Adult mesenchymal stem cell-based approaches for osteoarthritis: current perspectives and challenges

Osteoarthritis (OA) is a degenerative joint disease that may cause joint inflammation, stiffness, and pain. Current therapy for OA involves symptomatic treatment, mainly pain management. Therefore, it does not repair degenerated cartilage or attenuate joint inflammation. Because articular cartilage cannot heal or regenerate these tissues, tissue regeneration remains one of the most important objectives of new and potential OA therapeutics. The main features of adult mesenchymal stem cells (MSCs) are simple acquisition from adult tissues, rapid proliferation in vitro, immunomodulation in vivo, and lasting existence in the host, which are beneficial for OA treatment. In the past 15 years, adult MSCs, including bone marrow-, adipose-, and synovial membrane-derived MSCs, and their secretome have been successfully used in different animal (preclinical) models or in genetic manipulation for regenerating degenerated cartilage, reducing inflammation, or relieving pain. Furthermore, the implantation of adult MSCs showed pain reduction, anti-inflammation, and cartilage protection or healing in early-phase clinical trials. Adult MSCs are the most extensively explored as potential regenerative medicine for OA because of their efficacy in chondrocyte differentiation and their immunomodulatory properties. In this review paper, we highlighted current knowledge and future perspectives regarding preclinical tests, clinical application, and MSC-based/related products for curing OA.