Stem cell-based therapeutic strategies for cartilage defects and osteoarthritis
Stem cell-based therapeutic strategies for cartilage defects and osteoarthritis
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DOI：
10.1016/j.coph.2018.03.009
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发表时间：
2018-06-01
影响因子：
4
通讯作者：
Roelofs, Anke J.
中科院分区：
文献类型：
--
作者：
De Bari, Cosimo;Roelofs, Anke J.
自体软骨细胞植入是修复关节软骨缺损的金标准细胞疗法，长期疗效良好。来自骨髓或结缔组织（如脂肪）的间充质基质/干细胞（MSCs）正被寻求作为软骨修复的替代品，并通过关节内给药在膝关节骨关节炎患者中进行试验。早期临床研究在安全性和有效性方面取得了一致意见，但作用机制仍不清楚。最近的研究表明，细胞外囊泡是间充质干细胞作用的重要介质，具有令人兴奋的治疗前景。我们对内在关节软骨维持和修复机制的了解越来越多，这给我们带来了希望，即新的/重新定向的治疗方法可以通过激活内源性干细胞/祖细胞来诱导修复，从而维持关节健康并预防骨关节炎。
The gold standard cell therapy for repair of articular cartilage defects is autologous chondrocyte implantation, with good outcomes long-term. Mesenchymal stromal/stem cells (MSCs) from bone marrow or connective tissues such as fat are being pursued as alternatives for cartilage repair, and are trialled via intra-articular administration in patients with knee osteoarthritis. Early-phase clinical studies concur on safety and provide some promising insight into efficacy, but the mechanism of action remains unclear. Recent studies implicate extracellular vesicles as important mediators of MSC action, offering exciting therapeutic prospects. Our increasing understanding of the mechanisms underlying intrinsic articular cartilage maintenance and repair fosters hope that novel/ repurposed therapeutics could elicit repair through activation of endogenous stem/progenitor cells to maintain healthy joints and prevent osteoarthritis.