Human Umbilical Cord Mesenchymal Stem Cells Over Platelet Rich Fibrin Scaffold for Mandibular Cartilage Defects Regenerative Medicine

Ni Putu Mira  Sumarta; David Buntoro  Kamadjaja; Nike  Hendrijantini; Coen Pramono  Danudiningrat; Fedik Abdul  Rantam

Authors

Ni Putu Mira Sumarta
David Buntoro Kamadjaja
Nike Hendrijantini
Coen Pramono Danudiningrat
Fedik Abdul Rantam

Keywords:

Mesenchymal Stem Cells, Cord Blood Stem Cell Transplantation, Cartilage

Abstract

Objective: To evaluate the regeneration of mandibular cartilage defect after implantation of human umbilical cord mesenchymal stem cells (hUCMSC) over platelet rich fibrin (PRF) as scaffold. Material and Methods: 20 male Wistar rats were randomly divided into four experimental groups consisting of: a control group featuring untreated mandibular defects (C), experimental groups whose mandibular defects were implanted with hUCMSC (E1), mandibular defects implanted with PRF (E2), mandibular defects implanted with hUCMSC and PRF scaffold (E3). The subjects were sacrificed after six weeks of observation for immunohistochemical examination in order to evaluate the expression of Ki67, Sox9, FGF 18, type 2 collagen, and aggrecan, in addition to histology examination to evaluate chondrocyte number and cartilage thickness. Data was analyzed with univariate analysis (ANOVA). Results: The implantation of hUCMSC and PRF scaffold proved capable of regenerating mandibular cartilage defect through the expression of FGF 18, Sox9, Ki67, chondrosis counts, type 2 collagen, aggrecan, and cartilage thickness. The regeneration were significantly higher in group E3. Conclusion: Human umbilical cord mesenchymal stem cells in platelet rich fibrin scaffold proved capable of regenerating mandibular cartilage defect.

References

Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res 2008; 87(4):296-307. https://doi.org/10.1177/154405910808700406

Naujoks C, Meyer U, Weismann HP, Jäsche-Meyer J, Hohoff A, Depprich R et al. Principles of cartilage tissue engineering in TMJ reconstruction. Head Face Med 2008; 4(3):1-7. https://doi.org/10.1186/1746-160x-4-3

Learreta JÁ, Yavich LG. Structural modifications of the mandibular condylar process as one of the sequels of traumatism in infancy. J Cranio-Maxillofac Dis 2014; 3(2):85-8. https://doi.org/10.4103/2278-9588.138216

Goldring MB, Otero M, Plumb DA, Dragomir C, Favero M, El Hachem K, et al. Roles of inflamatory and anabolic cytokines in cartilage metabolism: signals and multiple effectors converge upon MMP-13 regulation in osteoarthritis. Eur Cell Mater 2011; 21:202-20. https://doi.org/10.22203/ecm.v021a16

Punwar S, Khan WS. Mesenchymal stem cells and articular cartilage repair: clinical studies and future direction. Open Orthop J 2011; 5(Suppl 2):296-301. https://doi.org/10.2174/1874325001105010296

Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 1994; 331(14):889-95. https://doi.org/10.1056/nejm199410063311401

Krampera M, Franchini M, Pizzolo G, Aprili G. Mesenchymal stem cells: from biology to clinical use. Blood transfus 2007; 5(3):120-9. https://doi.org/10.2450/2007.0029-07

Vinatier C, Mrugala D, Jorgensen C, Guicheux J, Noël D. Cartilage engineering: a crucial combination of cells, biomaterials and biofactors. Trends Biotechnol 2009; 27(5):307-14. https://doi.org/10.1016/j.tibtech.2009.02.005

Lindenmair A, Hatlapatka T, Kollwig G, Hennerbichler S, Gabriel C, Wolbank S, et al. Mesenchymal stem or stromal cells from amnion and umbilical cord tissue and their potential for clinical applications. Cells 2012; 1(4):1061-88. https://doi.org/10.3390/cells1041061

Baek HS, Lee HS, Kim BJ, Chung IK, Kim CH, Jin SM, et al. Effect of platelet-rich fibrin on repair of defect in the articular disc in rabbit temporomandibular joint by platelet-rich fibrin. Tissue Eng Reg Med 2011; 8(6):530-5.

Fortier LA, Barker JU, Strauss EJ, McCarrel TM, Cole BJ. The role of growth factors in cartilage repair. Clin Orthop Relat Res 2011; 469(10):2706-15. https://doi.org/10.1007/s11999-011-1857-3

Saluja H, Dehane V, Mahindra U. Platelet-rich fibrin: a second generation platelet concentrate and a new friend of oral and maxillofacial surgery. Ann Maxillofac Surg 2011; 1(1):53-7. https://doi.org/10.4103/2231-0746.83158

Kütük N, Baş B, Soylu E, Gӧnen ZB, Yilmaz C, Balcioğlu E, et al. Effect of platelet-rich plasma on fibrocartilage, cartilage, and bone repair in the temporomandibular joint. J Oral Maxillofac Surg 2014; 72(2):277-84. https://doi.org/10.1016/j.joms.2013.09.011

Sumarta NPM, Pramono DC, Hendrianto E, Susilowati H, Karsari D, Rantam FA. Chondrogenic differentiation capacity of human umbilical cord mesenchymal stem cells with platelet rich fibrin scaffold in cartilage regeneration (in vitro study). Bali Med J 2016; 5(3):420-6. https://doi.org/10.15562/bmj.v5i3.295

Hotwani K, Sharma K. Platelet rich fibrin - a novel acumen into regenerative endodontic therapy. Restor Dent Endod 2014; 39(1):1-6. https://doi.org/10.5395/rde.2014.39.1.1

Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet rich fibrina (PRF): A second-generation platelet concentrate. Part IV: Clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101(3):E56-60. https://doi.org/10.1016/j.tripleo.2005.07.011