Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways safety and efficacy Study review

Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways safety and efficacy Study review Abstract:
Osteoarthritis is a leading cause of pain and disability across the world. With an aging population its prevalence is
likely to further increase. Current accepted medical treatment strategies are aimed at symptom control rather than
disease modification. Surgical options including joint replacement are not without possible significant
complications. A growing interest in the area of regenerative medicine, led by an improved understanding of the
role of mesenchymal stem cells in tissue homeostasis and repair, has seen recent focused efforts to explore the
potential of stem cell therapies in the active management of symptomatic osteoarthritis. Encouragingly, results of
pre-clinical and clinical trials have provided initial evidence of efficacy and indicated safety in the therapeutic use of
mesenchymal stem cell therapies for the treatment of knee osteoarthritis. This paper explores the pathogenesis of
osteoarthritis and how mesenchymal stem cells may play a role in future management strategies of this disabling
condition.
Keywords: Mesenchymal Stem Cells, Osteoarthritis, Knee

Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways safety and efficacy Study review CONCLUSION:

Osteoarthritis is a progressive and degenerative condition. With an aging population it promises to remain a significant cause of pain and disability. Whilst osteoarthritis is an active, inflammatory and progressive condition, there has been no development of disease modifying pharmaceutical therapies. Indeed, all currently accepted therapies are aimed at symptom control rather than disease prevention. Current conservative management strategies fail to alter disease progression and surgical management in the form of joint replacement is associated with not insignificant complications. Methods for the repair of articular cartilage lesions – including surgical microfracture and cellular scaffold transplantation – have been investigated with success in both preclinical and clinical trials. Unfortunately, these techniques are limited to the repair of focal lesions only and are not easily transferable to osteoarthritis, where there is more generalized loss of cartilage volume. Intra-articular injections of MSCs have resulted in pain and functional improvement in a number of preclinical and clinical trials. Importantly, recent limited case series evidence has shown regrowth of cartilage volume and disease modification following MSC injections. Whilst recognizing the low level of scientific evidence (Level IV), a significant increase in cartilage volume in an accepted degenerative and progressive condition represents an exciting development. Despite initial concerns regarding MSC therapies, systematic review of clinical trials has indicated a relative safety in both intravascular and intra-articular injections. Evidence does support however that caution needs to be undertaken when culturing/expanding these cells. The burden of musculoskeletal disease is progressively expanding and highlights the need for both preventative and reparative therapies rather than commonly accepted pain management interventions. MSC based cell therapies offer an exciting possibility in the treatment of OA and importantly show promise in disease modification, with potential inhibition of progression and recent evidence of reversal of this degenerative process. Importantly further randomized controlled trials are needed to evaluate the most effective application of MSCs in osteoarthritis management.

Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways safety and efficacy Study review Below:

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