Transplantation of stem cells from different sources to treat osteoarthritis
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Transplantation of stem cells from different sources to treat osteoarthritis. Why did you get arthritis at a young age?
The clinical manifestations of osteoarthritis (OA) are pain, limited range of motion, crepitus when moving, joint instability and swelling. It is estimated that by 2032, 30% of people over 45 years old will have OA.
OA can affect the limb function and quality of life of patients. In developed countries, the cost of treatment for OA can reach 2.5% of the GDP.
As a multifunctional cell, stem cells can regenerate various tissues of the human body, so they have certain clinical potential in wound repair, especially in fracture healing, joint repair, cartilage healing and post-traumatic inflammation.
Osteoarthritis sounds like a senile disease. Many young and middle-aged patients are still surprised when they are diagnosed. Why do they develop arthritis at a young age?
Is osteoarthritis an exclusive disease of the elderly? Does it just mean knee problems? What factors can aggravate arthritis?
01. Does osteoarthritis refer to knee joint inflammation?
When we talk about bone joints, we subconsciously feel that the knee has “inflammation”. In fact, osteoarthritis can occur in many parts of the body, including our finger joints, wrist joints, knee joints and hip joints.
02. Is osteoarthritis a senile disease?
Before clarifying this issue, everyone has to clarify a concept, which is why you suffer from osteoarthritis.
There will be a layer of Q elastic cartilage between our bones, which can ensure the smooth friction surface between the bones.
But this layer of cushioning structure wrapped on the bone surface will continue to wear with age, which will gradually increase the friction on the bone surface.
If things go on like this, the joints will become inflamed and cause pain.
It seems that arthritis is indeed closely related to age. But this is not what the body must experience for aging. In fact, this disease is affecting more and more young people.
The development of osteoarthritis can cause great pain. Image source: Google
Moreover, as the onset of disease gradually became younger, osteoarthritis has also torn off the label of “senile disease”, becoming more and more common, and even becoming a disabled “top seed player.”
03. What factors are likely to cause osteoarthritis?
Many factors (age, obesity, trauma, gender, deformity, genetics, etc.) can cause an imbalance in articular cartilage repair and degradation, resulting in OA.
The pathogenesis of OA is more complicated, and multiple factors can be intersected. In the elderly, there is loss of water in joint cartilage, destruction of proteoglycans, aging and reduction of cartilage cells, increased matrix metalloproteinases, and enhanced matrix decomposition.
Improper weight bearing and mechanical changes can cause cartilage damage. Obese people bear more joint weight.
Among them, obesity is the main risk factor leading to the development of osteoarthritis.
According to survey data, obese people are much more likely to develop osteoarthritis than non-obese people. Obese men are five times more likely than non-obese people, and women are four times more likely to develop osteoarthritis.
This is because being overweight will put more pressure on the joints that bear the weight of the body, such as knees, hips and foot joints, and accelerate cartilage wear.
In addition, lack of exercise can also increase the risk of osteoarthritis. Long-term lack of exercise will cause the muscles around the joints to be weaker, and the cartilage will have to bear more pressure.
In addition to being obese and not sporting, there is another category of people who need to be vigilant, that is, people who have a history of joint damage. Because with age, the probability of suffering from osteoarthritis in the same part with a history of injury is high.
04. Disadvantages of traditional treatment methods
Artificial joint prosthesis replacement is the gold standard for the treatment of advanced OA, but the life of the prosthesis is limited and many complications will occur after the operation. Therefore, attention should be paid to the early and mid-term treatment of OA.
The ideal treatment plan is to improve the patient’s clinical symptoms and promote cartilage regeneration.
At present, symptomatic treatments such as physical therapy, auxiliary braces, anti-inflammatory drugs, analgesics, hyaluronic acid (HA), glucocorticoids, arthroscopic debridement and osteotomy cannot promote cartilage repair and cannot essentially Improve OA.
The mechanism of platelet-rich plasma in the treatment of 0A is not yet clear. It can relieve pain and improve joint function, but it has a poor ability to promote cartilage regeneration.
Microfractures are easy to operate and have little trauma, but the quality of regenerated cartilage and the recovery of the patient’s limb function are not as good as osteochondral transplantation.
The operation of osteochondral transplantation is highly invasive and can cause lesions in the donor site and poor fusion of the cartilage surface of the recipient site. If the donor is from a foreign body, an immune response may also occur.
05. Stem cells let you say goodbye to joint pain
Stem cells have self-renewal ability and multi-directional differentiation potential, which can differentiate into adipocytes, osteoblasts and chondrocytes. Further studies have found that mesenchymal stem cells can also use paracrine mechanisms to exert powerful immune regulation and anti-inflammatory activities, which are helpful For tissue repair. These characteristics of mesenchymal stem cells make them have unique advantages in the treatment of osteoarthritis cartilage damage.
The International Cell Therapy Association stated that MSCs should have the following characteristics:
① Stem cells secrete a variety of factors, such as transforming growth factor-β1, insulin-like growth factor-1, etc., which can induce stem cells to differentiate into chondrocytes, inhibit the progress of local inflammation, and promote the self-repair ability of locally damaged tissues, thereby achieving the purpose of intervention.
② It can differentiate into bone cells, chondrocytes and adipocytes when cultured in vitro. For the treatment of OA with MSCs, MSCs are more inclined to promote cartilage repair, while non-MSCs differentiate into cartilage in vivo.
③ Exosomes derived from MSCs can increase the expression of chondrocyte markers such as type II collagen and proteoglycans, reduce the expression of matrix metalloproteinases and other catabolism markers and inflammatory markers, promote the proliferation and migration of chondrocytes, and reduce chondrocytes Apoptosis, blocking macrophage activation and other pathways, preventing OA cartilage and bone degradation.
The development of stem cell technology has brought hope to patients with osteoarthritis. As a kind of cells with multi-differentiation potential, stem cells can theoretically regenerate various tissues of the human body, so they have good clinical application prospects in wound repair, especially in fracture healing, joint repair, cartilage healing and post-traumatic inflammation.
Transplantation of stem cells from different sources to treat osteoarthritis.
(source:internet, reference only)
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