Role of mesenchymal stem cells inosteoarthritis treatment
Ling Kong a, Li-Zhen Zheng a, Ling Qin a,b, Kevin K.W. Ho a,*
As the most common form of joint disorder, osteoarthritis (OA) imposes a tremen-dous burden on health care systems worldwide. Without effective cure, OA represents a uniqueopportunity for innovation in therapeutic development. In contrast to traditional treatmentsbased on drugs, proteins, or antibodies, stem cells are poised to revolutionize medicine as theypossess the capacity to replace and repair tissues and organs such as osteoarthritic joints.Among different types of stem cells, mesenchymal stem cells (MSCs) are of mesoderm originand have been shown to generate cells for tissues of the mesoderm lineage, thus, raisingthehopeforthembeingusedtotreatdiseasessuch as OA. However, given their ability todifferentiate into other cell types, MSCs have also been tested in treating a myriad of condi-tions from diabetes to Parkinson’s disease, apparently of the ectoderm and endoderm line-ages. There are ongoing debates whether MSCs can differentiate into lineages outside of themesoderm and consequently their effectiveness in treating conditions from the ectodermand endoderm lineages. In this review, we discuss the developmental origin of MSCs, their dif-ferentiation potential and immunomodulatory effects, as well as their applications in treatingOA. We suggest further investigations into new therapies or combination therapies that mayprovide more effective treatment for bone and joint diseases. Furthermore, cell-based ther-apy and its associated safety and effectiveness should be carefully evaluated before clinicaltranslation. This review provides updated information on recent approval of clinical trialsand related applications of MSCs, and discusses additional efforts on cell-based therapy fortreating OA and other joint and bone diseases.
Without an effective cure, OA remains a significant clinicalburden on our elderly population. The advancement ofregenerative medicine and innovative stem cell technologyoffers a unique opportunity to treat this disease. In thisreview, we examine OA and the likely resolution with MSCs.MSCs have been one of the highlights in stem cell researchin recent years. Although the application of MSCs in jointrepair is well established, it is particularly exciting aboutMSCs being used for OA treatment. Indeed, animal testinghas provided much needed encouragement and the ratio-nale to move forward with human trials. Future challengesmay include the efficient isolation and culture of MSCs fromdefined and reliable sources. MSCs made through goodmanufacturing practices must be carefully evaluatedthrough a combination of means including biochemical,genetic, and epigenetic markers, as well as bioactive assaysto establish the efficacy of cells, their proliferative activity,and reparative potentials before they can be used inhumans. Furthermore, delivery systems for MSCs and eval-uation of their safety and effectiveness also need to beinvestigated. It is hopeful that these studies can beaccomplished in the near future and OA patients mayreceive much needed help soon. In this review, we providesome updated information, including most recent approvalsof the clinical trials and related applications of MSCs.Future aspiration of MSCs resides in the realization ofclinical translation and the treatment of other musculo-skeletal disorders.