Biotechnology and Bioprocess Engineering 2019; 24(6): 839-853  
Recent Clinical Trials in Adipose-derived Stem Cell Mediated Osteoarthritis Treatment
Hyeran Cho1,†, Hyeyoung Kim1,3,†, Young Guk Kim, and Kyobum Kim1,2,*
1Division of Bioengineering, College of Life Sciences and Bioengineering, Incheon National University, Incheon 22012, Korea
2Department of Chemical & Biochemical Engineering, Dongguk University, Seoul 04620, Korea
3Department of Molecular Bioscience, University of Kansas, Lawrence, KS 66045, USA
Correspondence to: Kyobum Kim* (current address)
Department of Chemical & Biochemical Engineering, Dongguk University, Seoul 04620, Korea
Tel: +82-2-2260-8597
Email: kyobum.kim@dongguk.edu
Received: July 3, 2019; Revised: August 24, 2019; Accepted: August 24, 2019; Published online: December 31, 2019.
© The Korean Society for Biotechnology and Bioengineering. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Osteoarthritis (OA), a common chronic affliction amongst the elderly and athletes, is increasing every year. Due to the limited regenerative capacities of the cartilage, surgical or physical treatments have been developed for OA. The development of surgical treatment for OA has evolved from simple joint replacement to cell-based regeneration. Especially, compared with other types of stem cells, mesenchymal stem cells (bone-marrow derived stem cell (BMSC) and adipose-derived stem cell (ASC)) are well known for their high yield, excellent differentiation capacities and easy isolation, and hence are widely applied in tissue engineering. In addition, it has been known that a capability of chondrogenic differentiation of ASCs (i.e., mesenchymal stem cell population from a synovial origin) is higher than BMSCs. This review summarizes the recent clinical applications utilizing ASC and its clinical efficacy for OA treatment, estimated by applying available scoring systems. Current ASC therapy treatments in the clinical system include a direct injection of ASC supplemented with additional compounds such as platelet-rich plasma (PRP) and stromal vascular fraction (SVF) for enhancing differentiation of stem cells and the incorporation of ASC with biomaterial-based scaffolds such as fibrin and hyaluronic acid has been developed for more effective treatment than direct injection. Various scoring systems have demonstrated the clinical efficacy of ASC, and numerous results have validated the use of ASC as an OA therapy by relieving pain and improving the movement of cartilage. Furthermore, additional PRP or SVF combined with ASC have exhibited enhanced pain reduction and physiological movement of cartilage. Hence, clinical researches suggest that stem cell therapy utilizing ASC could be an effective OA treatment.
Keywords: adipose-derived stem cell, cartilage, human clinical trial, tissue regeneration


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