Bone Marrow and Peripheral Blood Mononuclear Cell Phenotype Changes after Cultivation and Autologous Infusion in Patients with Primary Biliary Cholangitis.

Background: Primary biliary cholangitis (PBC) is a condition affecting the liver and immune system. In this study, the impact of autologous bone marrow-derived mononuclear cell (BM-MNC) transplantation on PBC patients was investigated. Methods: Sixteen eligible PBC patients participated at the National Scientific Medical Center in Astana, Kazakhstan, between 2017 and 2022, and BM-MNCs were harvested from their anterior iliac crest. After isolating and cultivating the BM-MNCs, they were infused back into the patient's peripheral veins. Changes in BM-MNC and peripheral blood mononuclear cell (PB-MNC) phenotypes were assessed before and after a 24-hour cultivation period and 72 hours post-transplantation. We monitored liver function parameters over 6-month intervals and conducted flow cytometry analysis to assess CD markers on BM-MNCs before and after cultivation and PB-MNCs before and after transplantation. Statistical analysis included the Friedman test for liver parameters and the Wilcoxon signed-rank test for BM-MNC and PB-MNC comparisons. Results: Our findings revealed significant reductions in liver function tests after multiple transplantations. Flow cytometry analysis before and after a 24-hour culture and autologous BM-MNC infusion revealed the expansion of specific cell populations, with significant increases in CD3+, CD4+, CD16+, CD20+, CD25+, CD34+, CD105+, CD73+, СD117+, and CD34+populations, while CD4+25+, CD34+105+, and CD4+FOXP3+ populations decreased. Interestingly, a contradictory finding was observed with a decrease in bone marrow CD34+105+ cell lines (P=0.03) alongside an increase in peripheral CD34+105+ population (P=0.03). Conclusion: In summary, our study shows that BM-MNC transplantation in PBC patients leads to changes in immune cell populations and liver function. These findings suggest potential therapeutic applications of BM-MNC transplantation in managing PBC and offer insights into the dynamics of immune cells associated with this treatment approach.

[Avascular necrosis of the femoral head after COVID-19: clinical presentation and management. Clinical-functional outcomes of decompression and supplementation with bone marrow cell aspirate]. / Necrosis avascular de la cabeza femoral tras COVID-19: presentación clínica y manejo. Resultados clínico-funcionales de descompresión y suplementación con aspirado de células de médula ósea.

INTRODUCTION: the pandemic of COVID-19 has led to clinical complications such as avascular necrosis of the femoral head (AVNFH) associated with the use of corticosteroids. The aim of the study is to report the functional and radiographic results of 13 patients with post-COVID-19 ANFH after decompression using Forage and bone marrow aspirate concentrate (BMAC). MATERIAL AND METHODS: single-center, prospective, uncontrolled clinical study. From April 2020 to September 2021, 13 patients (21 hips) with post-COVID-19 ANFH were treated. All received corticosteroids during infection (average daily dose: 480 mg). Clinical, radiographic and magnetic resonance imaging evaluations were performed; the Ficat classification was applied for the classification of AVNFH. The surgical technique used was decompression with Forage and ACMO. RESULTS: the mean age was 47 years, with a follow-up of 30.4 months. Symptoms appeared with a mean of 4.2 months after COVID-19 infection. Harris score improved from 41.2 ± 5.2 to 86.6 ± 3.4. Radiographic evaluation showed that 14.3% of the sample experienced femoral head collapse and underwent total hip arthroplasty. CONCLUSIONS: post-COVID-19 ANFH is a clinical entity with rapid progression and different degrees of severity. Decompression with Forage and ACMO seems a promising initial treatment, however, the variable response and the probability of collapse emphasize the importance of long-term follow-up and identification of patients who may require additional interventions.

INTRODUCCIÓN: la pandemia de COVID-19 ha dado lugar a complicaciones clínicas como la necrosis avascular de la cabeza femoral (NAVCF) asociada con el uso de corticoesteroides. El objetivo del estudio es reportar los resultados funcionales y radiográficos de 13 pacientes con NAVCF post-COVID-19, después de la descompresión utilizando Forage y aspirado de células de medula ósea (ACMO). MATERIAL Y MÉTODOS: estudio clínico unicéntrico, prospectivo, no controlado. Desde Abril de 2020 hasta Septiembre de 2021, se trataron 13 pacientes (21 caderas) con NAVCF post-COVID-19. Todos recibieron corticoesteroides durante la infección (dosis promedio diaria: 480 mg). Se realizaron evaluaciones clínicas, radiográficas y por resonancia magnética nuclear; se aplicó la clasificación de Ficat para la clasificación de NAVCF. La técnica quirúrgica empleada fue descompresión con Forage y ACMO. RESULTADOS: la edad promedio fue 47 años, con un seguimiento de 30.4 meses. Los síntomas aparecieron con una media de 4.2 meses después de la infección por COVID-19. La escala de Harris mejoró de 41.2 ± 5.2 a 86.6 ± 3.4. La evaluación radiográfica demostró que 14.3% de la muestra experimentó colapso de la cabeza femoral por lo que se les realizó artroplastía total de cadera. CONCLUSIONES: la NAVCF post-COVID-19 es una entidad clínica con rápida progresión y diferentes grados de severidad. La descompresión con Forage y ACMO parece un tratamiento inicial prometedor; sin embargo, la respuesta variable y la probabilidad de colapso, enfatizan la importancia de seguimiento a largo plazo e identificación de los pacientes que puedan requerir intervenciones adicionales.

A case series utilizing bone marrow aspirate concentrate, cancellous bone autograft, platelet-rich plasma and autologous fibrin for the treatment of femur nonunions.

Aim: To assess the efficacy of a bioregenerative scaffold derived from bone marrow aspirate, cancellous bone autograft, platelet-rich plasma and autologous fibrin in treating supracondylar femur nonunions. Methods & materials: Three patients with nonunions following multiple surgical failures underwent bone stabilization and the application of a novel bioregenerative scaffold. x-rays and subjective scales were collected before surgery and at 6, 12 and 24 months post-surgery. Results: All nonunions exhibited healing with sufficient callus formation, as confirmed radiologically. After 6 months, all patients resumed full weight-bearing walking without pain. Statistical analysis showed improvements in all scales compared with pre-surgical values. Conclusion: This method presents itself as an option for treating supracondylar femur nonunions following multiple surgical failures.

What is this summary about? The objective of this case series study was to evaluate the effectiveness of a new biological autologous scaffold, comprised of stem and blood cells along with blood derivatives, in treating challenging cases of supracondylar femur nonunions.What were the results? Three participants underwent the application of this surgical method and were monitored for a period of 2 years. The therapy was well tolerated and deemed safe. Notably, all three patients experienced significant reductions in pain and improvements in functionality. Within a few months, they were able to walk with full weightbearing without pain, and clear indications of progressing toward bone union were evident by the 6 months.What do the results mean? This study demonstrates that the surgical application of autologous blood, cancellous bone and bone marrow, following the described concept and method, is an effective, safe and enduring treatment for femur nonunions. It markedly diminishes pain, enhances leg function and yields statistically significant improvements in quality of life.