Stem Cell Implantation In Patients Research Articles

Efficacy of autologous stem cell therapy in femoral head avascular necrosis: a comparative study

ObjectiveAvascular necrosis of the femoral head is a disease usually seen in middle-aged individuals. Although many aetiological factors have been blamed, there are still aetiological factors that have not been fully elucidated. Although treatment options show a wide range, early and appropriate treatment is of great importance to preserve the hip joint. In our study, we compared the results of core decompression and core decompression combined with bone marrow mesenchymal stem cell implantation in patients with avascular necrosis of the femoral head.Material methodIn this retrospective study, Steinberg stage 1–2 patients operated on for avascular necrosis of the femoral head between 2018 and 2023 were analysed. Separate groups were formed from patients who underwent isolated core decompression and core decompression + bone marrow mesenchymal stem cell implantation. Age, gender, Steinberg staging, aetiology of the disease, follow-up period, progression to hip arthroplasty, Vas scores, Harris hip scores (HHS), and complications were evaluated. Harris hip scores at preoperative and 2-year follow-up periods; VAS scores at preoperative, 3-month, 6-month, 1-year, and 2-year follow-up periods were analysed.ResultsIn the study, 44 patients were analysed. While 25 patients underwent core decompression only (group 1), 19 patients underwent core decompression and bone marrow mesenchymal stem cell implantation (group 2). The mean age of the patients in group 1 was 39.3 ± 6.5 years, and the mean age of the patients in group 2 was 38.4 ± 6.7 years. The mean follow-up was 31.85 ± 4.4 months in group 1 and 32.2 ± 4.1 months in group 2. Total hip arthroplasty was performed in 2 of the patients in group 1 (one of the patients underwent total hip arthroplasty at month 28 and the other at month 33).ConclusionThe treatment of avascular necrosis of the femoral head varies according to various staging methods. Early diagnosis of the disease and correct treatment are very important for the patient's quality of life in the future. In our research, we found that patients who received both core decompression and stem cell implantation for early-stage avascular necrosis of the femoral head exhibited decreased pain at the 6-month, 1-year, and 2-year follow-up examinations. Additionally, their hip function improved at the 24-month mark according to the HHS evaluation.

A new hope of CD133+ bone marrow stem cell for functional exercise capacity improvement in low ejection fraction coronary artery bypass graft patients: a clinical trial

Background: Patients with low ejection fraction who are undergoing coronary artery bypass graft (CABG) only have an insignificant improvement in ejection fraction. This condition will make a little hope to achieve an improvement in physical performance. But now, from a view study, CD133+ stem cells offer new hope for this situation. This study evaluates CD133+ bone marrow stem cells' role for functional exercise capacity improvement in low ejection fraction coronary artery bypass graft patients.Methods: Thirty patients with ischemic heart disease who had ejection fraction <35% at the National Cardiovascular Center were randomized into 2 groups. The treatment group undergoes the CABG + CD133+ procedure and the control group undergoes the CABG only. All research subjects underwent follow-up before and 6 months after the procedure. Fraction ejection, scar size, wall motion score index, ventricular dimensions, myocardial perfusion measured by cardiac MRI, 6 Minutes Walking Test (6MWT) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) as an additional parameter for physical performance and quality of life. Data was analyzed using SPSS version 21 for Windows.Results: The results of the fraction ejection parameters showed a significant improvement in the treatment group, from 25.88±5.66% to 34.57%±11.31% compared to CABG only 30.18±3.85% to 31.61±7.89% (p=0.040), in the perfusion defect showed improvement but not significant, left ventricular end-systolic volume and left ventricular end-diastolic volume showed improvement with no significant result, scar size was found to be an improvement in the treatment group 10 persons (76.92%) compared to the control group 5 persons (38, 46%) (p=0.040), the wall motion score index and 6MWT showed a significant improvement in the treatment group (p=0.003 and p=0.03, respectively). The MLHFQ parameter showed improvement but not significant.Conclusion: CD 133+ stem cell implantation in patients with low ejection fraction who undergo CABG provides improved myocardial function and indirectly improves functional exercise capacity and patients' quality of life.

