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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Cell-Based Meniscus Repair and Regeneration: At the Brink of Clinical Translation?
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Cell-Based Meniscus Repair and Regeneration: At the Brink of Clinical Translation?

机译：基于细胞的半月板修复和再生：处于临床翻译的边缘？

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Background:Meniscus damage can be caused by trauma or degeneration and is therefore common among patients of all ages. Repair or regeneration of the menisci could be of great importance not only for pain relief or regaining function but also to prevent degenerative disease and osteoarthritis. Current treatment does not offer consistent long-term improvement. Although preclinical research focusing on augmentation of meniscal tear repair and regeneration after meniscectomy is encouraging, clinical translation remains difficult.Purpose:To systematically evaluate the literature on in vivo meniscus regeneration and explore the optimal cell sources and conditions for clinical translation. We aimed at thorough evaluation of current evidence as well as clarifying the challenges for future preclinical and clinical studies.Study Design:Systematic review.Methods:A search was conducted using the electronic databases of MEDLINE, Embase, and the Cochrane Collaboration. Search terms included meniscus, regeneration, and cell-based.Results:After screening 81 articles based on title and abstract, 51 articles on in vivo meniscus regeneration could be included; 2 additional articles were identified from the references. Repair and regeneration of the meniscus has been described by intra-articular injection of multipotent mesenchymal stromal (stem) cells from adipose tissue, bone marrow, synovium, or meniscus or the use of these cell types in combination with implantable or injectable scaffolds. The use of fibrochondrocytes, chondrocytes, and transfected myoblasts for meniscus repair and regeneration is limited to the combination with different scaffolds. The comparative in vitro and in vivo studies mentioned in this review indicate that the use of allogeneic cells is as successful as the use of autologous cells. In addition, the implantation or injection of cell-seeded scaffolds increased tissue regeneration and led to better structural organization compared with scaffold implantation or injection of a scaffold alone. None of the studies mentioned in this review compare the effectiveness of different (cell-seeded) scaffolds.Conclusion:There is heterogeneity in animal models, cell types, and scaffolds used, and limited comparative studies are available. The comparative in vivo research that is currently available is insufficient to draw strong conclusions as to which cell type is the most promising. However, there is a vast amount of in vivo research on the use of different types of multipotent mesenchymal stromal (stem) cells in different experimental settings, and good results are reported in terms of tissue formation. None of these studies compare the effectiveness of different cell-scaffold combinations, making it hard to conclude which scaffold has the greatest potential.
机译：背景：半月板损伤可能由外伤或变性引起，因此在所有年龄段的患者中都很常见。半月板的修复或再生不仅对于减轻疼痛或恢复功能，而且对于预防退行性疾病和骨关节炎都可能非常重要。目前的治疗方法不能长期持续改善病情。尽管临床前研究侧重于半月板切除术后半月板撕裂修复和再生的增强是令人鼓舞的，但临床翻译仍然困难。我们旨在彻底评估当前证据，并阐明未来临床前和临床研究面临的挑战。研究设计：系统评价。方法：使用MEDLINE，Embase和Cochrane Collaboration的电子数据库进行搜索。结果：筛选出81篇基于标题和摘要的文章，可以纳入51篇有关体内半月板再生的文章;从参考文献中发现了2篇其他文章。通过关节内注射来自脂肪组织，骨髓，滑膜或半月板的多能间充质基质（干）细胞，或将这些细胞类型与可植入或可注射的支架结合使用，描述了半月板的修复和再生。纤维状软骨细胞，软骨细胞和转染的成肌细胞在半月板修复和再生中的使用仅限于与不同支架的组合。这篇综述中提到的比较的体外和体内研究表明，同种异体细胞的使用与自体细胞的使用一样成功。另外，与单独的支架植入或注射相比，植入细胞的支架的植入或注射增加了组织再生并导致更好的结构组织。这篇综述中提到的研究都没有一个能比较不同的（细胞接种的）支架的有效性。结论：动物模型，细胞类型和所使用的支架存在异质性，目前仅有有限的比较研究。目前可用的体内比较研究不足以得出哪种细胞类型最有前景的强有力结论。然而，在不同的实验环境中，关于使用不同类型的多能间充质基质（干）细胞的研究有大量的体内研究，并且据报道在组织形成方面有良好的结果。这些研究没有一个能比较不同细胞支架组合的有效性，因此很难得出哪种支架具有最大潜力的结论。

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