Sains Malaysiana 48(9)(2019): 1947–1958

http://dx.doi.org/10.17576/jsm-2019-4809-16

A Systematic Review on Peripheral Blood-derived Mesenchymal Stem Cells as a Therapy for Cartilage Repair

(Ulasan Sistematik pada Sel Tunjang Mesenkima daripada Darah Periferal sebagai Terapi untuk Pembaikan Rawan)

RUFAIDAH OTHMAN¹, PAN PAN CHONG¹*, NAHRIZUL ADIB KADRI² & TUNKU KAMARUL¹

¹Tissue Engineering Group (TEG), National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

²Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

Received: 12 February 2018/Accepted: 1 July 2019

ABSTRACT

Comprehensive analysis showed that the popularity of research peripheral blood-derived mesenchymal stem cells for knee cartilage repair is still lacking, as they peripherally exist at a very low level. Despite its small cell number, peripheral blood is yet one of the most convenient sources of mesenchymal stem cells due to its less invasive method to harvest. This study aimed to systematically review the current evidence of peripheral blood-derived mesenchymal stem cells towards the repair of articular cartilage defect. A comprehensive literature search was performed to identify all in vivo studies reporting the structural outcome of articular cartilage repair in the knee following electronic databases: PubMed, WOS and SCOPUS. The in vitro characterizations of peripheral blood-derived mesenchymal stem cells were evaluated to enable quality assessment. Literature from 1934 to 2019 showed 4822 of total articles with only three findings related to pre-clinical studies were included in the analysis. The selection of animal model, type of transplantation, mobilization of the peripheral blood, in vitro culture condition, type of scaffold, assessments on the cartilage defect, and the outcome measures were heterogeneous. Evidence showed that mobilized peripheral blood-derived mesenchymal stem cells were more superior in repairing articular cartilage compared to those that were non-mobilized. These cells also showed a comparable capability in repairing articular cartilage than the commonly used bone marrow mesenchymal stem cells. Overall, more progress is needed to expand the usage of peripheral blood-derived mesenchymal stem cells from basic biological science to the translational studies in clinical practice.

Keywords: Circulating cell; knee osteoarthritis; mesenchymal stem cell; peripheral blood; pre-clinical

ABSTRAK

Analisis secara komprehensif menunjukkan bahawa kajian yang berkaitan dengan rawatan lutut yang melibatkan penggunaan sel stem mesenkima daripada darah periferal adalah masih pada tahap yang rendah kerana kuantiti sel stem tersebut yang amat rendah di dalam darah periferal. Namun begitu, proses memperoleh sel stem mesenkima daripada darah periferal adalah mudah kerana ia kurang invasif. Kajian ini adalah bertujuan untuk menyelidik kesemua penemuan semasa yang berkaitan dengan sel stem mesenkima daripada darah periferal, yang terlibat dalam meningkatkan pemulihan secara in vivo terhadap kerosakan rawan artikul. Carian kepustakaan telah dilakukan secara komprehensif dengan menggunakan pangkalan data elektronik seperti: PubMed, WOS dan SCOPUS. Pencirian in vitro untuk sel stem ini telah dinilai dalam menentukan tahap kualiti kajian. Kajian kepustakaan bermula dari tahun 1934 sehingga tahun 2019 menunjukkan bahawa daripada sejumlah 4822 artikel, hanya terdapat tiga kajian pra-klinikal yang berkaitan. Setiap kajian melibatkan pelbagai kriteria yang heterogen daripada segi pemilihan model haiwan, jenis transplan, kaedah mobilasi darah periferal, kondisi kultur in vitro, jenis rangka (skafold) yang digunakan, tahap kerosakan rawan serta kesan pemulihan. Bukti menunjukkan bahawa sel stem mesenkima yang diperoleh daripada darah periferal yang telah dimobilasi memiliki kebolehan yang lebih baik dalam memperbaiki rawan artikul berbanding dengan sel stem mesenkima yang tidak dimobilasi. Malah, sel ini juga mempunyai keupayaan pembaikian yang setanding dengan sel stem mesenkima yang sering diperoleh daripada sumsum tulang. Secara keseluruhannya, penggunaan sel stem mesenkima daripada darah periferal perlu diperluaskan lagi bermula daripada bidang asas sains biologi hingga ke kajian translasi yang melibatkan pengamalan secara klinikal.

Kata kunci: Darah periferal; osteoartritis lutut; peredaran sel; pre-klinikal; sel stem mesenkima

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*Corresponding author; email: pan2chong@gmail.com