Cell Therapy and Tissue Engineering for Cartilage Repair (original) (raw)
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Cell Therapy and Tissue Engineering Approaches for Cartilage Repair and/or Regeneration
International Journal of Stem Cells, 2015
Articular cartilage injuries caused by traumatic, mechanical and/or by progressive degeneration result in pain, swelling, subsequent loss of joint function and finally osteoarthritis. Due to the peculiar structure of the tissue (no blood supply), chondrocytes, the unique cellular phenotype in cartilage, receive their nutrition through diffusion from the synovial fluid and this limits their intrinsic capacity for healing. The first cellular avenue explored for cartilage repair involved the in situ transplantation of isolated chondrocytes. Latterly, an improved alternative for the above reparative strategy involved the infusion of mesenchymal stem cells (MSC), which in addition to a self-renewal capacity exhibit a differentiation potential to chondrocytes, as well as a capability to produce a vast array of growth factors, cytokines and extracellular matrix compounds involved in cartilage development. In addition to the above and foremost reparative options up till now in use, other therapeutic options have been developed, comprising the design of biomaterial substrates (scaffolds) capable of sustaining MSC attachment, proliferation and differentiation. The implantation of these engineered platforms, closely to the site of cartilage damage, may well facilitate the initiation of an 'in situ' cartilage reparation process. In this mini-review, we examined the timely and conceptual development of several cell-based methods, designed to repair/regenerate a damaged cartilage. In addition to the above described cartilage reparative options, other therapeutic alternatives still in progress are portrayed.
Emerging Potential of Cell Based Therapies for Articular Cartilage Repair and Regeneration
Advances in Tissue Engineering & Regenerative Medicine: Open Access, 2017
Osteoarthritis (OA), also known as degenerative arthritis, is a debilitating disease of joints that results in pain, stiffness, reduced movement and eventually requires replacement of the joint. This is the most common form of arthritis especially in elderly population, affecting about 237 million of total population out of which approximately 60% could result in complete physical disability. Most commonly affected joints are the knee, hip, lower back, ends of hands and fingers. Current available data shows that conventional treatment like exercise, osteotomy, arthroplasty, arthrodesis, and total knee replacement (TKR), only help in relieving pain and do not reverse the cartilage damage or help in cartilage repair or regeneration. Therefore, new advanced treatment modalities are required which can repair the damaged cartilage with healthy chondrocytes and re-establish knee structure and physiology. This review article mainly focuses on different cellular based treatment options like implantation of autologous bone marrow concentrate (BMC), autologous chondrocyte progenitor cells, mesenchymal stem cells (MSCs) and platelet rich plasma (PRP). These cell therapy options may provide long term relief of symptoms and rapid restoration of cartilage function. But it is still under research and not clearly understood whether cell therapy could cure osteoarthritis or simply delay the need for knee replacement.
Current Clinical Therapies for Cartilage Repair, their Limitation and the Role of Stem Cells
Current Stem Cell Research & Therapy, 2012
The management of osteochondral defects of articular cartilage, whether from trauma or degenerative disease, continues to be a significant challenge for Orthopaedic surgeons. Current treatment options such as abrasion arthroplasty procedures, osteochondral transplantation and autologous chondrocyte implantation fail to produce repair tissue exhibiting the same mechanical and functional properties of native articular cartilage. This results in repair tissue that inevitably fails as it is unable to deal with the mechanical demands of articular cartilage, and does not prevent further degeneration of the native cartilage. Mesenchymal stem cells have been proposed as a potential source of cells for cell-based cartilage repair due to their ability to self-renew and undergo multi-lineage differentiation. This proposed procedure has the advantage of not requiring harvesting of cells from the joint surface, and its associated donor site morbidity, as well as having multiple possible adult donor tissues such as bone marrow, adipose tissue and synovium. Mesenchymal stem cells have multi-lineage potential, but can be stimulated to undergo chondrogenesis in the appropriate culture medium. As the majority of work with mesenchymal stem cell-derived articular cartilage repair has been carried out in vitro and in animal studies, more work still has to be done before this technique can be used for clinical purposes. This includes realizing the ideal method of harvesting mesenchymal stem cells, the culture medium to stimulate proliferation and differentiation, appropriate choice of scaffold incorporating growth factors directly or with gene therapy and integration of repair tissue with native tissue.
