Osteoarthritis is the most common form of arthritis. The prevalence of osteoarthritis has increased in the past decade due to diabetes, obesity, and many other disorders resulting from physical inactivity and unhealthy diet. The lack of desired outcomes with the present treatment options has encouraged scientists to search for an alternative. Regenerative medicine approaches the treatment from a different direction, effectively restoring the organ structure and function. Thus, Stem Cell Therapy for Arthritis Pain Relief has remarkable therapeutic potential, encouraging its use for treatment.
Cartilage
The disorder starts at the cartilage region of joints. Articular or hyaline cartilage is a protective covering over bones in the joint. It lubricates bones and allows their gliding over each other for a smooth movement. By distributing the weight in its layers, cartilage bears the mechanical load. It also serves as a cushion by reducing stress during movements. It contains cells (chondrocytes) and matrix (composed of proteins and proteoglycans). The absence of blood vessels in cartilage restricts its capacity to repair itself.
Osteoarthritis
Osteoarthritis begins with cartilage damage. The damage can occur due to genetic predisposition, high mechanical load, or other biochemical factors. Mechanical osteoarthritis occurs due to high load on joints, whereas structural osteoarthritis arises from prior abnormalities in the tissue, making it prone to injury. Injury damages the matrix, triggering repair pathways. Dysregulated repairing leads to bony outgrowths, inadequate matrix formation, and thickening of the bone beneath the cartilage. Gradually, the damage extends to the surrounding tissue, extending to nearby bones, ligaments, and tendons. It also induces inflammation in the synovial fluid present between the joint bones, further worsening the disorder. Pain when moving the afflicted joint is one of the disorder's symptoms. It even limits mobility during hip or knee joint involvement, leading to disability.
Stem Cell Therapy for Osteoarthritis
There has been interest in mesenchymal stem cells (MSCs) for treating osteoarthritis. Their therapeutic effects focus on different mechanisms of the disorder
Anti-inflammation: Chronic inflammation worsens the damage in the disorder and spreads it to the nearby structures. MSCs alleviate inflammation by the production of anti-inflammatory cytokines.
Regeneration: MSCs develop into chondrocytes and other bone cells. Therefore, they can form bone and cartilage tissue as well as the nearby tissue cells, resulting in effective regeneration.
Antioxidant: Osteoarthritis significantly alters the cellular metabolism, producing reactive oxygen species that further deteriorate cellular machinery. MSCs lower the levels of these molecules to prevent them from inflicting more damage.
Immune Modulation: Inflammation promotes migration of immune cells to the injury site. These cells cause more harm. MSCs shift the response of these cells towards the reparative process.
Types of MSCs
MSCs are immune evasive, resulting in reduced risk of immune rejection. Over time, many sources of MSCs have surfaced with higher accessibility, and MSCs from all these sources have been employed in clinical trials.
Bone Marrow MSCs (BMMSCs): MSCs were first identified in bone marrow. They are still considered the gold standard of MSCs. However, the extraction of MSCs from bone marrow is a painful process with a low yield of cells.
Adipose Tissue MSCs (ADMSCs): Adipose tissue or fat deposits are present throughout the body and provide an abundant source of MSCs. Their use in MSC-based therapy has grown considerably.
Umbilical Cord MSCs (UCMSCs): They are located in the cord tissue of the umbilical cord. The cord tissue is discarded at birth, providing a cost-effective source. UC-MSCs also have higher regeneration potential and proliferation rate than other MSCs.
Stem Cell Pathways
Osteoarthritis Stem Cell Treatment is effective due to the alteration of the following signaling pathways:
Cartilage
The disorder starts at the cartilage region of joints. Articular or hyaline cartilage is a protective covering over bones in the joint. It lubricates bones and allows their gliding over each other for a smooth movement. By distributing the weight in its layers, cartilage bears the mechanical load. It also serves as a cushion by reducing stress during movements. It contains cells (chondrocytes) and matrix (composed of proteins and proteoglycans). The absence of blood vessels in cartilage restricts its capacity to repair itself.
Osteoarthritis
Osteoarthritis begins with cartilage damage. The damage can occur due to genetic predisposition, high mechanical load, or other biochemical factors. Mechanical osteoarthritis occurs due to high load on joints, whereas structural osteoarthritis arises from prior abnormalities in the tissue, making it prone to injury. Injury damages the matrix, triggering repair pathways. Dysregulated repairing leads to bony outgrowths, inadequate matrix formation, and thickening of the bone beneath the cartilage. Gradually, the damage extends to the surrounding tissue, extending to nearby bones, ligaments, and tendons. It also induces inflammation in the synovial fluid present between the joint bones, further worsening the disorder. Pain when moving the afflicted joint is one of the disorder's symptoms. It even limits mobility during hip or knee joint involvement, leading to disability.
Stem Cell Therapy for Osteoarthritis
There has been interest in mesenchymal stem cells (MSCs) for treating osteoarthritis. Their therapeutic effects focus on different mechanisms of the disorder
Anti-inflammation: Chronic inflammation worsens the damage in the disorder and spreads it to the nearby structures. MSCs alleviate inflammation by the production of anti-inflammatory cytokines.
Regeneration: MSCs develop into chondrocytes and other bone cells. Therefore, they can form bone and cartilage tissue as well as the nearby tissue cells, resulting in effective regeneration.
