Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways, safety and efficacy – a review

Abstract

Osteoarthritis is a leading cause of pain and disability across the world. With an aging population its prevalence is likely to further increase. Current accepted medical treatment strategies are aimed at symptom control rather than disease modification. Surgical options including joint replacement are not without possible significant complications. A growing interest in the area of regenerative medicine, led by an improved understanding of the role of mesenchymal stem cells in tissue homeostasis and repair, has seen recent focused efforts to explore the potential of stem cell therapies in the active management of symptomatic osteoarthritis. Encouragingly, results of pre-clinical and clinical trials have provided initial evidence of efficacy and indicated safety in the therapeutic use of mesenchymal stem cell therapies for the treatment of knee osteoarthritis. This paper explores the pathogenesis of osteoarthritis and how mesenchymal stem cells may play a role in future management strategies of this disabling condition.

Emerging Potential of Cell Based Therapies for Articular Cartilage Repair and Regeneration

“…Therefore, treatment with MSC have been actively explored in the field of tissue engineering and cartilage repair. 7 Regardless of the MSC origin, they have the capacity to differentiate into many cell types depending on the environment, stimuli and culture conditions used, including cells of connective tissue lineages such as bone, fat, cartilage and muscle. 41,42 Also, MSCs are promising cell sources for tissue engineering and cellbased therapeutics because of their self-renewal and differentiation ability and are of major interest for researchers in the treatment of arthritis, in particular knee OA.…”

“…3,5 OA can affect any joint, but it most often occurs in the knee, hip, lower back and neck, small joints in the finger and base of the big toe ( Figure 2). 6,7 Osteoarthritis of the knee is the most common chronic condition affecting all races, gender and ages, but known to be the most common in elderly and obese people. 8,9 The knee acts as a conduit for transferring body weight essential for normal human mobility and the menisci is known to maintain the normal function of the knee, distribute load, lubricate the joint and provide joint stability.…”

“…Some studies have not shown any significant improvement in pain and function with disease progression, while some researchers have successfully shown disease modulation. 7 In a monoiodoacetate induced rat model of OA, treatment with intra-articular injections of bone marrow derived MSCs resulted in the animals being able to distribute significantly greater weight through the affected limb. However, in contrast to this functional improvement, no statistically significant difference was observed between the treatment and control groups with respect to cartilage and subchondral bone pathology and synovial inflammation.…”

Cellular therapy, an autologous cellular point of care approach to satisfy patient needs

“…A consequence of this restrictive philosophy, even not consumer friendly policy, in certain countries is, that it favours the growing international medical tourism and the loss of new applied medical PoC know-how in over-regulated countries, while patients wonder each time more why they cannot have the same treatment in their home country [1][2][3][4][5][6][7][8][9].…”

Osteoarthritis and Mesenchymal Stem Cell Therapy: An Overview

“…MSCs are multipotent stem cells that can differentiate toward mesodermal lineage, including osteoblasts, chondrocytes, and adipocytes [38][39][40][41][42][43][44]. The aim in using stem cells is to support the self-healing process of the knee joint cartilage that results in relief from OA symptoms [10].…”