Mesenchymal Stem Cells for Orthopedic Treatments and Regenerative Medicine

Abstract

Cartilage defects in joints as a result of injury or degeneration are a major clinical and scientific problem that causes immense health care costs. In recent years, the importance of cell therapies using mesenchymal stem cells (MSC) for the treatment of orthopedic disorders has greatly increased. The authors compared MSC from umbilical cord tissue, dental pulp, hair follicles, bone marrow, and adipose tissue with regard to their suitability for autologous and allogenic therapy concepts. The MSCs of the different donor tissues have been extensively characterized: donor eligibility for donation of tissue age of donor number of cells obtainable process of isolation of MSC from tissue expression of MSC-specific surface antigens trilinear differentiation potential immunomodulatory potential Umbilical cord tissue-derived MSCs (hUC-MSC) are best suited for both autologous and allogenic therapy concepts due to their high availability; simple, noninvasive, and ethically uncritical recoverability; technically easy-to-isolate high numbers of MSC from tissue; and easy cryopreservation. The hUC-MSC are tested in Good Clinical Laboratory Practice (GLP) studies for biodistribution and tumorigenicity. A Scientific Advice Meeting was held with the Paul Ehrlich Institute (Agency of German Federal Ministry of Health). The work focuses on clinical trial phase II. The second part of the presentation compares procedures for treatment of focal cartilage defects at the knee joint, including CartiCure (allogenic hUC-MSC on scaffold), MSC-MACT (autologous BM-MSC based matrix-associated chondro-cyte transplantation), and Spherox. In a first-in-man study, umbilical cord tissue-derived, allo-genic, expanded, and cryopreserved MSCs were used to treat focal cartilage defects in knee joints of patients with more recent sports injuries during knee arthroscopy. Spherox is a European Medicines Agency (EMA)-approved cell-based medicinal product containing spheroids from autolo-gous chondrocytes developed, produced and marketed by Codon AG, Germany.