Jiang Shuangpeng, Tian Guangzhao, Li Xu, Yang Zhen, Wang Fuxin, Tian Zhuang, Huang Bo, Wei Fu, Zha Kangkang, Sun Zhiqiang, Sui Xiang, Liu Shuyun, Guo Weimin, Guo Quanyi
Institute of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries PLA, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
Department of Orthopedics, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001 Liaoning Province, China.
Stem Cells Int. 2021 Feb 12;2021:8882505. doi: 10.1155/2021/8882505. eCollection 2021.
Injury of articular cartilage can cause osteoarthritis and seriously affect the physical and mental health of patients. Unfortunately, current surgical treatment techniques that are commonly used in the clinic cannot regenerate articular cartilage. Regenerative medicine involving stem cells has entered a new stage and is considered the most promising way to regenerate articular cartilage. In terms of theories on the mechanism, it was thought that stem cell-mediated articular cartilage regeneration was achieved through the directional differentiation of stem cells into chondrocytes. However, recent evidence has shown that the stem cell secretome plays an important role in biological processes such as the immune response, inflammation regulation, and drug delivery. At the same time, the stem cell secretome can effectively mediate the process of tissue regeneration. This new theory has attributed the therapeutic effect of stem cells to their paracrine effects. The application of stem cells is not limited to exogenous stem cell transplantation. Endogenous stem cell homing and in situ regeneration strategies have received extensive attention. The application of stem cell derivatives, such as conditioned media, extracellular vesicles, and extracellular matrix, is an extension of stem cell paracrine theory. On the other hand, stem cell pretreatment strategies have also shown promising therapeutic effects. This article will systematically review the latest developments in these areas, summarize challenges in articular cartilage regeneration strategies involving stem cells, and describe prospects for future development.
关节软骨损伤可导致骨关节炎，并严重影响患者的身心健康。不幸的是，目前临床上常用的手术治疗技术无法使关节软骨再生。涉及干细胞的再生医学已进入一个新阶段，被认为是关节软骨再生最有前景的方法。在作用机制理论方面，过去认为干细胞介导的关节软骨再生是通过干细胞向软骨细胞的定向分化来实现的。然而，最近有证据表明，干细胞分泌组在免疫反应、炎症调节和药物递送等生物学过程中发挥着重要作用。同时，干细胞分泌组能够有效介导组织再生过程。这一新理论将干细胞的治疗作用归因于其旁分泌效应。干细胞的应用并不局限于外源性干细胞移植。内源性干细胞归巢和原位再生策略受到了广泛关注。干细胞衍生物如条件培养基、细胞外囊泡和细胞外基质的应用是干细胞旁分泌理论的延伸。另一方面，干细胞预处理策略也显示出了有前景的治疗效果。本文将系统综述这些领域的最新进展，总结涉及干细胞的关节软骨再生策略中的挑战，并描述未来的发展前景。
