Department of Orthopaedic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
Department of Orthopaedic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China; Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, Australia.
Prog Mol Biol Transl Sci. 2023;199:199-225. doi: 10.1016/bs.pmbts.2023.02.006. Epub 2023 Mar 16.
Widely used for cell-based therapy in various medical fields, mesenchymal stem cells (MSCs) show capacity for anti-inflammatory effects, anti-apoptotic activity, immunomodulation, and tissue repair and regeneration. As such, they can potentially be used to treat osteoarthritis (OA). However, MSCs from different sources have distinct advantages and disadvantages, and various animal models and clinical trials using different sources of MSCs are being conducted in OA regenerative medicine. It is now widely believed that the primary tissue regeneration impact of MSCs is via paracrine effects, rather than direct differentiation and replacement. Cytokines and molecules produced by MSCs, including extracellular vesicles with mRNAs, microRNAs, and bioactive substances, play a significant role in OA repair. This chapter outlines the properties of MSCs and recent animal models and clinical trials involving MSCs-based OA therapy, as well as how the paracrine effect of MSCs acts in OA cartilage repair. Additionally, it discusses challenges and controversies in MSCs-based OA therapy. Despite its limits and unanticipated hazards, MSCs have the potential to be translated into therapeutic therapy for future OA treatment.
间充质干细胞（MSCs）在各种医学领域中广泛用于细胞治疗，具有抗炎作用、抗凋亡活性、免疫调节、组织修复和再生能力。因此，它们有可能用于治疗骨关节炎（OA）。然而，不同来源的间充质干细胞具有不同的优缺点，并且在 OA 再生医学中正在使用不同来源的间充质干细胞进行各种动物模型和临床试验。现在人们普遍认为，MSCs 的主要组织再生作用是通过旁分泌作用，而不是直接分化和替代。MSCs 产生的细胞因子和分子，包括带有 mRNAs、microRNAs 和生物活性物质的细胞外囊泡，在 OA 修复中发挥重要作用。本章概述了 MSCs 的特性，以及最近涉及 MSCs 治疗 OA 的动物模型和临床试验，以及 MSCs 的旁分泌作用如何在 OA 软骨修复中发挥作用。此外，还讨论了基于 MSCs 的 OA 治疗的挑战和争议。尽管存在局限性和意外的危险，但 MSCs 有可能转化为未来 OA 治疗的治疗方法。
