Konstantinos I. Papadopoulos1*
Thana Turajane2- 1THAI StemLife Co., Ltd, Bangkok, Thailand
- 2Department of Orthopedics, Police General Hospital, Bangkok, Thailand
A Commentary on
The Use of Peripheral Blood-Derived Stem Cells for Cartilage Repair and Regeneration In Vivo:
A Review byChen, Y.-R., Yan, X., Yuan, F.-Z., Ye, J., Xu, B.-B., Zhou, Z.-X. et al. (2020). Front. Pharmacol. 11:404. doi:10.3389/fphar.2020.00404
Introduction
We read with interest the review of Chen et al. “The Use of Peripheral Blood-Derived Stem Cells for Cartilage Repair and Regeneration In Vivo: A Review” (Chen et al., 2020). Meta-analyses are a key component of evidence-based health care that by pooling together selected randomized controlled trials (RCTs) calculate an overall estimate or of the effect of the intervention under consideration (Moher and Olkin, 1995). The present review only includes one human RCT.
Materials and Methods
We believe that our RCT in 60 early osteoarthritis patients (of which 40 were actively treated with autologous hG-CSF activated PBSC and 20 received conventional hyaluronic acid treatment) (Turajane et al., 2017) should have been included. Our RCT showed statistically significant avoidance of total knee arthroplasty, and potent, early, and sustained symptom alleviation. Furthermore, our in vitro investigation (Turajane et al., 2014) shed light on the autologous PBSC mechanism of action by confirming chondrogenic differentiation potential for autologous PBSC through potentiated Sox9 transcription resulting in sequential COL-2 and aggrecan mRNA increases that ultimately resulted in histologically confirmed increased proteoglycan and glycosaminoglycan content in newly formed hyaline cartilage.
Discussion
We thus believe that the results presented in the current metanalysis are incomplete since the omitted patient number is half of the included (55 omitted vs. 130 included) (Jancewicz et al., 2004; Saw et al., 2011; Skowroński et al., 2012; Saw et al., 2013; Skowroński and Rutka, 2013; Turajane et al., 2013; Fu et al., 2014a; Saw et al., 2015). Comprising the 2017 RCT of Turajane et al. (Turajane et al., 2017) would have included a second RCT in the review, thus considerably strengthening the conclusion that autologous PBSCs show superiority in procurement, safety, and positive therapeutic effects in clinical settings where cartilage repair and regeneration are required.
Author Contributions
All authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.
Conflict of Interest
KP was employed by THAI StemLife Co., Ltd.
The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
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Turajane, T., Chaveewanakorn, U., Fongsarun, W., Aojanepong, J., and Papadopoulos, K. I. (2017). Avoidance of total knee arthroplasty in early osteoarthritis of the knee with intra-articular implantation of autologous activated peripheral blood stem cells versus hyaluronic acid: a randomized controlled trial with differential effects of growth factor addition. Stem Cell Int. 2017, 8925132. doi:10.1155/2017/8925132
Turajane, T., Thitiset, T., Honsawek, S., Chaveewanakorn, U., Aojanepong, J., and Papadopoulos, K. I. (2014). Assessment of chondrogenic differentiation potential of autologous activated peripheral blood stem cells on human early osteoarthritic cancellous tibial bone scaffold. Musculoskelet. Surg. 98, 35–43. doi:10.1007/s12306-013-0303-y
Keywords: osteoarthritis, knee, peripheral blood, stem cells, granulocyte colony stimulating factor hG-CSF, leukapheresis, autologous, PBSC
Citation: Papadopoulos KI and Turajane T (2021) Commentary: Autologous Peripheral Blood Stem Cells (PBSC) are Safe and Effective in Knee Osteoarthritis. Front. Pharmacol. 12:652738. doi: 10.3389/fphar.2021.652738
Received: 13 January 2021; Accepted: 22 February 2021;
Published: 20 April 2021.
Edited by:
Roberto Paganelli, University of Studies G.d’Annunzio Chieti and Pescara, Chieti, ItalyReviewed by:
Aurelio Muttini, University of Teramo, ItalyLivia Roseti, Rizzoli Orthopedic Institute (IRCCS), Italy
Copyright © 2021 Papadopoulos and Turajane. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Konstantinos I. Papadopoulos, kostas@thaistemlife.co.th