CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo)
DOI: 10.1055/s-0041-1733797
Relato de Caso

Effects of Adipose-derived Stem Cells in the Treatment of Knee Osteoarthritis: A Case Report in Brazil's Unified Health System

Article in several languages: português | English
1   Centro de Estudos em Células Tronco, Terapia Celular e Genética Toxicológica – CeTroGen, Hospital Universitário Maria Aparecida Pedrossian – HUMAP/EBSERH, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, Mato Grosso do Sul, MS, Brasil
2   Programa de Pós-graduação em Saúde e Desenvolvimento da Região Centro-Oeste, Faculdade de Medicina Dr. Hélio Mandetta – Famed, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, Mato Grosso do Sul, MS, Brasil
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3   Ambulatório de Ortopedia e Traumatologia, Hospital Universitário Maria Aparecida Pedrossian – HUMAP/EBSERH, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, Mato Grosso do Sul, MS, Brasil
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1   Centro de Estudos em Células Tronco, Terapia Celular e Genética Toxicológica – CeTroGen, Hospital Universitário Maria Aparecida Pedrossian – HUMAP/EBSERH, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, Mato Grosso do Sul, MS, Brasil
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4   Faculdade de Ciências da Saúde – FCS, Universidade Federal da Grande Dourados – UFGD, Dourados, Mato Grosso do Sul, MS, Brasil
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1   Centro de Estudos em Células Tronco, Terapia Celular e Genética Toxicológica – CeTroGen, Hospital Universitário Maria Aparecida Pedrossian – HUMAP/EBSERH, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, Mato Grosso do Sul, MS, Brasil
2   Programa de Pós-graduação em Saúde e Desenvolvimento da Região Centro-Oeste, Faculdade de Medicina Dr. Hélio Mandetta – Famed, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, Mato Grosso do Sul, MS, Brasil
,
1   Centro de Estudos em Células Tronco, Terapia Celular e Genética Toxicológica – CeTroGen, Hospital Universitário Maria Aparecida Pedrossian – HUMAP/EBSERH, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, Mato Grosso do Sul, MS, Brasil
2   Programa de Pós-graduação em Saúde e Desenvolvimento da Região Centro-Oeste, Faculdade de Medicina Dr. Hélio Mandetta – Famed, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, Mato Grosso do Sul, MS, Brasil
5   Programa de Pós-Graduação em Genética e Biologia Molecular, Centro de Ciências Biológicas – CCB, Universidade Estadual de Londrina – UEL, Londrina , Paraná, PR, Brasil
› Author Affiliations

Abstract

Osteoarthritis (OA) can incapacitate the individual to perform their activities of daily living due to pain. This is an important public health issue that worsens worldwide and in Brazil, since the population goes through an aging process, and has caused increased public spending on the monitoring and maintenance of treatments that can last for years and still not be resolutive. Thus, the search for innovative and effective therapies that can reduce costs becomes necessary. In this context, the present study reports the first application of cell therapy with adipose-derived stem cells in the treatment of cases of OA that are refractory to the conservative treatment, performed in the Brazilian Unified Health System (Sistema Único de Saúde, SUS). The evaluation was performed with the application of the Visual Analog Scale (VAS), the Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities (WOMAC), specifics for OA evaluation, and also an analysis of the synovial fluid (inflammatory cytokines). The cell therapy improved the scores on the WOMAC, SF-36 and EVA, and reduced the inflammatory process. We observed a decrease of 0.73x in the TNF, of 0,71x in IL-1b, of 0,68x in IL-8, and of 0,70x in IL-10. For IL-6, an increase of 1,48x was observed. Therefore, this cell therapy can be considered promising in aiding the management of this disease, since it improved the patient's pain, decrease inflammatory markers, and enabled the return to activities of daily living, which resulted in an improvement in their quality of life.



Publication History

Received: 29 October 2020

Accepted: 11 February 2021

Article published online:
01 October 2021

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  • Referências

  • 1 Biazzo A, D'Ambrosi R, Masia F, Izzo V, Verde F. Autologous adipose stem cell therapy for knee osteoarthritis: where are we now?. Phys Sportsmed 2020; 48 (04) 392-399
  • 2 Hermeto LC, DeRossi R, Oliveira RJ. et al. Effects of intra-articular injection of mesenchymal stem cells associated with platelet-rich plasma in a rabbit model of osteoarthritis. Genet Mol Res 2016; 15 (03) DOI: 10.4238/gmr.15038569.
  • 3 Pesarini JR, Oliveira RJ, Pessatto LR. et al. Vitamin D: Correlation with biochemical and body composition changes in a southern Brazilian population and induction of cytotoxicity in mesenchymal stem cells derived from human adipose tissue. Biomed Pharmacother 2017; 91: 861-871
  • 4 Schweich LC, Oliveira EJT, Pesarini JR. et al. All-trans retinoic acid induces mitochondria-mediated apoptosis of human adipose-derived stem cells and affects the balance of the adipogenic differentiation. Biomed Pharmacother 2017; 96: 1267-1274
  • 5 Lee WS, Kim HJ, Kim KI, Kim GB, Jin W. Intra-articular injection of autologous adipose tissue-derived mesenchymal stem cells for the treatment of knee osteoarthritis: a phase IIb, randomized, placebo-controlled clinical trial. Stem Cells Transl Med 2019; 8 (06) 504-511
  • 6 Lu L, Dai C, Zhang Z. et al. Treatment of knee osteoarthritis with intra-articular injection of autologous adipose-derived mesenchymal progenitor cells: a prospective, randomized, doubleblind, active-controlled, phase IIb clinical trial. Stem Cell Res Ther 2019; 10 (1–10): 143
  • 7 Pers YM, Rackwitz L, Ferreira R. et al; ADIPOA Consortium. Adipose Mesenchymal Stromal Cell-Based Therapy for Severe Osteoarthritis of the Knee: A Phase I Dose-Escalation Trial. Stem Cells Transl Med 2016; 5 (07) 847-856
  • 8 Saraiva M, O'Garra A. The regulation of IL-10 production by immune cells. Nat Rev Immunol 2010; 10 (03) 170-181
  • 9 Wang T, He C. Pro-inflammatory cytokines: The link between obesity and osteoarthritis. Cytokine Growth Factor Rev 2018; 44: 38-50
  • 10 Franco RN, Cintra Neto PF, Pimentel ER, Cohen M, Lima GEG, Mattiello-Rosa SMG. Correlation between inflammatory cells and sulfated glycosaminoglycan concentration in synovial fluid of subjects with secondary knee osteoarthritis. J Rheumatol 2008; 35 (06) 1096-1101