Second Autologous Stem Cell Implantation in Patients with Chronic Spinal Cord Injuries

Second Autologous Stem Cell Implantation in Patients with Chronic Spinal Cord Injuries

Umbilical cord-derived mesenchymal stem cell implantation in patients with optic atrophy.

Optic nerve cells can be irreversibly damaged by common various causes. Unfortunately optic nerve and retinal ganglion cells have no regenerative capacity and undergo apoptosis in case of damage. In this study, our aim is to investigate the safety and efficacy of suprachoroidal umbilical cord-derived MSCs (UC-MSCs) implantation in patients with optic atrophy. This study enrolled 29 eyes of 23 patients with optic atrophy who were followed in the ophthalmology department of our hospital. BCVA, anterior segment, fundus examination, color photography, and optical coherence tomography (OCT) were carried out at each visit. Fundus fluorescein angiography and visual field examination were performed at the end of the first, third, sixth months, and 1 year follow-up. After suprachoroidal UC-MSCs implantation there were statistically significant improvements in BCVA and VF results during 12 months follow-up (p < 0.05). When we evaluate the results of VF tests, the mean deviation (MD) value at baseline was -26.11 ± 8.36 (range -14.18 to -34.41). At the end of the first year it improved to -25.01 ± 8.73 (range -12.56 to -34.41) which was statistically significant (p < 0.05). When we evaluate the mean RNFL thickness measurements at baseline and at 12 month follow-up the results were 81.8 ± 24.9 μm and 76.6 ± 22.6 μm, respectively. There was not a significant difference between the mean values (p > 0.05). Stem cell treatment with suprachoroidal implantation of UCMSCs seems to be safe and effective in the treatment for optic nerve diseases that currently have no curative treatment options.

Safety and Effectiveness of Autologous Adipose Tissue Derived Mesenchymal Stem Cell Implantation in Patients With CP

Safety and Effectiveness of Autologous Adipose Tissue Derived Mesenchymal Stem Cell Implantation in Patients With CP

Assessment of clinical and MRI outcomes after mesenchymal stem cell implantation in patients with knee osteoarthritis: a prospective study

Cartilage regenerative procedures using the cell-based tissue engineering approach involving mesenchymal stem cells (MSCs) have been receiving increased interest because of their potential for altering the progression of osteoarthritis (OA) by repairing cartilage lesions. The aim of this study was to investigate the clinical and magnetic resonance imaging (MRI) outcomes of MSC implantation in OA knees and to determine the association between clinical and MRI outcomes. Twenty patients (24 knees) who underwent arthroscopic MSC implantation for cartilage lesions in their OA knees were evaluated at 2 years after surgery. Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed according to the MRI Osteoarthritis Knee Score (MOAKS) and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. The clinical outcomes significantly improved (P<0.001 for both). The cartilage lesion grades (as described in MOAKS [grades for size of cartilage-loss area and percentage of full-thickness cartilage loss]) at follow-up MRI were significantly better than the preoperative values (P<0.001 for both). The clinical outcomes at final follow-up were significantly correlated with the MOAKS and MOCART score at follow-up MRI (P<0.05 for all). Considering the encouraging clinical and MRI outcomes obtained and the significant correlations noted between the clinical and MRI outcomes, MSC implantation seems to be useful for repairing cartilage lesions in OA knees. However, a larger sample size and long-term studies are needed to confirm our findings.

Safety and Effect of Adipose Tissue-Derived Stem Cell Implantation in Patients With Critical Limb Ischemia

