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Can engineered cartilage transplants be used for treating rheumatic diseases?

Nature Clinical Practice Rheumatology volume 2, pages 172–173 (2006)Cite this article

Tissue engineering is an emerging field that promises to deliver viable transplant substitutes for deficient cartilage tissue. Tissue engineering is particularly attractive for cartilage reconstruction and will have tremendous clinical implications if it can be applied to chronic joint disease.

Culture-expanded autologous chondrocytes are the most common cellular material used in cartilage tissue engineering. Viable chondrocytes can be isolated reliably and efficiently from arthroscopic biopsies of healthy cartilage and it is widely accepted that expanded chondrocytes have significant potential for redifferentiation in certain 3D culture conditions.1 Since the method of autologous chondrocyte transplantation was published,2 there have been many documented cases with encouraging results.3 Mesenchymal stem or progenitor cells (MSCs) have been suggested in many preclinical studies as an alternative to articular chondrocytes. In contrast to expanded chondrocytes, however, stem cells fail to generate cartilage tissue in heterotopic in vivo models.4 Although MSCs could be engineered to develop into cartilage closer to natural form than is achievable with cultured chondrocytes, in vivo differentiation of chondrocytes is more reliable. Progenitor cells seem to need stronger differentiation signals than expanded chondrocytes. Impaired cartilage homeostasis in chronic joint diseases,5 however, seems to be caused by the reduced abilities of the patient's own MSCs, thus encouraging the use of autologous MSCs for regenerative therapies. MSCs are also less immunogenic than chondrocytes and avoid allogeneic rejection.

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Authors and Affiliations

  1. Head of the Tissue Engineering Laboratory,

    Michael Sittinger & Gerd R Burmester

  2. Director of the Department of Medicine and Clinical Rheumatology at the Charité University Medicine, Berlin, Germany

    Michael Sittinger & Gerd R Burmester

Authors
  1. Michael Sittinger
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  2. Gerd R Burmester
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Corresponding author

Correspondence to Michael Sittinger.

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Competing interests

M Sittinger is a consultant for Transtissue Technologies. GR Burmester declared he has no competing interests.

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Sittinger, M., Burmester, G. Can engineered cartilage transplants be used for treating rheumatic diseases?. Nat Rev Rheumatol 2, 172–173 (2006). https://doi.org/10.1038/ncprheum0141

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