Regenerative Cells for the Management of Osteoarthritis and Joint Disorders: A Concise Literature Review

Abstract

As the global population ages, the prevalence of osteoarthritis (OA) and joint disorders represent a major cause of disability and a significant public health burden. As current approaches for the management of OA focus on slowing the progression of disease, without repairing the underlying damage, novel treatments are necessary to improve outcomes. Over the past decade, autologous cell-based therapies using regenerative cells from fat or bone marrow have become a major focus of research into new approaches for the treatment of osteoarthritis and joint disorders. This review is intended to summarize findings in existing literature and identify gaps in knowledge that should be addressed in order to advance the field. We acknowledge that some findings may appear inconsistent, but show that apparent inconsistency in the literature may be attributable to variation in source of cells, stage of disease, method of delivery, follow-up time, evaluation method, and a number of other idiosyncrasies of individual studies. Still, a number of themes emerge from the data and some broader conclusions may be drawn that can be used to guide future studies. Ultimately, we conclude that there is overwhelming evidence demonstrating the safety of the autologous cell-based therapies. Furthermore, the data support the claim that regenerative cells are capable of reversing progression of OA. Regenerative cells, and especially those from adipose tissue, represent a promising new approach for the treatment of OA. Future work should include appropriate controls, and focus on answering questions related to dose required, appropriate delivery vehicle, and the impact of multiple treatments. Additionally, future studies should look at short and long-term effects of the treatments, and use functional as well as radiologic methods to evaluate efficacy.

MiR-34a Enhances Chondrocyte Apoptosis, Senescence and Facilitates Development of Osteoarthritis by Targeting DLL1 and Regulating PI3K/AKT Pathway

“…OA features chronic degradation of joint cartilage, subchondral bone sclerosis, and degradation of the articular fringe [6]. OA is prevalent on the articular surfaces of the hands, elbows, hips, and knees [27].…”

<p>Assessment of a Single Intra-Articular Stifle Injection of Pure Platelet Rich Plasma on Symmetry Indices in Dogs with Unilateral or Bilateral Stifle Osteoarthritis from Long-Term Medically Managed Cranial Cruciate Ligament Disease</p>

“…[7][8][9] Orthobiologic products (such as mesenchymal stem cells, bone marrow aspirate concentrate, and platelets rich products) are showing promise as safe and effective treatments for musculoskeletal diseases including osteoarthritis in people and animals. [10][11][12][13][14][15][16][17][18] Platelets possess anabolic and anti-inflammatory properties attributed to the delivery of various growth factors and cell signaling molecules that can modulate inflammation and promote tissue healing. 19,20 Because various methods exist to create different platelet-derived orthobiologics, we define platelet-rich plasma (PRP) as any product in which the concentration of platelets is increased relative to whole blood and partially or fully isolated from leukocytes and red cells within a plasma medium.…”

Per2 attenuates LPS-induced chondrocyte injury through the PTEN/PI3K/Akt signalling pathway

“…Joint cartilage, ligaments, subchondral bone, capsule and adjacent muscles are vulnerable to OA [21,22]. OA has the characteristics of chronic joint cartilage degradation and articular fringe as well as subchondral bone sclerosis of the hands, elbows, knees and hips [23,24]. The proliferation and apoptosis of normal articular chondrocytes are in a certain state of equilibrium that ensures the number of articular chondrocytes.…”