Treatment of critical limb ischemia (CLI) by bypass operation or percutaneous vascular intervention is occasionally difficult. The safety and efficacy of multiple intramuscular adipose tissue-derived mesenchymal stem cells (ATMSC) injections in CLI patients was determined in the study. The study included 15 male CLI patients with ischemic resting pain in 1 limb with/without non-healing ulcers and necrotic foot. ATMSC were isolated from adipose tissue of thromboangiitis obliterans (TAO) patients (B-ATMSC), diabetes patients (D-ATMSC), and healthy donors (control ATMSC). In a colony-forming unit assay, the stromal vascular fraction of TAO and diabetic patients yielded lesser colonies than that of healthy donors. D-ATMSC showed lower proliferation abilitythan B-ATMSC and control ATMSC, but they showed similar angiogenic factor expression with control ATMSC and B-ATMSC. Multiple intramuscular ATMSC injections cause no complications during the follow-up period (mean follow-up time: 6 months). Clinical improvement occurred in 66.7% of patients. Five patients required minor amputation during follow-up, and all amputation sites healed completely. At 6 months, significant improvement was noted on pain rating scales and in claudication walking distance. Digital subtraction angiography before and 6 months after ATMSC implantation showed formation of numerous vascular collateral networks across affected arteries. Multiple intramuscular ATMSC injections might be a safe alternative to achieve therapeutic angiogenesis in patients with CLI who are refractory to other treatment modalities.

Abstract 8381: Safety and Effect of Adipose Tissue Derived Stem Cell Implantation in Patients with Critical Limb Ischemia

Adipose tissue-derived mesenchymal stem cells (ADSCs) are potent and effective for inducing regeneration of damaged tissue. Treatment of critical limb ischemia (CLI) is occasionally difficult through bypass operation or percutaneous vascular intervention. ADSC transplantation shows proangiogenic action in animal hindlimb ischemia models. We performed multiple intramuscular ADSC injections in CLI patients to treat diabetic foot and thromboangiitis obliterans (TAO) and assessed its safety and efficacy. The study included 15 CLI patients (15 men, median age: 52 years, range: 24-73 years) with ischemic resting pain in one limb with/without nonhealing ulcers and necrotic foot (Rutherford class II-4: n = 3, III-5: n = 9, III-6: n = 3) who did not undergo nonsurgical or surgical revascularization. ADSCs were isolated from adipose tissue of TAO patients (B-ADSCs), diabetes patients (D-ADSCs), and healthy donors (control ADSCs) by using 0.075% collagenase digestion. In a colony forming unit (CFU) assay using stromal vascular fraction, B-ADSCs and D-ADSCs yielded lesser colonies than normal ADSCs. However, culture-expanded B-ADSCs showed normal proliferation ability compared to control ADSCs. Adipogenic and osteogenic differentiation potential did not differ between B-ADSCs and control ADSCs. Culture-expanded D-ADSCs showed lower proliferation ability and osteogenic differentiation and higher adipogenic differentiation than control ADSCs. Multiple intramuscular ADSC injections cause no complications during the follow-up period (mean follow-up time: 6 months). Clinical improvement occurred in 66.7% of patients. Five patients required minor amputation during follow-up. All amputation sites healed completely. At 6 months, significant improvement was noted on pain rating scales and in claudication walking distance. Digital subtraction angiography (DSA) before and 6 months after ADSC implantation showed formation of numerous vascular collateral networks across affected arteries. Multiple intramuscular ADSC injections may be a safe alternative to achieve therapeutic angiogenesis in patients with CLI who are refractory to other treatment modalities

Stem Cell Experiments and Initial Clinical Trial of Cellular Cardiomyoplasty

Growing myocardial cells from human stem cells and stem cell transplantation to repair injured myocardium are new frontiers in cardiovascular research. The 1st stage of this study was conducted to determine whether transplantation of autologous bone marrow stem cells into infarcted myocardium of sheep could differentiate into beating cardiomyocytes. The 2nd stage was to demonstrate transdifferentiation of human bone marrow mesenchymal stem cells to precursor cardiomyocytes in vitro, using a novel conditioning medium. In the 3rd stage, a clinical trial of stem cell implantation in patients with severe myocardial dysfunction involved injection of peripheral blood-derived endothelial precursor cells in 11 patients and autologous bone marrow mononuclear cells in 29. A marginal improvement in myocardial function was noted at 3 months (mean increase in ejection fraction, 6% +/- 1%), although it plateaued at 6 months. The trial proved to be safe because there was no procedure-related mortality. There is growing optimism that stem cell therapy may delay heart transplantation.