Cell Therapy and Tissue Engineering for Cartilage Repair

Abstract

The integrity of the articular cartilage is necessary for the proper functioning of the diarthrodial joint. The self-repair capacity of this tissue is very limited and, currently, there is no effective treatment capable of restoring it. The degradation of the articular cartilage leads to osteoarthritis (OA), a leading cause of pain and disability mainly among older people.Different cell treatments have been developed with the aim of forming a repair tissue with the characteristics of native articular cartilage, including cellular therapy and tissue engineering. Cell therapy-based approaches include bone marrow-stimulating techniques, implants of periosteum and perichondrium, ostechondral grafting and implantation of chondrogenic cells as chondrocytes, mesenchymal stem cells or induced pluripotent stem cells. In tissue engineering-based approaches cell-free scaffolds capable of recruiting endogenous cells or chondrogenic cell-loaded scaffolds may be used.However, despite the numerous treatments available nowadays, no technique has been able to consistently regenerate native articular cartilage in clinical trials. Although many cell therapy and tissue engineering studies have shown promising results and clinical improvement, these treatments generate a fibrocartilaginous tissue different from native articular cartilage. More research is needed to improve cell-based approaches and prove its efficacy

Usefulness of Mesenchymal Cell Lines for Bone and Cartilage Regeneration Research

“…Therapeutic options capable of restoring the physiological properties of bone and cartilage are still lacking [1,2]. Due to the increase in life expectancy of the population, the incidence of musculoskeletal disorders, such as fractures, osteoporosis, maxillofacial pathologies, and rheumatic diseases such as osteoarthritis, is rising [3,4]. In this context, tissue engineering has emerged as a potential alternative treatment that could provide biological tissue substitutes for replacing the damaged ones, using scaffolds and cells.…”

“…In this context, tissue engineering has emerged as a potential alternative treatment that could provide biological tissue substitutes for replacing the damaged ones, using scaffolds and cells. However, although many efforts have been made, very few tissue engineering techniques have been translated into clinical practice, and the ideal scaffold for engineering bone and cartilage substitutes has not yet been developed [1,[4][5][6].…”

“…Several clones have been generated and analyzed 3. Not completely immortalized because E6/E7 was sufficient to extend lifespan but not to bypass senescence 4. Probably incompletely immortalized 5 [30,68,69].…”

Versatility of Induced Pluripotent Stem Cells (iPSCs) for Improving the Knowledge on Musculoskeletal Diseases

“…Moreover, the loss of progenitor cells in the intervertebral disc with aging [ 124 , 125 ] or a non-favorable environment for bone-resident MSCs [ 126 ] can lead to the failed tissue repair. Different approaches and strategies were largely developed by either cell therapy (using cells) or tissue engineering (using cells, scaffolds and biofactors) [ 127 ] to try to solve defective tissue regeneration.…”

“…Progenitor cells, responsible for the renewal of most normal tissues in the body, have largely been proposed as the alternative to adult mature cells in therapeutic strategies to treat musculoskeletal disorders [ 127 ]. The use of adult cells presents several challenges, such as variation among donors, dependence of functionality on the donor’s age and health condition, heterogenicity, cell scarcity and the use of invasive techniques to obtain them [ 3 , 31 , 128 ].…”