Orth Patrick, Rey-Rico Ana, Venkatesan Jagadeesh K, Madry Henning, Cucchiarini Magali
Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg, Germany.
Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg, Germany.
Stem Cells Cloning. 2014 Jan 16;7:1-17. doi: 10.2147/SCCAA.S42880. eCollection 2014.
Protocols based on the delivery of stem cells are currently applied in patients, showing encouraging results for the treatment of articular cartilage lesions (focal defects, osteoarthritis). Yet, restoration of a fully functional cartilage surface (native structural organization and mechanical functions) especially in the knee joint has not been reported to date, showing the need for improved designs of clinical trials. Various sources of progenitor cells are now available, originating from adult tissues but also from embryonic or reprogrammed tissues, most of which have already been evaluated for their chondrogenic potential in culture and for their reparative properties in vivo upon implantation in relevant animal models of cartilage lesions. Nevertheless, particular attention will be needed regarding their safe clinical use and their potential to form a cartilaginous repair tissue of proper quality and functionality in the patient. Possible improvements may reside in the use of biological supplements in accordance with regulations, while some challenges remain in establishing standardized, effective procedures in the clinics.
基于干细胞递送的方案目前已应用于患者,在治疗关节软骨损伤(局灶性缺损、骨关节炎)方面显示出令人鼓舞的结果。然而,迄今为止,尚未有关于完全功能性软骨表面(天然结构组织和机械功能)恢复的报道,尤其是在膝关节中,这表明需要改进临床试验设计。现在有多种祖细胞来源,既来自成体组织,也来自胚胎或重编程组织,其中大多数已经在培养中评估了其软骨生成潜力,以及在植入软骨损伤相关动物模型后在体内的修复特性。尽管如此,在其临床安全使用以及在患者体内形成具有适当质量和功能的软骨修复组织的潜力方面,仍需要特别关注。可能的改进在于根据规定使用生物补充剂,而在临床建立标准化、有效的程序方面仍存在一些挑战。