Combination of Mesenchymal Stem Cells, Cartilage Pellet and Bioscaffold Supported Cartilage Regeneration of a Full Thickness Articular Surface Defect in Rabbits

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, Hyalofast™ 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: BMMSCs (1 × 10⁶ cells) + Hyalofast™; Group-III: BMMSCs (1 × 10⁶ cells) + cartilage pellet (CP); and Group-IV: BMMSCs (1 × 10⁶ cells) + Hyalofast™+ 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: Hyalofast™ 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.

Derivation and Differentiation of Bone Marrow Mesenchymal Stem Cells from Osteoarthritis Patients

Osteoarthritis (OA) of the knee is a degenerative joint disease caused by the progressive reduction of the articular cartilage surface that leads to reduced joint function. Cartilage degeneration occurs through gradual loss in extracellular matrix components including type II collagen and proteoglycan. Due to limited inherent self repair capacity of the cartilage, the use of cell-based therapies for articular cartilage regeneration is considered promising. Bone marrow mesenchymal stem cells (BM-MSCs) are multipotent cells and are highly capable of multilineage differentiation which render them valuable for regenerative medicine. In this study, BM-MSCs were isolated from OA patients and were characterized for MSC specific CD surface marker antigens using flowcytometry and their differentiation potential into adipocytes, osteocytes and chondrocytes were evaluated using histological and gene expression studies. BM-MSCs isolated from OA patients showed short spindle shaped morphology in culture and expressed positive MSC related CD markers. They also demonstrated positive staining with oil red O, alizarin red and alcian blue following differentiation into adipocytes, osteocytes and chondrocytes, respectively. In addition, chodrogenic related genes such as collagen type II alpha1, cartilage oligomeric matrix protein, fibromodulin, and SOX9 as well as osteocytic related genes such as alkaline phosphatase, core-binding factor alpha 1, osteopontin and RUNX2 runt-related transcription factor 2 were upregulated following chondrogenic and osteogenic differentiation respectively. We have successfully isolated and characterized BM-MSCs from OA patients. Although BM-MSCs has been widely studied and their potential in regenerative medicine is reported, the present study is the first report in our series of experiments on the BMSCs isolated from OA patients at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Comparison of the effects of spinal anaesthesia vs general anaesthesia on apgar score in neonates born after elective caesarean section

Delivery of baby by caesarean section has become increasingly common, Caesarean section can be performed under general or regional anaesthesia like spinal or epidural technique, and both have advantages and disadvantages. It is important to clarify what type of anaesthesia is safest for the mother and baby. To compare the effect of spinal anaesthesia versus general anaesthesia on Apgar score of neonates born by elective caesarean section in Baghdad teaching hospital. The study was carried out in Baghdad teaching hospital from February 2011 to July 2011 .this study was performed on 60 women presenting for Elective lower segment caesarean section .thirty mothers were given general anaesthesia and other 30 mothers received spinal anaesthesia. The Apgar score was recorded at1 minute and 5 minute interval after each delivery. Out of 30 mothers, who received general anaesthesia, 25 patients [83.3%] give birth to neonates having Apgar score /= 7. On the other hand out of 30 mothers who received spinal anaesthesia only 10 mothers give birth to neonate having Apgar score /= 7. It had been found that those neonates who were born under G.A were ten folds more likely to have Apgar score less than or equal to 6 at first minute compared to those with spinal anaesthesia, the odds ratio=10 and 95%confidence interval of the odds ratio [2.94-34] and p=0.00024 which is highly significant, G.A had greater risk on infant at the first minute. There is a significant difference between the effects of general anaesthesia and spinal anaesthesia on Apgar score of neonate one minute after delivery of full term neonate by elective caesarean section, but there is no significant difference between the effect of general anaesthesia and spinal anaesthesia on Apgar score 5minutes after birth

Silent ischemia in diabetic patients

In order to assess the association between autonomic dysfunction and abnormal but silent ST segment depression, 120 diabetic patients [age [25 - 77 years]; 38 type 1 DM,. 82 type 2 DM, 66 males, 54 females] and 65 without diabetes i.e. control subjects [age [25 - 72 years], 48 males, 17 females], without a history of chest pain were investigated. Autonomic dysfunction was evaluating by autonomic function tests. Transient ST segment depression was assessed by exercise treadmill testing [ETT] [Bruce Protocol]. Abnormal [>/= 1 mm] ST segment depression horizontally or down sloping below the baseline i.e. PR segment, measured 0.08 seconds after the J point was observed in 40 [33.3%] of diabetic group [30 [37.5%] in diabetes, with autonomic dysfunction and 10 [25%] in diabetes without autonomic dysfunction] and 7 [1.0.8%] of control group. It was calculated that autonomic dysfunction could be a possible explanation for lacking symptoms from abnormal ST segment depression in diabetic patients [P <0.05]