- Email: [email protected]
Tendon and bone repair by mesenchymal cells
Abstracts / Biomedicine & Pharmacotherapy 62 (2008) 487e502
In a case to 5 months we have made a second look with the standard method that in addition to confirming the good impressions already indicated with the innervue has allowed us to make a biopsy of the surface. the histological exam has shown the presence of cartilage cells in the context of the extracellular matrix with the presence of collagen fibers of type II and this histological aspect is found only in the hyaline cartilage. Even if the number of the treated cases statistically is not still remarkable and the follow-up is brief, the use of the TruFitÒ has given us good clinic impressions with the complete resolution of the knee pain in all the cases and also the histological results that we have gotten with the arthroscopic second look are very encouraging. We can affirm then that the use of this scaffold represents a fascinating solution in the treatment of the osteochondral defects of the knee that, if confirmed with a longer clinical follow-up and with further histological and histochemical comparisons, it is set decidedly in the foreground as the best methodic for this type of lesions. Besides we have had good results also in over-sixty subject with enough wide lesions, is also hypothesized the complete substitution of the osteochondral portion of load of a femoral condyle, when the axle of load allows it, in alternative to a very more invasive surgery of unicompartimental prosthesis. We will get, by the arthroscopic technique, a ‘‘biological prosthesis’’. 16
495
Although two short inductions increased osteogenic markers in hMSCs, inside the clot the cells were able to terminally differentiate into osteoblasts. Moreover we show that the clot is able to sustain cell proliferation under appropriate cell culture conditions. Our results suggested that clot could be useful for hMSC delivery into the site of the lesion to promote bone formation. Moreover, the plasticity of this material allowed good ‘‘in vitro’’ hMSC spreading and proliferation. The advantages of using this autologous biological material are its biocompatibility and reabsorption; furthermore, using a gel as scaffold, it is possible to mould it to the shape of a bone cavity. Attempts to repair tendon lesions have been performed, mainly using scaffold carriers in experimental settings. In this report we describe the clinical use of undifferentiated mesenchymal cells in race horses. Repair of superficial digital flexor tendon was achieved in nine of eleven horses evaluated by ultrasound analysis and their ability to return to racing. Our results show that the suspension of a relatively low number of undifferentiated mesenchymal cells may be sufficient to repair damaged tendons without the use of scaffold support. Interestingly, ultrasound scanning showed that fibers were correctly oriented. By using undifferentiated cells, no ectopic bone deposition occurred. All but one case recovered sufficient number of cells for therapeutic purposes. We suggest that the use of autologous mesenchymal cells is a safe therapeutic method for treating incompletely (i.e. not full-thickness) damaged tendons. E-mail address: [email protected] (M. Petrini).
Tendon and bone repair by mesenchymal cells
17
Trombi Luisa, Pacini Simone, Rita Fazzi, Michele Lisanti, Steafano Giannotti, Giulio Guido, Mario Petrini
Nerve regeneration using novel biomaterial supports
Hematology and Orthopedic Clinics, University of Pisa, Italy Mesenchymal stromal cells have been shown to be able to differentiate towards several lines. In this paper we report the possible use of biological scaffolds for clinical applications in bone repair and their use in tendon repair. Human mesenchymal stem cells were cultured ‘‘in vitro’’ in order to establish a method for their orthopaedic clinical use. These cells, derived from bone marrow of eight donors, were partially induced towards osteogenic lineage and included into gelled autologous plasma. Inside the clot the cells were viable, proliferated and were able to terminally differentiate into osteoblasts. Clot seems to be useful for cell delivery, for its biocompatibility, reabsorption and plasticity. hMSCs, isolated from the bone marrow of eight normal adult patients, were minimally expanded ‘‘ex vivo’’ and pulsed twice towards osteogenic lineage. The cells were then included into autologous plasma-derived clots. Cytofluorimetric analysis, immunocytochemistry (osteopontin), histochemistry (alkaline phosphatase, Von Kossa and alizarin red staining), and viable/proliferation tests were performed in order to study both stem and differentiating cells.
