Nagelli Christopher V, Korpershoek Jasmijn V, Lydon Katy, Vonk Lucienne, Custers Roel, Krych Aaron J, Saris Daniel
Department of Orthopedic Surgery, Division of Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
Curr Rev Musculoskelet Med. 2025 Apr;18(4):133-139. doi: 10.1007/s12178-025-09949-8. Epub 2025 Feb 11.
Cartilage injury does not heal spontaneously. The current cell-based cartilage treatments have either demonstrated poor clinical outcomes, require two surgeries, or are costly and logistically challenging. To overcome these challenges, our team has developed a one-stage, two cell-type surgical cell therapy for acute chondral defects. This procedure combines allogeneic mesenchymal stromal cells (MSCs) and autologous chondrons to harness MSCs as signaling cells to stimulate chondrons to promote tissue repair. This procedure has been investigated in clinical trials conducted in both Europe and the United States which are called IMPACT and RECLAIM, respectively. This article provides a review of our preclinical and clinical research which led to the development of this cell therapy.
The combination of allogeneic MSCs and autologous chondrons in preclinical studies have demonstrated to synergistically stimulate cartilage repair, and the combination of cells outperforms either cell-type alone. In clinical trials, the combined cell therapy was safe to use, improved knee function, and demonstrated durable pain reduction. Our single-stage, combined cell therapy of allogeneic MSCs and autologous chondrons is a viable cell therapy for acute articular cartilage defects. We anticipate this combined cell therapy may be a platform cell therapy for a wide range of musculoskeletal repair applications.
软骨损伤无法自行愈合。当前基于细胞的软骨治疗方法要么临床效果不佳，要么需要进行两次手术，要么成本高昂且在后勤保障方面存在挑战。为克服这些挑战，我们的团队开发了一种用于治疗急性软骨缺损的单阶段、双细胞类型手术细胞疗法。该手术将同种异体间充质基质细胞（MSCs）和自体软骨粒相结合，利用MSCs作为信号细胞来刺激软骨粒促进组织修复。此手术已分别在欧洲和美国进行的名为IMPACT和RECLAIM的临床试验中得到研究。本文对导致这种细胞疗法得以发展的临床前和临床研究进行了综述。
临床前研究表明，同种异体MSCs和自体软骨粒的组合能协同刺激软骨修复，且这种细胞组合的效果优于单独使用任何一种细胞类型。在临床试验中，联合细胞疗法使用安全，改善了膝关节功能，并显示出持久的疼痛缓解效果。我们的同种异体MSCs和自体软骨粒单阶段联合细胞疗法是治疗急性关节软骨缺损的一种可行的细胞疗法。我们预计这种联合细胞疗法可能成为用于广泛肌肉骨骼修复应用的平台细胞疗法。
