Mesenchymal stromal cells for articular cartilage repair: preclinical studies

Abstract

Rheumatic diseases such as osteoarthritis (OA) are a major social and economic burden because of the population aging and the lack of curative solutions. An effective cell therapy may be the best treatment option for OA and other cartilage diseases. However, the main cellular strategy used to repair articular cartilage, the transplantation of autologous chondrocytes, is limited to a small number of patients with traumatic lesions. The use of joint replacement after years of disease progression proves the great medical need in current practice. Mesenchymal stromal/stem cells (MSCs) provide an alternative cell source for cartilage regeneration due to numerous advantages, comprising relative ease to isolate and culture, chondrogenic capacity, and antiinflammatory effects. Initial clinical trials with MSCs have led to encouraging results, but many variables have to be considered to attain true amelioration of disease or repair (type and status of cartilage disease, source and conditions of cells, administration regime, combinatorial approaches). Particularly, allogeneic MSCs are an advantageous cellular product. The animal models chosen for preclinical evaluation are also relevant for successful translation into clinical practice. Considering the limitations in the field, rigorous comparative and validating studies in well-established animal models (including large animals) are still needed to set up the bases for additional clinical trials. The present review of studies performed in small and large animal models should help clarify the applicability of MSC-based therapies for articular cartilage repair.

Current problems and persprectives of the treatment of cartilage injuries using mesenchimal stem cells

“…Analyzing scientific publications, it can be noted that at the present time, among the lesions of the cartilage tissue, for the therapy of which the features of the use of MSCs are being investigated, the most popular is the lesion of the cartilage of the joints, especially osteoarthritis [49], because the ability of the articular cartilage is limited, the ability to regenerate is low, and this type of disease is a serious social and economic problem in countries with an aging population [13].…”

Vaspin promotes chondrogenic differentiation of BMSCs via Akt activation in osteoarthritis

“…Therefore, attenuating chondrocyte dysfunction and ECM degradation have been proposed as a strategy for delaying the progression of OA. MSCs with self-renewal capacity and multi-differentiation potential have received much attention as an alternative approach in the management of chondrocyte dysfunction and ECM degradation in OA [ 14 , 15 ]. Numerous studies have confirmed that chondrocyte differentiation and cartilage regeneration of MSCs are regulated by appropriate chondrogenic factors including adipokines [ 16 – 18 ].…”

An Improved Diagnostic Tool to Predict Cartilage Formation in an Osteoarthritic Joint Environment

“…OA is a very heterogenous disease and the local joint microenvironment can differ enormously within OA knee joint patients 39 . In multiple animal studies, MSC injection resulted in cartilage repair 40 . However, limited studies have been performed in humans and the results are not consistent 13,[41][42][43] .…”