Osteoarthritis is a degenerative process that affects the cartilage in joints. The immune system is involved in the process, producing local inflammatory reactions. These reactions lead to the production of pro-inflammatory cytokines and metalloproteinases. The healing process is slow, and a secondary fibrosis process occurs where damage repair is impossible. This process leads to continued degeneration in patients.
Knee OA is a common form of osteoarthritis, especially in Asian countries. OA is a debilitating disease that can significantly impact an individual’s quality of life. There is currently no treatment available to improve or reverse the process. The medical community is looking to develop alternative therapies that can address the root causes of this condition.
Stem cell therapy offers new hope for the treatment of many incurable diseases, including osteoarthritis. Mesenchymal stem cells (MSCs) are attractive for clinical use due to a number of properties, such as immunosuppression.
A study, Mesenchymal stem cell therapy for knee osteoarthritis: Preliminary report of four patients, The aim of this study was to examine whether MSC transplantation could reverse the OA process in the knee joint. The project was approved by the Tehran University of Medical Sciences Research Committee and Ethical Committee. The results of the study showed that MSC transplantation could indeed reverse the OA process in the knee joint, providing new hope for the treatment of this condition.
Results of the Study
Four patients were selected for treatment in the study of the effects of bone marrow-derived mesenchymal stem cells on knee osteoarthritis. The patients ranged in age from 55 to 65 years and had moderate to severe OA. The study included four patients, two males and two females. All were overweight, with BMIs ranging from 28.5 to 37.1. The patients had been experiencing clinical symptoms for an average of 10 years.
30 mL of bone marrow was taken from each patient and cultured for MSC growth. After 4-5 weeks, when enough MSCs had been produced, the cells were injected into the patients’ knees. All safety measures were considered during the course of treatment. A mean volume of 5.5 mL containing approximately 8,000,000 to 9,000,000 cells was injected into the most painful knee of each patient.
No previous preparation or premedication was given, and all anti-inflammatory or analgesic drugs were stopped before the study. The first follow-up after the procedure was at one week, then every month up to 1 year. At each visit, parameters that were checked before the procedure were rechecked, including x-rays of both knees in a standing position.
The results of the study were extremely promising. The walking time for the pain to appear in patients was 20, 0, 1, and 10 minutes at the start of the study. After receiving treatment, the times improved to 25, 60, and 6 minutes for the first three patients. The fourth patient did not show any improvement in walking time until pain.
Another symptom the researchers looked into was the number of stairs patients could climb before they felt knee pain. Before the injection, patients could climb 5, 3, 1, and 8 stairs. After receiving the injection, patients could climb 10, 70, 15, and 20 stairs before pain appeared.
The researchers also looked into the amount of pain patients experienced on the VAS scale. Before the treatment, the scores were 90, 80, 90, and 85. After the treatment, patient scores improved to 50, 40, 55, and 65. The results of the study showed that the MSCs were effective in improving the symptoms of OA. The patients experienced increased mobility and reduced pain after treatment. This study provides evidence that MSCs may be a promising treatment for knee OA.
While mesenchymal stem cells (MSCs) have shown promise in treating a variety of diseases, further investigations are necessary to determine the most effective ways to use them. For example, researchers need more experience with large-scale MSC treatments to determine the proper dose of cells, the number and timing of injections, and the best way to track the transplanted cells.
Additionally, it remains unclear which cell subtypes are most effective for treating different diseases and what stage of a disease is most appropriate for MSC transplantation. As researchers continue to study MSCs, they will likely identify new and better ways to use these versatile cells to treat a wide range of diseases.
