Abstract
Osteoarthritis (OA) has generally been introduced as a degenerative disease; however, it has recently been understood as a low-grade chronic inflammatory process that could promote symptoms and accelerate the progression of OA. Current treatment strategies, including corticosteroid injections, have no impact on the OA disease progression. Mesenchymal stem cells (MSCs) based therapy seem to be in the spotlight as a disease-modifying treatment because this strategy provides enlarged anti-inflammatory and chondroprotective effects. Currently, bone marrow, adipose derived, synovium-derived, and Wharton’s jelly-derived MSCs are the most widely used types of MSCs in the cartilage engineering. MSCs exert immunomodulatory, immunosuppressive, antiapoptotic, and chondrogenic effects mainly by paracrine effect. Because MSCs disappear from the tissue quickly after administration, recently, MSCs-derived exosomes received the focus for the next-generation treatment strategy for OA. MSCs-derived exosomes contain a variety of miRNAs. Exosomal miRNAs have a critical role in cartilage regeneration by immunomodulatory function such as promoting chondrocyte proliferation, matrix secretion, and subsiding inflammation. In the future, a personalized exosome can be packaged with ideal miRNA and proteins for chondrogenesis by enriching techniques. In addition, the target specific exosomes could be a gamechanger for OA. However, we should consider the off-target side effects due to multiple gene targets of miRNA.
Highlights
Osteoarthritis (OA) has a multifactorial etiology, including aging, obesity, previous injury, female, hormone level, and epigenetics [1,2,3]
Chondrocytes are confined within the extracellular matrix (ECM), which possibly limits their ability to migrate to injured areas [7]
Nonsteroidal anti-inflammatory drugs (NSAIDs) medication and corticosteroid injections are often used for many years; these strategies have no impact on the progressive degeneration of joint tissues [10,11]
Summary
Osteoarthritis (OA) has a multifactorial etiology, including aging, obesity, previous injury, female, hormone level, and epigenetics [1,2,3]. The damaged cartilage has limited self-regenerative potential and is replaced by fibrocartilage or scar tissue with poorer functional and structural properties. Nonsteroidal anti-inflammatory drugs (NSAIDs) medication and corticosteroid injections are often used for many years; these strategies have no impact on the progressive degeneration of joint tissues [10,11]. Mesenchymal stromal/stem cells (MSCs)-based therapy seems to be in the spotlight because this strategy could provide an enlarged anti-inflammatory and regenerative potential. The regenerative effects of MSCs are mediated by their paracrine effects with chondroprotective and anti-inflammatory functions [17,18]. Owing to the capacity of MSCs for self-renewal, multi-differentiation, and immunoregulatory function, MSC-based therapy has excellent potential for cartilage regeneration. We discuss the current status of MSCs therapies, focusing on the immunomodulatory effects for OA
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