Minimally Invasive Cellular Therapies for Osteoarthritis Treatment
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REVIEW
Minimally Invasive Cellular Therapies for Osteoarthritis Treatment Shiv Shah 1,2,3,4 & Takayoshi Otsuka 1,2,3 & Maumita Bhattacharjee 1,2,3 & Cato T. Laurencin 1,2,3,4,5,6,7,8 Received: 2 July 2020 / Revised: 21 August 2020 / Accepted: 25 August 2020 # The Regenerative Engineering Society 2020
Abstract Osteoarthritis (OA) is a chronic degenerative disease characterized by multiple pathological conditions such as synovitis, degeneration of the articular cartilage, subchondral bone remodeling, and osteophyte formation. Local chronic inflammation response induces degradation of cartilage and the poor regenerative ability of articular cartilage due to its avascular nature and limited regeneration of chondrocytes affecting the microenvironment of the joint. Current clinical treatments provide temporal pain relief but have failed to treat OA pathogenesis. In addition, surgical invasive methods have the risk of adverse complications such as long-term pain and increased morbidity. Therefore, there is a need to develop novel therapeutic strategies to prevent adverse effects seen in current surgical approaches. Minimally invasive therapies have been explored to overcome the limitations of conventional OA therapies. In recent years, cellular-based therapies have been employed to suppress inflammation and promote cartilage regeneration by using progenitor cells and stem cells including induced pluripotent stem cells (iPSCs) and genetically modified cells. The present review summarizes the status of cellular-based therapy for OA treatment. We suggest that minimally invasive intervention in the microenvironment of the joint may overcome the current limitation for OA treatment. Lay Summary Osteoarthritis is a chronic degenerative disease for which many therapies are insufficient in treating disease pathogenesis and instead provide transient symptomatic relieves such as pain and inflammation. Those treatments that do target the progression of the disease include surgical intervention and, depending on the age of the patient, these procedures may not even be an option. Minimally invasive cellular-based therapies help to lower the financial burden and attenuate disease progression rather than providing temporary relief of the symptoms. These cellular therapies are reviewed in this manuscript. Keywords Osteoarthritis . Minimally invasive therapies . Cellular therapies . Stem cell therapies . Injectable
Introduction (OA) is a chronic degenerative disease affecting more than 50 million adults, imposing a huge socio-economic and financial burden [1]. OA is a complex disease that affects not only the cartilage tissue but also the synovium and sub-chondral bone.
* Cato T. Laurencin [email protected] 1
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Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health, Farmington, CT, USA Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, The University of Connecticut Health, 263 Farmington Ave, Farmington, CT 06030, USA Departmen
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