Laboratory of Stem Cell and Tissue Engineering, West China Hospital, Sichuan University, Chengdu, China.
Centro di Ricerca E. Menni, Fondazione Poliambulanza-Istituto Ospedaliero, Brescia, Italy.
Stem Cell Rev Rep. 2017 Oct;13(5):575-586. doi: 10.1007/s12015-017-9753-1.
Large articular cartilage defects remain an immense challenge in the field of regenerative medicine because of their poor intrinsic repair capacity. Currently, the available medical interventions can relieve clinical symptoms to some extent, but fail to repair the cartilaginous injuries with authentic hyaline cartilage. There has been a surge of interest in developing cell-based therapies, focused particularly on the use of mesenchymal stem/progenitor cells with or without scaffolds. Mesenchymal stem/progenitor cells are promising graft cells for tissue regeneration, but the most suitable source of cells for cartilage repair remains controversial. The tissue origin of mesenchymal stem/progenitor cells notably influences the biological properties and therapeutic potential. It is well known that mesenchymal stem/progenitor cells derived from synovial joint tissues exhibit superior chondrogenic ability compared with those derived from non-joint tissues; thus, these cell populations are considered ideal sources for cartilage regeneration. In addition to the progress in research and promising preclinical results, many important research questions must be answered before widespread success in cartilage regeneration is achieved. This review outlines the biology of stem/progenitor cells derived from the articular cartilage, the synovial membrane, and the synovial fluid, including their tissue distribution, function and biological characteristics. Furthermore, preclinical and clinical trials focusing on their applications for cartilage regeneration are summarized, and future research perspectives are discussed.
由于关节软骨的内在修复能力较差,大的关节软骨缺损仍然是再生医学领域的巨大挑战。目前,现有的医疗干预措施可以在一定程度上缓解临床症状,但无法用透明软骨修复软骨损伤。人们对开发基于细胞的治疗方法产生了浓厚的兴趣,特别是对使用间充质干细胞/祖细胞(有或没有支架)的方法。间充质干细胞/祖细胞是组织再生有前途的移植物细胞,但最适合用于软骨修复的细胞来源仍存在争议。间充质干细胞/祖细胞的组织来源显著影响其生物学特性和治疗潜力。众所周知,与源自非关节组织的细胞相比,源自滑膜关节组织的间充质干细胞/祖细胞具有更好的成软骨能力;因此,这些细胞群被认为是软骨再生的理想来源。除了研究进展和有前途的临床前结果外,在广泛成功实现软骨再生之前,还必须回答许多重要的研究问题。本综述概述了源自关节软骨、滑膜和滑液的干细胞/祖细胞的生物学特性,包括其组织分布、功能和生物学特性。此外,还总结了专注于其在软骨再生应用的临床前和临床试验,并讨论了未来的研究方向。