Study Design

Meta-analysis.

Objectives

Our objective is to review the randomized controlled trials (RCTs) that have been conducted previously on the topic of osteoarthritis of the knee to assess and compare the efficacy and safety of autologous and allogeneic sources of mesenchymal stromal cells (MSCs) in the treatment of osteoarthritis.

Materials and methods

We searched the electronic databases PubMed, Embase, Web of Science, and the Cochrane Library until August 2021 for randomised controlled trials (RCTs) analysing the efficacy and safety of autologous and allogeneic sources of MSCs in the management of knee osteoarthritis. These searches were conducted independently and in duplicate. The outcomes that were taken into consideration for analysis were the visual analogue score (VAS) for pain, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), the Lysholm score, and adverse events. The OpenMeta [Analyst] software was utilised to carry out the analysis in the R platform.

Results

In total, 21 studies with a total of 936 patients were considered for this analysis. Because none of the studies made a direct comparison of the autologous and allogeneic sources of MSCs, we pooled the results of all of the included studies of both sources and made a comparative analysis of how the two types of MSCs fared in their respective applications. Although both allogeneic and autologous sources of MSCs demonstrated significantly better VAS improvement after 6 months (p = 0.006, p = 0.001), this trend was not maintained after 1 year for the allogeneic source (p = 0.171, p = 0.027). When compared to their respective controls based on WOMAC scores after 1 year, autologous sources (p = 0.016) of MSCs performed better than allogeneic sources (p = 0.186).A similar response was noted between the sources at 2 years in their Lysholm scores (p = 0.682, p = 0.017), respectively. Moreover, allogeneic sources (p = 0.039) of MSCs produced significant adverse events than autologous sources (p = 0.556) compared to their controls.

Conclusion

Our analysis of literature showed that autologous sources of MSCs stand superior to allogeneic sources of MSC with regard to their consistent efficacy for pain, functional outcomes, and safety. However, we strongly recommend that further studies be conducted that are of a high enough quality to validate our findings and reach a consensus on the best source of MSCs for use in cellular therapy treatments for knee osteoarthritis.

中文翻译：

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使用同种异体与自体 MSC 治疗膝关节骨关节炎的随机对照试验符合 PRISMA 标准的荟萃分析：疗效和安全性分析

学习规划

荟萃分析。

目标

我们的目的是回顾之前就膝关节骨关节炎主题进行的随机对照试验 (RCT)，以评估和比较自体和异体来源的间充质基质细胞 (MSC) 在治疗骨关节炎中的功效和安全性。

材料和方法

我们在电子数据库 PubMed、Embase、Web of Science 和 Cochrane Library 中检索了截至 2021 年 8 月的随机对照试验 (RCT)，这些试验分析了自体和同种异体来源的 MSC 在治疗膝骨关节炎中的有效性和安全性。这些搜索是独立进行的，并且一式两份。分析时考虑的结果包括疼痛视觉模拟评分 (VAS)、西安大略麦克马斯特大学骨关节炎指数 (WOMAC)、Lysholm 评分和不良事件。利用OpenMeta [Analyst]软件在R平台中进行分析。

结果

此次分析总共考虑了 21 项研究，涉及 936 名患者。由于没有一项研究对自体和同种异体来源的间充质干细胞进行直接比较，因此我们汇总了这两种来源的所有纳入研究的结果，并对两种类型的间充质干细胞在各自应用中的表现进行了比较分析。尽管同种异体和自体来源的间充质干细胞在 6 个月后均表现出显着更好的 VAS 改善（p  = 0.006，p  = 0.001），但同种异体来源的这一趋势在 1 年后并未维持（p  = 0.171，p  = 0.027）。1 年后根据 WOMAC 评分与各自的对照进行比较时，自体来源的间充质干细胞 ( p  = 0.016) 的表现优于同种异体来源的 ( p  = 0.186)。 2 年时，来源间的 Lysholm 评分也出现了类似的反应 ( p  = 0.682，p  = 0.017）。 此外，与对照相比，同种异体来源的间充质干细胞（p = 0.039）比自体来源的间充质干细胞（ p = 0.556） 产生显着的不良事件。

结论

我们对文献的分析表明，自体间充质干细胞在疼痛、功能结果和安全性方面的一致疗效优于异体间充质干细胞。然而，我们强烈建议进行质量足够高的进一步研究，以验证我们的研究结果，并就用于膝骨关节炎细胞疗法的最佳 MSC 来源达成共识。