Abstract
Osteoarthritis (OA) is the most common form of the joint disease associated with age, obesity, and traumatic injury. It is a disabling degenerative disease that affects synovial joints and leads to cartilage deterioration. Despite the prevalence of this disease, the understanding of OA pathophysiology is still incomplete. However, the onset and progression of OA are heavily associated with the inflammation of the joint. Therefore, studies on OA treatment have sought to intra-articularly deliver anti-inflammatory drugs, proteins, genes, or cells to locally control inflammation in OA joints. These therapeutics have been delivered alone or increasingly, in delivery vehicles for sustained release. The use of hydrogels in OA treatment can extend beyond the delivery of anti-inflammatory components to have inherent immunomodulatory function via regulating immune cell polarization and activity. Currently, such immunomodulatory biomaterials are being developed for other applications, which can be translated into OA therapy. Moreover, anabolic and proliferative levels of OA chondrocytes are low, except initially, when chondrocytes temporarily increase anabolism and proliferation in response to structural changes in their extracellular environment. Therefore, treatments need to restore matrix protein synthesis and proliferation to healthy levels to reverse OA-induced damage. In conjugation with injectable and/or adhesive hydrogels that promote cartilage tissue regeneration, immunomodulatory tissue engineering solutions will have robust potential in OA treatment. This review describes the disease, its current and future immunomodulatory therapies as well as cartilage-regenerative injectable and adhesive hydrogels.
Highlights
This review describes the disease, its current and future immunomodulatory therapies as well as cartilage-regenerative injectable and adhesive hydrogels
There are still limitations to autologous chondrocyte implantation (ACI) related to the complexity and of two surgical procedures, and the de-differentiation and consequent capacity loss associated with cost of two surgical procedures, and the de-differentiation and consequent capacity loss associated with in vitro expansion of isolated chondrocytes [27]
Mesenchymal stem cells (MSCs) add a level of complexity and sophistication to research, the advantages of using Embryonic stem cells (ESCs)- or induced pluripotent stem cells (iPSCs)-derived MSCs cannot outcompete the disadvantages
Summary
Articular cartilage, which covers the end of each bone, acts as a cushion between the bones and provides a smooth, gliding surface for joint motion. OA has a multifactorial etiology and can be considered the product of an interplay between primary and secondary factors, age and obesity are key risk factors that predispose patients to wear and tear of the cartilage and altered joint biomechanics. These risk factors play roles in OA development and progression in weight-bearing joints such as the knee. OA is increasingly prevalent in the aged and obese populations, the same population that is afflicted with adult diseases such as hypertension and diabetes mellitus [7] These comorbidities add considerably to the costs and complexity of treatment of patients with OA. The clinical approaches to OA are expected to change considerably and research on effective OA treatments should be actively conducted
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