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Moderní terapie chondrálních defektů kloubů

Název práce v češtině:	Moderní terapie chondrálních defektů kloubů
Název v anglickém jazyce:	Modern therapy of chondral defects
Klíčová slova:	buněčná terapie, defekt chrupavky, kolenní kloub, kmenové buňky, kostní dřeň
Klíčová slova anglicky:	bone marrow, cartilage defect, cell therapy, mesenchymal stem cells, knee joint
Akademický rok vypsání:	2014/2015
Typ práce:	disertační práce
Jazyk práce:	čeština
Ústav:	Klinika dětské a dospělé ortopedie a traumatologie (13-382)
Vedoucí / školitel:	prof. MUDr. Vojtěch Havlas, Ph.D.
Řešitel:	skrytý - zadáno a potvrzeno stud. odd.
Datum přihlášení:	30.03.2015
Datum zadání:	30.03.2015
Datum potvrzení stud. oddělením:	30.03.2015
Datum a čas obhajoby:	06.12.2023 10:00
Datum odevzdání elektronické podoby:	22.09.2023
Datum odevzdání tištěné podoby:	26.09.2023
Datum proběhlé obhajoby:	06.12.2023
Oponenti:	prof. MUDr. Petr Zeman, MBA, Ph.D.
	doc. MUDr. Michal Tuček, Ph.D.

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Předběžná náplň práce

Práce se zabývá aplikací kultivovaných kmenových buněk kostní dřeně v terapii fokálního chondrálního defektu kolenního kloubu. V experimentální části práce bylo cílem kvantitativní a kvalitativní porovnání dvou odběrových míst monocytárních aspirátů kostní dřeně, z ilické kosti a proximální tibie, za účelem určení vhodného buněčného zdroje pro moderní buněčnou terapii. Analýza vzorků prokázala, že množství monocytárních buněk i výtěžnost kmenových buněk ze získaného aspirátu byla signifikantně vyšší z kostní dřeně lopaty kosti kyčelní. Neprokázali jsme signifikantní kvalitativní rozdíly mezi oběma zdroji kmenových buněk. V klinické práci uvádím popis chirurgického postupu a výsledky ročního sledování pacientů po implantaci kultivovaných kmenových buněk z kostní dřeně pánevní kosti, pod označením BiCure®orthoMSCp (Bioinova, Praha, Česká republika), fixovaných na komerčně dostupném 3D nosiči Chondrotissue® (BioTissue AG, Ženeva, Švýcarsko) pomocí koagulované autologní obohacené plazmy. Primární cíl klinické studie zahrnoval vyhodnocení krátkodobé a dlouhodobé bezpečnosti aplikovaného medicínského produktu. Sekundárním cílem práce bylo posoudit účinnost terapie pomocí dotazníkového šetření a posouzení strukturální změny ošetřeného defektu pomocí magnetické rezonance 1 rok od operace. Práce prokazuje bezpečnost a velmi dobrý klinický výsledek léčby fokálního chrupavčitého defektu kolenního kloubu pomocí kultivovaných kmenových buněk z kostní dřeně.

Předběžná náplň práce v anglickém jazyce

The thesis describes the application of cultured bone marrow stem cells in the therapy of focal chondral defect of the knee joint. In the experimental part of the work, the goal was to quantitatively and qualitatively compare two sampling sites of bone marrow monocytic aspirates, the iliac crest bone and the proximal tibia, in order to determine a suitable cell source for advanced cell therapy. The sample analysis showed that the amount of monocytic cells and the yield of stem cells from the aspirate obtained were significantly higher in the bone marrow from the iliac crest. We did not find significant qualitative differences between the two sources of stem cells. In the clinical part of the work, I present a description of the surgical procedure and the results of a 1-year follow-up of patients after the implantation of cultured stem cells from the bone marrow, under the name BiCure® orthoMSCp (Bioinova, Prague, Czech Republic), fixed on a commercially available 3D scaffold Chondrotissue® (BioTissue AG, Geneva, Switzerland) using coagulated autologous platelet-rich plasma. The primary objective of the clinical study included the evaluation of the short-term and long-term safety of the applied medical product. The secondary objective of the work included the assessment of the effectiveness of the therapy using a questionnaire survey and the assessment of structural changes in the treated defect using magnetic resonance 1 year after the operation. The work demonstrates the safety and very good clinical result of the treatment of a focal cartilaginous defect of the knee joint using cultured stem cells from the bone marrow.