CARTILAGE REGENERATION STRATEGIES INVOLVING STEM CELLS
Articular cartilage tissue itself can be regenerated to a certain extent, including chondrocytes, cartilage matrix, and elastic fibers; however, the regeneration process is slow and difficult to bear the heavy pressure placed on the joint. In fact, mesenchymal stem cells (MSCs) in the synovial fluid have cartilage-regenerating potential, but their differentiated cartilage tissue is very fragile, even if the joint is under minimal pressure. In addition, the number of MSCs with articular cartilage potential in the articular cavity is small, and the process of differentiation into cartilage is slow.
Cartilage defects are the most common joint disease that can cause subsequent loss of joint functions along with severe pain and swelling. The capacity of the cartilage to self-repair is very limited due to its unique structure as it lacks nerves, blood supply and lymphangion. Therefore, early osteoarthritis (OA) and traumatic cartilage injuries cause pain, dysfunction and accelerate arthrosis. Meniscus injury can also cause extreme pain to patients, limiting their body movement and accelerating the occurrence and progression of OA.
Intervertebral disc cartilage injuries are the leading causes for chronic back pain. The subsequent tissue degeneration that takes place after cartilage damage can cause long-term diseases whose treatments can cost a fortune and demand large amount of medical resources. However, with recent advancements in the field of regenerative medicine, developments have been observed in repairing damaged cartilage.
Parkinson’s disease, a very common clinical disorder and progressive neurodegenerative disease, is one of the major causes of multifunctional impairment. Therapeutic approaches such as dopaminergic agonist administration, L‐3,4‐dihydroxy‐phenylalanine replacement therapy, and neurosurgical treatment are often used to counter the effects of PD and bring relief from its progression. However, these therapies have not been able to replace the lost cells and they could not effectively slow down the relentless neurodegenerative process.
Why Stem Cells Therapy?
Due to the lack of eligible PD treatment, stem cells therapy is considered as a viable treatment and Autologous cartilage is considered the gold standard for cartilage seed cells in the field of regenerative medicine. As the donor source of autologous chondrocytes is limited, cells are needed to be amplified in monolayers to meet the repair requirements.
Stem cells have exceptionally high potential for self-renewal and differentiation into multiple cell lines. These cells can be divided into distinct categories. Stem cells are attracting attention as a key element in future medicine, satisfying the desire to live a healthier life with the possibility that they can regenerate tissue damaged or degenerated by disease or aging. Intravenous infusions of bone marrow cells in 1957 from a healthy donor to a leukemia patient following radiation and chemotherapy would come to be considered a kind of hematopoietic stem cell therapy.
Today, treatment with stem cells has received increasing attention as a solution to overcome the limitations of conventional treatment and medicine for intractable diseases. Stem cell therapy has been tried for various diseases, such as Lou Gehrig’s disease, Burger’s disease, spinal cord injury, Parkinson’s disease, and intractable osteoarthritis.
The genuine properties of stem cells that are attributable to regenerating damaged or degenerative tissue are the self-reproduction or self-renewal and plasticity of differentiation. Self-renewal refers to the ability to multiply themselves through the generations of daughter cells that have the same characteristics, as undifferentiated stem cells.
All in all
The purpose of stem cell therapy is to is to reduce or eliminate pain, correct deformity, improve or restore joint function, and improve quality of life and unlike other conventional treatment, it is intended to regenerate articular cartilage.
Abd-Elsayed, A., 2018. Stem cells for the treatment of knee osteoarthritis: a comprehensive review. Pain physician, 21, pp.229-241.
Bagheri‐Mohammadi, S., Karimian, M., Alani, B., Verdi, J., Tehrani, R.M. and Noureddini, M., 2019. Stem cell‐based therapy for Parkinson’s disease with a focus on human endometrium‐derived mesenchymal stem cells. Journal of cellular physiology, 234(2), pp.1326-1335.
Han, Y.H., Kim, K.H., Abdi, S. and Kim, T.K., 2019. Stem cell therapy in pain medicine. The Korean journal of pain, 32(4), p.245.