Efficacy of autologous stem cells from adipose tissue in the treatment of degenerative joint disease

Article translated by Dr. Dam Thi Minh Phuong – Cell Therapy Block, Vinmec
High-Tech Center

In degenerative joint disease, mesenchymal stem cells (MSCs) are becoming a new therapeutic direction with great potential. The source of MSCs stem cells is diverse, easy to harvest, safe and has the ability to differentiate into cartilage tissue. Furthermore, MSCs are known for their parasecretory, anti-inflammatory and immunomodulatory effects through the secretion of several growth factors and cytokines.

Since osteoarthritis is the result of joint degeneration and inflammation, with the ability to secrete parasecretory substances, reduce immune response and stimulate tissue repair, MSCs will help improve the internal environment joints thereby helping to improve the disease.
Several types of MSCs have been used for intra-articular injection to treat osteoarthritis of the knee. Orozco et al used autologous MSCs stem cells from bone marrow for intra-articular injection, the results showed an improvement in clinical score at 12 months after injection. Vega et al also performed a randomized controlled study with BM-MSC allograft cell injection in patients with grade 2 to 4 K-L osteoarthritis. The results showed a significant improvement in pain and cartilage quality, but the analgesic effect was lower than that found in the study using autologous BM-MSC.
However, direct comparisons are difficult because previous studies did not include a control group. Lee et al conducted a study to evaluate the efficacy and safety of single dose AD-MSC injection in patients with knee osteoarthritis. It was a double-blind, randomized, phase IIb clinical trial.

AD-MSC was administered to 12 patients (MSC group) and a control group of 12 normal saline-injected knees (control group) for up to 6 months. All procedures were performed in the outpatient clinic.
The primary assessment result is the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Secondary evaluation results include clinical and radiological examination, and safety following stem cell injection. The change in cartilage deficiency after injection was assessed by magnetic resonance imaging (MRI).
Results showed that injection of AD-MSC led to a significant improvement in WOMAC score at 6 months. In the control group, there was no significant change in the WOMAC score at 6 months. No serious adverse events were noted in either group during follow-up.
MRI results showed no significant change in cartilage deficiency at 6 months in the MSC group while cartilage deficiency in the control group increased. The results of the study demonstrated that AD-MSC injection improved function and pain relief in patients with knee osteoarthritis in the outpatient setting, without causing adverse effects after 6 months of follow-up.
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