Comparative effectiveness of adipose-derived mesenchymal stromal cells in the management of knee osteoarthritis:A meta-analysis

作     者：Sathish Muthu Sandesh C Patil Naveen Jeyaraman Madhan Jeyaraman Prakash Gangadaran Ramya Lakshmi Rajendran Eun Jung Oh Manish Khanna Ho Yun Chung Byeong-Cheol Ahn 

作者机构：Department of OrthopaedicsGovernment Medical College and HospitalDindigul 624001Tamil NaduIndia Department of BiotechnologySchool of Engineering and TechnologySharda UniversityGreater Noida 201310Uttar PradeshIndia JeyaramanResearch AssociateOrthopaedic Research GroupCoimbatore 641045Tamil NaduIndia Indian Stem Cell Study Group AssociationLucknow 226001Uttar PradeshIndia Department of Orthopaedic RheumatologyDr.RML National Law UniversityLucknow 226012Uttar PradeshIndia ACS Medical College&HospitalDr MGR Educational and Research InstituteChennai 600056Tamil NaduIndia BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future TalentsDepartment of Biomedical SciencesSchool of MedicineKyungpook National UniversityDaegu 41944South Korea Department of Nuclear MedicineSchool of MedicineKyungpook National UniversityDaegu 41944South Korea Department of Plastic and Reconstructive SurgeryCMRIKyungpook National UniversityKyungpook National University HospitalDaegu 41944South Korea Department of Plastic and Reconstructive SurgerySchool of MedicineKyungpook National UniversityDaegu 41944South Korea Department of Nuclear MedicineKyungpook National University HospitalDaegu 41944South Korea 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2023年第14卷第1期

页      面：23-41页

学科分类：0403[教育学-体育学] 1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Supported by the Basic Science Research Program through the National Research Foundation of Korea,NRF-2021R1I1A1A01040732 and NRF-2022R1I1A1A01068652 the National Research Foundation of Korea grant funded by the Korean Government,Ministry of Science and ICT,2020R1A2C2009496 

主　　题：Mesenchymal stromal cell Adipose tissue-derived mesenchymal stromal cell Bone-marrow derived mesenchymal stromal cell Cartilage regeneration Knee osteoarthritis Meta-analysis Efficacy Safety 

摘      要：BACKGROUND Osteoarthritis(OA)is the most common joint disorder,is associated with an increasing socioeconomic impact owing to the ageing *** To analyze and compare the efficacy and safety of bone-marrow-derived mesenchymal stromal cells(BM-MSCs)and adipose tissue-derived MSCs(AD-MSCs)in knee OA management from published randomized controlled trials(RCTs).METHODS Independent and duplicate electronic database searches were performed,including PubMed,EMBASE,Web of Science,and Cochrane Library,until August 2021 for RCTs that analyzed the efficacy and safety of AD-MSCs and BM-MSCs in the management of knee *** visual analog scale(VAS)score for pain,Western Ontario McMaster Universities Osteoarthritis Index(WOMAC),Lysholm score,Tegner score,magnetic resonance observation of cartilage repair tissue score,knee osteoarthritis outcome score(KOOS),and adverse events were *** was performed on the R-platform using OpenMeta(Analyst)***-one studies,involving 936 patients,were *** one study compared the two MSC sources without patient randomization;hence,the results of all included studies from both sources were pooled,and a comparative critical analysis was *** At six months,both AD-MSCs and BM-MSCs showed significant VAS improvement(P=0.015,P=0.012);this was inconsistent at 1 year for BM-MSCs(P0.001,P=0.539),and AD-MSCs outperformed BM-MSCs compared to controls in measures such as WOMAC(P0.001,P=0.541),Lysholm scores(P=0.006;P=0.933),and KOOS(P=0.002;P=0.012).BM-MSC-related procedures caused significant adverse events(P=0.003)compared to AD-MSCs(P=0.673).CONCLUSION Adipose tissue is superior to bone marrow because of its safety and consistent efficacy in improving pain and functional *** trials are urgently warranted to validate our findings and reach a consensus on the ideal source of MSCs for managing knee OA.