Lana José Fábio, de Brito Gabriela Caponero, Kruel André, Brito Benjamim, Santos Gabriel Silva, Caliari Carolina, Salamanna Francesca, Sartori Maria, Barbanti Brodano Giovanni, Costa Fábio Ramos, Jeyaraman Madhan, Dallo Ignácio, Bernaldez Pedro, Purita Joseph, Andrade Marco Antonio Percope de, Everts Peter Albert
Department of Orthopaedics, Brazilian Institute of Regenerative Medicine (BIRM), Indaiatuba 13334-170, SP, Brazil.
Regenerative Medicine, Orthoregen International Course, Indaiatuba 13334-170, SP, Brazil.
Bioengineering (Basel). 2024 Sep 28;11(10):979. doi: 10.3390/bioengineering11100979.
Bone marrow cellular therapy has undergone a remarkable evolution, significantly impacting the treatment of musculoskeletal disorders. This review traces the historical trajectory from early mythological references to contemporary scientific advancements. The groundbreaking work of Friedenstein in 1968, identifying fibroblast colony-forming cells in bone marrow, laid the foundation for future studies. Caplan's subsequent identification of mesenchymal stem cells (MSCs) in 1991 highlighted their differentiation potential and immunomodulatory properties, establishing them as key players in regenerative medicine. Contemporary research has focused on refining techniques for isolating and applying bone marrow-derived MSCs. These cells have shown promise in treating conditions like osteonecrosis, osteoarthritis, and tendon injuries thanks to their ability to promote tissue repair, modulate immune responses, and enhance angiogenesis. Clinical studies have demonstrated significant improvements in pain relief, functional recovery, and tissue regeneration. Innovations such as the ACH classification system and advancements in bone marrow aspiration methods have standardized practices, improving the consistency and efficacy of these therapies. Recent clinical trials have validated the therapeutic potential of bone marrow-derived products, highlighting their advantages in both surgical and non-surgical applications. Studies have shown that MSCs can reduce inflammation, support bone healing, and enhance cartilage repair. However, challenges remain, including the need for rigorous characterization of cell populations and standardized reporting in clinical trials. Addressing these issues is crucial for advancing the field and ensuring the reliable application of these therapies. Looking ahead, future research should focus on integrating bone marrow-derived products with other regenerative techniques and exploring non-surgical interventions. The continued innovation and refinement of these therapies hold promise for revolutionizing the treatment of musculoskeletal disorders, offering improved patient outcomes, and advancing the boundaries of medical science.
骨髓细胞疗法经历了显著的发展，对肌肉骨骼疾病的治疗产生了重大影响。本综述追溯了从早期神话记载到当代科学进步的历史轨迹。1968年弗里德斯坦的开创性工作，即在骨髓中鉴定出成纤维细胞集落形成细胞，为未来的研究奠定了基础。1991年卡普兰随后鉴定出间充质干细胞（MSC），突出了它们的分化潜能和免疫调节特性，使其成为再生医学中的关键角色。当代研究集中于完善分离和应用骨髓源性MSC的技术。由于这些细胞具有促进组织修复、调节免疫反应和增强血管生成的能力，它们在治疗骨坏死、骨关节炎和肌腱损伤等病症方面显示出前景。临床研究已证明在缓解疼痛、功能恢复和组织再生方面有显著改善。诸如ACH分类系统等创新以及骨髓抽吸方法的进步使实践标准化，提高了这些疗法的一致性和疗效。最近的临床试验验证了骨髓源性产品的治疗潜力，突出了它们在手术和非手术应用中的优势。研究表明，MSC可以减轻炎症、支持骨愈合并增强软骨修复。然而，挑战依然存在，包括需要对细胞群体进行严格表征以及在临床试验中进行标准化报告。解决这些问题对于推动该领域发展并确保这些疗法的可靠应用至关重要。展望未来，未来的研究应专注于将骨髓源性产品与其他再生技术相结合，并探索非手术干预措施。这些疗法的持续创新和完善有望彻底改变肌肉骨骼疾病的治疗方式，改善患者预后，并推动医学科学的边界向前发展。
