骨关节炎（oa）的特征是对关节的严重损害和使人衰弱的疼痛，影响了全球数百万的人，并且长期以来一直带来重大的临床和经济负担。在诊断，药物和短期疼痛管理解决方案方面取得了进步，这是难以捉摸的目标修改疾病的oa药物仍无法触及。但是，近年来，使用干细胞疗法的使用已成为手术和改善患者生活质量的有希望的替代品。通过marcus foundation的赠款，与全国其他招聘站点合作的埃默里调查员团队探索了间充质干细胞的潜力，这是膝盖oa的改变游戏的治疗选择，这是慢性膝盖疼痛的最常见原因之一。这种类型的治疗方法旨在利用患者自身细胞修复受损组织的能力。然而，从设计良好的随机对照试验中获得可靠的数据受到限制，特别是与膝关节oa的金色标准相比，皮质类固醇注射（csi）（csi）。自然医学，描述了一项首先的随机临床试验，以确定膝盖oa的最有效细胞注射来源。研究小组比较了三种类型的细胞制剂，包括自体骨髓抽吸浓缩液（bmac），自体基质血管分数（svf）和同种异体人脐带组织msc（uct）。主要结果指标是视觉模拟量表（vas）和膝关节损伤和骨关节炎结局评分（koo），从基线到一年。推动研究的问题是细胞疗法在一年中是否可以胜过皮质类固醇在治疗膝关节骨关节炎方面的皮质类固醇。虽然研究结果表明，每组的疼痛和功能都有可衡量的改善，但使用任何一项都没有明显的优势。与金标准抗炎性皮质类固醇相比，在12个月的随访中，对细胞产物进行了相比，关于vas疼痛评分的变化是基线的变化。同样，对koos疼痛评分的分析产生了一致的结果，在基线的分数变化中，组在12个月的分数之间没有显着差异。一年的过程。”斯科特（scott d）说。埃默里骨科和脊柱中心主任博登医学博士，这项研究的高级作者。“尽管对干细胞的再生能力充满热情，但这些发现引起了人们的质疑，质疑各种注射膝关节骨关节炎的比较有效性，并强调了个性化方法在为每个患者选择正确的治疗方面的重要性。”广泛的覆盖范围也扩大了评估这些程序的安全性，这些程序测量了每种不良反应，从轻度关节不适和肿胀到无关的住院治疗。重要的是，该研究发现随访期间的任何时候，任何治疗组中没有与研究相关的严重不良事件或有症状的膝关节感染。boden，对我们数据的持续分析进行的未来论文将确定某些患者的某些亚组是否可能优先从其中一种受益于其中的一种而不是另一种治疗方法。这些发现在回答有关某些oa治疗方案的比较有效性的关键问题方面迈出了重要一步，但是使用mris和每种注射液的细胞分析进行了更深入的分析，将继续有助于告知护理标准。characterized by extensive damage to joints and debilitating pain, osteoarthritis (oa) impacts millions of people worldwide and has long posed a substantial clinical and economic burden.in spite of advances in diagnosis, medications, and short-term pain management solutions, the elusive goal of a disease-modifying oa drug has remained out of reach. in recent years though, the use of stem cell therapy has gained traction as a promising alternative to surgery and for improving patients’ quality of life. through a grant from the marcus foundation, an emory team of investigators in collaboration with other recruitment sites throughout the nation explored the potential of mesenchymal stem cells as a game-changing treatment option for knee oa, one of the most common causes of chronic knee pain. this type of treatment seeks to harness the ability of a patient’s own cells to repair damaged tissue. however, the availability of robust data from well-designed randomized controlled trials has been limited, particularly in comparison to the gold-standard of treatment for knee oa, corticosteroid injections (csi).the initial findings of this study, which were just published in nature medicine, describe a first-of-its-kind randomized clinical trial to identify the most effective source of cellular injections for knee oa. the research team compared three types of cellular preparations, including autologous bone marrow aspirate concentrate (bmac), autologous stromal vascular fraction (svf), and allogenic human umbilical cord tissue mscs (uct) against csi. the primary outcome measures were the visual analog scale (vas) and the knee injury and osteoarthritis outcome score (koos) for pain from baseline to one year. the question driving the research was whether cell therapies could outperform corticosteroids in the treatment of knee osteoarthritis at the one-year mark.while the findings showed each group had a measurable improvement in pain and function, there was no significant advantage to using any of the tested cell products compared to the gold standard anti-inflammatory corticosteroid treatment at the 12-month follow-up regarding the change in vas pain score from baseline. similarly, the analysis of the koos pain score produced consistent results, with no significant differences between groups at the 12-month mark in the change in score from baseline.“the study demonstrated no superiority of any cell therapy over corticosteroids in reducing pain intensity over the course of a year,” says scott d. boden, md, director of the emory orthopaedics and spine center, and a senior author on the study. “while there is much enthusiasm about the regenerative capacity of stem cells, the findings call into question the comparative effectiveness of various injections for knee osteoarthritis and underscores the importance of a personalized approach in selecting the right treatment for each patients unique needs.”the studys extensive reach also extended to evaluating the safety of these procedures measuring every adverse reaction, ranging from mild joint discomfort and swelling to unrelated hospitalizations. importantly, the study found no study-related serious adverse events or symptomatic knee infections across any of the treatment groups at any point during the follow-up.according to dr. boden, future papers from the ongoing analysis of our data will determine if certain subgroups of patients might preferentially benefit from one of these treatments more than another. the findings offer an important step forward in answering key questions about the comparative effectiveness of certain oa treatment options, but more in-depth analysis using mris and cellular analysis of each injectate will continue to help inform standards of care.亲，点击此处在线申请留学咨询服务和报名评估！我们将竭诚提供最佳评估服务！
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