Wu Kun-Chi, Chang Yu-Hsun, Ding Dah-Ching, Lin Shinn-Zong
Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan.
Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan.
Int J Mol Sci. 2024 Nov 30;25(23):12911. doi: 10.3390/ijms252312911.
Cartilage degeneration is a key feature of aging and osteoarthritis, characterized by the progressive deterioration of joint function, pain, and limited mobility. Current treatments focus on symptom relief, not cartilage regeneration. Mesenchymal stromal cells (MSCs) offer a promising therapeutic option due to their capability to differentiate into chondrocytes, modulate inflammation, and promote tissue regeneration. This review explores the potential of MSCs for cartilage regeneration, examining their biological properties, action mechanisms, and applications in preclinical and clinical settings. MSCs derived from bone marrow, adipose tissue, and other sources can self-renew and differentiate into multiple cell types. In aging cartilage, they aid in tissue regeneration by secreting growth factors and cytokines that enhance repair and modulate immune responses. Recent preclinical studies show that MSCs can restore cartilage integrity, reduce inflammation, and improve joint function, although clinical translation remains challenging due to limitations such as cell viability, scalability, and regulatory concerns. Advancements in MSC delivery, including scaffold-based approaches and engineered exosomes, may improve therapeutic effectiveness. Potential risks, such as tumorigenicity and immune rejection, are also discussed, emphasizing the need for optimized treatment protocols and large-scale clinical trials to develop effective, minimally invasive therapies for cartilage regeneration.
软骨退变是衰老和骨关节炎的关键特征,其特点是关节功能逐渐恶化、疼痛以及活动受限。目前的治疗方法侧重于缓解症状,而非软骨再生。间充质基质细胞(MSCs)因其能够分化为软骨细胞、调节炎症和促进组织再生,提供了一种有前景的治疗选择。本综述探讨了MSCs在软骨再生方面的潜力,研究了它们的生物学特性、作用机制以及在临床前和临床环境中的应用。源自骨髓、脂肪组织和其他来源的MSCs能够自我更新并分化为多种细胞类型。在衰老的软骨中,它们通过分泌生长因子和细胞因子来促进组织修复并调节免疫反应,从而帮助组织再生。最近的临床前研究表明,MSCs可以恢复软骨完整性、减轻炎症并改善关节功能,不过由于细胞活力、可扩展性和监管问题等限制,临床转化仍然具有挑战性。MSCs递送方面的进展,包括基于支架的方法和工程化外泌体,可能会提高治疗效果。还讨论了潜在风险,如致瘤性和免疫排斥,强调需要优化治疗方案并开展大规模临床试验,以开发有效的、微创的软骨再生疗法。