Croatian scientists from the St. Catherine Specialty Hospital published an extremely important scientific paper in the Genes scientific journal, showing that the injection of the stromal and the mesenchymal stem cells into the knee joint shows long-term effects when measured 24 months after application.
The paper, which you can read here (full text of the paper is available if the reading of highly technical and scientific papers is your thing) is called "A 24-Month Follow-up Study of the Effect of Intra-Articular Injection of Autologous Microfragmented Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis”. It's a multicentric project, with the goal to confirm the effect of micro-fragmented fat tissue (stromal vascular fraction from microfragmented lipoaspirate, so-called SVF) intra-articular injection 24 months after application, in the patients suffering from osteoarthritis (OA). The project head and the corresponding author of the paper was professor Dragan Primorac, M.D.,Ph.D., and the other authors are St. Catherine's drs. Igor Borić, Damir Hudetz, Eduard Rod, Željko Jeleč, Andrea Skelin, Mihovil Plečko, Trpimir Vrdoljak and their partners from other Croatian scientific institutions drs Ozren Polašek, Irena Trbojević-Akmačić and Gordan Lauc.
The results of this study suggest that the mesenchymal stromal and the mesenchymal stem cells separated from the microfragmented fat tissue lead to the increase of the key molecules of cartilage (the so-called glycosaminoglycans (GAGs) two years after the application within the joint. Although the level of GAGs for 24 months after the application were somewhat lower than when measured 12 months after the application, in over 50% of the subjects (52 per cent) they were higher than before the treatment. The glycosaminoglycans (GAG) content in cartilage was measured by means of delayed gadolinium (Gd)-enhanced magnetic resonance imaging of cartilage (dGEMRIC), while the clinical outcome on observed level of GAG using standard orthopaedic physical examination.
Lucija Zenić and Denis Polančec from the Srebrnjak Children's Hospital helped the team in using the methods of immunophenotyping and flow cytometry to determine the types and the content of the SVF, determining the dominant populations of cells. At the same time, while examining the clinical results of the treatment of the knee with the autologous micro-fragmented fat tissue it was determined that 85 per cent of the patients report the significant improvement, as confirmed by the standard orthopaedic tests, such as Knee Injury and Osteoarthritis Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as well as pain intensity measurement - VAS scale.
Simultaneously, the team at St. Catherine's hospital wanted to report that Springer the publisher of the leading scientific magazine Nature published a chapter on "The Future of Cartilage Repair” in the book entitled "Personalized medicine in Healthcare Systems", in which the physicians from St. Catherine Hospital participated as authors. They've argued that the production of the bioactive molecules increases the improvement of a number of measurable parameters in patients, and because of that specific effect they would like the "Mesenchymal Stem Cells" to be renamed the "Medicinal SIgnaling Cells". The new findings in the modern regenerative medicine and the available methods of therapy, performed at the St. Catherine's Specialty Hospital give new hope to the patient, provide the newest breakthroughs in the treatment of this disease, but also position the Croatian health system powerfully worldwide.
Osteoarthritis is one of the most common health problems in the world with the increasingly ageing population, and some estimated say that currently, over 600 million people suffer from it. The treatment has been based on relieving the symptoms and implanting the endoprosthesis when it was determined that the cartilage can not be salvaged.
Prof. Dragan Primorac, M.D.,Ph.D., said that the results published in the Genes and the results published earlier will be changing some existing paradigms, and show the way towards a better understanding of the biology and the treatment of the osteoarthritis with autologous mesenchymal stromal and stem cells present within the microfragmented fat tissue. In osteoarthritis and in numerous other diseases, the future of medicine will be based on the integration of the principles of personalized and regenerative medicine into the clinical practice. I am happy that the Croatian experts once more proved their global excellence, and I'm especially happy that the results of our research have a great impact on the treatment of the patients suffering from osteoarthritis. It is clear that our results have an extraordinary significance in the development of the new diagnostic, therapeutic and prognostic algorithms related to osteoarthritis.
