Intra-articular injection choice for osteoarthritis: making sense of cell source—an updated systematic review and dual network meta-analysis
Abstract Background Intra-articular injection is indicated for mild or moderate osteoarthritis (OA). However, the superiority of cell-based injection and the role of diverse cell sources are still unclear. This study aimed to compare the therapeutic effect of intra-articular injection with mesenchym...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13075-022-02953-0 |
| _version_ | 1797985478707773440 |
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| author | Yijian Zhang Huilin Yang Fan He Xuesong Zhu |
| author_facet | Yijian Zhang Huilin Yang Fan He Xuesong Zhu |
| author_sort | Yijian Zhang |
| collection | DOAJ |
| description | Abstract Background Intra-articular injection is indicated for mild or moderate osteoarthritis (OA). However, the superiority of cell-based injection and the role of diverse cell sources are still unclear. This study aimed to compare the therapeutic effect of intra-articular injection with mesenchymal stem cells (MSCs) and cell-free methods for OA treatment. Methods A literature search of published scientific data was carried out from PubMed, MEDLINE, Embase, Cochrane Library, Web of Science, and China National Knowledge Internet (CNKI). Randomized controlled trials (RCTs) compared the efficacy and safety of MSC and cell-free intra-articular injection treatments for OA with at least 6-month follow-up. Results Dual network meta-analysis validated the therapeutic advantages of MSC treatments (VAS, Bayesian: 90% versus 10% and SUCRA: 94.9% versus 5.1%; WOMAC total, Bayesian: 83% versus 17% and SUCRA: 90.1% versus 9.9%) but also suggested a potential negative safety induced by cell injection (adverse events, Bayesian: 100% versus 0% and SUCRA: 98.2% versus 1.8%). For the MSC source aspect, adipose mesenchymal stem cells (ADMSCs) and umbilical cord mesenchymal stem cells (UBMSCs) showed a better curative effect on pain relief and function improvement compared with bone marrow mesenchymal stem cells (BMMSCs). Conclusion Intra-articular injection of MSCs is associated with more effective pain alleviation and function improvement than cell-free OA treatment. However, the potential complications induced by MSCs should be emphasized. A comparative analysis of the MSC sources showed that ADMSCs and UBMSCs exerted a better anti-arthritic efficacy than BMMSCs. Graphical Abstract Schematic illustration of MSC-based intra-articular injection for treating OA. Three major MSCs (UBMSCs, ADMSCs, and BMMSCs) are extracted and expanded in vitro. Subsequently, the amplified MSCs are concentrated and injected into the knee joint to treat OA. |
| first_indexed | 2024-04-11T07:17:50Z |
| format | Article |
| id | doaj.art-7b4e63b2e91c4958972e35d0dd414494 |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-04-11T07:17:50Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj.art-7b4e63b2e91c4958972e35d0dd4144942022-12-22T04:37:51ZengBMCArthritis Research & Therapy1478-63622022-11-0124111410.1186/s13075-022-02953-0Intra-articular injection choice for osteoarthritis: making sense of cell source—an updated systematic review and dual network meta-analysisYijian Zhang0Huilin Yang1Fan He2Xuesong Zhu3Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow UniversityDepartment of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow UniversityOrthopaedic Institute, Medical College, Soochow UniversityDepartment of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow UniversityAbstract Background Intra-articular injection is indicated for mild or moderate osteoarthritis (OA). However, the superiority of cell-based injection and the role of diverse cell sources are still unclear. This study aimed to compare the therapeutic effect of intra-articular injection with mesenchymal stem cells (MSCs) and cell-free methods for OA treatment. Methods A literature search of published scientific data was carried out from PubMed, MEDLINE, Embase, Cochrane Library, Web of Science, and China National Knowledge Internet (CNKI). Randomized controlled trials (RCTs) compared the efficacy and safety of MSC and cell-free intra-articular injection treatments for OA with at least 6-month follow-up. Results Dual network meta-analysis validated the therapeutic advantages of MSC treatments (VAS, Bayesian: 90% versus 10% and SUCRA: 94.9% versus 5.1%; WOMAC total, Bayesian: 83% versus 17% and SUCRA: 90.1% versus 9.9%) but also suggested a potential negative safety induced by cell injection (adverse events, Bayesian: 100% versus 0% and SUCRA: 98.2% versus 1.8%). For the MSC source aspect, adipose mesenchymal stem cells (ADMSCs) and umbilical cord mesenchymal stem cells (UBMSCs) showed a better curative effect on pain relief and function improvement compared with bone marrow mesenchymal stem cells (BMMSCs). Conclusion Intra-articular injection of MSCs is associated with more effective pain alleviation and function improvement than cell-free OA treatment. However, the potential complications induced by MSCs should be emphasized. A comparative analysis of the MSC sources showed that ADMSCs and UBMSCs exerted a better anti-arthritic efficacy than BMMSCs. Graphical Abstract Schematic illustration of MSC-based intra-articular injection for treating OA. Three major MSCs (UBMSCs, ADMSCs, and BMMSCs) are extracted and expanded in vitro. Subsequently, the amplified MSCs are concentrated and injected into the knee joint to treat OA.https://doi.org/10.1186/s13075-022-02953-0Mesenchymal stem cellsOsteoarthritisIntra-articular injectionPain reliefFunction improvementAdverse effects |
| spellingShingle | Yijian Zhang Huilin Yang Fan He Xuesong Zhu Intra-articular injection choice for osteoarthritis: making sense of cell source—an updated systematic review and dual network meta-analysis Arthritis Research & Therapy Mesenchymal stem cells Osteoarthritis Intra-articular injection Pain relief Function improvement Adverse effects |
| title | Intra-articular injection choice for osteoarthritis: making sense of cell source—an updated systematic review and dual network meta-analysis |
| title_full | Intra-articular injection choice for osteoarthritis: making sense of cell source—an updated systematic review and dual network meta-analysis |
| title_fullStr | Intra-articular injection choice for osteoarthritis: making sense of cell source—an updated systematic review and dual network meta-analysis |
| title_full_unstemmed | Intra-articular injection choice for osteoarthritis: making sense of cell source—an updated systematic review and dual network meta-analysis |
| title_short | Intra-articular injection choice for osteoarthritis: making sense of cell source—an updated systematic review and dual network meta-analysis |
| title_sort | intra articular injection choice for osteoarthritis making sense of cell source an updated systematic review and dual network meta analysis |
| topic | Mesenchymal stem cells Osteoarthritis Intra-articular injection Pain relief Function improvement Adverse effects |
| url | https://doi.org/10.1186/s13075-022-02953-0 |
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