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Unformatted text preview: KNEE Mesenchymal stem cell-based therapy for cartilage repair: a review Hideyuki Koga Æ Lars Engebretsen Æ Jan E. Brinchmann Æ Takeshi Muneta Æ Ichiro Sekiya Received: 23 January 2009 / Accepted: 4 March 2009 Ó Springer-Verlag 2009 Abstract Articular cartilage injury remains one of the major concerns in orthopaedic surgery. Mesenchymal stem cell (MSC) transplantation has been introduced to avoid some of the side effects and complications of current techniques. The purpose of this paper is to review the lit- erature on MSC-based cell therapy for articular cartilage repair to determine if it can be an alternative treatment for cartilage injury. MSCs retain both high proliferative potential and multipotentiality, including chondrogenic differentiation potential, and a number of successful results in transplantation of MSCs into cartilage defects have been reported in animal studies. However, the use of MSCs for cartilage repair is still at the stage of preclinical and phase I studies, and no comparative clinical studies have been reported. Therefore, it is difficult to make conclusions in human studies. This requires randomized clinical trials to evaluate the effectiveness of MSC-based cell therapy for cartilage repair. Keywords Mesenchymal stem cells Á Cartilage repair Á Cell transplantation Á Chondrocytes Introduction Cartilage defects have very limited intrinsic healing capacity. Partial thickness defects that do not penetrate the subchondral bone do not usually repair spontaneously [ 25 ], while repair of full thickness cartilage defects that pene- trate the subchondral bone depends on the circumstances, such as age, defect size and location [ 17 ]. Small defects can repair spontaneously with production of hyaline cartilage, whereas larger defects will only repair with production of fibrous tissue or fibrocartilage which are biochemically and biomechanically different from normal hyaline cartilage. As a result, degeneration subsequently occurs which may progress to osteoarthritic change in some cases [ 91 ]. Various surgical methods have been proposed to regenerate articular cartilage. However, they all have inherent problems, leaving many patients with inade- quately treated cartilage lesions. Recently, mesenchymal stem cells (MSCs) have been suggested as a source of cells for cell-based treatment of cartilage lesions. MSCs are known to play important roles in development, post-natal growth, repair and regeneration of mesenchymal tissues. They are easily isolated, and retain high expansion poten- tial and multipotentiality that includes chondrogenic H. Koga ( & ) Á L. Engebretsen Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, PO Box 4014, Ullevaal Stadion, 0806 Oslo, Norway e-mail: [email protected] L. Engebretsen Orthopaedic Center, Ullevaal University Hospital, 0407 Oslo, Norway L. Engebretsen Faculty of Medicine, University of Oslo, 0407 Oslo, Norway J. E. Brinchmann Laboratory for Cell Therapy, Institute of Immunology,...
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This note was uploaded on 07/25/2011 for the course EMA 6580 taught by Professor Staff during the Spring '08 term at University of Florida.
- Spring '08