A Systematic Review on Preclinical and Clinical Evidence
Introduction: There is still no definitive treatment to either inhibit the degradation process or restore the damaged cartilage in osteoarthritis (OA). Various cell sources have been studied and in vitro studies showed that infrapatellar fat pad-derived mesenchymal stem cells (IFPDMSCs) exhibit higher chondrogenic potential than other adipose-derived cells. Still, very few in vivo studies on IFPDMSCs for cartilage healing in OA have been reported.
Aims: This systematic review will analyze the therapeutic potential of IFPDMSCs for cartilage healing in osteoarthritis from preclinical and clinical studies. Design, Methods, and Data Source: Using the PubMed, EMBASE, and Cochrane Library database up to November 30, 2020, a systematic review according to PRISMA reporting guideline was conducted on IFPDMSCs application to treat osteoarthritis in vivo studies. Inclusion criteria were in vivo preclinical and clinical studies from January 2010 to November 2020 involving the OA model or cases using IFPDMSCs to promote healing.
Results: In vivo studies are scarce. Only four studies are included: two animals and two clinical studies. All included studies demonstrate favourable results of IFPDMSCs in osteoarthritis, but there is heterogeneity in outcome measurement among all studies. Conclusion: The in vitro and currently limited in vivo studies showed that infrapatellar fat pad-derived mesenchymal stem cells offer an alternative cell source with promising chondrogenic healing potential.
Impact: More preclinical and clinical in vivo studies should be encouraged to explore and support the efficacy of IFPDMSCs in cell-based OA treatment to prove the promising result as those of the in vitro studies.
Keywords: Osteoarthritis, In vivo, Infrapatellar fat pad, Mesenchymal stem cells, Cell-based treatment
Osteoarthritis (OA) involves not only the degradation of articular cartilage but also the intraarticular inflammatory process. The degenerative process progression may eventually result in permanent disabling conditions, affecting an individual’s daily activity and quality of life (1,2). Current treatments, both pharmacological and surgical, aim to improve patients’ quality of life by reducing pain, but no definitive treatment to either inhibit the degradation process or restore the damaged cartilage has been agreed upon. One of the emerging efforts to delay the disease progression is the application of cell-based therapy using mesenchymal stem cells (MSCs), thanks to their abilities of multipotency, selfrenewal, and immunomodulation. These abilities differ according to cell sources (3–6).
Adipose-derived mesenchymal stem cells (ADMSCs) are believed to have more edges than the more conventional bone marrow mesenchymal stem cells (BMSCs) due to their advantages in abundance, ease of harvesting, higher differentiation and proliferation potential, and resilience over multiple culture passages. Among the ADMSCs, the cells harvested from the infrapatellar fat pad (IFP) are reported to yield higher chondrogenic potential. In vitro studies on the chondrogenic potential of IFP-derived mesenchymal stem cells (IFPDMSCs) showed encouraging results of larger cell volume and higher proliferative capacity (7–9). Still, very few in vivo studies on IFPDMSCs for cartilage repair in OA have been reported. This systematic review aims to analyze the therapeutic potential of IFPDMSCs for cartilage healing in osteoarthritis from preclinical and clinical studies.