Articular cartilage primarily consists of chondrocytes and extracellular matrix and has an essential role in the process of joint movement, including lubrication, shock absorption, and conduction. However, over time, damage to the articular cartilage caused by acute or repetitive trauma or disease of the joints – including osteoarthritis – often results in pain, lack of mobility, and reduced quality of life for an estimated 500 million people worldwide.
Current treatments to address articular cartilage defects include physiotherapy, medication, intra-articular injection, and intra-articular irrigation; none of these treatments are able to regenerate the new cartilage needed to correct the issue.
In recent years, mesenchymal stem cells (MSCs) have been found to be potential solutions for a number of diseases, including OA, specifically because of their ability to differentiate and produce a variety of cells. MSCs have also been found to be safe for use in humans and have demonstrated the ability to improve clinical symptoms such as pain, disability, and physical function.
Additionally, hyaluronic acid (HA) has demonstrated itself to be an important component of the synovial fluid by protecting joint cartilage by providing lubrication and acting as a shock absorber. However, in the presence of OA, HA concentration decreases and results in increased aggravation and joint damage to cartilage. Like MSCs, clinical studies have also demonstrated HA’s ability to relieve pain in patients with OA.
In this study, Li et al, investigate the therapeutic effects of bone marrow mesenchymal stem cells (BMSCs) combined with HA on articular cartilage repairs.
Specifically, 24 healthy canines were operated on to induce cartilage defect model before being randomly divided into 3 groups; each of these groups received a different treatment: bone marrow mesenchymal stem cells (MBSCs) plus HA, HA alone, or saline. After 28 weeks, Li et al. found that the canines treated with BMSCs plus HA (BMSC-HA) showed significant improvement in cartilage defects compared to those receiving just HA or just saline.
The authors also found that while BMSCs-HA demonstrated the most significant improvement in cartilage defect, treatment with HA alone also demonstrated improvements when compared to those receiving saline alone.
Li et al. also identified a number of important limitations of this study, including the limited level of cells and proteins; the repair of cartilage defects in this study was a dynamic process that limited the study to the terminal point of repair; and that this was a preliminary and non-blinded study, which could have affected the evaluation of ICRS macroscopic and histological score. Considering this, the authors call for further blinded and basic experiments as a way to further improve understanding.
As a result of this study, Li et al. concluded that both BMSCs-HA and HA alone could significantly promote new cartilage formation, with BMSCs-HA demonstrating a better way to repair cartilage defects in a canine model.
Source: “Mesenchymal Stem Cells in Combination with Hyaluronic Acid for ….” 2 Jul. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028658/.