Diaz-Flores Lucio, Gutierrez Ricardo, Madrid Juan Francisco, Acosta Elisa, Avila Julio, Diaz-Flores Lucio, Martin-Vasallo Pablo
Department of Pathology, Histology and Radiology, School of Medicine, La Laguna University, Canary Islands, Spain.
Front Biosci (Schol Ed). 2012 Jun 1;4(4):1275-94. doi: 10.2741/s331.
Tissue and cell sources for cartilage repair are revised, including: 1) cartilage and subchondral bone (auto and allografts; single or multiple/mosaicplasty grafts), 2) cultured chondrocytes (autologous/ACI, characterized/CCI, matrix assisted/MAC, or allogenic), 3) adult mesenchymal stem cells (MSCs), 4) progenitor cells from perichondrium and periosteum, 5) embryonic and prenatal stem cells, 6) induced pluripotent stem cells, and 7) genetically modified cells. We consider the biological mechanisms that explain usage and possible complications, advantages and limitations, emerging technologies and possible modulations on extracellular matrix properties and on migration, proliferation, de-differentiation, re-differentiation, morphology, function and integration of the cells. The study of MSC role involve: a) identification, b) location (perivascular niche hypothesis, pericytes as progenitor cells), c) lineage (myoadipofibrogenic system: transit amplifying cells, fibroblast/myofibroblasts, chondrocytes, osteoblasts, odontoblasts, vascular smooth muscle cells and adipocytes), and d) use in cartilage repair, comprising: 1) MSCs recruited from neighbouring tissues (bone marrow stimulation, MSCs based "in situ" cartilage repair, microfracture) and 2) MSCs cultured and expanded from bone marrow, adipose tissue, synovial membrane or granulation tissue.
软骨修复的组织和细胞来源得到了修订，包括：1）软骨和软骨下骨（自体和异体移植；单块或多块/镶嵌成形术移植），2）培养的软骨细胞（自体/自体软骨细胞移植术、特征性培养软骨细胞植入、基质辅助/基质辅助自体软骨细胞移植术，或同种异体），3）成人间充质干细胞，4）来自软骨膜和骨膜的祖细胞，5）胚胎和产前干细胞，6）诱导多能干细胞，以及7）基因修饰细胞。我们考虑了解释其应用及可能并发症、优点和局限性、新兴技术以及对细胞外基质特性以及细胞迁移、增殖、去分化、再分化、形态、功能和整合的可能调节的生物学机制。对间充质干细胞作用的研究涉及：a）鉴定，b）定位（血管周围微环境假说，周细胞作为祖细胞），c）谱系（肌成脂纤维生成系统：过渡放大细胞、成纤维细胞/肌成纤维细胞、软骨细胞、成骨细胞、成牙本质细胞、血管平滑肌细胞和脂肪细胞），以及d）在软骨修复中的应用，包括：1）从邻近组织募集的间充质干细胞（骨髓刺激、基于间充质干细胞的“原位”软骨修复、微骨折）和2）从骨髓、脂肪组织、滑膜或肉芽组织培养和扩增的间充质干细胞。
