Open AccessAllogeneic MSCs and Recycled Autologous Chondrons Mixed in a One‐Stage Cartilage Cell Transplantion: A First‐in‐Man Trial in 35 Patients
Author(s) -
de Windt Tommy S.,
Vonk Lucienne A.,
SlaperCortenbach Ineke C. M.,
Nizak Razmara,
van Rijen Mattie H. P.,
Saris Daniel B. F.
Publication year - 2017
Publication title -
stem cells
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.159
H-Index - 229
eISSN - 1549-4918
pISSN - 1066-5099
DOI - 10.1002/stem.2657
Subject(s) - mesenchymal stem cell , cartilage , hyaline cartilage , biology , transplantation , stem cell transplantation for articular cartilage repair , regenerative medicine , stem cell , pathology , cell therapy , medicine , surgery , microbiology and biotechnology , anatomy , adult stem cell , cellular differentiation , osteoarthritis , articular cartilage , biochemistry , alternative medicine , gene
MSCs are known as multipotent mesenchymal stem cells that have been found capable of differentiating into various lineages including cartilage. However, recent studies suggest MSCs are pericytes that stimulate tissue repair through trophic signaling. Aimed at articular cartilage repair in a one‐stage cell transplantation, this study provides first clinical evidence that MSCs stimulate autologous cartilage repair in the knee without engrafting in the host tissue. A phase I (first‐in‐man) clinical trial studied the one‐stage application of allogeneic MSCs mixed with 10% or 20% recycled defect derived autologous chondrons for the treatment of cartilage defects in 35 patients. No treatment‐related serious adverse events were found and statistically significant improvement in clinical outcome shown. Magnetic resonance imaging and second‐look arthroscopies showed consistent newly formed cartilage tissue. A biopsy taken from the center of the repair tissue was found to have hyaline‐like features with a high concentration of proteoglycans and type II collagen. DNA short tandem repeat analysis delivered unique proof that the regenerated tissue contained patient‐DNA only. These findings support the hypothesis that allogeneic MSCs stimulate a regenerative host response. This first‐in‐man trial supports a paradigm shift in which MSCs are applied as augmentations or “signaling cells” rather than differentiating stem cells and opens doors for other applications. S tem C ells 2017;35:1984–1993