Orthopedic cellular therapy: An overview with focus on clinical trials

Abstract

In this editorial, the authors tried to evaluate the present state of cellular therapy in orthopedic field. The topics the authors try to cover include not only the clinical trials but the various research areas as well. Both the target diseases for cellular therapy and the target cells were reviewed. New methods to activate the cells were interesting to review. Most advanced clinical trials were also included because several of them have advanced to phase Ⅲ clinical trials. In the orthopedic field, there are many diseases with a definite treatment gap at this time. Because cellular therapies can regenerate damaged tissues, there is a possibility for cellular therapies to become disease modifying drugs. It is not clear whether cellular therapies will become the standard of care in any of the orthopedic disorders, however the amount of research being performed and the number of clinical trials that are on-going make the authors believe that cellular therapies will become important treatment modalities within several years.

The effect of nacre extract on cord blood‐derived endothelial progenitor cells: A natural stimulus to promote angiogenesis?

“…However, these surgeries involve important financial costs and present some significant limits such as significant post‐operative morbidity, the need for an additional invasive procedure (second site), a limited availability and a resorption that is difficult to anticipate . These limitations have induced the development of bone substitutes such as allograft, xenograft and alloplastic materials . However, these techniques produce unsatisfactory results especially regarding the lack of vascularization in the new‐formed bone .…”

“…Studies have suggested that the biodegradation of nacre progresses as induction of biomineralization when implanted in rodents, sheeps or humans . It has been reported that powdered nacre was totally resorbable . Kim et al demonstrated in ovariectomized (OVX)‐induced osteoporotic mouse model that water‐soluble nacreous factors can both stimulate osteoblastic bone formation and inhibit osteoclastic bone resorption.…”

“…4,5 These limitations have induced the development of bone substitutes such as allograft, xenograft and alloplastic materials. [6][7][8] However, these techniques produce unsatisfactory results especially regarding the lack of vascularization in the newformed bone. 9,10 It has opened the road toward the creation of an ideal prevascularized tissue engineered bone substitute.…”

“…[24][25][26][27] It has been reported that powdered nacre was totally resorbable. 6,7,22 Kim et al 28 demonstrated in ovariectomized (OVX)induced osteoporotic mouse model that water-soluble nacreous factors can both stimulate osteoblastic bone formation and inhibit osteoclastic bone resorption. In humans, it was shown that a 6-month nacre supplementation of postmenopausal women led to a 5% increase of bone mineral density without any adverse drug reaction.…”

Cell-based Approaches for Augmentation of Tendon Repair

“…This preliminary finding finally led to the first successful human bone marrow transplantation in 1968 1 . Since then, orthopedic diseases have been one of the earliest targets for cellular therapy, and cartilage repair was the first indication for this therapeutic approach 2 . In 1994, Lars Peterson’s group designed a study to regenerate cartilage tissue with autologous cartilage cells and showed evidence of regeneration in both animals and humans 3 .…”