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Cartilage regeneration in 2022

New refinements aim to optimize articular cartilage tissue engineering

Nature Reviews Rheumatology volume 19, pages 66–67 (2023)Cite this article

Subjects

Successful, long-term treatment of articular cartilage injuries is important for the prevention of osteoarthritis but remains a major challenge. Three studies in 2022 highlight new approaches to improving articular cartilage regeneration.

Key advances

  • A synthetic artificial stem cell (SASC) system, designed to mimic the secretome of mesenchymal stem cells, attenuated cartilage degeneration and improves the biomechanical properties of articular cartilage in vivo3.

  • A zonal microstructured scaffold proved to be robust and mechanically stable in a large-animal model of osteochondral defects4.

  • Scaffolds derived from solubilized articular cartilage extracellular matrix were able to successfully repair chondral lesions, particularly when loaded with TGFβ3 (ref. 5).

Shah et al.3 established a synthetic artificial stem cell (SASC) system to mimic the paracrine secretome of mesenchymal stem cells (MSCs) with the goal of attenuating OA. Their system comprises essential chondrogenic factors (IGF1, TGFβ1, FGF18 and HGH) embedded in a poly(lactic-co-glycolic) acid matrix (Fig. 1a). In an indirect in vitro model of OA, the addition of the SASC system to IL-1β-stimulated chondrocytes decreased the expression of nitric oxide and ADAMTS5 and increased the expression of SOX9 mRNA compared with the addition of adipose-derived stem cells (ADSCs). In an in vivo rat model of OA, joint swelling and cartilage degeneration (defined by loss of proteoglycan staining) were lower in ADSC-treated and SASC-treated joints than in untreated joints. Cartilage stiffness also improved in OA joints injected with ADSCs or SASCs. Whereas MSC-based therapies face several obstacles on the path to clinical application — such as immunogenicity, isolation of cells from human tissues, inhibition of spontaneous dedifferentiation and maintenance of growth and passaging in vitro — the SASC system represents an innovative cell-free approach3.

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Fig. 1: Three new therapeutic strategies for articular cartilage regeneration.

References

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Authors and Affiliations

  1. Experimental Orthopaedics, Centre for Medical Biotechnology (ZMB), University of Regensburg, Bavaria, Germany

    Nicole Schäfer & Susanne Grässel

  2. Department of Orthopaedic Surgery, University of Regensburg, Bavaria, Germany

    Susanne Grässel

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  1. Nicole Schäfer
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  2. Susanne Grässel
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Correspondence to Susanne Grässel.

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The authors declare no competing interests.

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Schäfer, N., Grässel, S. New refinements aim to optimize articular cartilage tissue engineering. Nat Rev Rheumatol 19, 66–67 (2023). https://doi.org/10.1038/s41584-022-00889-y

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