Synergistic effect of carboxymethyl chitosan and adipose-derived mesenchymal stem cells on osteoarthritis model in rabbits

The purpose of this study is to investigate the clinical effects of carboxymethyl chitosan (CMC) and adipose-derived mesenchymal stem cells (MSCs) on osteoarthritis (OA). Thirty New Zealand white rabbits were used as cranial cruciate ligament transection and partial meniscectomy models. The rabbits were divided into five groups (n = 6) according to the intra-articular injection materials: the control group with PBS, the HA group with hyaluronic acid, the CMC group with CMC, the MSC group with MSCs emerged in PBS, and the MSC+CMC group with CMC and MSCs. Knee thickness, extension angle, gross morphology, histopathology and immunohistochemistry were performed to evaluate the effects of CMC and MSCs on rabbit OA. On the morphologic and histologic examination, the articular surfaces of the femur and tibia were markedly damaged in control group with higher Mankin score and lower cartilage surface thickness. However, OA related cartilage defects were alleviated by the treatment of MSC and/ or CMC. The expressions of apoptotic and inflammatory cytokines were decreased and cartilage extracellular matrix (ECM) related collagens I and II were enhanced by the treatment of MSC and/or CMC. In conclusion, this study showed that CMC and MSC treatments have a beneficial effects on OA via the protection of cartilage damage, the stimulation of ECM, and the inhibition of inflammatory and apoptotic reaction.