Therapeutic application of mesenchymal stem cells in osteoarthritis

Abstract

Introduction: Osteoarthritis (OA) is a degenerative disease characterized by cartilage degradation and subchondral bone alterations. This disease represents a global public health problem whose prevalence is rapidly growing with the increasing aging of the population. With the discovery of mesenchymal stem cells (MSC) as possible therapeutic agents, their potential for repairing cartilage damage in OA is under investigation.

Areas covered: Characterization of MSCs and their functional properties are mentioned with an insight into their trophic function and secretory profile. We present a special focus on the types of extracellular vesicles (EVs) that are produced by MSCs and their role in the paracrine activity of MSCs. We then discuss the therapeutic approaches that have been evaluated in pre-clinical models of OA and the results coming out from the clinical trials in patients with OA.

Expert opinion: MSC-based therapy seems a promising approach for the treatment of patients with OA. Further research is still needed to demonstrate their efficacy in clinical trials using controlled, prospective studies. However, the emergence of MSC-derived EVs as possible therapeutic agents could be an alternative to cell-based therapy.

Keywords:

• extracellular vesicles
• mesenchymal stem cells
• osteoarthritis
• regenerative medicine
• trophic factors

Acknowledgements

M Ruiz and S Cosenza contributed equally to this work.

Declaration of interest

Work in the laboratory Inserm U1183 was supported by the Inserm Institute and the University of Montpellier. Funding was obtained from the European Community’s Horizon 2020 program for the collaborative project: “ADIPOA2: Clinical trial of autologous adipose-derived mesenchymal stromal cells in the treatment of mild to moderate osteoarthritis” (#: 643809). We are grateful to Arthritis R&D through the program “ROAD: Research on OsteoArthritis Diseases” and to the Fondation de l’Avenir (grant number AP-RMA-2015-013), Paris-France. We also thank the Agence Nationale pour la Recherche for support of the national infrastructure: “ECELLFRANCE: Development of a national adult mesenchymal stem cell based therapy platform” (ANR-11-INSB-005). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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