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Stem Cell Treatments for Joint Pain

2018-04-28 12:19:25.421786+00 by Dan Lyke 2 comments

Just a place to hang a bunch of links about stem cell treatments for joint pain.

The NIH points to http://www.closerlookatstemcells.org/

comments in ascending chronological order (reverse):

#Comment Re: Stem Cell Treatments for Joint Pain made: 2018-04-28 12:19:44.556688+00 by: Dan Lyke

==== Negative ====

Stem cell injections in knee osteoarthritis: a systematic review of the literature. doi: 10.1136/bjsports-2016-096793. Epub 2017 Mar 3.

Six trials with high risk of bias showed level-3 or level-4 evidence in favour of stem cell injections in KOA. In the absence of high-level evidence, we do not recommend stem cell therapy for KOA.

Stem cell application for osteoarthritis in the knee joint: A minireview Published online 2014 Nov 26. doi: 10.4252/wjsc.v6.i5.629

In conclusion, stem cell therapy may not become a standard treatment for knee OA till the end of the decade due to various aspects regarding the clinical safety (e.g., risk of complications after surgery, compatibility of donor stem cells) and the affordability of this treatment for the general public. Moreover, there is still no sufficient amount of clinical data on the effectiveness of stem cell therapy when compared with pharmacological treatments for this particular disease.

Stem cells in articular cartilage regeneration 2016 Apr 12. doi: 10.1186/s13018-016-0378-x

This systematic review revealed a high interest of researchers in the clinical use of MSCs for cartilage and OA treatment, as testified by the increasing number of reports published over time. Whereas the lack of contraindication and generally promising clinical outcomes have been reported, the prevalence of low-quality studies, with many variables, shows several aspects that still need to be optimized, such as the best cell source and the most appropriate processing method, the most effective dose and delivery procedure. On the other hand, the first hints on the kind of patients who might benefit more from these procedures are being drawn. High-level studies with large number of patients and long-term follow-up are mandatory to evaluate the real potential of this biological approach for cartilage repair.

==== Positive ====

Current perspectives in stem cell research for knee cartilage repair Published online 2014 Jan 16. doi: 10.2147/SCCAA.S42880

urther, standardization of the implantation procedure needs to be addressed from the clinical point of view, depending on the age and background of patients with possible associated pathologies, on the type, size, and localization of the lesion(s), on the length of follow-up, and on the methods used for assessment of cartilage repair. From a laboratory point of view, standardization is also necessary regarding the optimal source and amount of cells requested, the number of injections, the benefits of isolated cells versus culture-expanded cells versus cell concentrates (ie, one-step versus two-step procedure) with specified conditions of preparation and maintenance, and the use of autologous versus allogeneic samples.

Advances and Prospects in Stem Cells for Cartilage Regeneration Published online 2017 Jan 26. doi: 10.1155/2017/4130607

There are many clinical examples of stem cells showing a satisfactory curative effect in cartilage damage repair, but larger sample sizes and longer follow-up periods in clinical studies are required to test the effectiveness and safety of stem cells for cartilage repair.

Clinical efficacy and safety of mesenchymal stem cell transplantation for osteoarthritis treatment: A meta-analysis 2017 Apr 27. doi: 10.1371/journal.pone.0175449

Eleven selected publications regarding knee OA with 582 patients were included in the present meta-analysis. This analysis of MSC therapy in knee OA patients yielded encouraging results, with superiority in VAS, WOMAC and Lequesne scores; improvements in IKDC, Lysholm, and Tegner scores; and low rates of AEs. Hence, these results suggest that MSC therapy has great potential as an efficacious treatment for patients with knee OA. However, the safety and efficacy must be evaluated with a more rigorous, larger sample size validation before MSC therapy can be used in clinical practice.

Treatment of Knee Osteoarthritis With Allogeneic Bone Marrow Mesenchymal Stem Cells: A Randomized Controlled Trial. 2015 Aug;99(8):1681-90. doi: 10.1097/TP.0000000000000678.

Feasibility and safety were confirmed and indications of clinical efficacy were identified. The MSC-treated patients displayed significant improvement in algofunctional indices versus the active controls treated with hyaluronic acid. Quantification of cartilage quality by T2 relaxation measurements showed a significant decrease in poor cartilage areas, with cartilage quality improvements in MSC-treated patients.

Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: A meta-analysis 2016 Oct 11. doi: 10.3892/etm.2016.3791

The present meta-analysis suggested that MSC treatment significantly improved pain and functional status, relative to the basal evaluations in KOA, and the beneficial effect was maintained for two years after treatment. ...

==== Neutral ====

Update on mesenchymal stem cell therapies for cartilage disorders Published online 2017 Dec 18. doi: 10.5312/wjo.v8.i12.853

.From a basic science perspective, the mechanisms underlying chondrogenic differentiation of MSCs and subsequent matrix production require elucidation. As it stands, the quality of repair tissue generated by marrow stimulation is known to be mechanically inferior to native articular cartilage. It may be the case that disruption to the subchondral plate contributes to this phenomenon, and implantation of autologous MSC or ADSC could circumvent this issue.

#Comment Re: Stem Cell Treatments for Joint Pain made: 2018-04-29 00:45:00.430595+00 by: Dan Lyke

Sanjay Gupta writes what looks a lot like a paid ad featuring Jack Nicklaus

HOw the media bothced the Gordie Howe stem cell story

... For example, “stroke patients often improve on their own within six months,” as Wiedeman pointed out. So the way to determine whether the Stemedica treatment works would be to set up an experiment: to compare a group of stroke victims who get that treatment to a group of stroke patients, as similar as possible, who don’t. Then, and only then — and the bigger the sample size, the better — can you even start to make any claims about the efficacy of the treatment.

Stem cell hype: Media portrayal of therapy translation

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