Abstract：
OBJECTIVE: The aim of this systematic review was to determine if adipose tissue-derived cell-based injectable therapies can induce disease-modifying effects in joints affected by osteoarthritis (OA).
METHODS: A systematic review was performed on three electronic databases (PubMed, Web of Science, Embase) according to PRISMA guidelines. A synthesis of the results was performed investigating disease-modifying effects in preclinical studies comparing injectable adipose-derived products with OA controls or other products, different formulations or injection intervals, and the combination with other products. The risk of bias was assessed according to the SYRCLE\'s tool.
RESULTS: Seventy-one studies were included (2,086 animals) with an increasing publication trend over time. Expanded cells were used in 65 studies, 3 studies applied point of care products, and 3 studies investigated both approaches. Overall, 48 out of 51 studies (94%) reported better results with adipose-derived products compared to OA controls, with positive findings in 17 out of 20 studies (85%) in macroscopic, in 37 out of 40 studies (93%) in histological, and in 22 out of 23 studies (96%) in immunohistochemical evaluations. Clinical and biomarker evaluations showed positive results in 14 studies out of 18 (78%) and 12 studies out of 14 (86%), while only 9 studies out of 17 (53%) of the imaging evaluations were able to detect differences versus controls. The risk of bias was low in 38% of items, unclear in 51%, and high in (11%).
CONCLUSIONS: The current preclinical models document consistent evidence of disease-modifying effects of adipose-derived cell-based therapies for the treatment of OA. The high heterogeneity of the published studies highlights the need for further targeted research to provide recommendations on the optimal methodologies for a more effective application of these injective therapies for the treatment of OA in clinical practice.
METHODS: II.
METHODS: A systematic review was performed on three electronic databases (PubMed, Web of Science, Embase) according to PRISMA guidelines. A synthesis of the results was performed investigating disease-modifying effects in preclinical studies comparing injectable adipose-derived products with OA controls or other products, different formulations or injection intervals, and the combination with other products. The risk of bias was assessed according to the SYRCLE\'s tool.
RESULTS: Seventy-one studies were included (2,086 animals) with an increasing publication trend over time. Expanded cells were used in 65 studies, 3 studies applied point of care products, and 3 studies investigated both approaches. Overall, 48 out of 51 studies (94%) reported better results with adipose-derived products compared to OA controls, with positive findings in 17 out of 20 studies (85%) in macroscopic, in 37 out of 40 studies (93%) in histological, and in 22 out of 23 studies (96%) in immunohistochemical evaluations. Clinical and biomarker evaluations showed positive results in 14 studies out of 18 (78%) and 12 studies out of 14 (86%), while only 9 studies out of 17 (53%) of the imaging evaluations were able to detect differences versus controls. The risk of bias was low in 38% of items, unclear in 51%, and high in (11%).
CONCLUSIONS: The current preclinical models document consistent evidence of disease-modifying effects of adipose-derived cell-based therapies for the treatment of OA. The high heterogeneity of the published studies highlights the need for further targeted research to provide recommendations on the optimal methodologies for a more effective application of these injective therapies for the treatment of OA in clinical practice.
METHODS: II.
摘要：
目的：本系统综述的目的是确定脂肪组织来源的基于细胞的注射疗法是否可以在受骨关节炎（OA）影响的关节中诱导疾病缓解作用。
方法：对三个电子数据库（PubMed，WebofScience,Embase)根据PRISMA指南。对结果进行了综合研究，研究了临床前研究中的疾病改善作用，将可注射的脂肪衍生产品与OA对照或其他产品进行比较。不同的配方或注射间隔，以及与其他产品的结合。根据SYRCLE的工具评估偏倚风险。
结果：纳入了71项研究（2,086只动物），随着时间的推移，其发表趋势不断增加。扩增的细胞用于65项研究，3项研究应用了护理产品，3项研究调查了这两种方法。总的来说,51项研究中有48项（94％）报告了与OA对照相比，脂肪衍生产品的结果更好。在20项宏观研究中的17项(85%)得到了积极的结果，在40项组织学研究中的37项（93%），在23项研究中的22项（96％）进行了免疫组织化学评估。临床和生物标志物评估在18项研究中的14项(78%)和14项研究中的12项(86%)中显示出阳性结果。而17项影像学评估中只有9项(53%)能够检测出与对照组的差异.在38%的项目中，偏倚的风险很低，51%不清楚，高（11%）。
结论：当前的临床前模型记录了基于脂肪来源的细胞疗法治疗OA的疾病改善作用的一致证据。已发表研究的高度异质性突出了需要进一步的针对性研究，以提供有关最佳方法的建议，以便在临床实践中更有效地应用这些注射疗法来治疗OA。
方法：II.
方法：对三个电子数据库（PubMed，WebofScience,Embase)根据PRISMA指南。对结果进行了综合研究，研究了临床前研究中的疾病改善作用，将可注射的脂肪衍生产品与OA对照或其他产品进行比较。不同的配方或注射间隔，以及与其他产品的结合。根据SYRCLE的工具评估偏倚风险。
结果：纳入了71项研究（2,086只动物），随着时间的推移，其发表趋势不断增加。扩增的细胞用于65项研究，3项研究应用了护理产品，3项研究调查了这两种方法。总的来说,51项研究中有48项（94％）报告了与OA对照相比，脂肪衍生产品的结果更好。在20项宏观研究中的17项(85%)得到了积极的结果，在40项组织学研究中的37项（93%），在23项研究中的22项（96％）进行了免疫组织化学评估。临床和生物标志物评估在18项研究中的14项(78%)和14项研究中的12项(86%)中显示出阳性结果。而17项影像学评估中只有9项(53%)能够检测出与对照组的差异.在38%的项目中，偏倚的风险很低，51%不清楚，高（11%）。
结论：当前的临床前模型记录了基于脂肪来源的细胞疗法治疗OA的疾病改善作用的一致证据。已发表研究的高度异质性突出了需要进一步的针对性研究，以提供有关最佳方法的建议，以便在临床实践中更有效地应用这些注射疗法来治疗OA。
方法：II.
