Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
Adv Exp Med Biol. 2023;1420:59-80. doi: 10.1007/978-3-031-30040-0_5.
Articular cartilage covers the ends of bones in synovial joints acting as a shock absorber that helps movement of bones. Damage of the articular cartilage needs treatment as it does not repair itself and the damage can progress to osteoarthritis. In osteoarthritis all the joint tissues are involved with characteristic progressive cartilage degradation and inflammation. Autologous chondrocyte implantation is a well-proven cell-based treatment for cartilage defects, but a main downside it that it requires two surgeries. Multipotent, aka mesenchymal stromal cell (MSC)-based cartilage repair has gained attention as it can be used as a one-step treatment. It is proposed that a combination of immunomodulatory and regenerative capacities make MSC attractive for the treatment of osteoarthritis. Furthermore, since part of the paracrine effects of MSCs are attributed to extracellular vesicles (EVs), small membrane enclosed particles secreted by cells, EVs are currently being widely investigated for their potential therapeutic effects. Although MSCs have entered clinical cartilage treatments and EVs are used in in vivo efficacy studies, not much attention has been given to determine their potency and to the development of potency assays. This chapter provides considerations and suggestions for the development of potency assays for the use of MSCs and MSC-EVs for the treatment of cartilage defects and osteoarthritis.
关节软骨覆盖在滑膜关节的骨端，起到减震器的作用，帮助骨骼运动。关节软骨损伤需要治疗，因为它不会自行修复，而且损伤会进展为骨关节炎。在骨关节炎中，所有的关节组织都受到影响，其特征是进行性软骨降解和炎症。自体软骨细胞移植是一种经过充分验证的基于细胞的软骨缺损治疗方法，但主要缺点是需要进行两次手术。多能性，又名间充质基质细胞（MSC）为基础的软骨修复已经引起了人们的关注，因为它可以作为一种一步治疗方法。有人提出，免疫调节和再生能力的结合使 MSC 成为治疗骨关节炎的有吸引力的选择。此外，由于 MSC 的旁分泌作用部分归因于细胞外囊泡（EVs），即细胞分泌的小膜封闭颗粒，因此 EVs 目前正在广泛研究其潜在的治疗效果。尽管 MSC 已进入临床软骨治疗，EVs 也用于体内疗效研究，但对于确定其效力和开发效力检测方法，并没有给予太多关注。本章提供了关于开发用于治疗软骨缺损和骨关节炎的 MSC 和 MSC-EV 的效力检测方法的考虑和建议。
