Cell Therapy in Joint Disorders

Abstract

Context:Articular cartilage possesses poor natural healing mechanisms, and a variety of non-cell-based and cell-based treatments aim to promote regeneration of hyaline cartilage.Data Sources:A review of the literature to December 2013 using PubMed with search criteria including the keywords stem cell, cell therapy, cell transplantation, cartilage, chondral, and chondrogenic.Study Selection:Forty-five articles were identified that employed local mesenchymal stem cell (MSC) therapy for joint disorders in humans. Nine comparative studies were identified, consisting of 3 randomized trials, 5 cohort studies, and 1 case-control study.Study Type:Clinical review.Level of Evidence:Level 4.Data Extraction:Studies were assessed for stem cell source, method of implantation, comparison groups, and concurrent surgical techniques.Results:Two studies comparing MSC treatment to autologous chondrocyte implantation found similar efficacy. Three studies reported clinical benefits with intra-articular MSC injection over non-MSC controls for cases undergoing debridement with or without marrow stimulation, although a randomized study found no significant clinical difference at 2-year follow-up but reported better 18-month magnetic resonance imaging and histologic scores in the MSC group. No human studies have compared intra-articular MSC therapy to non-MSC techniques for osteoarthritis in the absence of surgery.Conclusion:Mesenchymal stem cell–based therapies appear safe and effective for joint disorders in large animal preclinical models. Evidence for use in humans, particularly, comparison with more established treatments such as autologous chondrocyte implantation and microfracture, is limited.

Effect of mesenchymal stem cells combined with chondroitin sulfate in an osteoarthritis in vitro model

“…MSCs are an attractive alternative candidate to the conventional treatment for regenerative therapies [32]. They have been suggested as a new cell source for OA treatment because of their capability of differentiating in chondrocytes and the paracrine effects of secreted bioactive substances as well as their immunomodulatory effects [33]. CS is the major GAG component of native cartilage tissue which could provide cues to stimulate cells so as to proliferate, migrate, differentiate and produce the ECM compounds [34].…”

Comparison of Bone Marrow Concentrate, Non-Operative Care and Fusion for Discogenic Back Pain

“…Mesenchymal stem cells have many positive attributes and have mounting evidence of safety and efficacy in human use [21,22,32,35]. MSCs are antiinflammatory, secrete numerous growth factors, stimulate blood vessel formation, modulate your immune system and can differentiate into cartilage cells to potentially help heal damaged discs [18,21,33,34]. Data supporting the use of mesenchymal stem cells to treat disc degeneration continues to increase.…”

Stem cell therapy in the treatment of bilateral elbow joint osteoarthritis in dog

“…Because of ineffective healing of chondral defects, there is a need to develop therapies to restore articular cartilage to near normal (Counsel et al, 2015). The best treatment of OA is focused on blocking the catabolic activity of cartilage and enhancing regeneration of normal cartilage.…”

“…MSCs were able to aggregate, multiply, and bridge injured tissue by forming vasculaturecontrolled chondrocytes for cartilage formation and osteoblast for bone formation (Hansen et al, 2018). Intra-articular injection holds several potential advantages, including reduced recovery time and cost (Counsel et al, 2015). In veterinary medicine, the number of animals already treated provides a substantial basis for assessing the effectiveness of cell therapy in the treatment of a large number of diseases.…”