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Regenerative medicine in rheumatic disease—progress in tissue engineering

Nature Reviews Rheumatology volume 8, pages 493–498 (2012)Cite this article

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Abstract

Joint destruction occurs in both osteoarthritis and rheumatoid arthritis. Even in the era of biologic agents, this destruction can be delayed but not averted. As cartilage has limited ability to self-regenerate, joint arthroplasty is required. Here, we outline current tissue engineering procedures (including autologous chondrocyte implantation and in situ mesenchymal stem cell recruitment) that are routinely applied for the regenerative treatment of injured or early osteoarthritic cartilage. Potential future regenerative therapies, including administration of multipotent or pluripotent stem cells, are also discussed. In the future, cell-free, material-based (for cartilage lesions) or cell-free, factor-based (for osteoarthritic cartilage) therapies to facilitate the recruitment of repair cells and improve cartilage metabolism are likely to become more important. Moreover, delivery of anti-inflammatory factors or immunomodulatory cells could be a regenerative treatment option for rheumatoid arthritis. Tissue engineering faces a crucial phase to translate products into clinical routine and the regulatory framework for cell-based products in particular is an important issue.

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Figure 1: Components, mode of administration and regulatory categories of regenerative therapies.
Figure 2: Major principles for the regenerative treatment of cartilage lesions.

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Acknowledgements

This work was supported by the Deutsche Forschungsgemeinschaft (Grant: DFG SI 569/7-1) and the Bundesministerium für Bildung und Forschung (Grant: BCRT 0315848A).

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Authors and Affiliations

  1. Department of Rheumatology and Clinical Immunology, Tissue Engineering Laboratory and Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany

    Jochen Ringe, Gerd R. Burmester & Michael Sittinger

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  1. Jochen Ringe
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All authors contributed equally to researching of data, writing, and reviewing/editing of the manuscript before submission. J. Ringe and M. Sittinger made equal contributions to discussion of content.

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Correspondence to Michael Sittinger.

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Competing interests

M. Sittinger is a shareholder of CellServe GmbH (Berlin, Germany) and BioRetis GmbH (Berlin, Germany), and works as consultant for BioTissue Technologies GmbH (Freiburg, Germany) that develops tissue transplants for the regeneration of bone and cartilage. G.R. Burmester and J. Ringe have no competing interests.

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Ringe, J., Burmester, G. & Sittinger, M. Regenerative medicine in rheumatic disease—progress in tissue engineering. Nat Rev Rheumatol 8, 493–498 (2012). https://doi.org/10.1038/nrrheum.2012.98

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