间充质干细胞(MSC)是几种骨科适应症的有前途的基于细胞的疗法治疗选择。由于MSC的文化扩张是时间和成本密集型的,使用床边浓度的骨髓(BM)抽吸物作为替代方案。许多商用系统是可用的,但是关于这些系统的可用文献和知识是有限的。我们通过关注技术特征和质量参数来比较集中BM(BMC)的不同护理点设备,以帮助外科医生在选择适当设备的同时做出明智的决定。
我们比较了动脉细胞BMC装置的公开数据,Arthrex,Celling生物科学,EmCyte,Exactech,ISTOTech,收获技术/TerumoBCT,和Zimmer/BIOMET关于技术特征(离心速度/时间,输入/输出音量,套件组件,抽吸式注射器的类型,过滤器使用)和最终BMC产品的质量参数(血细胞比容,血小板和总有核细胞的浓度,MSC和结缔组织祖细胞的浓度)。
系统的技术特征和离心参数有很大不同。只有全自动系统使用通用套件,这允许处理不同体积的BM。只有Arthrex系统允许选择最终的血细胞比容。没有标准化的报告方法来描述生物学效能。
根据本评论获得的数据,由于无法在设备之间比较报告的数据,因此无法推荐单个设备。为了进行有效的比较,需要一种标准化的报告方法。此外,临床结果需要确定这些系统的真实疗效.我们正在进行其他研究,以便在设备之间进行更仔细的比较。
Mesenchymal stem cells (MSCs) are a promising cell-based therapy treatment option for several orthopedic indications. Because culture expansion of MSC is time and cost intensive, a bedside concentration of bone marrow (BM) aspirate is used as an alternative. Many commercial systems are available but the available literature and knowledge regarding these systems is limited. We compared different point-of-care devices that concentrate BM (BMC) by focusing on technical features and quality parameters to help surgeons make informed decisions while selecting the appropriate device.
We compared published data on the BMC devices of Arteriocyte, Arthrex, Celling Biosciences, EmCyte, Exactech, ISTO Tech, Harvest Tech/Terumo BCT, and Zimmer/BIOMET regarding technical features (centrifugation speed/time, input/output volume, kit components, type of aspiration syringes, filter usage) and quality parameters of their final BMC product (hematocrit, concentration of platelets and total nucleated cells, concentration of MSC and connective tissue progenitor cells).
The systems differ significantly in their technical features and centrifugation parameters. Only the fully automated systems use universal kits, which allow processing different volumes of BM. Only the Arthrex system allows selection of final hematocrit. There was no standardized reporting method to describe biologic potency.
Based on the data obtained in this
review, recommending a single device is not possible because the reported data could not be compared between devices. A standardized reporting method is needed for valid comparisons. Furthermore, clinical outcomes are required to establish the true efficacy of these systems. We are conducting additional studies for more careful comparison among the devices.