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Device-Based Enrichment of Knee Joint Synovial Cells to Drive MSC Chondrogenesis Without Prior Culture Expansion In Vitro

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View the page of Ala Al-Taie

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Cartilage repair may benefit from synovial fluid-derived MSCs. Without culture expansion, Ala Altaei found that the STEM device boosted MSC release and chondrogenesis.

Image courtesy of interviewee. December 13, 2023

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The video discusses the potential of stem cells, particularly those found in synovial fluid, for cartilage regeneration in osteoarthritis patients. Stem cells can differentiate into various cell types, including cartilage, bone, and muscle, depending on their environment. Research from 2004 identified synovial fluid stem cells as effective candidates for cartilage production, especially in joint conditions.

The study focuses on developing a one-stage procedure that allows the collection and manipulation of these cells directly from the joint during arthroscopy, using a device called the STEM device. This video video device facilitates the release of stem cells from the synovium without the need for prior culture expansion. The researchers aimed to ascertain whether these released cells could effectively produce cartilage and whether the joint environment changed from pro-inflammatory to anti-inflammatory following this procedure.

Patients undergoing arthroscopy provided synovial fluid samples before and after using the STEM device, along with blood for platelet concentrate, which is rich in growth factors. Results indicated that agitation of the synovium increased stem cell populations and enhanced their potential for cartilage formation. Additionally, the immune cell environment shifted towards an anti-inflammatory state, supporting cartilage regeneration. Continuous release of stem cells was observed for up to ten days post-procedure, confirming the effectiveness of the approach in promoting cartilage healing.

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X-TIMESTAMP-MAP:LOCAL=00:00:00.000,MPEGTS=900000

00:00.000 --> 00:02.180
First of all, let's say what is the stem cells?

00:02.225 --> 00:04.445
The stem cells are types of cells.

00:04.515 --> 00:06.445
They can, they have the potential

00:06.445 --> 00:08.845
to differentiate into a different types of cells.

00:09.265 --> 00:12.045
So they can make a cartilage, they can make a bone,

00:12.115 --> 00:15.325
they can make a fat, they can make, muscles.

00:15.745 --> 00:19.725
It depends on the environment they create. You put them in.

00:20.385 --> 00:24.005
Uh, and recently in 2004 in our group, we found

00:24.035 --> 00:27.325
that those cells that are present in the,

00:27.445 --> 00:31.845
synovial fluid, they have a potential for making cartilage.

00:32.545 --> 00:35.605
Um, that's why there is the interest of using them since

00:36.025 --> 00:39.885
for osteoarthritis, especially patients,

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because they are in the joint

00:41.665 --> 00:45.605
and they have the higher potential for making re comparing

00:45.605 --> 00:47.445
to the other types of the stem cells.

00:47.785 --> 00:51.965
So we have a bone marrow stem cells, we have,

00:52.355 --> 00:53.645
adipocyte stem cells.

00:54.145 --> 00:58.645
So the synovial fluid, we found they were the best candidate

00:59.145 --> 01:00.845
for making cartilage.

01:01.065 --> 01:03.485
So that's why we were interested in working with them.

01:03.635 --> 01:06.645
They don't, you don't need to take them from other side

01:06.705 --> 01:08.205
and inject them to that side.

01:08.705 --> 01:10.845
So our main philosophy, we trying

01:10.865 --> 01:14.045
to work toward one stage procedure where

01:14.825 --> 01:18.365
at the same point when you open the joint,

01:18.585 --> 01:22.365
you can get the cells, manipulate the joints in terms

01:22.385 --> 01:26.685
of make it more into making cartilage rather than

01:27.295 --> 01:29.205
catalyzing the cartilage

01:29.465 --> 01:31.085
and increasing the numbers of the cells,

01:31.235 --> 01:34.445
providing the right growth factor to make the cartilage.

01:34.705 --> 01:37.445
The major purpose of this study is like just a little

01:37.445 --> 01:41.085
background before that is most of the studies

01:41.115 --> 01:43.685
that working on regenerating cartilage get,

01:43.685 --> 01:44.845
and as I mentioned earlier,

01:45.345 --> 01:47.245
we get the cells from different site

01:47.705 --> 01:50.645
and we take them o vivo.

01:50.705 --> 01:54.125
We have to culture expand them to increase their number

01:54.305 --> 01:57.085
to be clinically relevant for making cartilage

01:57.105 --> 02:00.565
and then inject them back again to the joint.

