Gene therapy for articular cartilage repair

Articular cartilage serves as the gliding surface of joints. It is susceptible to damage from trauma and from degenerative diseases. Restoration of damaged articular cartilage may be achievable through the use of cell-regulatory molecules that augment the reparative activities of the cells, inhibit the cells\u27; degradative activities, or both. A variety of such molecules have been identified. These include insulin-like growth factor I, fibroblast growth factor 2, bone morphogenetic proteins 2, 4, and 7, and interleukin-1 receptor antagonist. It is now possible to transfer the genes encoding such molecules into articular cartilage and synovial lining cells. Although preliminary, data from in-vitro and in-vivo studies suggest that gene therapy can deliver such potentially therapeutic agents to protect existing cartilage and to build new cartilage. Keywords: gene therapy, vectors, articular cartilage, arthritis, animal model

Platelet rich plasma injection grafts for musculoskeletal injuries: a review

In Europe and the United States, there is an increasing prevalence of the use of autologous blood products to facilitate healing in a variety of applications. Recently, we have learned more about specific growth factors, which play a crucial role in the healing process. With that knowledge there is abundant enthusiasm in the application of concentrated platelets, which release a supra-maximal quantity of these growth factors to stimulate recovery in non-healing injuries. For 20 years, the application of autologous PRP has been safely used and documented in many fields including; orthopedics, sports medicine, dentistry, ENT, neurosurgery, ophthalmology, urology, wound healing, cosmetic, cardiothoracic, and maxillofacial surgery. This article introduces the reader to PRP therapy and reviews the current literature on this emerging treatment modality. In summary, PRP provides a promising alternative to surgery by promoting safe and natural healing. However, there are few controlled trials, and mostly anecdotal or case reports. Additionally the sample sizes are frequently small, limiting the generalization of the findings. Recently, there is emerging literature on the beneficial effects of PRP for chronic non-healing tendon injuries including lateral epicondylitis and plantar fasciitis and cartilage degeneration (Mishra and Pavelko, The American Journal of Sports Medicine 10(10):1–5, 2006; Barrett and Erredge, Podiatry Today 17:37–42, 2004). However, as clinical use increases, more controlled studies are needed to further understand this treatment

Umbilical Cord Stem Cell Seeding on Fast-Resorbable Calcium Phosphate Bone Cement

Tissue engineering offers immense promise for bone regeneration. Human umbilical cord mesenchymal stem cells (hUCMSCs) can be collected without invasive procedures required for bone marrow MSCs. The objective of this study was to investigate the physical properties and the differentiation capacity of hUCMSCs on calcium phosphate cement (CPC) scaffolds with improved dissolution/resorption rates. CPC consisted of tetracalcium phosphate and dicalcium phosphate anhydrous, with various tetracalcium phosphate/dicalcium phosphate anhydrous ratios. At 1/3 ratio, CPC had a dissolution rate 40% faster than CPC control at 1/1. The faster-resorbable CPC had strength and modulus similar to CPC control. Their strength and modulus exceeded the reported values for cancellous bone, and were much higher than those of hydrogels and injectable polymers for cell delivery. hUCMSCs attached to the nano-apatitic CPC and proliferated rapidly. hUCMSCs differentiated into the osteogenic lineage, with significant increases in alkaline phosphatase activity, osteocalcin, collagen I, and osterix gene expression. In conclusion, in this study we reported that hUCMSCs attaching to CPC with high dissolution/resorption rate showed excellent proliferation and osteogenic differentiation. hUCMSCs delivered via high-strength CPC have the potential to be an inexhaustible and low-cost alternative to the gold-standard human bone marrow mesenchymal stem cells. These results may broadly impact stem-cell-based tissue engineering