06 Nov Cartilage Regeneration with SVF Therapy
Osteoarthritis (OA) is extremely common degenerative disease in the elderly population, and it is characterized by cartilage destruction. At present, there is no definite cure for OA in conventional medicine. However, adipose tissue-derived stem cells (ADSCs) and stromal vascular fraction (SVF) therapies are beginning to shift the paradigm.
ADSCs are mesenchymal stem cells that can differentiate into chondrocytes and promote cartilage repair. ADSCs in SVF along with platelet-rich plasma (PRP), can be used for cartilage repair in OA. Currently, only ADSCs in the form of SVF are allowed for clinical use.
How do stem cells from SVF cause cartilage repair isn’t fully clear. It could be due to the secretory effects of the stem cells injected or direct engraftment and differentiation of the stem cells introduced into the diseased joints, or a combination of both. Adipose stem cells excrete chemicals, such as cytokines, chemokines, growth factors that stimulate the surrounding progenitor cells.
Research still needs to be done to ascertain the most optimal dosage of the stem cells to be injected, the best mode of injection, the best method of promoting stem cell adherence to the lesions, and the most potential growth factors.
Why is SVF better than BMC for Cartilage regeneration
Simply put, SVF yields more stem cells than bone marrow concentrate (BMC). The number of stem cells that can be obtained from one gram of adipose tissue can range from 5,000 to 200,000 cells as measured by flow cytometry and indirect immunofluorescence. Patients with a large number of stem cells will have better cartilage regeneration.
Jang and Koh showed that adipose-derived cells are a far better source of stem cells than bone marrow concentrate (BMC) for a cartilage regeneration stem cell procedure by doing a multi-part analysis comparing SVF to BMC. They showed that SVF contained 10 times more MSC’s and 5 times more adherent cells than BMC.
They also showed that SVF had 200 times more stromal cells and 18 times more pericytes, also very important for joints and soft tissue regeneration. Furthermore, the BMC contained 6 times more white blood cells which can improve healing at the site of the injury.
The evidence in the literature in favor of ADSCs in the form of SVF for the use of cartilage repair in OA and other similar diseases is beginning to pile up. The benefit is both in demonstrable improvement in cartilage thickness as well as symptomatic improvement. Yet, these therapies and these methods remain experimental. Future studies on safety testing will need to be performed to bring these treatments to clinics. The preparation methods will also need to be standardized as well as an important step toward that goal. Major clinical trials that formidably establish the efficacy and safety profiles of these therapeutic interventions will need to take place in order to realize their true potential.