Stromal vascular fraction therapy for knee osteoarthritis: a systematic review

Background: Regenerative cell therapies, such as adipose-derived stromal vascular fraction (SVF), have been postulated as potential treatments for knee osteoarthritis (KOA). Objectives: To assess the efficacy and safety of SVF treatment against placebo and other standard therapies for treating KOA in adult patients. Design: A systematic review. Data sources and methods: We searched the following databases: MEDLINE via PubMed, Epistemonikos, PEDro, DynaMed, TripDatabase, Elsevier via Clinicalkey and Cochrane Controlled Trials Register. We included prospective interventional studies where treatment with SVF in adults with KOA was compared against placebo or other standard therapies, and results were objectively measured with at least one widely recognised osteoarthritis scale. Results: Among 266 studies published until May 2021, nine met our inclusion criteria. A total of 239 patients (274 knees) were included in our study. The follow-up ranged from 6 to 24 months. Six studies had a control group (only one being placebo). All studies showed that SVF improved pain and functionality measured, in most cases, with the visual analogue scale and the Western Ontario and McMaster Universities Osteoarthritis Index. In addition, five studies reported an improvement in anatomical structures, as detected in MR images. However, the number of cells contained in SVF varied substantially between different studies, which could induce a comparison bias. Conclusion: Although based on a small number of dissimilar studies, SVF was considered a safe treatment for KOA and could be promising in terms of pain, functionality and anatomical structure improvement. However, SVF products need to be standardised, the number of cells homogenised and the use of concomitant treatments reduced to establish proper comparisons

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Diagnòstic genètic preimplantacional en estadis embrionaris tardans

La incorporació de la biòpsia de blastocist en la pràctica clínica pot ser considerada com una alternativa vàlida per als cicles de diagnòstic genètic preimplantacional (DGP). La disponibilitat d'un major nombre de cèl·lules obre la possibilitat de realitzar diagnòstics múltiples en paral·lel en el mateix embrió, i es poden detectar teòricament malalties multigèniques o bé combinar diversos tipus de diagnòstic mitjançant FISH i PCR. Els embrions transferits en estadi de blastocist estan subjectes a una doble selecció: genètica i mitjançant el cultiu, i això es veu reflectit en elevades taxes d'implantació, fet que permet reduir el nombre d'embrions a transferir per tal d'evitar gestacions múltiples. Tot i que l'aplicació clínica de la biòpsia de blastocist per al DGP és encara limitada i recent, els bons resultats obtinguts pel que fa a taxes d'implantació i d'embaràs, així com les possibilitats diagnòstiques que obre, suggereixen que es tracta d'una tècnica que esdevindrà més freqüent en el futur.The incorporation of blastocyst biopsy into clinical practice can be considered as a valid alternative when performing PGD. The fact that it makes more material available for analysis is of particular value in those cases where the aim is to diagnose monogenic diseases. The availability of a greater number of cells opens the possibility of performing multiple diagdiagnoses in parallel on the same embryo; these could be used to detect multigenic diseases or for the combined diagnosis of different disorders through diagnostic approaches based on both FISH and PCR. Embryos transferred at the blastocyst stage are subjected to a dual selection process (genetic and through culture) and this is reflected in their greater implantation potential, thus enabling a lower number of embryos to be transferred, which in turn reduces the risk of multiple pregnancy. Although the clinical application of blastocyst biopsy for PGD remains a limited and recent development, the good results in terms of implantation and pregnancy rates obtained so far, as well as the diagnostic possibilities it opens up, suggest that this technique can become more widely used in the early future

Criopreservació i tècniques de reproducció assistida

La criopreservació és la preservació de la funcionalitat de les cèl·lules o teixits mitjançant la reducció de la temperatura per sota del punt on les reaccions químiques poden tenir lloc. D'aquesta manera es poden mantenir durant llargs períodes de temps mantenint la seva viabilitat, encara que aquesta pot estar compromesa per l'efecte negatiu que causa el descens de temperatura i també durant el retorn a la normotèrmia. És una part essencial de les tècniques de reproducció assistida. La criopreservació de semen facilita en gran mesura la planificació dels cicles de fecundació in vitro i la utilització de semen de donant i ha donat lloc a milers de nens nascuts sans, ja que augmenta les taxes d'embaràs acumulat per punció fol·licular. Actualment els embrions sobrants són criopreservats rutinàriament en els laboratoris de fecundació in vitro. Els naixements a partir d'embrions criopreservats representen al voltant del 8 % del total de nens nascuts amb les tècniques reproducció assistida. La criopreservació d'oòcits i teixit ovàric està adquirint un paper protagonista en els últims anys i està centrant tots els esforços per a l'optimització dels procediments, ja que ofereix grans possibilitats per als pacients que volen preservar la fertilitat.Cryopreservation is the preservation of the viability of cells and tissues by means of temperature reduction of the under the point where chemical reactions take place. Their viability can be preserved during long time although this state can be involved by the negative effect caused by temperature decrease and also by the return to normotermia. Semen and embryo cryopreservation has been an essential techniques of reproduction attended. Sedefenmen cryopreservation facilitates in great measure the planning of the cycles of fertilization in vitro mainly when donor semen is used. Embryo cryopreservation of embryos has given rise to thousands of healthy born children, enlarging accumulated rates of pregnancies by follicular puncture. Today, the surplus embryos are routinely cryopreserved in IVF laboratories. Births from cryopreserved embryos represents 8% of born children by using assisted reproduction techniques. Actually oocyte and ovarian tissue cryopreservation are acquiring high relevance and are centering all the efforts for protocol optimization since offer large possibilities for patients who want to preserve their fertility

