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Research Progress on Stem Cell Therapies for Articular Cartilage Regeneration - PubMed

  • ️Fri Jan 01 2021

Review

. 2021 Feb 12:2021:8882505.

doi: 10.1155/2021/8882505. eCollection 2021.

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Review

Research Progress on Stem Cell Therapies for Articular Cartilage Regeneration

Shuangpeng Jiang et al. Stem Cells Int. 2021.

Abstract

Injury of articular cartilage can cause osteoarthritis and seriously affect the physical and mental health of patients. Unfortunately, current surgical treatment techniques that are commonly used in the clinic cannot regenerate articular cartilage. Regenerative medicine involving stem cells has entered a new stage and is considered the most promising way to regenerate articular cartilage. In terms of theories on the mechanism, it was thought that stem cell-mediated articular cartilage regeneration was achieved through the directional differentiation of stem cells into chondrocytes. However, recent evidence has shown that the stem cell secretome plays an important role in biological processes such as the immune response, inflammation regulation, and drug delivery. At the same time, the stem cell secretome can effectively mediate the process of tissue regeneration. This new theory has attributed the therapeutic effect of stem cells to their paracrine effects. The application of stem cells is not limited to exogenous stem cell transplantation. Endogenous stem cell homing and in situ regeneration strategies have received extensive attention. The application of stem cell derivatives, such as conditioned media, extracellular vesicles, and extracellular matrix, is an extension of stem cell paracrine theory. On the other hand, stem cell pretreatment strategies have also shown promising therapeutic effects. This article will systematically review the latest developments in these areas, summarize challenges in articular cartilage regeneration strategies involving stem cells, and describe prospects for future development.

Copyright © 2021 Shuangpeng Jiang et al.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1

Two theories of articular cartilage regeneration involving stem cells. (a) Stem cell differentiation theory. Stem cells are affected by the microenvironment and directly differentiate into chondrocytes. (b) Paracrine theory of stem cells. Stem cells are affected by the microenvironment and secrete various derivatives, including growth factors, EVs, and ECM. These derivatives have been proven to induce homing of endogenous stem cells, promote the differentiation of endogenous stem cells into chondrocytes, promote the proliferation of chondrocytes, induce macrophages to polarize to the M2 type, and regulate the level of inflammatory factors to exert anti-inflammatory effects. EVs: extracellular vesicles; ECM: extracellular matrix.

Figure 2
Figure 2

Stem cell delivery for repairing articular cartilage defects or treating OA. (a) Cell-scaffold construct. Stem cells are planted on a tissue engineering scaffold, cultured in vitro until the cells adhere to the scaffold, and then, the cell-scaffold construct is implanted into the cartilage defect. (b) Magnetic targeting. Place a magnet on the back of the cartilage defect (popliteal fossa), use nanoiron particles to label stem cells, and then implant the stem cells into the cartilage defect. Under the attraction of the magnet, the stem cells are tightly fixed to the bottom of the cartilage defect. (c) Intra-articular injection. The stem cells are resuspended in hyaluronic acid (HA), phosphate-buffered saline (PBS), physiological saline or platelet-rich fibrin releasate (PRFr), and other carriers and then injected into the joint cavity. (d) Chondrocyte pellets. The stem cells are cultured and differentiated in vitro to form cartilage pellets, and then, the cartilage pellets are implanted into the cartilage defect. (e) Cell-hydrogel construct. The stem cells are mixed into the injectable hydrogel material, and then, the cell-hydrogel construct is injected into the cartilage defect.

Figure 3
Figure 3

Treatment methods and new idea for articular cartilage injury. (a) Joint cartilage defects cause joint inflammation. (b) Medication can relieve symptoms. (c) Traditional repair techniques such as MF form fibrocartilage. (d) Artificial joint replacement surgery reconstructs the articular surface. (e) Ideal form of cartilage regeneration. (f) New ideas for cartilage regeneration.

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