Cell-Free Strategies for Repair and Regeneration of Meniscus Injuries through the Recruitment of Endogenous Stem/Progenitor Cells

Abstract

The meniscus plays a vital role in protecting the articular cartilage of the knee joint. The inner two-thirds of the meniscus are avascular, and injuries to this region often fail to heal without intervention. The use of tissue engineering and regenerative medicine techniques may offer novel and effective approaches to repairing meniscal injuries. Meniscal tissue engineering and regenerative medicine typically use one of two techniques, cell-based or cell-free. While numerous cell-based strategies have been applied to repair and regenerate meniscal defects, these techniques possess certain limitations including cellular contamination and an increased risk of disease transmission. Cell-free strategies attempt to repair and regenerate the injured tissues by recruiting endogenous stem/progenitor cells. Cell-free strategies avoid several of the disadvantages of cell-based techniques and, therefore, may have a wider clinical application. This review first compares cell-based to cell-free techniques. Next, it summarizes potential sources for endogenous stem/progenitor cells. Finally, it discusses important recruitment factors for meniscal repair and regeneration. In conclusion, cell-free techniques, which focus on the recruitment of endogenous stem and progenitor cells, are growing in efficacy and may play a critical role in the future of meniscal repair and regeneration.

Wnt5a/Platelet‐rich plasma synergistically inhibits IL‐1β‐induced inflammatory activity through NF‐κB signaling pathway and prevents cartilage damage and promotes meniscus regeneration

“…Any loss of meniscus integrity is associated with a loss of knee joint function (Niu et al., 2016; Yoon & Park, 2014). If left untreated, meniscus injuries will inevitably lead to the development of osteoarthritis (OA; Guo et al., 2018; Vrancken et al., 2013). However, partial meniscectomy still remains the main treatment option for the meniscus (Steadman et al., 2015).…”

Extracellular vesicles derived from mesenchymal stromal cells mediate endogenous cell growth and migration via the CXCL5 and CXCL6/CXCR2 axes and repair menisci

“…The low cellularity of endogenous recruited MSCs and chondrocytes impedes meniscus healing and regeneration [ 40 ]. While endogenous MSCs and chondrocytes were found to be successfully recruited for meniscus regeneration in animal models, no disease-modifying treatment is available to regenerate human menisci [ 41 ]. EV transplantation may orchestrate cellular processes, such as migration, cell growth, and matrix synthesis, which are associated with tissue regeneration [ 39 , 42 ].…”

Feasibility of a self‐assembling peptide hydrogel scaffold for meniscal defect: An in vivo study in a rabbit model

“…Therefore, hydrogels have been co‐applied with cells and bioactive molecules to stimulate regeneration 31,32 . Mesenchymal stem cells (MSCs) are pluripotent stem cells that are found in various tissues including bone marrow, adipose tissue, blood, and synovium 33–35 . MSCs are often usedin research on meniscal repair and regeneration, and have the potential to promote meniscal healing 36 .…”