Chitosan: A promising polymer for cartilage repair and viscosupplementation

Abstract

Osteoarthritis (OA) is a painful, degenerative and inflammatory disease that affects the entire synovial joints. Nowadays, no cure exists, and the pharmacological treatments are limited to symptoms alleviation. There is a need for a new efficient and safe treatment. Viscosupplementation is a process that aims to restore the normal rheological properties of synovial fluid. For the past years, hyaluronic acid was usually used but this molecule has some limitations including the short residency time in joint cavity. Recently, in vitro studies have suggested that chitosan could promote the expression of cartilage matrix components and reduce inflammatory and catabolic mediator's production by chondrocytes. In vivo, chitosan prevented cartilage degradation and synovial membrane inflammation in OA induced rabbit model. Several studies have also shown that chitosan could induce chondrogenic differentiation of mesenchymal stem cells. Therefore, chitosan is an interesting polymer to design scaffold and hydrogel for cartilage lesion repair, cells transplantation, sustained drug release and viscosupplementation.

Effects of intra‐articular hyaluronic acid associated to Chitlac (arty‐duo®) in a rat knee osteoarthritis model

“…Although many preclinical and clinical studies evaluating the efficacy and safety of HA, showed that it is an established treatment for knee OA, its rapid clearance and the short residency time in joint cavity limits its use . Nowadays, preclinical research is focusing on the evaluation of new treatments and molecules able to prevent or delay cartilage degradation . In this contest, chitosan seems to be an interesting candidate.…”

“…Chitosan, a partially deacetylated derivative from chitin, composed of D‐gucosamine and N‐acetylglucosamine, is structurally similar to glycosaminoglycans . Due to its ability to interact with negatively charged cell surfaces, chitosan is extensively applied to prepare nanocarriers for different applications in the biomedical field . Several preclinical studies suggested that chitosan has a chondroprotective effect and is able to increase chondrocyte proliferation, expression of cartilage matrix components and reduce inflammatory and catabolic mediators following i.a.…”

“…injection in rat and rabbit OA models. In addition, chitosan seems to prevent cartilage degradation and synovial membrane inflammation . An attractive characteristic of chitosan is the presence of amino groups deriving from glucosamine units; the physico‐chemical and biological properties of polycation can be significantly modified exploiting the reactivity of glucosamine residues, i.e., acylation, alkylation, carboxymethylation, and quaternarization of chitosan .…”

Preliminary evaluation of an osteochondral autograft, a prosthetic implant, and a biphasic absorbable implant for osteochondral reconstruction in a sheep model

“…The development of acellular polymers may provide an attractive alternative to overcome the cost and complexity of cell‐based approaches . Chitosan is one of the most widely investigated polymers for regenerative medicine, in particular for cartilage regeneration because it displays structural properties that are similar to natural glycosaminoglycans . Chitosan promotes the expression of cartilage matrix compounds and reduces production of inflammatory and catabolic mediators by chondrocytes .…”

Chitosan composite scaffolds for articular cartilage defect repair: a review

“…As a result, chitosan is a promising natural biomaterial scaffold for cartilage defect repair. 35 Furthermore, the positive charge on chitosan could facilitate scaffold binding to negatively charged tissue cells or body uid.…”