02:01.185 --> 02:05.485
So in our group, we developed a device called STEM device,

02:05.495 --> 02:10.285
which is cell mobilization, device mainly for

02:10.995 --> 02:14.565
releasing the cells from the joint itself by agitation,

02:14.705 --> 02:16.965
the synovium during arthroscopy.

02:17.395 --> 02:19.405
It's a very simple procedure

02:19.825 --> 02:21.925
and we prove we are increasing the numbers

02:22.025 --> 02:24.805
of the cells using that device in the joint.

02:25.105 --> 02:29.045
So we don't need to take them out for Culture X, maam.

02:29.345 --> 02:32.645
So the purpose for the study was to show and prove

02:33.175 --> 02:37.565
after these cells that being released from the synovium,

02:38.345 --> 02:41.325
do they have a good potential for making cartilage

02:42.145 --> 02:44.525
and without culture expanding?

02:45.145 --> 02:47.205
Uh, 'cause that was the tricky question.

02:47.685 --> 02:50.805
'cause all the time that we need to culture expand the cells

02:50.905 --> 02:53.295
and then make a cartilage.

02:53.715 --> 02:55.375
So that was the main question.

02:55.875 --> 02:58.175
And the second object, like after

02:58.565 --> 03:00.085
Agitation the svia,

03:00.505 --> 03:02.645
are you changing the environment in term

03:02.645 --> 03:05.325
of making changes from anti-inflammatory from

03:05.425 --> 03:09.125
pro-inflammatory to anti-inflammatory basically from

03:09.555 --> 03:12.405
environment that eat the cartilage to environment,

03:12.405 --> 03:14.165
that support building of the cartridge.

03:14.625 --> 03:18.725
So we had, patient coming for arthroscopy,

03:19.105 --> 03:20.365
for several purpose.

03:20.745 --> 03:22.965
We collected two samples from the patient

03:23.125 --> 03:24.405
synovial fluid sample.

03:24.585 --> 03:28.485
The first sample was before using the STEM device

03:29.025 --> 03:31.405
and then the second sample, it was immediately

03:31.405 --> 03:32.885
after using the STEM device.

03:33.545 --> 03:37.805
At the same time we collected a blood from the patient,

03:38.545 --> 03:41.125
in terms to be able

03:41.225 --> 03:43.725
to prepare a platelet concentrate,

03:43.725 --> 03:45.445
which is very rich in the growth factor.

03:45.945 --> 03:50.125
So here we can have autologous, model

03:50.305 --> 03:51.685
to work on exvivo.

03:52.545 --> 03:57.445
Uh, we also collected synovium from

03:57.805 --> 03:59.845
a patient going totally knee replacement.

03:59.945 --> 04:03.285
And we did ex vivo, agitation for a

04:03.385 --> 04:06.525
or ion to see if the process

04:06.705 --> 04:10.045
of agitation the synovium, does it stop at the point of

04:10.155 --> 04:13.885
what we did or the release of the MSC

04:13.985 --> 04:17.245
or the stem cells continues afterwards.

04:18.145 --> 04:20.525
So in the beginning we confirmed first that

04:20.575 --> 04:24.325
after you brushing or agitation the Sunovion, the stem cells

04:24.425 --> 04:26.725
and the fluid were increased comparing to

04:26.725 --> 04:31.605
before then we confirmed that using autologous

04:32.185 --> 04:34.285
platelet concentrate

04:34.745 --> 04:38.325
or allogenic was efficient to be used

04:38.465 --> 04:41.365
for generating cartilage without culture

04:41.595 --> 04:42.725
expanding the cells.

04:43.505 --> 04:47.405
And then we tested the potential of the brushed

04:48.085 --> 04:50.845
synovium MSC that being released

04:50.975 --> 04:53.205
after the, agitation.

04:53.945 --> 04:55.045
Do they have the potential

04:55.065 --> 04:58.085
for making cartridge without culture expansion?

04:58.225 --> 05:00.925
And they had higher potential actually

05:00.945 --> 05:04.485
for making cartridge comparing to the one before agitation.

05:05.305 --> 05:09.405
And the second object one, we looked at the immune cells

05:09.825 --> 05:12.845
to see if we are changing the environment of the joint

05:12.935 --> 05:16.925
after we are performing the brushing or vegetation.

05:17.465 --> 05:20.205
And we found there is a change in the compositions

05:20.225 --> 05:23.765
of the immune cells from raw inflammatory

05:23.785 --> 05:24.925
to anti-inflammatory.

