J Korean Orthop Assoc.
2023 Dec;58(6):452-459. 10.4055/jkoa.2023.58.6.452.
Latest Trends in Non-Clinical and Clinical Research on Mesenchymal Stem Cell Therapy for Tendon Regeneration
- Affiliations
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- 1Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2549819
- DOI: http://doi.org/10.4055/jkoa.2023.58.6.452
Abstract
- Stem cell-based biological treatments are steadily progressing as an approach to promote the fundamental regeneration of tendons. In particular, mesenchymal stem cells (MSCs), which have the least severity of bioethics and carcinogenicity and can be separated relatively easily, have been applied widely. In this review, the efficacy of MSC therapy for tendon regeneration was compared and analyzed in nonclinical and clinical studies published in PubMed data base within the last three years, and the possibility was considered. In light of nonclinical study trends, to improve loss problems after cell transplantation and regeneration, 1) stem cell sheets, 2) use of scaffolds made with biomaterials of low immunogenicity, such as human-derived extracellular matrix and umbilical cord Wharton jelly, or innovative technologies such as three-dimensional printing, 3) stem cell-derived exosomes were directly injected into the body. Various animal models of rotator cuff tear have shown that tendon regeneration was improved when repair combined with these methods compared to a simple repair. In light of clinical study trends, efficacy, and safety evaluation were conducted by administering MSCs obtained through an expansion culture process (stem cell drug) or directly transplanting fresh biomaterials containing MSCs obtained during surgery without an expansion culture process (stem cell procedure). Although MSC therapy has many unresolved problems, the efficacy of MSCs for tendon regeneration has been reported repeatedly through numerous non-clinical and clinical studies. In addition, as new alternatives for the acquisition and transplantation of cells or biological materials have been proposed with the developments in other engineering fields, the possibilities are further increasing.
