Cell therapy for cartilage repair

Abstract

Regenerative medicine, using cells as therapeutic agents for the repair or regeneration of tissues and organs, offers great hope for the future of medicine. Cell therapy for treating defects in articular cartilage has been an exemplar of translating this technology to the clinic, but it is not without its challenges. These include applying regulations, which were designed for pharmaceutical agents, to living cells. In addition, using autologous cells as the therapeutic agent brings additional costs and logistical challenges compared with using allogeneic cells. The main cell types used in treating chondral or osteochondral defects in joints to date are chondrocytes and mesenchymal stromal cells derived from various sources such as bone marrow, adipose tissue or umbilical cord. This review discusses some of their biology and pre-clinical studies before describing the most pertinent clinical trials in this area.

New Insights into Cartilage Tissue Engineering: Improvement of Tissue-Scaffold Integration to Enhance Cartilage Regeneration

“…Cell therapy of cartilage defects is vastly investigated in preclinical and clinical settings [ 63 ]. Although the short-term outcomes of these studies are pretty compelling, only patients with minimal or surface cartilage injuries benefit from these therapies in long-term [ 64 ].…”

Adipose Stem Cells in Regenerative Medicine: Looking Forward

“…In general, cartilage has a narrow potential for regeneration ( Tiku and Sabaawy, 2015 ). Of the different types of cartilage, articular cartilage is the most common therapy target, with joint injury and osteoarthritis (OA) being the main targets of regenerative medicine ( Hulme et al, 2021 ). Clinical trials using autologous and allogeneic ASCs injections, ASCs-Exo, ASCs-CM to treat knee osteoarthritis have been reported to be well-tolerated and yield positive results in pain amelioration, decreased stiffness, and increased physical function with no severe side effects ( Chen et al, 2021 ).…”

Functionalized Hydrogels for Cartilage Repair: The Value of Secretome-Instructive Signaling

“…Despite the beneficial result obtained with these interventions, the tissue formed is more fibrous cartilage than the original hyaline cartilage, and the surgery may have secondary consequences. New approaches have focused on tissue engineering and regenerative medicine strategies, including using signaling molecules, e.g., platelet-rich plasma or growth factors (GFs), and cell therapy, which may or may not be associated with matrices and scaffolds [ 21 , 22 , 23 , 24 , 25 ]. The main treatment options for cartilage injury and the new approaches are represented in Figure 1 .…”