BLINDED PLACEBO STUDY OF BILATERAL OSTEOARTHRITIS TREATMENT USING ADIPOSE DERIVED MESENCHYMAL STEM CELLS

Abstract

Mesenchymal stem cell therapies attract a lot of attention and also controversy in veterinary medicine. In the present study, mesenchymal stem cell therapy, using autologous cells from adipose tissue was evaluated for the treatment of osteoarthritis in the knee. Ten dogs with bilateral osteoarthritis in the knees were included in the study. After collection of adipose tissue and expansion of cells, 2 to 3 millions of mesenchymal stem cells were injected into one knee while sterile phosphate buffer (same as used for resuspension of cells) was injected into the other knee as a placebo. Dog owners were blind in regard which knee received cells and which placebo. Dogs were clinically evaluated before treatment and 3, 6 and 12 months after the treatment, and synovial fluid was collected and evaluated before treatment and after 12 months. Radiographs of both knees were taken before treatment and 6 and 12 months after the treatment. In 9 out of 10 dogs enrolled in the study, there was a significant improvement of lameness after 1 year. Radiographs did not show improvement in the cartilage condition 1 year after the treatment. However, in 7 out of 10 treated joints the osteoarthritis did not progress while in all 10 of placebo treated joints there was a significant worsening of the osteoarthritis. Analysis of the synovial fluid before and 1 year after the treatment showed no statistically significant differences between mesenchymal stem cells treated and placebo treated knees. Results of this study suggest beneficial effects of mesenchymal stem cells treatment in osteoarthritis in dogs and confirm that mesenchymal stem cells treatment is a viable option for managing this debilitating disease in dogs. Key words: dog; osteoarthritis; knee; mesenchymal stem cells SLEPA PLACEBO RAZISKAVA ZDRAVLJENJA VNETJA KOLENSKEGA SKLEPA Z MEZENHIMSKIMI MATIČNIMI CELICAMI Zdravljenje z mezenhimskimi matiènimi celicami v zadnjih letih priteguje veliko pozornosti in tudi razprav v veterinarski medicini. V predstavljeni raziskavi smo preverjali uèinkovitost zdravljenja z matiènimi celicami pri ventju kolenskih sklepov pri psih. V raziskavo je bilo vkljuèenih 10 psov z vnetjem obeh kolenskih sklepov. Psom je bil odvzet košèek mašèobnega tkiva, iz katerega smo osamili in pripravili mezenhimske matiène celice. Dva do tri milijone celic v sterilnem fosfatnem pufru smo nato injicirali v eno obolelo koleno, medtem ko smo v drugo obolelo koleno injicirali samo fosfatni pufer kot placebo. Lastniki psov niso vedeli, v katero koleno so psi prejeli celice in v katero koleno placebo. Psi so bili klinièno pregledani 3, 6 in 12 mesecev po zdravljenju. Sinovialno tekoèino smo iz sklepa odvzeli ob vnosu matiènih celic ter 12 mesecev po zdravljenju. Ob zaèetku zdravljenja ter 6 in 12 mesecev po zdravljenju smo naredili tudi rentgenske posnetke obeh kolenskih sklepov. Od 10 zdravljenih psov smo po enem letu pri devetih opazili znaèilno izboljšanje šepanja po enem letu. Rentgenske slike po enem letu sicer niso pokazale izboljšanja sklepne površine, vendar pa pri 7 od 10 zdravljenih sklepov ni prišlo do napredovanja bolezni, medtem ko je pri vseh 10 nezdravljenih sklepih prišlo do znaèilnega poslabšanja sklepne površine (veèje število oziroma velikost izrastkov). Analiza sinovialne tekoèine ob zaèetku zdravljenja ter eno leto po zdravljenju ni pokazala statistièno znaèilnih razlik v preiskovanih parametrih, kar kaže, da v sklepih ni prišlo do vnetnih sprememb kot posledica zdravljenja z mezenhimskimi matiènimi celicami. Rezultati te raziskave kažejo pomembne uèinke mezenhimskih matiènih celic pri zdravljenju vnetja sklepov pri psih in potrjujejo, da je takšno zdravljenje primeren naèin zdravljenja te nevarne kroniène bolezni psov. Kljuène besede: pes; vnetje sklepov; koleno; mezenhimske matiène celice