Mohammed Abbas1,2, Mohammed Alkaff1,2, Asim Jilani3, Haneen Alsehli4, Laila Damiati5, Mamdooh Kotb6, Moahmmed Abdelwahed7, Fahad Alghamdi8, Gauthaman Kalamegam2,9,10. 1. 1Department of Orthopaedic Surgery, Faculty of Medicine, King Abdulaziz University, PO BOX 80216, Jeddah, 21589 Kingdom of Saudi Arabia. 2. 2Sheikh Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis by Stem Cells, King Abdulaziz University, PO BOX 80216, Jeddah, 21589 Kingdom of Saudi Arabia. 3. 3Center of Nanotechnology, King Abdulaziz University, Jeddah, 21589 Kingdom of Saudi Arabia. 4. 4Center of Innovation in Personalized Medicine, Faculty of Applied Medical Sciences, King Abdulaziz University, PO BOX 80216, Jeddah, 21589 Kingdom of Saudi Arabia. 5. 5Stem Cells Unit, King Fahd Medical Research Center, King Abdulaziz University, PO BOX 80216, Jeddah, 21589 Kingdom of Saudi Arabia. 6. 6Department of Radiology, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589 Kingdom of Saudi Arabia. 7. 7Department of Pathology, Faculty of Medicine, University of Jeddah, PO BOX 80327, Jeddah, 21589 Kingdom of Saudi Arabia. 8. 8Department of Pathology, Faculty of Medicine, King Abdulaziz University, PO BOX 80216, Jeddah, 21589 Kingdom of Saudi Arabia. 9. 9Stem Cells Unit, Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University (KAU), PO BOX 80216, Jeddah, 21589 Kingdom of Saudi Arabia. 10. 10Faculty of Medicine, AIMST University, Jalan Bedong-Semeling, 08100 Bedong, Kedah Darul Aman, Malaysia.
Abstract
BACKGROUND: Mesenchymal stem cells (MSCs) and/or biological scaffolds have been used to regenerate articular cartilage with variable success. In the present study we evaluated cartilage regeneration using a combination of bone marrow (BM)-MSCs, HyalofastTM and/or native cartilage tissue following full thickness surgical cartilage defect in rabbits. METHODS: Full-thickness surgical ablation of the medial-tibial cartilage was performed in New Zealand white (NZW) rabbits. Control rabbits (Group-I) received no treatment; Animals in other groups were treated as follows. Group-II: BM-MSCs (1 × 106 cells) + HyalofastTM; Group-III: BMMSCs (1 × 106 cells) + cartilage pellet (CP); and Group-IV: BM-MSCs (1 × 106 cells) + HyalofastTM + CP. Animals were sacrificed at 12 weeks and cartilage regeneration analyzed using histopathology, International Cartilage Repair Society (ICRS-II) score, magnetic resonance observation of cartilage repair tissue (MOCART) score and biomechanical studies. RESULTS: Gross images showed good tissue repair (Groups IV > III > Group II) and histology demonstrated intact superficial layer, normal chondrocyte arrangement, tidemark and cartilage matrix staining (Groups III and IV) compared to the untreated control (Group I) respectively. ICRS-II score was 52.5, 65.0, 66 and 75% (Groups I-IV) and the MOCART score was 50.0, 73.75 and 76.25 (Groups II-IV) respectively. Biomechanical properties of the regenerated cartilage tissue in Group IV closed resembled that of a normal cartilage. CONCLUSION: HyalofastTM together with BM-MSCs and CP led to efficient cartilage regeneration following full thickness surgical ablation of tibial articular cartilage in vivo in rabbits. Presence of hyaluronic acid in the scaffold and native microenvironment cues probably facilitated differentiation and integration of BM-MSCs.
BACKGROUND: Mesenchymal stem cells (MSCs) and/or biological scaffolds have been used to regenerate articular cartilage with variable success. In the present study we evaluated cartilage regeneration using a combination of bone marrow (BM)-MSCs, HyalofastTM and/or native cartilage tissue following full thickness surgical cartilage defect in rabbits. METHODS: Full-thickness surgical ablation of the medial-tibial cartilage was performed in New Zealand white (NZW) rabbits. Control rabbits (Group-I) received no treatment; Animals in other groups were treated as follows. Group-II: BM-MSCs (1 × 106 cells) + HyalofastTM; Group-III: BMMSCs (1 × 106 cells) + cartilage pellet (CP); and Group-IV: BM-MSCs (1 × 106 cells) + HyalofastTM + CP. Animals were sacrificed at 12 weeks and cartilage regeneration analyzed using histopathology, International Cartilage Repair Society (ICRS-II) score, magnetic resonance observation of cartilage repair tissue (MOCART) score and biomechanical studies. RESULTS: Gross images showed good tissue repair (Groups IV > III > Group II) and histology demonstrated intact superficial layer, normal chondrocyte arrangement, tidemark and cartilage matrix staining (Groups III and IV) compared to the untreated control (Group I) respectively. ICRS-II score was 52.5, 65.0, 66 and 75% (Groups I-IV) and the MOCART score was 50.0, 73.75 and 76.25 (Groups II-IV) respectively. Biomechanical properties of the regenerated cartilage tissue in Group IV closed resembled that of a normal cartilage. CONCLUSION: HyalofastTM together with BM-MSCs and CP led to efficient cartilage regeneration following full thickness surgical ablation of tibial articular cartilage in vivo in rabbits. Presence of hyaluronic acid in the scaffold and native microenvironment cues probably facilitated differentiation and integration of BM-MSCs.