New therapeutic strategies for osteoarthritis : injective cell therapy

Abstract

Osteoarthritis is a chronic joint disorder characterized by the progressive degeneration of the articular components with an increasing incidence. Its aethiology is multifactorial, including several risk factors, namely ageing, obesity, genetic predisposition, female sex and trauma. Its current therapy relies on the alleviation of symptoms that does not prevent or even slow down its progression. With the need for a therapy able to stop the progression of the disease, several strategies have been attempted. Particularly, cell therapy has been suggested to be able to reverse some of the mechanisms responsible for the symptoms and pathophysiology of osteoarthritis. Both non-stem cells and stem cells may be used in cell therapy, which consists in the delivery of the aforementioned cells hoping to replace or repair the damaged tissue. This thesis aims at critically reviewing available data concerning the use of injective cell therapies to promote cartilage repair in osteoarthritis affected joints. For this, a brief review of osteoarthritis and its current treatment will be presented in the introduction, followed by the identification and characterization of the cell types used or proposed to be used for articular cartilage repair. Then, the pre-clinical studies that analysed the efficacy of injective cell-based therapies for osteoarthritis will be presented. Finally, the clinical trials performed in the last 10 years that studied the efficacy and safety of the intra-articular injection of MSCs on osteoarthritis will be presented and discussed.