Tratamento da epicondilite lateral com células-tronco mesenquimais: uma revisão narrativa

Autores

DOI:

https://doi.org/10.33448/rsd-v11i16.37965

Palavras-chave:

Cotovelo de Tenista; Células-Tronco Mesenquimais; Células da medula óssea.

Resumo

As doenças dos tendões são frequentemente observadas na prática clínica, ainda mais em atletas. Essa doença pode ser acompanhada de uma dor musculoesquelética incapacitante, sendo de grande impacto na vida dos pacientes. Apesar das diversas formas de tratamento do LE, a maioria dos resultados não é satisfatória, e não há evidências de uma terapia mais eficaz que o placebo ou nenhum tratamento. Assim, ao longo das últimas décadas, surgiram novas perspectivas para o manejo da LE, como a terapia com células-tronco mesenquimais (CTMs), que demonstrou resultados promissores em um bom número de estudos. Este estudo apresenta-se com o objetivo de revisar a literatura existente sobre o uso de células-tronco mesenquimais como tratamento da epicondilite lateral, resumindo as evidências clínicas existentes e avaliando sua eficácia, de modo a criar uma visão clara das pesquisas atuais e seus avanços na tal terapia. Revisar a literatura sobre a eficácia do uso de células-tronco no tratamento da epicondilite lateral. A revisão ocorreu em julho de 2022, utilizando publicações originais e de alto nível de evidência científica nas bases de dados MEDLINE e Cochrane Library. Também foram analisadas as referências nas quais os estudos se basearam. Foram selecionados cinco estudos prospectivos que avaliaram a eficácia das células-tronco mesenquimais na epicondilite lateral e outras doenças do tendão. Todos os estudos concluíram que houve uma recuperação significativa da tendinopatia. Embora os estudos mostrem potencial terapêutico das células-tronco mesenquimais para o tratamento da epicondilite lateral, a falta de ensaios clínicos dificulta a determinação de que tipo de transplante deve ser feito, de onde as células devem vir e quantas células são ideais para uso clínico.

Referências

Aydın, A., & Atiç, R. (2018). Comparison of extracorporeal shock-wave therapy and wrist-extensor splint application in the treatment of lateral epicondylitis: a prospective randomized controlled study. Journal of Pain Research, Volume 11, 1459–1467. https://doi.org/10.2147/jpr.s166679

Barros, A. J. S., & Lehfeld, N. A. S. (2000) Fundamentos de metodologia científica: um guia para a iniciação científica.Makron Editora.

Branson, R., et al. (2017). Comparison of corticosteroid, autologous blood or sclerosant injections for chronic tennis elbow. Journal of Science and Medicine in Sport, 20(6), 528–533. https://doi.org/10.1016/j.jsams.2016.10.010

Cho, W. S., et al. (2021). Mesenchymal Stem Cells Use in the Treatment of Tendon Disorders: A Systematic Review and Meta-Analysis of Prospective Clinical Studies. Annals of Rehabilitation Medicine, 45(4), 274–283. https://doi.org/10.5535/arm.21078

Evans, J. P., et al. (2019). Patient-centred outcomes in lateral elbow tendinopathy: A systematic review of available evidence in UK populations. Shoulder & Elbow, 11(6), 440–449. https://pubmed.ncbi.nlm.nih.gov/32269604/

Fujihara, Y., et al. (2018). The Effect of Impactful Articles on Clinical Practice in the United States. Plastic and Reconstructive Surgery, 141(5), 1183–1191. https://doi.org/10.1097/prs.0000000000004317

Gianakos, A. L., et al. (2017). Clinical application of concentrated bone marrow aspirate in orthopaedics: A systematic review. World Journal of Orthopedics, 8(6), 491. https://doi.org/10.5312/wjo.v8.i6.491

Hare, J. M., et al. (2012). Comparison of allogeneic vs autologous bone marrow–derived mesenchymal stem cells delivered by transendocardial injection in patients with ischemic cardiomyopathy: the POSEIDON randomized trial. JAMA, 308(22), 2369–2379. https://doi.org/10.1001/jama.2012.25321

Havlas, V., et al. (2015). [Use of cultured human autologous bone marrow stem cells in repair of a rotator cuff tear: preliminary results of a safety study]. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, 82(3), 229–234. https://pubmed.ncbi.nlm.nih.gov/26317295/

Houck, D. A., et al. (2019). Treatment of Lateral Epicondylitis With Autologous Blood, Platelet-Rich Plasma, or Corticosteroid Injections: A Systematic Review of Overlapping Meta-analyses. Orthopaedic Journal of Sports Medicine, 7(3), 232596711983105. https://doi.org/10.1177/2325967119831052

