A Comprehensive Review of Stem Cells for Cartilage Regeneration in Osteoarthritis

Abstract

Osteoarthritis (OA) is an age related joint disease associated with degeneration and loss of articular cartilage. Consequently, OA patients suffer from chronic joint pain and disability. Weight bearing joints and joints that undergo repetitive stress and excessive 'wear and tear' are particularly prone to developing OA. Cartilage has a poor regenerative capacity and current pharmacological agents only provide symptomatic pain relief. OA patients that respond poorly to conventional therapies are ultimately treated with surgical procedures to promote cartilage repair by implantation of artificial joint structures (arthroplasty) or total joint replacement (TJR). In the last two decades, stem cells derived from various tissues with varying differentiation and tissue regeneration potential have been used for the treatment of OA either alone or in combination with natural or synthetic scaffolds to aid cartilage repair. Although stem cells can be differentiated into chondrocytes in vitro or aid cartilage regeneration in vivo, their potential for OA management remains limited as cartilage regenerated by stem cells fails to fully recapitulate the structural and biomechanical properties of the native tissue. Efficient tissue regeneration remains elusive despite the simple design of cartilage, which unlike most other tissues is avascular and aneural, consisting of a single cell type. In this article, we have comprehensively reviewed the types of stem cells that have been proposed or tested for the management of OA, their potential efficacy as well as their limitations. We also touch on the role of biomaterials in cartilage tissue engineering and examine the prospects for their use in cell-based therapies.

Glycosaminoglycan and Proteoglycan Biotherapeutics in Articular Cartilage Protection and Repair Strategies: Novel Approaches to Visco‐supplementation in Orthobiologics

“…[431] HA has cell interactive properties and is known to promote cell migration. [47] Transplantation of MSCs seeded in such biomatrices represents a promising strategy [434] given the high proliferative capacity of MSCs and their potential to differentiate into cartilage-producing cells; [435] however, further work is required before this will become a modality suitable for clinical evaluation. [432] Nano-fibres have also been developed which stimulate chondrogenesis and cartilage repair.…”

Inhibition of Osteoarthritis-Related Molecules by Isomucronulatol 7-O-β-d-glucoside and Ecliptasaponin A in IL-1β-Stimulated Chondrosarcoma Cell Model

“…Recently, new biological agents, such as bone morphogenetic protein-7 and growth factors etc., are known to stimulate chondrogenesis, inhibit matrix degradation and reduce inflammation [ 18 ]. However, in addition to an increased side effect such as gastrointestinal, cardiovascular adverse events and complications [ 19 ], these agents have failed to block the progression of OA [ 18 , 20 ]. Therefore, safer and better-tolerated solutions for the treatment of OA need to be developed.…”

Over-Production of Therapeutic Growth Factors for Cartilage Regeneration by Protein Production Platforms and Protein Packaging Cell Lines: A Narrative Review of the Current State-of-the-Art

“…The readers are referred to a series of excellent research and review articles that cover this topic [42,43] including several comprehensive reviews from our own group [44] that discuss the potential for using primary chondrocytes [45] adipose, bone marrow and synovial mesenchymal stromal cells (MSCs) [46][47][48], menstrual blood-derived stem cells [49] and induced pluripotent stem cells (iPSCs) [50]. The most important point to make is that MSCs derived from patients with advanced OA exhibit attenuated chondrogenic activity, suggesting that these cells may be poor candidates for cell-based therapies for OA [51].…”