Laboratory of Stem Cell Biology and Orthopaedic Tissue Engineering, Department of Surgery, Division of Orthopaedic Surgery, University of Alberta Hospital, University ofAlberta, Edmonton AB T6G 2R3, Canada.
Curr Stem Cell Res Ther. 2012 Mar;7(2):143-8. doi: 10.2174/157488812799219009.
The management of osteochondral defects of articular cartilage, whether from trauma or degenerative disease, continues to be a significant challenge for Orthopaedic surgeons. Current treatment options such as abrasion arthroplasty procedures, osteochondral transplantation and autologous chondrocyte implantation fail to produce repair tissue exhibiting the same mechanical and functional properties of native articular cartilage. This results in repair tissue that inevitably fails as it is unable to deal with the mechanical demands of articular cartilage, and does not prevent further degeneration of the native cartilage. Mesenchymal stem cells have been proposed as a potential source of cells for cell-based cartilage repair due to their ability to self-renew and undergo multi-lineage differentiation. This proposed procedure has the advantage of not requiring harvesting of cells from the joint surface, and its associated donor site morbidity, as well as having multiple possible adult donor tissues such as bone marrow, adipose tissue and synovium. Mesenchymal stem cells have multi-lineage potential, but can be stimulated to undergo chondrogenesis in the appropriate culture medium. As the majority of work with mesenchymal stem cell-derived articular cartilage repair has been carried out in vitro and in animal studies, more work still has to be done before this technique can be used for clinical purposes. This includes realizing the ideal method of harvesting mesenchymal stem cells, the culture medium to stimulate proliferation and differentiation, appropriate choice of scaffold incorporating growth factors directly or with gene therapy and integration of repair tissue with native tissue.
关节软骨的骨软骨缺损的管理，无论是创伤还是退行性疾病，仍然是骨科医生的一个重大挑战。目前的治疗选择，如磨蚀关节成形术、骨软骨移植和自体软骨细胞移植，无法产生具有天然关节软骨相同机械和功能特性的修复组织。这导致修复组织不可避免地失败，因为它无法应对关节软骨的机械需求，并且不能防止天然软骨的进一步退化。间充质干细胞因其自我更新和多能分化的能力，被提议作为细胞基软骨修复的潜在细胞来源。该方法的优点是不需要从关节表面采集细胞，以及其相关的供体部位发病率，并且有多个可能的成人供体组织，如骨髓、脂肪组织和滑膜。间充质干细胞具有多能性，但可以在适当的培养基中被刺激分化为软骨细胞。由于大多数间充质干细胞衍生的关节软骨修复工作都是在体外和动物研究中进行的，因此在该技术可用于临床目的之前，仍需要做更多的工作。这包括实现收获间充质干细胞的理想方法、刺激增殖和分化的培养基、直接或基因治疗结合生长因子的合适支架选择以及修复组织与天然组织的整合。
