Lee Wayne Yuk-Wai, Wang Bin
Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, PR China.
Stem Cells and Regenerative Medicine Laboratory, Li Ka Shing Institute of Health Sciences, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, PR China.
J Orthop Translat. 2017 Apr 9;9:76-88. doi: 10.1016/j.jot.2017.03.005. eCollection 2017 Apr.
Osteoarthritis is a degenerative disease of joints with destruction of articular cartilage associated with subchondral bone hypertrophy and inflammation. OA is the leading cause of joint pain resulting in significant worsening of the quality-of-life in the elderly. Numerous efforts have been spent to overcome the inherently poor healing ability of articular cartilage. Mesenchymal stem cells (MSCs) have been in the limelight of cell-based therapies to promote cartilage repair. Despite progressive advancements in MSC manipulation and the introduction of various bioactive scaffolds and growth factors in preclinical studies, current clinical trials are still at early stages with preliminary aims to evaluate safety, feasibility and efficacy. This review summarises recently reported MSC-based clinical trials and discusses new research directions with particular focus on the potential application of MSC-derived extracellular vehicles, miRNAs and advanced gene editing techniques which may shed light on the development of novel treatment strategies. : This review summarises recent MSC-related clinical research that focuses on cartilage repair. We also propose a novel possible translational direction for hyaline cartilage formation and a new paradigm making use of extra-cellular signalling and epigenetic regulation in the application of MSCs for cartilage repair.
骨关节炎是一种关节退行性疾病，伴有关节软骨破坏，并与软骨下骨肥大和炎症相关。骨关节炎是导致关节疼痛的主要原因，会使老年人的生活质量显著下降。人们已经付出了诸多努力来克服关节软骨固有的愈合能力差的问题。间充质干细胞（MSCs）一直是促进软骨修复的细胞疗法的焦点。尽管在临床前研究中，间充质干细胞的操控取得了不断进展，并且引入了各种生物活性支架和生长因子，但目前的临床试验仍处于早期阶段，初步目标是评估安全性、可行性和疗效。本综述总结了最近报道的基于间充质干细胞的临床试验，并讨论了新的研究方向，特别关注间充质干细胞衍生的细胞外囊泡、微小RNA和先进基因编辑技术的潜在应用，这些可能为新型治疗策略的开发提供线索。：本综述总结了最近专注于软骨修复的与间充质干细胞相关的临床研究。我们还提出了一种新的可能的透明软骨形成的转化方向，以及一种在间充质干细胞应用于软骨修复中利用细胞外信号传导和表观遗传调控的新范式。
