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https://www.arca.fiocruz.br/handle/icict/62426
CLINICAL TRIALS WITH MESENCHYMAL STEM CELL THERAPIES FOR OSTEOARTHRITIS: CHALLENGES IN THE REGENERATION OF ARTICULAR CARTILAGE
Osteoartrite
Células-tronco mesenquimais
Injeção intra-articular
Regeneração de cartilagem
Osteoarthritis
Esenchymal stem cells
Intra-articular injection
Cartilage regeneration
Osteoartrite
Células-Tronco Mesenquimais
Injeções Intra-Articulares
Regeneração
Cartilagem
Author
Affilliation
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Centro Universitário SENAI CIMATEC. Instituto SENAI de Sistemas Avançados de Saúde. Salvado, BA, Brasil.
Abstract
Osteoarthritis (OA) is a whole-joint disease primarily characterized by the deterioration of hyaline cartilage. Current treatments include microfracture and chondrocyte implantation as early surgical strategies that can be combined with scaffolds to repair osteochondral lesions; however, intra-articular (IA) injections or implantations of mesenchymal stem cells (MSCs) are new approaches that have presented encouraging therapeutic results in animal models and humans. We critically reviewed clinical trials with MSC therapies for OA, focusing on their effectiveness, quality, and outcomes in the regeneration of articular cartilage. Several sources of autologous or allogeneic MSCs were used in the clinical trials. Minor adverse events were generally reported, indicating that IA applications of MSCs are potentially safe. The evaluation of articular cartilage regeneration in human clinical trials is challenging, particularly in the inflammatory environment of osteoarthritic joints. Our findings indicate that IA injections of MSCs are efficacious in the treatment of OA and the regeneration of cartilage, but that they may be insufficient for the full repair of articular cartilage defects. The possible interference of clinical and quality variables in the outcomes suggests that robust clinical trials are still necessary for generating reliable evidence with which to support these treatments. We suggest that the administration of just-sufficient doses of viable cells in appropriate regimens is critical to achieve effective and durable effects. In terms of future perspectives, genetic modification, complex products with extracellular vesicles derived from MSCs, cell encapsulation in hydrogels, and 3D bioprinted tissue engineering are promising approaches with which to improve MSC therapies for OA.
Keywords in Portuguese
Testes clínicosOsteoartrite
Células-tronco mesenquimais
Injeção intra-articular
Regeneração de cartilagem
Keywords
Clinical trialsOsteoarthritis
Esenchymal stem cells
Intra-articular injection
Cartilage regeneration
DeCS
Diagnóstico ClínicoOsteoartrite
Células-Tronco Mesenquimais
Injeções Intra-Articulares
Regeneração
Cartilagem
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