Primarily a result of its avascular structure and the relatively low metabolic activities of chondrocytes, cartilage has demonstrated a very limited ability to self-repair.
Currently, the primary interventions for cartilage-related injuries only postpone further cartilage deterioration and fail to fully restore or repair cartilage. The limited success of current clinical treatment options for cartilage-related injuries has led to the development of several regenerative medical therapies, including using mesenchymal stem cells (MSCs) as a new strategy in the treatment of cartilage injuries.
Specifically, MSCs have been found to be isolated from mesenchymal tissue and be differentiated into chondrocytes with the support of chondrogenic factors or scaffolds to repair damaged cartilage tissue.
As part of this review, Le et al. highlight the successful repair of cartilage using MSCs or MSCs in combination with chondrogenic factors and/or scaffolds. The authors also provide a detailed presentation of the outcomes of different MSC-based strategies for cartilage regeneration and discuss their prospective translation to use in clinical practice.
Additionally, the authors discuss a number of specific MSC or MSC-combination factors that have shown potential for positive cartilage regeneration outcomes.
The use of MSC alone demonstrated the potential to possibly delay future cartilage degeneration and has been successful in relieving pain and improving joint function in patients with OA and RA. While the implantation of MSCs alone failed to regenerate the injured cartilage, it did prevent chondrocyte apoptosis.
The authors also pointed out that the application of chondrogenic factors could regulate the differentiation, proliferation, and metabolic activity of MSC and have been shown to increase the therapeutic efficacies of MSCs.
The 3D environment provided through scaffolding has a crucial role in maintaining the chondrocyte phenotype of MSCs, primarily by enabling the homogeneous distribution of MSCs and providing appropriate substrate for cell growth and mechanical integrity for post-surgical implantation. According to Le et al. using this approach could induce the regeneration required for complete and functional cartilage tissue.
While there is still much to be investigated in the area of using MSC-based therapies to create bionic tissues, the authors conclude that the integration of these therapies into current clinical approaches will overcome the current existing challenges and result in a biomimetic cartilage regenerative therapy. Source: Le H, Xu W, Zhuang X, Chang F, Wang Y, Ding J. Mesenchymal stem cells for cartilage regeneration. J Tissue Eng. 2020;11:2041731420943839. Published 2020 Aug 26. doi:10.1177/2041731420943839
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