Health and Technology, 2012
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A Review Study: Using Stem Cells in Cartilage Regeneration and Tissue Engineering
Articular cartilage, the load-bearing tissue of the joint, has limited repair and regeneration ability. The scarcity of treatment modalities for large chondral defects has motivated researchers to engineer cartilage tissue constructs that can meet the functional demands of this tissue in vivo. Cartilage tissue engineering requires 3 components: cells, scaffold, and environment. Owning to their easy isolation, expansion, and multilineage differentiation, adult stem cells, specifically multipotential mesenchymal stem cells, are considered the proper candidate for tissue engineering. Successful outcome of cell-based cartilage tissue engineering ultimately depends on the proper differentiation of stem cells into chondrocytes and assembly of the appropriate cartilaginous matrix to achieve the load-bearing capabilities of the natural articular cartilage. Furthermore, multiple parameters such as growth factors, signaling molecules, and physical conditions must be considered. Adult mesenchymal stem-cell-based tissue engineering is a promising technology for creating a transplantable cartilage replacement to improve joint function.
Study : Using Stem Cells in Cartilage Regeneration and Tissue Engineering
2016
His interst is researching on mesenchmal stem cell, drug delivery, chondroblast, effect of growth factors on differentiation to chondroblast, evaluation of adhesion and growth of chondrocyte cells on PHB based scaffolds. Articular cartilage, the load-bearing tissue of the joint, has limited repair and regeneration ability. The scarcity of treatment modalities for large chondral defects has motivated researchers to engineer cartilage tissue constructs that can meet the functional demands of this tissue in vivo. Cartilage tissue engineering requires 3 components: cells, scaffold, and environment. Owning to their easy isolation, expansion, and multilineage differentiation, adult stem cells, specifically multipotential mesenchymal stem cells, are considered the proper candidate for tissue engineering. Successful outcome of cell-based cartilage tissue engineering ultimately depends on the proper differentiation of stem cells into chondrocytes and assembly of the appropriate cartilaginous matrix to achieve the load-bearing capabilities of the natural articular cartilage. Furthermore, multiple parameters such as growth factors, signaling molecules, and physical conditions must be considered. Adult mesenchymal stem-cell-based tissue engineering is a promising technology for creating a transplantable cartilage replacement to improve joint function.
Tissue engineering and cell therapy of cartilage and bone
Matrix Biology, 2003
Trauma and disease of bones and joints, frequently involving structural damage to both the articular cartilage surface and the subchondral bone, result in severe pain and disability for millions of people worldwide and represent major challenges for the orthopedic surgeons. Therapeutic repair of skeletal tissues by tissue engineering has raised the interest of the scientific community, providing very promising results in preclinical animal models and clinical pilot studies. In this review, we discuss this approach. The choice of a proper cell type is addressed. The use of terminally differentiated cells, as in the case of autologous chondrocyte implantation, is compared with the advantagesydisadvantages of using more undifferentiated cell types, such as stem cells or early mesenchymal progenitors that retain multi-lineage and self-renewal potentials. The need for proper scaffold matrices is also examined, and we provide a brief overview of their fundamental properties. A description of the natural and biosynthetic materials currently used for reconstruction purposes, either of cartilage or bone, is given. Finally, we highlight the positive aspects and the remaining problems that will drive future research in articular cartilage and bone repair. ᮊ
Cartilage Tissue Engineering: Towards a Biomaterial-Assisted Mesenchymal Stem Cell Therapy
Current Stem Cell Research & Therapy, 2009
Injuries to articular cartilage are one of the most challenging issues of musculoskeletal medicine due to the poor intrinsic ability of this tissue for repair. Despite progress in orthopaedic surgery, the lack of efficient modalities of treatment for large chondral defects has prompted research on tissue engineering combining chondrogenic cells, scaffold materials and environmental factors. The aim of this review is to focus on the recent advances made in exploiting the potentials of cell therapy for cartilage engineering. These include: 1) defining the best cell candidates between chondrocytes or multipotent progenitor cells, such as multipotent mesenchymal stromal cells (MSC), in terms of readily available sources for isolation, expansion and repair potential; 2) engineering biocompatible and biodegradable natural or artificial matrix scaffolds as cell carriers, chondrogenic factors releasing factories and supports for defect filling, 3) identifying more specific growth factors and the appropriate scheme of application that will promote both chondrogenic differentiation and then maintain the differentiated phenotype overtime and 4) evaluating the optimal combinations that will answer to the functional demand placed upon cartilage tissue replacement in animal models and in clinics. Finally, some of the major obstacles generally encountered in cartilage engineering are discussed as well as future trends to overcome these limiting issues for clinical applications.