Mesenchymal stem cells as therapeutic target of biophysical stimulation for the treatment of musculoskeletal disorders

Abstract

BackgroundMusculoskeletal disorders are regarded as a major cause of worldwide morbidity and disability, and they result in huge costs for national health care systems. Traditional therapies frequently turned out to be poorly effective in treating bone, cartilage, and tendon disorders or joint degeneration. As a consequence, the development of novel biological therapies that can treat more effectively these conditions should be the highest priority in regenerative medicine.Main body of the abstractMesenchymal stem cells (MSCs) represent one of the most promising tools in musculoskeletal tissue regenerative medicine, thanks to their proliferation and differentiation potential and their immunomodulatory and trophic ability. Indeed, MSC-based approaches have been proposed for the treatment of almost all orthopedic conditions, starting from different cell sources, alone or in combination with scaffolds and growth factors, and in one-step or two-step procedures. While all these approaches would require cell harvesting and transplantation, the possibility to stimulate the endogenous MSCs to enhance their tissue homeostasis activity represents a less-invasive and cost-effective therapeutic strategy. Nowadays, the role of tissue-specific resident stem cells as possible therapeutic target in degenerative pathologies is underinvestigated. Biophysical stimulations, and in particular extracorporeal shock waves treatment and pulsed electromagnetic fields, are able to induce proliferation and support differentiation of MSCs from different origins and affect their paracrine production of growth factors and cytokines.Short conclusionsThe present review reports the attempts to exploit the resident stem cell potential in musculoskeletal pathologies, highlighting the role of MSCs as therapeutic target of currently applied biophysical treatments.

Pulsed Electromagnetic Fields Improve Tenogenic Commitment of Umbilical Cord-Derived Mesenchymal Stem Cells: A Potential Strategy for Tendon Repair—An In Vitro Study

“…Indeed, the in vivo microenvironment at the lesion site and the presence of the natural inflammatory reaction may cause possible variations with regard to the positive effects of PEMF described in the present work. Albeit several observations in literature are in line with our results [ 8 , 11 , 25 ], the promising effect and the efficacy of the association of PEMF and UC-MSCs need to be further clarified in preclinical studies before any hypothetical clinical applications. Furthermore, UC-MSC culture was performed in a monolayer setting while, during any in vivo conceivable use of the “stem cell therapy,” a scaffold is needed to host the cells and to maintain the cells at the lesion site.…”

“…This perception may suggest a broader application of this technique after common reconstructive orthopaedic procedures as well as rotator cuff reconstruction. Indeed, during the early postoperative period, it is presumable that PEMF may exert both an anti-inflammatory and anabolic effect at the surgical site, by interacting with the endogenous tissue-specific resident MSCs, as suggested by Viganò et al [ 25 ]. Evidence has also been recently shown by Huegel et al [ 8 ] in a preclinical study of acute rotator cuff injury.…”

The effect of pulsed electromagnetic field exposure on osteoinduction of human mesenchymal stem cells cultured on nano-TiO2 surfaces

“…This great interest has emerged because of the multipotent ability of hBM-MSCs to naturally differentiate in several cell lineages, such as chondrocytes, adipocytes and osteoblasts. Noticeably, hBM-MSCs are the most susceptible to osteogenic differentiation among several populations of adult stem cells [ 1 , 2 ]. Cultivation of hBM-MSCs for regenerative purposes is a promising technique, but it requires special and expensive facilities to provide in vitro expansion to obtain an adequate number of cells to be implanted in the injured tissue.…”

Ultrasound-guided Musculoskeletal Interventions for the Most Common Hip and Pelvis Conditions: A Step-by-Step Approach

“…12 PRP should not be used in conjunction with any local anesthetics or steroids because they interfere with the repair process. 13 The most common PRP types are presented in ►Table 3.…”