Methods and compositions for optimized expansion and implantation of mesenchymal stem cells
Compositions and methods are provided for the optimized expansion and implantation of mesenchymal stem cells into a patient in need thereof. Autologous mesenchymal stem cells (MSCs) to a patient in need of MSCs are harvested, expanded within novel growth parameters under the influence of autologous growth factors located on the patient's platelets.
1. A method of expanding mesenchymal stem cells (MSCs) in vitro for use in an implant to regenerate cartilage, the method comprising:
(a) obtaining (MSCs) from an older patient in the 5 th to 7 th decade of life who is diagnosed with osteoarthritis, avascular necrosis, or severe degenerative joint disease;
(b) expanding the MSCs with a growth medium comprising the patient's platelet lysate in an initial amount of 5 and less than 15% of the growth medium for at least one passage to obtain at least 10 million to 100 million cells;
(c) determining whether the MSCs of step (b) have one or more of the following parameters:
(i) a doubling time of greater than 3 days;
(ii) a cellular confluence greater than 23 calculated according to the equation
Surface area×(% Confluence)/Cell Number;
(iii) a clumped or uneven distribution of MSCs as a monolayer culture; or
(iv) greater than 30% of MSCs without a spindle shape; and
(d) adjusting the growth medium in the following passages when the MSCs have at least one parameter in step (c) by at least one of: adjusting the amount of platelet lysate in the growth medium to 15-20%, or by reseeding the MSCs at a higher density than used in step (b);
wherein the expanded MSCs with no later than the tenth ex-vivo passage are capable of regenerating new cartilage when implanted into the patient at a site in need thereof.
2. The method of claim 1 further comprising implanting the expanded MSC into a site in need thereof and in-vivo monitoring of the site in the patient after implantation of expanded MSCs.
3. The method of claim 1 further comprising injecting platelets or platelet lysate directly into the site of the patient during or after implantation of the expanded MSCs to further facilitate MSC expansion.
4. The method of claim 1 wherein the MSCs are expanded up to a 7 th ex-vivo passage.
5. The method of claim 1 wherein the site in need thereof is a degenerated joint.
6. The method of claim 1 wherein the obtaining MSCs from the patient comprises a marrow draw technique, wherein the marrow draw technique comprises taking one or more 1-10 ml draws to boost MSC yield.
7. The method of claim 2 , wherein the in-vivo monitoring includes direct visualization of the site being treated surgically and/or arthroscopically.
8. The method of claim 1 , wherein the step of adjusting the culture conditions comprises reseeding the MSC at a higher density of about 12 ×10 3 to 15 ×10 3 cells/cm 2 .