探索骨科干细胞方法治疗骨关节炎:现状与未来。

Exploring Orthopedic Stem-Cell Approaches for Osteoarthritis Management: Current Trends and Future Horizons.

机构信息

Medical College of Wisconsin, Milwaukee, USA.

Eastern Virginia Medical School, Norfolk, USA.

出版信息

Curr Pain Headache Rep. 2024 Jan;28(1):27-35. doi: 10.1007/s11916-023-01191-6. Epub 2023 Nov 27.

Abstract

PURPOSE OF REVIEW

Osteoarthritis (OA) is a prevalent and debilitating condition characterized by joint degeneration and pain. Current treatment options aim to alleviate symptoms and slow disease progression but lack curative potential. Stem cell therapies have emerged as a promising alternative. This article explores the epidemiology, pathophysiology, clinical manifestations of hip and knee OA, and the evolving role of stem cell therapies in their treatment.

RECENT FINDINGS

The global prevalence of OA, with knee OA being the most common form, has fueled the demand for stem cell therapies. Despite limited robust evidence supporting their efficacy, clinical trials investigating stem-cell treatments for OA have reported encouraging radiological and clinical improvements. Stem cell therapies offer potential disease-modifying benefits through immunomodulatory actions, growth factor secretion, and chondrogenic capabilities. Adipose-derived mesenchymal stem cells (ADMSCs) have shown promise in clinical trials for OA treatment, offering potential pain relief and functional improvement. ADMSCs possess advantages such as accessibility and a favorable safety profile, making them a viable option for OA management. Although other stem-cell types, including human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs), have been used in OA treatment, ADMSCs have demonstrated superior outcomes. By providing a comprehensive overview of the evolving landscape of stem cell therapies for hip and knee OA, this article highlights the potential of stem-cell treatments to address the limitations of current therapies. However, further research is required to establish their long-term efficacy, identify optimal stem-cell types, and develop standardized protocols.

摘要

目的综述

骨关节炎(OA)是一种普遍且使人虚弱的疾病,其特征为关节退化和疼痛。目前的治疗选择旨在缓解症状和减缓疾病进展,但缺乏治愈潜力。干细胞疗法已成为一种有前途的替代方法。本文探讨了髋部和膝部 OA 的流行病学、病理生理学、临床表现,以及干细胞疗法在其治疗中的不断发展的作用。

最近的发现

OA 的全球患病率,其中膝部 OA 最为常见,这加剧了对干细胞疗法的需求。尽管有有限的有力证据支持其疗效,但正在进行的临床试验表明,干细胞治疗 OA 可带来影像学和临床改善。干细胞疗法通过免疫调节作用、生长因子分泌和软骨生成能力提供潜在的疾病修饰益处。脂肪来源的间充质干细胞(ADMSCs)在 OA 治疗的临床试验中显示出前景,为疼痛缓解和功能改善提供了潜力。ADMSCs 具有易于获取和良好的安全性特征,使其成为 OA 管理的可行选择。尽管其他干细胞类型,包括人类胚胎干细胞(hESCs)和诱导多能干细胞(iPSCs)已用于 OA 治疗,但 ADMSCs 已显示出更好的结果。本文通过全面概述髋部和膝部 OA 的干细胞疗法不断发展的领域,突出了干细胞疗法解决当前疗法局限性的潜力。然而,需要进一步的研究来确定其长期疗效、识别最佳的干细胞类型并制定标准化方案。

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