The limited regenerative capacity of articular cartilage contributes to progressive joint dysfunction associated with cartilage injury or osteoarthritis. Cartilage tissue engineering seeks to provide a biological substitute for repairing damaged or diseased cartilage, but requires a cell source with the capacity for extensive expansion without loss of chondrogenic potential. In this study, we hypothesized that decreased expression of the cell cycle inhibitor p21 would enhance the proliferative and chondrogenic potential of differentiated induced pluripotent stem cells (iPSCs). Murine iPSCs were directed to differentiate toward the chondrogenic lineage with an established protocol and then engineered to express a short hairpin RNA (shRNA) to reduce the expression of p21. Cells expressing the p21 shRNA demonstrated higher proliferative potential during monolayer expansion and increased synthesis of glycosaminoglycans (GAGs) in pellet cultures. Furthermore, these cells could be expanded *150-fold over three additional passages without a reduction in the subsequent production of GAGs, while control cells showed reduced potential for GAG synthesis with three additional passages. In pellets from extensively passaged cells, knockdown of p21 attenuated the sharp decrease in cell number that occurred in control cells, and immunohistochemical analysis showed that p21 knockdown limited the production of type I and type X collagen while maintaining synthesis of cartilage-specific type II collagen. These findings suggest that manipulating the cell cycle can augment the monolayer expansion and preserve the chondrogenic capacity of differentiated iPSCs, providing a strategy for enhancing iPSC-based cartilage tissue engineering.
IntroductionA rticular cartilage provides a low-friction loadbearing surface in diarthrodial joints such as the knee and hip.1 However, cartilage degeneration or loss that occurs with osteoarthritis (OA) is associated with significant pain and joint dysfunction. 2 The risk for cartilage degeneration is enhanced by the presence of focal damage, 3,4 prompting efforts to treat cartilage defects using techniques such as marrow stimulation.5 Using a combination of cells, scaffolds, and growth factors to engineer cartilage for transplantation has been proposed as a potential therapy, but the optimal cell source has yet to be identified. 6 The use of autologous chondrocytes requires an additional procedure to harvest healthy cartilage and follow-up studies have indicated the presence of suboptimal fibrocartilage tissue after repair.7 Adult stem cells also have limitations, as bone marrow-derived mesenchymal stem/stromal cells (MSCs) display a propensity for mineralization 8,9 and adiposederived stem cells (ASCs) may need additional growth factors for full chondrogenesis in some systems.10,11 Embryonic stem cells and induced pluripotent stem cells (iPSCs) have emerged as other alternatives, but require extensive differentiation protocols to avoid a remnant of undifferentiated cells with tumor-forming potential....