Osteoarthritis (OA) is a debilitating, degenerative joint disease characterized by progressive destruction of articular cartilage. Given the poor repair capacity of articular cartilage and the associated local destructive immune/inflammatory responses involving all joint structures, OA frequently ends up as a "whole joint failure" requiring prosthetic replacement. Current pharmacological efforts, belatedly started, mainly aim at symptomatic pain relief, underscoring the need for novel therapeutic schemes designed to modify the course of the disease. Mesenchymal stem cell (MSC)-based therapy has gained significant interest, sparking the design of multiple trials proving safety while providing promising preliminary efficacy results. MSCs possess 'medicinal signaling cell' properties related to their immunomodulatory and anti-inflammatory effects, which induce the establishment of a pro-regenerative microenvironment at the injured tissue. Those trophic effects are paralleled by the long-established chondroprogenitor capacity that can be harnessed to ex vivo fabricate engineered constructs to repair damaged articular cartilage. The present review focuses on these two aspects of the use of MSCs for articular cartilage damage, namely, cell therapy and tissue engineering, providing information on their use criteria, advancements, challenges and strategies to overcome them.

中文翻译：

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间充质干细胞治疗关节软骨退变：对旧细胞的新生物学见解

骨关节炎 (OA) 是一种使人衰弱的退行性关节疾病，其特征是关节软骨的进行性破坏。鉴于关节软骨的修复能力较差，以及涉及所有关节结构的相关局部破坏性免疫/炎症反应，OA 经常以需要假体更换的“全关节衰竭”告终。目前的药理学努力起步较晚，主要旨在缓解症状性疼痛，强调需要旨在改变疾病进程的新型治疗方案。基于间充质干细胞 (MSC) 的疗法引起了极大的兴趣，激发了多项试验设计，证明安全性，同时提供有希望的初步疗效结果。MSCs拥有“药用信号细胞” 与它们的免疫调节和抗炎作用相关的特性，这些特性诱导在受伤组织中建立促进再生的微环境。这些营养效应与长期建立的软骨祖细胞能力相平行，该能力可用于离体制造工程结构以修复受损的关节软骨。本综述重点关注 MSC 用于关节软骨损伤的这两个方面，即细胞治疗和组织工程，提供有关其使用标准、进展、挑战和克服它们的策略的信息。这些营养效应与长期建立的软骨祖细胞能力相平行，该能力可用于离体制造工程结构以修复受损的关节软骨。本综述重点关注 MSC 用于关节软骨损伤的这两个方面，即细胞治疗和组织工程，提供有关其使用标准、进展、挑战和克服它们的策略的信息。这些营养效应与长期建立的软骨祖细胞能力相平行，该能力可用于离体制造工程结构以修复受损的关节软骨。本综述重点关注 MSC 用于关节软骨损伤的这两个方面，即细胞治疗和组织工程，提供有关其使用标准、进展、挑战和克服它们的策略的信息。