Kong Ling, Zheng Li-Zhen, Qin Ling, Ho Kevin K W
Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
J Orthop Translat. 2017 Apr 12;9:89-103. doi: 10.1016/j.jot.2017.03.006. eCollection 2017 Apr.
As the most common form of joint disorder, osteoarthritis (OA) imposes a tremendous burden on health care systems worldwide. Without effective cure, OA represents a unique opportunity for innovation in therapeutic development. In contrast to traditional treatments based on drugs, proteins, or antibodies, stem cells are poised to revolutionize medicine as they possess the capacity to replace and repair tissues and organs such as osteoarthritic joints. Among different types of stem cells, mesenchymal stem cells (MSCs) are of mesoderm origin and have been shown to generate cells for tissues of the mesoderm lineage, thus, raising the hope for them being used to treat diseases such as OA. However, given their ability to differentiate into other cell types, MSCs have also been tested in treating a myriad of conditions from diabetes to Parkinson's disease, apparently of the ectoderm and endoderm lineages. There are ongoing debates whether MSCs can differentiate into lineages outside of the mesoderm and consequently their effectiveness in treating conditions from the ectoderm and endoderm lineages. In this review, we discuss the developmental origin of MSCs, their differentiation potential and immunomodulatory effects, as well as their applications in treating OA. We suggest further investigations into new therapies or combination therapies that may provide more effective treatment for bone and joint diseases. Furthermore, cell-based therapy and its associated safety and effectiveness should be carefully evaluated before clinical translation. This review provides updated information on recent approval of clinical trials and related applications of MSCs, and discusses additional efforts on cell-based therapy for treating OA and other joint and bone diseases.
作为最常见的关节疾病形式，骨关节炎（OA）给全球医疗保健系统带来了巨大负担。由于缺乏有效的治愈方法，OA为治疗性开发的创新提供了独特的机会。与基于药物、蛋白质或抗体的传统治疗方法不同，干细胞有能力替代和修复诸如骨关节炎关节等组织和器官，有望给医学带来变革。在不同类型的干细胞中，间充质干细胞（MSCs）起源于中胚层，已被证明能生成中胚层谱系组织的细胞，因此，人们对其用于治疗OA等疾病寄予厚望。然而，鉴于MSCs能够分化为其他细胞类型，它们也被用于测试治疗从糖尿病到帕金森病等众多疾病，这些疾病显然属于外胚层和内胚层谱系。关于MSCs是否能分化为中胚层以外的谱系以及它们在治疗外胚层和内胚层谱系疾病方面的有效性，目前仍存在争议。在这篇综述中，我们讨论了MSCs的发育起源、分化潜能和免疫调节作用，以及它们在治疗OA中的应用。我们建议进一步研究新的疗法或联合疗法，这些疗法可能为骨和关节疾病提供更有效的治疗。此外，在临床转化之前，应仔细评估基于细胞的疗法及其相关的安全性和有效性。这篇综述提供了关于MSCs临床试验近期获批情况及相关应用的最新信息，并讨论了在基于细胞的疗法治疗OA和其他关节及骨骼疾病方面的更多努力。
