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Autologous Bone Marrow-Derived Mesenchymal Stem Cells

This article discusses a phase III clinical trial investigating the use of Autologous Bone Marrow-Derived Mesenchymal Stem Cells (BM-MSCs) for treating knee osteoarthritis. The study compares the effectiveness of autologous and allogeneic mesenchymal stem cells against hyaluronic acid, a common treatment for this condition. We’ll explore the trial’s objectives, eligibility criteria, and potential implications for patients suffering from knee osteoarthritis.

Table of Contents

What are Autologous BM-MSCs?

Autologous Bone Marrow-Derived Mesenchymal Stem Cells (BM-MSCs) are a type of cell therapy used in advanced medical treatments. Let’s break down this term:

  • Autologous: This means the cells come from your own body.
  • Bone Marrow-Derived: The cells are taken from your bone marrow, the soft tissue inside your bones.
  • Mesenchymal Stem Cells: These are special cells that can develop into different types of tissues, such as cartilage, bone, and fat.

This treatment is considered an advanced therapy and falls under the category of cell therapy[1]. It’s being studied as a potential treatment for various conditions, including knee osteoarthritis.

Treatment for Knee Osteoarthritis

Knee osteoarthritis is a condition where the cartilage in your knee joint wears down over time, causing pain and difficulty in movement. Autologous BM-MSCs are being investigated as a potential treatment for this condition[1].

The idea behind this treatment is that these stem cells might help:

  • Reduce inflammation in the knee joint
  • Regenerate damaged cartilage
  • Improve overall knee function

Clinical Trial Overview

A Phase III clinical trial is currently underway to study the effectiveness of Autologous BM-MSCs for knee osteoarthritis. This trial is comparing three treatments[1]:

  1. Autologous Mesenchymal Stromal Cells (MSCs): These are stem cells taken from your own body.
  2. Allogeneic Mesenchymal Stromal Cells (MSCs): These are stem cells from a donor.
  3. Hyaluronic Acid: This is a substance already used in knee osteoarthritis treatment.

The main goal of this trial is to see how well the stem cell treatments work compared to the hyaluronic acid treatment in terms of improving knee function, reducing pain, and potentially repairing damaged cartilage[1].

Eligibility Criteria

To participate in this clinical trial, patients must meet certain criteria. Some key points include[1]:

  • Having knee osteoarthritis (specifically grades 2, 3, or 4 on the Kellgren and Lawrence scale)
  • Being between 18 and 75 years old
  • Having a Body Mass Index (BMI) between 20 and 35 kg/m²
  • Not having certain health conditions that might interfere with the treatment or results

It’s important to note that pregnant or breastfeeding women, people with cancer, and those who have had recent knee treatments are not eligible for this trial[1].

Treatment Process

If you’re receiving the Autologous BM-MSC treatment, here’s what you can expect[1]:

  1. Stem cell collection: A small amount of bone marrow will be taken from your body.
  2. Cell processing: The mesenchymal stem cells will be isolated and grown in a laboratory.
  3. Treatment: You’ll receive an injection of 40 million stem cells (in 4 ml solution) directly into your knee joint.

The entire process is designed to use your own cells to potentially help heal your knee[1].

Potential Benefits

While the effectiveness of this treatment is still being studied, researchers hope it might lead to[1]:

  • Reduced knee pain
  • Improved knee function
  • Better quality of life
  • Potential slowing or reversal of cartilage damage (as seen on MRI scans)

The study will measure these outcomes over a period of 24 months to understand both short-term and long-term effects[1].

Safety Considerations

As with any medical treatment, safety is a top priority. The clinical trial is designed to monitor for any side effects or complications. Some key safety points include[1]:

  • The cells used in the autologous treatment come from your own body, which may reduce the risk of rejection.
  • The treatment is given as a single injection, minimizing the need for repeated procedures.
  • Patients will be monitored closely for any adverse effects throughout the study.

It’s important to note that this is still an experimental treatment, and all potential risks may not be known at this time[1].