Imam, M. A., et al. (2017). A systematic review of the concept and clinical applications of Bone Marrow Aspirate Concentrate in Orthopaedics. SICOT-J, 3, 17. https://doi.org/10.1051/sicotj/2017007

Imam, M. A., et al. (2017). A systematic review of the concept and clinical applications of bone marrow aspirate concentrate in tendon pathology. SICOT-J, 3, 58. https://doi.org/10.1051/sicotj/2017039

Itro, A., et al. (2022). Why Use Adipose-Derived Mesenchymal Stem Cells in Tendinopathic Patients: A Systematic Review. Pharmaceutics, 14(6), 1151. https://doi.org/10.3390/pharmaceutics14061151

Lee, S. Y., et al. (2015). Treatment of Lateral Epicondylosis by Using Allogeneic Adipose-Derived Mesenchymal Stem Cells: A Pilot Study. STEM CELLS, 33(10), 2995–3005. https://doi.org/10.1002/stem.2110

Lenoir, H., Mares, O., & Carlier, Y. (2019). Management of lateral epicondylitis. Orthopaedics & Traumatology: Surgery & Research, 105(8). https://doi.org/10.1016/j.otsr.2019.09.004

Linnanmäki, L., et al. (2020). Platelet-rich Plasma or Autologous Blood Do Not Reduce Pain or Improve Function in Patients with Lateral Epicondylitis: A Randomized Controlled Trial. Clinical Orthopaedics & Related Research, 478(8), 1892–1900. https://doi.org/10.1097/corr.0000000000001185

Lu, V., et al. (2021). Mesenchymal Stem Cell-Derived Extracellular Vesicles in Tendon and Ligament Repair—A Systematic Review of In Vivo Studies. Cells, 10(10), 2553. https://doi.org/10.3390/cells10102553

Pascual-Garrido, C., Rolón, A., & Makino, A. (2012). Treatment of Chronic Patellar Tendinopathy with Autologous Bone Marrow Stem Cells: A 5-Year-Followup. Stem Cells International, 2012, 1–5. https://doi.org/10.1155/2012/953510

Jo, C. H., et al. (2018). Intratendinous Injection of Autologous Adipose Tissue-Derived Mesenchymal Stem Cells for the Treatment of Rotator Cuff Disease: A First-In-Human Trial. STEM CELLS, 36(9), 1441–1450. https://doi.org/10.1002/stem.2855

Rhatomy, S., et al. (2020). Prospect of stem cells conditioned medium (secretome) in ligament and tendon healing: A systematic review. STEM CELLS Translational Medicine, 9(8), 895–902. https://doi.org/10.1002/sctm.19-0388

Singh, A., Gangwar, D., & Singh, S. (2014). Bone marrow injection: A novel treatment for tennis elbow. Journal of Natural Science, Biology and Medicine, 5(2), 389. https://doi.org/10.4103/0976-9668.136198

Torres-Torrillas, M., et al. (2019). Adipose-Derived Mesenchymal Stem Cells: A Promising Tool in the Treatment of Musculoskeletal Diseases. International Journal of Molecular Sciences, 20(12), 3105. https://doi.org/10.3390/ijms20123105

Trebinjac, S., & Gharairi, M. (2020). Mesenchymal Stem Cells for Treatment of Tendon and Ligament Injuries-clinical Evidence. Medical Archives, 74(5), 387. https://doi.org/10.5455/medarh.2020.74.387-390

van den Boom, N. A. C., et al. (2020). Efficacy of Stem Cell Therapy for Tendon Disorders: A Systematic Review. Orthopaedic Journal of Sports Medicine, 8(4), 2325967120915857. https://doi.org/10.1177/2325967120915857

Yao, G., et al. (2020). Efficacy of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis: A Systematic Review and Meta-Analysis. BioMed Research International, 2020, 1–8. https://doi.org/10.1155/2020/2064781

Young, M. (2012). Stem Cell Applications in Tendon Disorders: A Clinical Perspective. Stem Cells International, 2012, 1–10. https://doi.org/10.1155/2012/637836

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Publicado

01/12/2022

Como Citar

STECCA, T. M. .; SILVA, E. L. D. da .; ROCHA, F. A. .; SOUZA, F. M. de .; SILVEIRA JUNIOR, P. F. A. da .; VIEIRA JÚNIOR, R. F. .; GEHHLEN, S. H. J. . Tratamento da epicondilite lateral com células-tronco mesenquimais: uma revisão narrativa. Research, Society and Development, [S. l.], v. 11, n. 16, p. e96111637965, 2022. DOI: 10.33448/rsd-v11i16.37965. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/37965. Acesso em: 23 dez. 2024.

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Ciências da Saúde