Treatment of Lateral Epicondylosis by Using Allogeneic Adipose-Derived Mesenchymal Stem Cells: A Pilot Study
Treatment of Lateral Epicondylosis by Using Allogeneic Adipose-Derived Mesenchymal Stem Cells: A Pilot Study
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DOI：
10.1002/stem.2110
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发表时间：
2015-10-01
期刊：
影响因子：
5.2
通讯作者：
Chung, Sun G.
中科院分区：
文献类型：
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作者：
Lee, Sang Yoon;Kim, Won;Chung, Sun G.
间充质干细胞治疗是一种新的再生治疗肌腱病变的方法。在这里，我们评估了同种异体脂肪间充质干细胞（allo-ASC）治疗外上髁（LE）的安全性和有效性。在超声引导下，将与纤维蛋白胶混合的allo-ASC注射到12名慢性LE参与者的低回声总伸肌肌腱病变中; 6名受试者每人给予10（6）或10（7）个细胞，每毫升。在注射后第3天和第2、6、12、26和52周评价安全性。通过测量患者肘关节疼痛的视觉模拟量表（VAS）评分、手肘关节改良马约临床性能指数，以及通过评估6、12、26和52周后肌腱缺损区域的纵向和横向超声图像来评估疗效。通过52周的随访，未观察到allo-ASC注射的显著不良反应。从基线至52周定期随访，VAS评分从66.8+/-14.5 mm逐渐降低至14.8+/-13.1 mm，肘关节功能评分从64.0+/-13.5改善至90.6+/-5.8。在此期间，肌腱缺陷也显著减少。因此，Allo-ASC治疗在改善肘关节疼痛、性能和结构缺陷方面安全有效，持续52周。这项临床研究首次揭示了间充质干细胞注射治疗慢性肌腱病的治疗价值。
Mesenchymal stem cell therapy is a novel regenerative approach for treating tendinopathy. Here, we evaluated the safety and efficacy of allogeneic adipose-derived mesenchymal stem cells (allo-ASC) in treating lateral epicondylosis (LE). Under ultrasound guidance, allo-ASCs mixed with fibrin glue were injected into the hypoechoic common extensor tendon lesions of 12 participants with chronic LE; 6 subjects each were administered 10(6) or 10(7) cells in 1 ml. Safety was evaluated at day 3 and weeks 2, 6, 12, 26, and 52 post-injection. Efficacy was assessed by measuring patients' visual analog scale (VAS) score for elbow pain, modified Mayo clinic performance index for the elbow, and by evaluating longitudinal and transverse ultrasound images of tendon defect areas after 6, 12, 26, and 52 weeks. No significant adverse effects of allo-ASC injection were observed through 52 weeks of follow-up. From baseline through 52 weeks of periodic follow-up, VAS scores progressively decreased from 66.8+/-14.5 mm to 14.8+/-13.1 mm and elbow performance scores improved from 64.0+/-13.5 to 90.6+/-5.8. Tendon defects also significantly decreased through this period. Allo-ASC therapy was thus safe and effective in improving elbow pain, performance, and structural defects for 52 weeks. This clinical study is the first to reveal therapeutic value of mesenchymal stem cell injection for treating chronic tendinopathy.