Knee osteoarthritis (KOA) affects more than 1 in 10 people over 40 years of age, impairing patients’ mobility and quality of life. With limited treatment options, stem cell injections have been promoted as a treatment option, but evidence of efficacy from clinical trials or claims from clinics selling untested options often lacking. Even where well-designed clinical trials were performed, there was no clear consensus about the benefit of stem cell injections for KOA, likely due to the many variables at play.  

 A major source of variability comes from the cells used for injections. Mesenchymal stromal cells (MSCs), which can be isolated from e.g. fat or bone marrow, are frequently used to treat KOA in clinical studies. Using a patient's own cells reduces the risk of an immune response and any inadvertent transmission of pathogens but the quality and the therapeutic potential of MSCs varies between patients, contributing to heterogeneous treatment outcomes. Predicting MSC potency could be a powerful tool to achieve more consistent therapeutic in such therapeutic settings. 

To tackle the issue of MSC treatment heterogeneity, Sowmya Viswanathan from the Schroeder Arthritis Institute, University Health Institute, Canada, along with colleagues performed a long-term follow-up to a Health Canada-authorized phase I/IIa clinical trial (NCT02351011) with KOA patients receiving MSC injections, whereby the MSCs were derived from the patients’ own bone marrow. The work was published today in Stem Cell Reports.

Cancer immunotherapy using T cells has proven to be effective against certain blood and skin cancers but is less effective in tumors like colorectal cancer, which is one of the most frequent cancers worldwide. One primary consideration with T cell immunotherapy is that it needs to be tailored to each patient individually through time- and cost-intensive, procedures. The procedures involve isolation of a patient’s own T cells, their expansion and genetic engineering to target the cells towards the patient’s cancer cells. This complex process that limits the widespread availability of such treatments. Consequently, an “off-the-shelf” T cell immunotherapy – one that can be universally used safely in any person – that is safe and effective in a wide range of cancer patients, including patients with solid cancers, is highly desirable.