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Hip Replacement Surgery Byproduct Yields Autologous Stem Cell

Review of "Arthritic Periosteal Tissue From Joint Replacement Surgery: A Novel, Autologous Source of Stem Cells" from Stem Cell Translational Medicine by Stuart P. Atkinson

Stem cell banking and cryopreservation of perinatal tissues is becoming an increasingly popular strategy for future regenerative therapies, if and when required. However, most adults currently requiring such an approach to disease/disorder may not have had this opportunity and therefore, other sources of autologous adult stem cells are currently under investigation. The periosteum is a membrane that covers the outer surface of all bones, and periosteum-derived cells (PDCs) from the shaft of the long bones have shown potential as a source of multipotent adult stem cells [1, 2], although the difficulty in accessibility has limited studies. Researchers from the laboratory of Melissa L. Knothe Tate at the University of New South Wales, Sydney, Australia now report on their work which takes advantage of hip replacement surgery to isolate and study PDCs and compare them to bone marrow-derived stem cells (BMSCs) [3].

They began by isolating two different types of PDCs from human femoral neck periosteum from osteoarthritic (OA) or rheumatoid arthritic (RA) bones acquired during total hip joint repair. Enzymatic digestion (d) of minced periosteum permitted the isolation of dPDCs, while the plating of minced cells and collection of migrated (m) cells after a week permitted the isolation of mPDCs. Both cell types were fibroblastic, and similar to BMSCs in relation to their morphology and proliferative rate. While 95% of all three cell types were positive for CD73, CD90 and CD105 (mesenchymal markers), dPDCs expressed higher levels of CD73, mPDCs expressed higher levels of CD105, and BMSCs expressed higher levels of CD34 (hematopoietic) and MyHC (skeletal muscle). The researchers did not see any correlation to age for the cell surface markers investigated. Adipogenic differentiation of all three cell types led to an increase in Oil Red O absorbance and adipogenic-related morphological changes. Osteogenic differentiation was also similar across all three cell types although the study did uncover high variability between cell types and donors. Chondrogenic differentiation yielded no differences in the size of differentiating cell pellets or qualitative differences in cellularity, although staining of BMSCs and PDCs demonstrated some obvious differences; dPDC and mPDC pellets had stronger matrix staining resembling less mature fibrocartilage. The researchers did not find any correlation between pellet size and the researchers observed no correlation to age in any of the differentiation studies. Further statistical analysis did not find differences in data between "healthy" (not treated for joint replacement) and arthritic donors, or between OA and RA donors.

Recent studies have indicated the potential therapeutic usefulness of the periosteum or periosteum-derived cells [1, 4-6]. This study not only describes the first report of the isolation of cells from the periosteum of the femoral neck of arthritic patients - an unprecedented and to date unstudied source of stem cells, but also suggests that these patient-specific adult cells have mesenchymal stem cell-like properties. Additionally, the differentiation capacity of these cells was not altered between patients with different pathophysiologies (AO and RA) or between arthritic and healthy patients, and nor were their characteristics linked to age. Overall, the study underlines the translational implications of femoral neck periosteum as a source of stem cells from arthritic tissue removed during joint replacement.


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