The therapeutic efficacy of mesenchymal stromal cells (MSCs) has been shown to rely on their immunomodulatory and regenerative properties. In order to obtain sufficient numbers of cells for clinical applications, MSCs have to be expanded ex vivo. Expansion media with xenogeneic-free (XF) growth-promoting supplements like human platelet lysate (PL) or serum- and xenogeneic-free (SF/XF) formulations have been established as safe and efficient, and both groups provide different beneficial qualities. In this study, MSCs were expanded in XF or SF/XF media as well as in mixtures thereof. MSCs cultured in these media were analyzed for phenotypic and functional properties. MSC expansion was optimal with SF/XF conditions when PL was present. Metabolic patterns, consumption of growth factors, and secretome of MSCs differed depending on the type and concentration of supplement. The lactate per glucose yield increased along with a higher proportion of PL. Many factors in the supernatant of cultured MSCs showed distinct patterns depending on the supplement (e.g., FGF-2, TGFβ, and insulin only in PL-expanded MSC, and leptin, sCD40L PDGF-AA only in SF/XF-expanded MSC). This also resulted in changes in cell characteristics like migratory potential. These findings support current approaches where growth media may be utilized for priming MSCs for specific therapeutic applications.

Background: Multiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients. The aim of this study was to investigate the potential of the adipokines leptin, resistin, interleukin-17A and interleukin-33 as possible biomarkers in the early posttraumatic inflammatory response and for identifying severely traumatized patients at risk of developing MODS.Methods: In total, 14 multiple trauma patients with an injury severity score (ISS) ≥ 16 as well as a control group of 14 non-multiple trauma patients were included in this study and blood samples were taken at the time points 0, 6, 24, 48 and 72 h after admission. For the trauma patients, the SIRS and Denver MOF score were determined daily. The quantitative measurement of the plasma concentrations of the adipokines was performed using ELISA.Results: In the statistical analysis, the multiple trauma patients showed statistically significant higher plasma concentrations of leptin, resistin, IL-17A and IL-33 compared to the control group. In addition, there was a statistically significant positive correlation between the concentrations of resistin, IL-17A and IL-33 and the corresponding SIRS scores and between the concentrations of resistin, IL-17A and IL-33 and the corresponding Denver MOF scores. Finally, ROC curve analysis revealed that the adipokines leptin and IL-17A are suitable diagnostic markers for the discrimination between multiple trauma patients with and without MOF.Conclusions: Leptin and IL-17A could be suitable diagnostic markers to identify severely injured patients with a developing SIRS and MOF earlier, to adjust surgical therapy planning and intensive care.

Background: Pathologic fractures of the humerus due to metastatic disease cause severe pain, loss of function and reduced quality of life. Surgical treatment is predominantly palliative and aims to achieve rapid pain relief, early functional recovery and minimal treatment-related morbidity. The photodynamic bone stabilization system (IlluminOss^®) is a minimally invasive, radiolucent, intramedullary device that may address these needs. Methods: This retrospective analysis of prospectively collected data from two centers included 51 patients with 52 pathologic humeral lesions (completed or impending fractures) treated with photodynamic intramedullary stabilization between 2013 and 2025. Baseline variables comprised demographics, Eastern Cooperative Oncology Group (ECOG) performance status, comorbidities, pain (numeric rating scale, NRS) and function (Musculoskeletal Tumor Society Upper Extremity Score, MSTS-UE; Toronto Extremity Salvage Score, TESS). Lesion characteristics, operative details, in-hospital course, follow-up outcomes (TESS, patient satisfaction/quality of life) and long-term endpoints (survival, complications) were recorded. Results: The study cohort (25 women, 26 men; mean age 68.5 years) represented a highly palliative population with advanced, disseminated malignant disease. Of the 52 humeral lesions, 35 (67.3%) presented as pathological fractures, whereas 17 lesions (32.7%) were classified as impending fractures due to extensive osteolysis. Among the impending fractures, Mirels scores ranged from 8 to 10, with three lesions scoring 8, eight lesions scoring 9, and six lesions scoring 10. ECOG performance status was 0–2 in 75.0% and 3–4 in 25.0% of patients. Preoperative pain was high (mean NRS 7.1) and function markedly reduced (median MSTS-UE 9.5/30; median TESS 36.5/100). Postoperatively, pain improved significantly from NRS 7.1 to 2.0 (p < 0.001). MSTS-UE increased from a median of 9.5 to 20 (p < 0.001). Follow-up showed further functional improvement with an increased TESS of 36.5 to 61 (p < 0.001), high patient satisfaction and subjective improvement in quality of life. Kaplan–Meier analysis (n = 44) demonstrated a median survival of 6 months for ECOG 0–2 and 3 months for ECOG 3–4. Implant failure (Henderson type III) occurred four times (7.7%) and was successfully revised with plate and/or screw osteosynthesis or diaphyseal replacement. Conclusions: Photodynamic intramedullary stabilization provides effective treatment for selected pathologic humeral lesions with low implant failure rate, offering rapid pain relief, functional improvement and low perioperative morbidity. Implant failure in complex fracture morphologies highlights the need for morphology-adapted indication and consideration of supplemental fixation in high-risk cases.

BackgroundMultiple organ dysfunction syndrome (MODS) and the consecutive multiple organ failure (MOF) are severe and dreaded complications with a high mortality in multiple trauma patients. The aim of this study was to investigate the potential of the adipokines leptin, resistin, interleukin-17A and interleukin-33 as possible biomarkers in the early posttraumatic inflammatory response and for identifying severely traumatized patients at risk of developing MODS.MethodsIn total, 14 multiple trauma patients with an injury severity score (ISS) ³ 16 as well as a control group of 14 non-multiple trauma patients were included in this study and blood samples were taken at the time points 0, 6, 24, 48 and 72h after admission. For the trauma patients, the SIRS and Denver MOF score were determined daily. The quantitative measurement of the plasma concentrations of the adipokines was performed using ELISA. ResultsIn the statistical analysis, the multiple trauma patients showed statistically significant higher plasma concentrations of leptin, resistin, IL-17A and IL-33 compared to the control group. In addition, there was a statistically significant positive correlation between the concentrations of resistin, IL-17A and IL-33 and the corresponding SIRS scores and between the concentrations of resistin, IL-17A and IL-33 and the corresponding Denver MOF scores. Finally, ROC curve analysis revealed that the adipokines leptin and IL-17A are suitable diagnostic markers for the discrimination between multiple trauma patients with and without MOF. ConclusionsThe results of this study may contribute to identify severely injured patients with a developing SIRS and MOF earlier, in order to adjust therapy strategies.