Sains Malaysiana 50(6)(2021): 1727-1744

http://doi.org/10.17576/jsm-2021-5006-19

Assessing the Potential of Bone Marrow Concentrate for Cartilage Repair and Regeneration in Animal Models: A Systemic Review

(Menilai Potensi Kepekatan Sumsum Tulang untuk Pembaikan dan Pembaharuan Tulang Rawan dalam Model Haiwan: Suatu Kajian Sistemik)

NABILLAH ABD RADZAK, MALLIGA RAMAN MURALI* & TUNKU KAMARUL

Tissue Engineering Group, Department of Orthopaedic Surgery, NOCERAL, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

Diserahkan: 21 Februari 2020/Diterima: 8 Oktober 2020

ABSTRACT

Bone marrow concentrate (BMC) has been emerging as a promising regenerative source to accelerate cartilage regeneration in cartilage injuries and osteoarthritis. Though the number of stem cells in BMC is limited, BMC is rich in growth factors that promote stem cell differentiation and tissue regeneration. Despite of multiple reports available on the use of BMC for cartilage repair in humans and its use in clinical settings, only limited number of pre-clinical proof of concept studies have been reported in animal models. Hence, a systematic review focusing on the potential of BMC for the treatment of cartilage defect in animal models has been conducted. The systematic search of literature using three popular databases, ISI Web of Knowledge, PubMed and Scopus, were conducted without year restriction. Fifteen (n = 15) studies were found appropriate and included in this review. All of the included studies were of different animal models with cartilage defect. 13 out of 15 studies reported that the usage of BMC gave the best outcome compared to other treatment methods. Most of the findings provided good scoring on the tissue repair and the histological outcome. However, most of the BMC group outcomes did not give a significant difference when compared with other interventions such as the addition of platelet rich plasma, erythropoietin, hyaluronic acid, transforming growth factor, autologous tissue implant, genetic modification or scaffoldings. In conclusion, the published studies do suggest that BMC could provide a better cartilage repair. However, more preclinical studies are required to provide definitive conclusions.

Keywords: Animal study; bone marrow aspirate; bone marrow concentrate; cartilage; systematic review

ABSTRAK

Konsentrasi sumsum tulang (BMC) telah muncul sebagai sumber penjanaan semula yang berpotensi untuk mempercepatkan pertumbuhan tulang rawan dalam kecederaan rawan dan osteoartritis. Walaupun jumlah sel stem di BMC adalah terhad, BMC kaya dengan faktor pertumbuhan yang membantu dalam proses pembezaan sel stem dan penjanaan semula tisu. Walaupun terdapat banyak laporan mengenai penggunaan BMC untuk pembaikan tulang rawan pada manusia dan penggunaannya dalam tetapan klinikal, hanya sebilangan kecil bukti kajian konsep pra-klinikal yang terhad telah dilaporkan dalam model haiwan. Oleh itu, semakan sistematik yang menumpukan kepada potensi BMC untuk rawatan kecacatan tulang rawan dalam model haiwan telah dijalankan. Pencarian sastera sistematik menggunakan tiga pangkalan data popular, ISI Web of Knowledge, PubMed dan Scopus, telah dijalankan tanpa pembatasan tahun. Sebanyak lima belas (n = 15) kajian didapati bersesuaian dan disertakan dalam kajian ini. Semua kajian yang terpilih termasuk model haiwan yang berbeza dengan kecacatan tulang rawan. 13 daripada 15 kajian melaporkan bahawa penggunaan BMC memberi hasil yang terbaik berbanding kaedah rawatan lain. Kebanyakan penemuan memberikan skor yang baik ke atas pembaikan tisu dan hasil histologi. Walau bagaimanapun, kebanyakan hasil kumpulan BMC tidak memberikan perbezaan yang signifikan jika dibandingkan dengan campur tangan lain seperti penambahan platelet kaya plasma, eritropoietin, asid hialuronik, mengubah faktor pertumbuhan, implan tisu autologos, pengubahsuaian genetik atau perancah. Kesimpulannya, kajian yang diterbitkan menunjukkan bahawa BMC dapat memberikan pembaikan rawan yang lebih baik. Walau bagaimanapun, lebih banyak kajian pra-klinikal diperlukan untuk memberikan kesimpulan yang pasti.

Kata kunci: Haiwan; konsentrasi sumsum aspirat; konsentrasi sumsum tulang; rawan; semakan sistematik

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*Pengarang untuk surat-menyurat; email: drmurali@um.edu.my