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Stem Cells for Articular Cartilage Repair and Regeneration

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Bone and Cartilage Regeneration

Part of the book series: Stem Cells in Clinical Applications ((SCCA))

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Abstract

Articular cartilage is a unique avascular load-bearing tissue comprising of dense extracellular matrix sparsely populated by chondrocytes. Due to the lack of vascularisation and low cell density, articular cartilage has a limited self-regenerative capacity. Many treatment modalities have been generated but with limited success due to formation of inferior fibrocartilage at the damaged area/injured site during the repair process. Recent advancements in stem cell biology and tissue engineering have provided notable strategies for stem cell-based therapies and cartilage tissue engineering. Several stem cell sources including adult and embryonic stem cells have been reported for their differentiation capabilities to form the cartilage. Among these various stem cell sources, mesenchymal stem cells (MSCs) represent the most promising stem cell source for cartilage regeneration, due to its availability, ease of isolation and high potency to differentiate into chondrocytes. Stem cells may be delivered directly by means of injection or seeded in scaffolds for implantation. To further enhance cartilage regeneration, advances in tissue engineering have enabled the use of scaffolds, coupled with biochemical and biophysical factors to influence stem cell chondrogenesis in their lineage-specific differentiation and phenotypic stability of the cartilage formation. Moving forward, a number of clinical trials using bone marrow-derived MSCs for articular cartilage repair have been carried out and showed successful cartilage regeneration, with features of hyaline cartilage, similar to those of the native cartilage. The translational use of stem cells, in particular MSCs, for articular cartilage repair is likely to advance rapidly in the ensuing decade.

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Abbreviations

3-D:

Three-dimensional

ACI:

Autologous chondrocyte implantation

ACI:

Autologous chondrocyte implantation

BMMSC:

Bone marrow-derived mesenchymal stem cells

ECM:

Extracellular matrix

ESCs:

Embryonic stem cells

GAGs:

Glycosaminoglycans

ICRS:

International Cartilage Research Society

IL:

Interleukin

iPSCs:

Induced pluripotent stem cells

MMPs:

Matrix metalloproteinases

MRI:

Magnetic resonance imaging

MSCs:

Mesenchymal stem cells

OA:

Osteoarthritis

PCM:

Pericellular matrix

PGA:

Polyglycolic acid

PLA:

Polylactic acid

PLGA:

Poly(lactic/glycolic acid)

PRP:

Platelet-rich plasma

SZP:

Superficial zone protein

TGF-β1:

Transforming growth factor-β1

TNF-α:

Tumour necrosis factor-α

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Acknowledgements

This work was supported by grants from the National University Health System, National University of Singapore (R221000070733, R221000077733, R221000083112 and R221000081133) and National Medical Research Council, Singapore (R221000080511).

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    Authors and Affiliations

    1. Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

      Dinesh A. Parate & James Hoi Po Hui

    2. Faculty of Dentistry, National University of Singapore, Singapore, Singapore

      Shipin Zhang & Wei Seong Toh

    3. Tissue Engineering Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore

      James Hoi Po Hui & Wei Seong Toh

    4. Cartilage Repair Program, Therapeutic Tissue Engineering Laboratory, National University Health System, Singapore, Singapore

      James Hoi Po Hui

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    1. Dinesh A. Parate
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    Correspondence to Wei Seong Toh .

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    1. Laboratory of Stem Cell Research and Application, University of Science Vietnam National University, Ho Chi Minh City, Vietnam

      Phuc Van Pham

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    Parate, D.A., Zhang, S., Hui, J.H.P., Toh, W.S. (2016). Stem Cells for Articular Cartilage Repair and Regeneration. In: Pham, P. (eds) Bone and Cartilage Regeneration. Stem Cells in Clinical Applications. Springer, Cham. https://doi.org/10.1007/978-3-319-40144-7_7

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