Repopulation of decellularized retinas with hiPSC-derived retinal pigment epithelial and ocular progenitor cells shows cell engraftment, organization and differentiation

The retinal extracellular matrix (ECM) provides architectural support, adhesion and signal guidance that controls retinal development. Decellularization of the ECM affords great potential to tissue engineering; however, how structural retinal ECM affects in vitro development, differentiation and maturation of ocular cells remains to be elucidated. Here, mouse and porcine retinas were decellularized and the protein profile analyzed. Acellular retinal ECM (arECM) scaffolds were then repopulated with human iPSC-derived retinal pigment epithelial (RPE) cells or ocular progenitor cells (OPC) to assess their integration, proliferation and organization. 3837 and 2612 unique proteins were identified in mouse and porcine arECM, respectively, of which 93 and 116 proteins belong to the matrisome. GO analysis shows that matrisome-related proteins were associated with the extracellular region and cell junction and KEGG pathways related to signalling transduction, nervous and endocrine systems and cell junctions were enriched. Interestingly, mouse and porcine arECMs were successfully repopulated with both RPE and OPC, the latter exhibiting cell lineage-specific clusters. Retinal cells organized into different layers containing well-defined areas with pigmented cells, photoreceptors, Müller glia, astrocytes, and ganglion cells, whereas in other areas, conjunctival/limbal, corneal and lens cells re-arranged in cell-specific self-organized areas. In conclusion, our results demonstrated that decellularization of both mouse and porcine retinas retains common native ECM components that upon cell repopulation could guide similar ocular cell adhesion, migration and organization

Repopulation of decellularized retinas with hiPSC-derived retinal pigment epithelial and ocular progenitor cells shows cell engraftment, organization and differentiation

Decellularization; Ocular progenitors; RetinaDescelularización; Progenitores oculares; RetinaDescel·lularització; Progenitors oculars; RetinaThe retinal extracellular matrix (ECM) provides architectural support, adhesion and signal guidance that controls retinal development. Decellularization of the ECM affords great potential to tissue engineering; however, how structural retinal ECM affects in vitro development, differentiation and maturation of ocular cells remains to be elucidated. Here, mouse and porcine retinas were decellularized and the protein profile analyzed. Acellular retinal ECM (arECM) scaffolds were then repopulated with human iPSC-derived retinal pigment epithelial (RPE) cells or ocular progenitor cells (OPC) to assess their integration, proliferation and organization. 3837 and 2612 unique proteins were identified in mouse and porcine arECM, respectively, of which 93 and 116 proteins belong to the matrisome. GO analysis shows that matrisome-related proteins were associated with the extracellular region and cell junction and KEGG pathways related to signalling transduction, nervous and endocrine systems and cell junctions were enriched. Interestingly, mouse and porcine arECMs were successfully repopulated with both RPE and OPC, the latter exhibiting cell lineage-specific clusters. Retinal cells organized into different layers containing well-defined areas with pigmented cells, photoreceptors, Müller glia, astrocytes, and ganglion cells, whereas in other areas, conjunctival/limbal, corneal and lens cells re-arranged in cell-specific self-organized areas. In conclusion, our results demonstrated that decellularization of both mouse and porcine retinas retains common native ECM components that upon cell repopulation could guide similar ocular cell adhesion, migration and organization.This work was supported by La Marató de TV3 Foundation (484/C/2012); ERA-NET EuroNanoMed III-AC19/00080/ISCIII (CELLUX); Instituto de Salud Carlos III (CA18/00045 and PI18/00219); and the European Social Fund, the Ministerio de Ciencia, Innovación y Universidades, which is part of the Agencia Estatal de Investigación (PTA2018-016371-I). A.D. was supported by PT13/0001/0041 PRB2-ISCIII-SGEFI-FEDER-PE I+D+i 2013–2016 and ISCIII-FEDER RETICS (Oftared; RD16/0008). We thank the CERCA Programme/Generalitat de Catalunya for institutional support

Cèl·lules mare embrionàries i medicina regenerativa

Embryonary stem cells and Regenerative Medicine.Embryonary stem cells have represented a scientific revolution in recent years given their potential capacity to turn into any cell type in the organism. Their therapeutic importance lies in the fact that they can be useful for treating diseases caused by a deficit in cell functioning. Numerous research groups world-wide are working to find out the differentiation mechanisms, as well as alternative techniques to using preembryos, in order to discover a safe and efficient therapy for these types of illness