA 相关的文章,排除了综述和 meta 分析等非基础和临床研究。共纳入 31 项基础实验研究和 12 项临床研究。系统分析 HUC-MSCs 抑制炎症因子、促进软骨细胞生成的作用及目前临床治疗情况。

结果

HUC-MSCs 可减少 MMP-13、ADAMTS-5、IL-1β、IL-1、IL-6、TNF-α 等炎症因子,诱导 OA 中 M1 向 M2 的转化,从而保护软骨损伤,减轻 OA 炎症。同时合成 ColII、SOX9、aggrecan。

结论

HUC-MSCs 不仅具有典型的干细胞生物学特性,而且来源丰富,取材方便。与其他来源的干细胞相比,HUC-MSCs 具有更强的增殖、分化和免疫调节能力。此外,使用 HUC-MSCs 不存在伦理问题。

安全性

主要与疼痛有关,大多数患者在注射后 24 小时内恢复。HUC-MSCs 具有缓解疼痛、增强膝关节功能的作用,并可能推迟非手术和其他情况下的手术干预需求,值得临床推广应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d18/10466768/d636f9675a3c/13018_2023_4131_Fig1_HTML.jpg

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