Abstract
It is widely accepted that chondral defects in articular cartilage of adult joints are never repaired spontaneously, which is considered to be one of the major causes of age-related degenerative joint disorders, such as osteoarthritis. Since mobilization of subchondral bone (marrow) cells and addition of chondrocytes or mesenchymal stromal cells into full-thickness defects show some degrees of repair, the lack of self-repair activity in adult articular cartilage can be attributed to lack of reparative cells in adult joints. In contrast, during a fetal or embryonic stage, joint articular cartilage has a scar-less repair activity, suggesting that embryonic joints may contain cells responsible for such activity, which can be chondrocytes, chondroprogenitors, or other cell types such as skeletal stem cells. In this respect, the tendency of pluripotent stem cells (PSCs) to give rise to cells of embryonic characteristics will provide opportunity, especially for humans, to obtain cells carrying similar cartilage self-repair activity. Making use of PSC-derived cells for cartilage repair is still in a basic or preclinical research phase. This review will provide brief overviews on how human PSCs have been used for cartilage repair studies.
Highlights
BackgroundJoint articular cartilage lacks spontaneous repair activity in adult humans and large animals [1,2], which can be attributed to lack of proper reparative cells and lack of environment for endogenous reparative cells to perform proper repair in the adult joint
Pros and Cons of Adult Chondrocyte- and Adult Stem Cell-Based Cartilage RepairJoint articular cartilage lacks spontaneous repair activity in adult humans and large animals [1,2], which can be attributed to lack of proper reparative cells and lack of environment for endogenous reparative cells to perform proper repair in the adult joint
Methods rely on mobilization of endogenous cells, and the autologous chondrocyte implantation (ACI) [5] and matrix-associated ACI (MACI) [6] methods rely on the addition of ex vivo expanded chondrocytes and lately, mesenchymal stromal cells (MSCs)
Summary
Joint articular cartilage lacks spontaneous repair activity in adult humans and large animals [1,2], which can be attributed to lack of proper reparative cells and lack of environment for endogenous reparative cells to perform proper repair in the adult joint. Methods rely on mobilization of endogenous cells, and the autologous chondrocyte implantation (ACI) [5] and matrix-associated ACI (MACI) [6] methods rely on the addition of ex vivo expanded chondrocytes and lately, mesenchymal stromal cells (MSCs) These surgical methods have been successfully applied to repair restricted types of injury, such as focal cartilage injury. MSCs are mesenchymal cells that can be isolated from a variety of tissues of patients, such as bone, bone marrow, fat, and synovial membrane and fluid [9,10] They are commonly defined in vitro by their ability to adhere to and grow on plastic, and differentiate into chondrocytes, as well as other lineages such as adipocytes and osteoblasts (tri-lineage potential) under conditions optimized for individual lineages. MSCs and SSCs in their capacity to form articular-like permanent cartilage and repair focal cartilage injury have been noted, either
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