05:25.345 --> 05:30.205
So here we kind of confirmed our main objective that

05:31.535 --> 05:34.525
using the STEM device during arthoscopy,

05:34.825 --> 05:38.285
you increasing the cell numbers of the synovial ES

05:38.385 --> 05:40.645
and those cells, they had a higher potential

05:40.645 --> 05:42.045
of making cartilage.

05:42.555 --> 05:46.285
Plus they get the support of the environment changing where

05:47.065 --> 05:50.845
the immune cells change from pro-inflammatory to anti

05:51.865 --> 05:55.365
the release of the MSEs after the depression.

05:55.425 --> 05:58.045
And we found there is a continuous release

05:58.065 --> 06:02.805
of the MSEs from the anovia till day 10, that,

06:03.695 --> 06:08.205
after the brush, which increased the potential of having a.

00:00 - First of all, let's say what is the stem cells? The stem cells are types of cells. They can, they have the potential to differentiate into a different types of cells. So they can make a cartilage, they can make a bone, they can make a fat, they can make, muscles.

00:15 - It depends on the environment they create. You put them in. and recently in 2004 in our group, we found that those cells that are present in the, synovial fluid, they have a potential for making cartilage. that's why there is the interest of using them since for osteoarthritis, especially patients, because they are in the joint and they have the higher potential for making re comparing to the other types of the stem cells. So we have a bone marrow stem cells, we have,

00:52 - adipocyte stem cells. So the synovial fluid, we found they were the best candidate for making cartilage. So that's why we were interested in working with them. They don't, you don't need to take them from other side and inject them to that side. So our main philosophy, we trying to work toward one stage procedure where at the same point when you open the joint, you can get the cells, manipulate the joints in terms

01:22 - of make it more into making cartilage rather than catalyzing the cartilage and increasing the numbers of the cells, providing the right growth factor to make the cartilage. The major purpose of this study is like just a little background before that is most of the studies that working on regenerating cartilage get, and as I mentioned earlier, we get the cells from different site and we take them o vivo.

01:50 - We have to culture expand them to increase their number to be clinically relevant for making cartilage and then inject them back again to the joint. So in our group, we developed a device called STEM device, which is cell mobilization, device mainly for releasing the cells from the joint itself by agitation, the synovium during arthroscopy. It's a very simple procedure and we prove we are increasing the numbers of the cells using that device in the joint.

02:25 - So we don't need to take them out for Culture X, maam. So the purpose for the study was to show and prove after these cells that being released from the synovium, do they have a good potential for making cartilage and without culture expanding? 'cause that was the tricky question. 'cause all the time that we need to culture expand the cells and then make a cartilage. So that was the main question. And the second object, like after

02:58 - Agitation the svia, are you changing the environment in term of making changes from anti-inflammatory from pro-inflammatory to anti-inflammatory basically from environment that eat the cartilage to environment, that support building of the cartridge. So we had, patient coming for arthroscopy, for several purpose. We collected two samples from the patient synovial fluid sample.

03:24 - The first sample was before using the STEM device and then the second sample, it was immediately after using the STEM device. At the same time we collected a blood from the patient, in terms to be able to prepare a platelet concentrate, which is very rich in the growth factor. So here we can have autologous, model to work on exvivo. we also collected synovium from

03:57 - a patient going totally knee replacement. And we did ex vivo, agitation for a or ion to see if the process of agitation the synovium, does it stop at the point of what we did or the release of the MSC or the stem cells continues afterwards. So in the beginning we confirmed first that after you brushing or agitation the Sunovion, the stem cells and the fluid were increased comparing to before then we confirmed that using autologous

04:32 - platelet concentrate or allogenic was efficient to be used for generating cartilage without culture expanding the cells. And then we tested the potential of the brushed synovium MSC that being released after the, agitation. Do they have the potential for making cartridge without culture expansion? And they had higher potential actually

05:00 - for making cartridge comparing to the one before agitation. And the second object one, we looked at the immune cells to see if we are changing the environment of the joint after we are performing the brushing or vegetation. And we found there is a change in the compositions of the immune cells from raw inflammatory to anti-inflammatory. So here we kind of confirmed our main objective that using the STEM device during arthoscopy, you increasing the cell numbers of the synovial ES

05:38 - and those cells, they had a higher potential of making cartilage. Plus they get the support of the environment changing where the immune cells change from pro-inflammatory to anti the release of the MSEs after the depression. And we found there is a continuous release of the MSEs from the anovia till day 10, that, after the brush, which increased the potential of having a.

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