Umbilical Cord MSCs for Knee Osteoarthritis

Knee Osteoarthritis 

Musculoskeletal disorders are the most common cause of severe long-term pain and physical disability affecting hundreds of millions of patients worldwide. Among these diseases osteoarthritis (OA), a chronic degenerative joint disorder involving articular cartilage and many of the surrounding tissues is the most common. 

OA is estimated to affect 250 million people worldwide and the most commonly affected joint is the knee, causing pain and stiffness and a decreased quality of life. 

Despite being an incredibly common condition, no effective therapy or procedure prevents the progressive destruction of OA, and most of them are more symptomatic than preventive. 

One commonly used treatment option is knee replacement, which although generally successful, is associated with numerous complications, and is not as attractive for younger patients due to the prosthesis lifespan (15 years on average). 

Use of Umbilical Cord MSCs 

Human umbilical cord MSCs (hUC-MSCs) have received much attention as a potential cell source of stem cells because they are easy to obtain and store. 

Different preclinical studies have demonstrated that hUC-MSCs can decrease osteogenic genes and inflammatory factors, and promote chondrocyte proliferation, prompting cartilage regeneration. 

In a clinical trial published in the European Journal of Orthopaedic Surgery & Traumatology, researchers evaluated the use of hUC-MSCs combined with hyaluronic acid (HA) as a vehicle, in a total of 29 patients with knee osteoarthritis.

The patients were injected 3 times in total, the first time with 10 million hUC-MSCs, and 2 ml of hyaluronic acid in the 2nd and 3rd weeks. Subjects were followed-up for 1 year. 

The patients had a significant improvement in IKDC and WOMAC scores at 6 and 12 months of follow ups. Considerable improvement was observed in walking time, climbing stairs, VAS level and range of motion. 

The combination of hUC-MSCs and HA implantation could be a potentially new regenerative modality for osteoarthritis of the knee, with the most significant effect achieved after 6 months of injection.

In another trial by Wang and colleagues, a total of 36 patients with moderate to severe degenerative knee OA were randomly divided into 2 groups, the first one received a hUC-MSCs injection containing 20-30 million cells was performed once a month for 2 times, and another group that received sodium hyaluronate once a week 5 times in the control group. 

In this study the team found that the use of hUC-MSCs significantly improved the joint function and quality of life of patients, and that the effect was observed after about 1 month and was sustained for 6 months.

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Sources:

Dilogo, I. H., Canintika, A. F., Hanitya, A. L., Pawitan, J. A., Liem, I. K., & Pandelaki, J. (2020). Umbilical cord-derived mesenchymal stem cells for treating osteoarthritis of the knee: a single-arm, open-label study. European Journal of Orthopaedic Surgery & Traumatology. doi:10.1007/s00590-020-02630-5  

Wang Y, [CURATIVE EFFECT OF HUMAN UMBILICAL CORD MESENCHYMAL STEM CELLS BY INTRA-ARTICULAR INJECTION FOR DEGENERATIVE KNEE OSTEOARTHRITIS]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Dec 8;30(12):1472-1477. Chinese. doi: 10.7507/1002-1892.20160305. PMID: 29786336.

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