Cartilage regeneration using human umbilical cord blood derived mesenchymal stem cells: A systematic review and meta-analysis

Journal article


Lee, D., Kim, Seon Ae, Song, Jun-Seob, Shetty, Asode Ananthram, Kim, Bo-Hyoung and Kim, S. 2022. Cartilage regeneration using human umbilical cord blood derived mesenchymal stem cells: A systematic review and meta-analysis. Medicina (Kaunas, Lithuania). 58 (12), p. 1801. https://doi.org/10.3390/medicina58121801
AuthorsLee, D., Kim, Seon Ae, Song, Jun-Seob, Shetty, Asode Ananthram, Kim, Bo-Hyoung and Kim, S.
Abstract

Background and Objectives: Human umbilical-cord-blood-derived mesenchymal stem cells (hUCB-MSCs) have recently been used in clinical cartilage regeneration procedures with the expectation of improved regeneration capacity. However, the number of studies using hUCB-MSCs is still insufficient, and long-term follow-up results after use are insufficient, indicating the need for additional data and research. We have attempted to prove the efficacy and safety of hUCB-MSC treatment in a comprehensive analysis by including all subjects with knee articular cartilage defect or osteoarthritis who have undergone cartilage repair surgery using hUCB-MSCs. We conducted a meta-analysis and demonstrated efficacy and safety based on a systematic review.

Materials and Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. For this study, we searched the PubMed, Embase, Web of Science, Scopus, and Cochrane Library literature databases up to June 2022. A total of seven studies were included, and quality assessment was performed for each included study using the Newcastle–Ottawa Quality Assessment Scale. Statistical analysis was performed on the extracted pooled clinical outcome data, and subgroup analyses were completed. Results: A total of 570 patients were included in the analysis. In pooled analysis, the final follow-up International Knee Documentation Committee (IKDC) score showed a significant increase (mean difference (MD), −32.82; 95% confidence interval (CI), −38.32 to −27.32; p < 0.00001) with significant heterogeneity (I2 = 93%, p < 0.00001) compared to the preoperative score. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at final follow-up were significantly decreased (MD, 30.73; 95% CI, 24.10–37.36; p < 0.00001) compared to the preoperative scores, with significant heterogeneity (I2 = 95%, p < 0.00001). The visual analog scale (VAS) score at final follow-up was significantly decreased (MD, 4.81; 95% CI, 3.17–6.46; p < 0.00001) compared to the preoperative score, with significant heterogeneity (I2 = 98%, p < 0.00001). Two studies evaluated the modified Magnetic Resonance Observation of Cartilage Repair Tissue (M-MOCART) score and confirmed sufficient improvement. In a study analyzing a group treated with bone marrow aspiration concentrate (BMAC), there was no significant difference in clinical outcome or M-MOCART score, and the post-treatment International Cartilage Repair Society (ICRS) grade increased.

Conclusion: This analysis demonstrated the safety, efficacy, and quality of repaired cartilage following hUCB-MSC therapy. However, there was no clear difference in the comparison with BMAC. In the future, comparative studies with other stem cell therapies or cartilage repair procedures should be published to support the superior effect of hUCB-MSC therapy to improve treatment of cartilage defect or osteoarthritis.

KeywordsStem cell therapy; Cartilage repair; Cartilage regeneration; Osteoarthritis treatment; Mesenchymal stem cells; Fetal blood; Arthroscopy; Mesenchymal stem cell transplantation
Year2022
JournalMedicina (Kaunas, Lithuania)
Journal citation58 (12), p. 1801
PublisherMDPI
ISSN1648-9144
1010-660X
Digital Object Identifier (DOI)https://doi.org/10.3390/medicina58121801
Official URLhttps://www.mdpi.com/1648-9144/58/12/1801
Publication dates
Online06 Dec 2022
Print01 Dec 2022
Publication process dates
Deposited26 Jan 2023
Publisher's version
License
Output statusPublished
LicenseCC BY
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