title: Mesenchymal stem cell therapy for knee osteoarthritis. Preliminary report of four patients.
abstract: BACKGROUND
  Osteoarthritis (OA) is a cartilage degenerative process, involving the immune system, producing local inflammatory reactions, with production of pro-inflammatory cytokines and metalloproteinases. No treatment is still available to improve or reverse the process. Stem cell therapy opened new horizons for treatment of many incurable diseases. Mesenchymal stem cells (MSCs) due to their multi-lineage potential, immunosuppressive activities, limited immunogenicity and relative ease of growth in culture, have attracted attentions for clinical use.
  
  
  OBJECTIVE
  The aim of this study was to examine whether MSC transplantation could reverse the OA process in the knee joint. The project was approved by the Tehran University of Medical Sciences Research Committee and Ethical Committee.
  
  
  METHODS
  Four patients with knee osteoarthritis were selected for the study. They were aged 55, 57, 65 and 54 years, and had moderate to severe knee OA. After their signed written consent, 30 mL of bone marrow were taken and cultured for MSC growth. After having enough MSCs in culture (4-5 weeks) and taking in consideration all safety measures, cells were injected in one knee of each patient.
  
  
  RESULTS
  The walking time for the pain to appear improved for three patients and remained unchanged for one. The number of stairs they could climb and the pain on visual analog scale improved for all of them. On physical examination, the improvement was mainly for crepitus. It was minor for the improvement of the range of motion.
  
  
  CONCLUSIONS
  Results were encouraging, but not excellent. Improvement of the technique may improve the results.
authors.affiliation: Rheumatology Research Center, Tehran University of Medical Sciences, Shariati Hospital, Kargar Avenue, Tehran, Iran. fddh@davatchi.net
authors.forename: Fereydoun
authors.initials: F
authors.lastname: Davatchi
authors.forename: Bahar Sadeghi
authors.initials: BS
authors.lastname: Abdollahi
authors.forename: Mandana
authors.initials: M
authors.lastname: Mohyeddin
authors.forename: Farhad
authors.initials: F
authors.lastname: Shahram
authors.forename: Behrooz
authors.initials: B
authors.lastname: Nikbin
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D002478:Cells, Cultured; D006801:Humans; D007492:Iran; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D045164:Mesenchymal Stem Cell Transplantation; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D010865:Pilot Projects; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking