Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.

<h4>Background</h4>Tissue engineering appears to be an attractive alternative to the traditional approach in the treatment of fracture non-unions. Mesenchymal stromal cells (MSCs) are considered an appealing cell source for clinical intervention. However, ex vivo cell expansion and diffe...

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Autores principales:	Stefano Giannotti, Luisa Trombi, Vanna Bottai, Marco Ghilardi, Delfo D'Alessandro, Serena Danti, Giacomo Dell'Osso, Giulio Guido, Mario Petrini
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/992529fc88744a4ca14f03f9716dc696
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spelling	oai:doaj.org-article:992529fc88744a4ca14f03f9716dc6962021-11-18T08:57:31ZUse of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.1932-620310.1371/journal.pone.0073893https://doaj.org/article/992529fc88744a4ca14f03f9716dc6962013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24023694/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Tissue engineering appears to be an attractive alternative to the traditional approach in the treatment of fracture non-unions. Mesenchymal stromal cells (MSCs) are considered an appealing cell source for clinical intervention. However, ex vivo cell expansion and differentiation towards the osteogenic lineage, together with the design of a suitable scaffold have yet to be optimized. Major concerns exist about the safety of MSC-based therapies, including possible abnormal overgrowth and potential cancer evolution.<h4>Aims</h4>We examined the long-term efficacy and safety of ex vivo expanded bone marrow MSCs, embedded in autologous fibrin clots, for the healing of atrophic pseudarthrosis of the upper limb. Our research work relied on three main issues: use of an entirely autologous context (cells, serum for ex vivo cell culture, scaffold components), reduced ex vivo cell expansion, and short-term MSC osteoinduction before implantation.<h4>Methods and findings</h4>Bone marrow MSCs isolated from 8 patients were expanded ex vivo until passage 1 and short-term osteo-differentiated in autologous-based culture conditions. Tissue-engineered constructs designed to embed MSCs in autologous fibrin clots were locally implanted with bone grafts, calibrating their number on the extension of bone damage. Radiographic healing was evaluated with short- and long-term follow-ups (range averages: 6.7 and 76.0 months, respectively). All patients recovered limb function, with no evidence of tissue overgrowth or tumor formation.<h4>Conclusions</h4>Our study indicates that highly autologous treatment can be effective and safe in the long-term healing of bone non-unions. This tissue engineering approach resulted in successful clinical and functional outcomes for all patients.Stefano GiannottiLuisa TrombiVanna BottaiMarco GhilardiDelfo D'AlessandroSerena DantiGiacomo Dell'OssoGiulio GuidoMario PetriniPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 8, p e73893 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stefano Giannotti Luisa Trombi Vanna Bottai Marco Ghilardi Delfo D'Alessandro Serena Danti Giacomo Dell'Osso Giulio Guido Mario Petrini Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.
description	<h4>Background</h4>Tissue engineering appears to be an attractive alternative to the traditional approach in the treatment of fracture non-unions. Mesenchymal stromal cells (MSCs) are considered an appealing cell source for clinical intervention. However, ex vivo cell expansion and differentiation towards the osteogenic lineage, together with the design of a suitable scaffold have yet to be optimized. Major concerns exist about the safety of MSC-based therapies, including possible abnormal overgrowth and potential cancer evolution.<h4>Aims</h4>We examined the long-term efficacy and safety of ex vivo expanded bone marrow MSCs, embedded in autologous fibrin clots, for the healing of atrophic pseudarthrosis of the upper limb. Our research work relied on three main issues: use of an entirely autologous context (cells, serum for ex vivo cell culture, scaffold components), reduced ex vivo cell expansion, and short-term MSC osteoinduction before implantation.<h4>Methods and findings</h4>Bone marrow MSCs isolated from 8 patients were expanded ex vivo until passage 1 and short-term osteo-differentiated in autologous-based culture conditions. Tissue-engineered constructs designed to embed MSCs in autologous fibrin clots were locally implanted with bone grafts, calibrating their number on the extension of bone damage. Radiographic healing was evaluated with short- and long-term follow-ups (range averages: 6.7 and 76.0 months, respectively). All patients recovered limb function, with no evidence of tissue overgrowth or tumor formation.<h4>Conclusions</h4>Our study indicates that highly autologous treatment can be effective and safe in the long-term healing of bone non-unions. This tissue engineering approach resulted in successful clinical and functional outcomes for all patients.
format	article
author	Stefano Giannotti Luisa Trombi Vanna Bottai Marco Ghilardi Delfo D'Alessandro Serena Danti Giacomo Dell'Osso Giulio Guido Mario Petrini
author_facet	Stefano Giannotti Luisa Trombi Vanna Bottai Marco Ghilardi Delfo D'Alessandro Serena Danti Giacomo Dell'Osso Giulio Guido Mario Petrini
author_sort	Stefano Giannotti
title	Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.
title_short	Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.
title_full	Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.
title_fullStr	Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.
title_full_unstemmed	Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.
title_sort	use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/992529fc88744a4ca14f03f9716dc696
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Use of autologous human mesenchymal stromal cell/fibrin clot constructs in upper limb non-unions: long-term assessment.

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