Regenerative Medicine Institute, National Centre for Biomedical Engineering Science, National University of Ireland, Galway, Ireland.
Hum Gene Ther. 2010 Oct;21(10):1239-50. doi: 10.1089/hum.2010.138.
Multipotent mesenchymal stromal or stem cells (MSCs) are likely to be agents of connective tissue homeostasis and repair. Because the hallmark of osteoarthritis (OA) is degeneration and failure to repair connective tissues it is compelling to think that these cells have a role to play in OA. Indeed, MSCs have been implicated in the pathogenesis of OA and, in turn, progression of the disease has been shown to be therapeutically modulated by MSCs. This review discusses current knowledge on the potential of both marrow- and local joint-derived MSCs in OA, the mode of action of the cells, and possible effects of the osteoarthritic niche on the function of MSCs. The use of stem cells for repair of isolated cartilage lesions and strategies for modulation of OA using local cell delivery are discussed as well as therapeutic options for the future to recruit and appropriately activate endogenous progenitors and/or locally systemically administered MSCs in the early stages of the disease. The use of gene therapy protocols, particularly as they pertain to modulation of inflammation associated with the osteoarthritic niche, offer an additional option in the treatment of this chronic disease. In summary, elucidation of the etiology of OA and development of technologies to detect early disease, allied to an increased understanding of the role MSCs in aging and OA, should lead to more targeted and efficacious treatments for this debilitating chronic disease in the future.
多能间充质基质或干细胞（MSCs）可能是结缔组织稳态和修复的介质。由于骨关节炎（OA）的标志是变性和结缔组织修复失败，因此认为这些细胞在 OA 中具有一定的作用。事实上，MSCs 已被牵连到 OA 的发病机制中，反过来，疾病的进展已被证明可以通过 MSCs 进行治疗调节。这篇综述讨论了骨髓和关节内源性 MSCs 在 OA 中的潜在作用、细胞的作用模式以及 OA 微环境对 MSCs 功能的可能影响。还讨论了使用干细胞修复孤立性软骨损伤以及使用局部细胞递送来调节 OA 的策略，以及未来在疾病早期招募和适当激活内源性祖细胞和/或局部全身给予 MSCs 的治疗选择。基因治疗方案的应用，特别是与调节与 OA 微环境相关的炎症相关的方案，为这种慢性疾病的治疗提供了另一种选择。总之，阐明 OA 的病因学和开发早期疾病检测技术，以及增加对 MSCs 在衰老和 OA 中作用的理解，应该会导致未来针对这种使人衰弱的慢性疾病更具针对性和更有效的治疗方法。
