Regenerative Medicine Laboratory, Petrópolis Medical School/ UNIFASE, Avenida Barão do Rio Branco 1003, Centro, Petrópolis, RJ 25680-120, Brazil.
Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Ave. Carlos Chagas Filho 373, Sala B1-011, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ 21941-590, Brazil.
Stem Cells Transl Med. 2024 Jul 15;13(7):593-605. doi: 10.1093/stcltm/szae026.
Condylar resorption is an aggressive and disability form of temporomandibular joint (TMJ) degenerative disease, usually non-respondent to conservative or minimally invasive therapies and often leading to surgical intervention and prostheses implantation. This condition is also one of the most dreaded postoperative complications of orthognathic surgery, with severe cartilage erosion and loss of subchondral bone volume and mineral density, associated with a painful or not inflammatory processes. Because regenerative medicine has emerged as an alternative for orthopedic cases with advanced degenerative joint disease, we conducted a phase I/IIa clinical trial (U1111-1194-6997) to evaluate the safety and efficacy of autologous nasal septal chondroprogenitor cells. Ten participants underwent biopsy of the nasal septum cartilage during their orthognathic surgery. The harvested cells were cultured in vitro and analyzed for viability, presence of phenotype markers for mesenchymal stem and/or chondroprogenitor cells, and the potential to differentiate into chondrocytes, adipocytes, and osteoblasts. After the intra-articular injection of the cell therapy, clinical follow-up was performed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and computed tomography (CT) images. No serious adverse events related to the cell therapy injection were observed during the 12-month follow-up period. It was found that autologous chondroprogenitors reduced arthralgia, promoted stabilization of mandibular function and condylar volume, and regeneration of condylar tissues. This study demonstrates that chondroprogenitor cells from the nasal septum may be a promise strategy for the treatment of temporomandibular degenerative joint disease that do not respond to other conservative therapies.
髁突吸收是一种侵袭性和致残性的颞下颌关节（TMJ）退行性疾病，通常对保守或微创治疗无反应，往往导致手术干预和假体植入。这种情况也是正颌手术最可怕的术后并发症之一，伴有严重的软骨侵蚀和软骨下骨体积和矿物质密度丧失，伴有疼痛或非炎症过程。由于再生医学已成为治疗进展性退行性关节疾病的骨科病例的替代方法，我们进行了一项 I/IIa 期临床试验（U1111-1194-6997），以评估自体鼻中隔软骨祖细胞的安全性和有效性。10 名参与者在正颌手术期间接受了鼻中隔软骨活检。收获的细胞在体外培养，并分析其活力、间充质干细胞和/或软骨祖细胞表型标志物的存在，以及分化为软骨细胞、脂肪细胞和成骨细胞的潜力。关节内注射细胞治疗后，使用颞下颌关节紊乱诊断标准（DC/TMD）和计算机断层扫描（CT）图像进行临床随访。在 12 个月的随访期间，未观察到与细胞治疗注射相关的严重不良事件。研究发现，自体软骨祖细胞可减轻关节炎，促进下颌功能和髁突体积的稳定，并促进髁突组织的再生。这项研究表明，鼻中隔的软骨祖细胞可能是一种有前途的治疗方法，用于治疗对其他保守治疗无反应的颞下颌退行性关节疾病。