G. Vozzi 1,2, V. Chiono 3, F. Vozzi 2,4, C. Salvadori 5, F. Dini 6, F. Carlucci 6, M. Arispici 5, S. Burchielli 4, G. Ciardelli 3, P.Giusti 1 1
Department of Chemical Engineering, Industrial Chemistry and Materials Science, University of Pisa, Via Diotisalvi 2, 56126 Pisa, Italy 2 Interdepartmental Research Center "E. Piaggio", University of Pisa, Via Diotisalvi 2, 56126 Pisa, Italy 3 Department of Mechanics, Politecnico in Turin, Corso Duca degli Abruzzi 24, 10129 Turin, Italy 4 C.N.R. Institute of Clinical Physiology, Via Moruzzi 1, 56126 Pisa, Italy 5 Department of Animal Pathology, Prophylaxis and Hygiene of Aliments, University of Pisa, Via delle Piagge 2, 56126 Pisa, Italy 6 Department of Veterinary Clinic, Faculty of Veterinary, University of Pisa, Via Livornese,56126 Pisa, Italy Many strategies have been developed for the repair of peripheral nerve injuries with substance loss, with the common goal to direct the regenerating nerve fibres into the proper distal endoneurial tubes. The methods for
In a case to 5 months we have made a second look with the standard method that in addition to confirming the good impressions already indicated with the innervue has allowed us to make a biopsy of the surface. the histological exam has shown the presence of cartilage cells in the context of the extracellular matrix with the presence of collagen fibers of type II and this histological aspect is found only in the hyaline cartilage. Even if the number of the treated cases statistically is not still remarkable and the follow-up is brief, the use of the TruFitÒ has given us good clinic impressions with the complete resolution of the knee pain in all the cases and also the histological results that we have gotten with the arthroscopic second look are very encouraging. We can affirm then that the use of this scaffold represents a fascinating solution in the treatment of the osteochondral defects of the knee that, if confirmed with a longer clinical follow-up and with further histological and histochemical comparisons, it is set decidedly in the foreground as the best methodic for this type of lesions. Besides we have had good results also in over-sixty subject with enough wide lesions, is also hypothesized the complete substitution of the osteochondral portion of load of a femoral condyle, when the axle of load allows it, in alternative to a very more invasive surgery of unicompartimental prosthesis. We will get, by the arthroscopic technique, a ‘‘biological prosthesis’’. 16
495
Although two short inductions increased osteogenic markers in hMSCs, inside the clot the cells were able to terminally differentiate into osteoblasts. Moreover we show that the clot is able to sustain cell proliferation under appropriate cell culture conditions. Our results suggested that clot could be useful for hMSC delivery into the site of the lesion to promote bone formation. Moreover, the plasticity of this material allowed good ‘‘in vitro’’ hMSC spreading and proliferation. The advantages of using this autologous biological material are its biocompatibility and reabsorption; furthermore, using a gel as scaffold, it is possible to mould it to the shape of a bone cavity. Attempts to repair tendon lesions have been performed, mainly using scaffold carriers in experimental settings. In this report we describe the clinical use of undifferentiated mesenchymal cells in race horses. Repair of superficial digital flexor tendon was achieved in nine of eleven horses evaluated by ultrasound analysis and their ability to return to racing. Our results show that the suspension of a relatively low number of undifferentiated mesenchymal cells may be sufficient to repair damaged tendons without the use of scaffold support. Interestingly, ultrasound scanning showed that fibers were correctly oriented. By using undifferentiated cells, no ectopic bone deposition occurred. All but one case recovered sufficient number of cells for therapeutic purposes. We suggest that the use of autologous mesenchymal cells is a safe therapeutic method for treating incompletely (i.e. not full-thickness) damaged tendons. E-mail address: [email protected] (M. Petrini).
Tendon and bone repair by mesenchymal cells
17
Trombi Luisa, Pacini Simone, Rita Fazzi, Michele Lisanti, Steafano Giannotti, Giulio Guido, Mario Petrini
Nerve regeneration using novel biomaterial supports
Hematology and Orthopedic Clinics, University of Pisa, Italy Mesenchymal stromal cells have been shown to be able to differentiate towards several lines. In this paper we report the possible use of biological scaffolds for clinical applications in bone repair and their use in tendon repair. Human mesenchymal stem cells were cultured ‘‘in vitro’’ in order to establish a method for their orthopaedic clinical use. These cells, derived from bone marrow of eight donors, were partially induced towards osteogenic lineage and included into gelled autologous plasma. Inside the clot the cells were viable, proliferated and were able to terminally differentiate into osteoblasts. Clot seems to be useful for cell delivery, for its biocompatibility, reabsorption and plasticity. hMSCs, isolated from the bone marrow of eight normal adult patients, were minimally expanded ‘‘ex vivo’’ and pulsed twice towards osteogenic lineage. The cells were then included into autologous plasma-derived clots. Cytofluorimetric analysis, immunocytochemistry (osteopontin), histochemistry (alkaline phosphatase, Von Kossa and alizarin red staining), and viable/proliferation tests were performed in order to study both stem and differentiating cells.
G. Vozzi 1,2, V. Chiono 3, F. Vozzi 2,4, C. Salvadori 5, F. Dini 6, F. Carlucci 6, M. Arispici 5, S. Burchielli 4, G. Ciardelli 3, P.Giusti 1 1
Department of Chemical Engineering, Industrial Chemistry and Materials Science, University of Pisa, Via Diotisalvi 2, 56126 Pisa, Italy 2 Interdepartmental Research Center "E. Piaggio", University of Pisa, Via Diotisalvi 2, 56126 Pisa, Italy 3 Department of Mechanics, Politecnico in Turin, Corso Duca degli Abruzzi 24, 10129 Turin, Italy 4 C.N.R. Institute of Clinical Physiology, Via Moruzzi 1, 56126 Pisa, Italy 5 Department of Animal Pathology, Prophylaxis and Hygiene of Aliments, University of Pisa, Via delle Piagge 2, 56126 Pisa, Italy 6 Department of Veterinary Clinic, Faculty of Veterinary, University of Pisa, Via Livornese,56126 Pisa, Italy Many strategies have been developed for the repair of peripheral nerve injuries with substance loss, with the common goal to direct the regenerating nerve fibres into the proper distal endoneurial tubes. The methods for