Aspect Details
Trial Type Phase III, multicenter, randomized, open-label clinical trial
Condition Knee osteoarthritis
Treatment Groups 1. Autologous MSCs (40 million cells/4 ml)
2. Allogeneic MSCs (40 million cells/4 ml)
3. Hyaluronic Acid (60mg/3ml)
Primary Endpoints Pain intensity (VAS scale), functional capacity (Lequesne scale), symptomatology and physical disability (WOMAC scale), lesion improvement (T2-mapping MRI)
Secondary Endpoints Quality of life (SF-12 scale), product compliance rates, adverse effects, genomic studies, immune system evaluation
Key Inclusion Criteria Age 18-75, Kellgren and Lawrence grade 2-4 osteoarthritis, chronic knee pain, BMI 20-35 kg/m²
Key Exclusion Criteria Pregnancy, neoplastic disease, recent intra-articular injections, participation in other clinical trials
Follow-up Period Up to 24 months

FAQ

  • What is the main goal of this clinical trial? The main goal is to compare the effectiveness of allogeneic and autologous mesenchymal stem cells (MSCs) with hyaluronic acid in treating knee osteoarthritis. The trial aims to evaluate clinical, functional, and radiological responses in patients.
  • Who can participate in this clinical trial? Participants must be between 18 and 75 years old, have knee osteoarthritis (Kellgren and Lawrence grade 2, 3, or 4), chronic knee pain, and a Body Mass Index between 20 and 35 kg/m2. They should not have significant health issues or recent knee treatments that could interfere with the study.
  • What are the different treatment groups in this trial? There are three treatment groups: 1) Autologous Mesenchymal Stromal Cells (MSCs), 2) Allogeneic Mesenchymal Stromal Cells (MSCs), and 3) Hyaluronic Acid (active control group). Each group receives a single intra-articular injection of their assigned treatment.
  • How will the effectiveness of the treatments be measured? The trial will measure pain intensity, functional capacity, and physical disability using various scales (VAS, Lequesne, and WOMAC) at 12 months. Additionally, MRI scans will be used to assess improvements in knee lesions, and quality of life will be evaluated using the SF-12 scale at 6, 12, and 24 months.
  • What are the potential benefits and risks of participating in this trial? Potential benefits include improved knee function and reduced pain. However, as with any medical treatment, there may be risks such as infection or adverse reactions to the injected substances. The trial will closely monitor participants for any side effects and collect data on adverse events in all treatment groups.

Ongoing Clinical Trials on Autologous Bone Marrow-Derived Mesenchymal Stem Cells

  • Study Comparing Allogeneic and Autologous Mesenchymal Stem Cells with Hyaluronic Acid for Patients with Knee Osteoarthritis

    Not recruiting

    3 1 1 1
    Investigated drugs:
    Spain

Glossary

  • Mesenchymal Stem Cells (MSCs): A type of adult stem cell that can develop into various cell types, including bone, cartilage, muscle, and fat cells. In this trial, they are derived from bone marrow and used to potentially repair damaged knee tissue.
  • Autologous: Referring to cells or tissues that come from the same individual. In this trial, autologous MSCs are harvested from the patient's own bone marrow.
  • Allogeneic: Referring to cells or tissues that come from a genetically different donor of the same species. In this trial, allogeneic MSCs are obtained from donors other than the patient receiving treatment.
  • Hyaluronic Acid: A naturally occurring substance in the body that acts as a lubricant and shock absorber in joints. It's commonly used as a treatment for osteoarthritis.
  • Osteoarthritis: A degenerative joint disease characterized by the breakdown of cartilage, causing pain, stiffness, and reduced mobility. In this trial, it specifically refers to knee osteoarthritis.
  • Intra-articular Injection: A procedure where medication is injected directly into a joint space, in this case, the knee joint.
  • Kellgren and Lawrence Grade: A system used to classify the severity of knee osteoarthritis based on X-ray findings, ranging from grade 0 (no visible signs) to grade 4 (severe osteoarthritis).
  • VAS Pain Scale: Visual Analog Scale for pain, a measurement tool used to help patients rate the intensity of their pain.
  • WOMAC Scale: Western Ontario and McMaster Universities Osteoarthritis Index, a widely used set of standardized questionnaires to evaluate the condition of patients with osteoarthritis of the knee and hip.
  • T2-mapping MRI: A specialized magnetic resonance imaging technique used to assess the quality of cartilage in joints.

References

  1. http://clinicaltrials.eu/trial/study-comparing-allogeneic-and-autologous-mesenchymal-stem-cells-with-hyaluronic-acid-for-patients-with-knee-osteoarthritis/