Antioxidant: Osteoarthritis significantly alters the cellular metabolism, producing reactive oxygen species that further deteriorate cellular machinery. MSCs lower the levels of these molecules to prevent them from inflicting more damage.
Immune Modulation: Inflammation promotes migration of immune cells to the injury site. These cells cause more harm. MSCs shift the response of these cells towards the reparative process.
Types of MSCs
MSCs are immune evasive, resulting in reduced risk of immune rejection. Over time, many sources of MSCs have surfaced with higher accessibility, and MSCs from all these sources have been employed in clinical trials.
Bone Marrow MSCs (BMMSCs): MSCs were first identified in bone marrow. They are still considered the gold standard of MSCs. However, the extraction of MSCs from bone marrow is a painful process with a low yield of cells.
Adipose Tissue MSCs (ADMSCs): Adipose tissue or fat deposits are present throughout the body and provide an abundant source of MSCs. Their use in MSC-based therapy has grown considerably.
Umbilical Cord MSCs (UCMSCs): They are located in the cord tissue of the umbilical cord. The cord tissue is discarded at birth, providing a cost-effective source. UC-MSCs also have higher regeneration potential and proliferation rate than other MSCs.
Stem Cell Pathways
Osteoarthritis Stem Cell Treatment is effective due to the alteration of the following signaling pathways:
- MSCs activate Akt and ERK signaling pathways in chondrocytes to boost their proliferation. They also release long non-coding RNA that induces cartilage repair.
- MSCs suppress the development of mature dendritic cells and activation of natural killer cells. They also promote the conversion of macrophages into M2 macrophages that stimulate repair. These cells also secrete IL6 and TGF-β to regulate immune response.
- MSCs also reduce pain via the COX2/PGE2 pathway.
Clinical Evidence of Stem Cell Treatment for Osteoarthritis
- In 2024, MAG200 - an adipose tissue stem cell product showed sustained pain improvements, increased cartilage volume, halted disorder progression, and improved quality of life for a year.
- A 5-year-long trial with BMMSCs showed improvement in walking time, stair climbing, pain, popping sound in the kneecap, and fixed or bent joints. WOMAC and VAS scores also improved 6 months post-treatment, with effects lasting up to 5 years.
- Two years after treatment with ADMSCs, patients showed increased tissue repair and less pain, improved WOMAC score, and enhanced functional capacity.
- Treatment with UCMSCs has demonstrated improvements in WOMAC and VAS scores, pain relief, recovery of daily activities, and improved functional outcomes.
None of the clinical trials showed any risks of tumors, infections, or any other life-threatening diseases, proving that.
Scaffolds
Scientists have proven the efficacy of stem cells but still attempt to maximize their potential. For cartilage regeneration, scaffold offers a novel method. These are 3D porous structures made of biocompatible materials. By providing support, they aid cell survival and proliferation. Conjugation of growth factors such as TGFβ and BMP2 further boost their potential of cell regeneration. 3D bioprinting takes this technology one step further by creating customized scaffolds with uniform porosity and cells. Scientists are trying to increase the potential of regenerative medicine by integrating it with scaffolds and 3D printing to offer the best stem cell therapy for knee osteoarthritis.
Conclusion
Osteoarthritis is a debilitating disease considered to be a leading cause of disability. Its dynamic and complex nature cannot be treated with conventional treatment that targets only symptoms. Instead, it requires a novel approach that can intelligently counter the different mechanisms of the disorder. Stem cell therapy is a smart treatment modality that can target the cellular-level signaling of this condition. Research studies have claimed their potential in osteoarthritis. Clinical trials with different types or sources of MSCs have also yielded improved outcomes through effective cartilage regeneration. The studies have supported the safety of the treatment, encouraging its clinical translation. With the ongoing research, stem cell therapy for arthritis pain relief will soon be available in the market. Advancells is increasing the pace of this therapy by delivering high-quality stem cells manufactured by an expert team of scientists.
Scaffolds
Scientists have proven the efficacy of stem cells but still attempt to maximize their potential. For cartilage regeneration, scaffold offers a novel method. These are 3D porous structures made of biocompatible materials. By providing support, they aid cell survival and proliferation. Conjugation of growth factors such as TGFβ and BMP2 further boost their potential of cell regeneration. 3D bioprinting takes this technology one step further by creating customized scaffolds with uniform porosity and cells. Scientists are trying to increase the potential of regenerative medicine by integrating it with scaffolds and 3D printing to offer the best stem cell therapy for knee osteoarthritis.
Conclusion
Osteoarthritis is a debilitating disease considered to be a leading cause of disability. Its dynamic and complex nature cannot be treated with conventional treatment that targets only symptoms. Instead, it requires a novel approach that can intelligently counter the different mechanisms of the disorder. Stem cell therapy is a smart treatment modality that can target the cellular-level signaling of this condition. Research studies have claimed their potential in osteoarthritis. Clinical trials with different types or sources of MSCs have also yielded improved outcomes through effective cartilage regeneration. The studies have supported the safety of the treatment, encouraging its clinical translation. With the ongoing research, stem cell therapy for arthritis pain relief will soon be available in the market. Advancells is increasing the pace of this therapy by delivering high-quality stem cells manufactured by an expert team of scientists.
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