Cell therapy: a challenge in modern medicine.
Cell therapies are unique in that the active component consists of living cells, which are difficult to define in their pharmacologic characteristics, and which produce variable and largely unknown amounts of bioactive molecules. Thus, the definition of the composition of a cellular product, mechanisms of action, pharmacokinetics, toxicity and efficacy assessment represent challenges never previously faced by traditional pharmacology. A pressing need for a routine use of cell therapies in the clinic is the development of quality controls for efficacy on the basis of clinically relevant potency assays, with prospective validation in human clinical trials. This review will focus on cell-based protocols for joint surface repair. In particular, we will present the case of autologous chondrocyte implantation as an example of advanced tissue engineering technology in the clinic, with the assumption that many issues discussed can be extrapolated to other cell-based approaches in regenerative medicine.
De Bari
Cosimo
C
Department of Rheumatology, King's College London, London, UK. cosimo.debari@kcl.ac.uk
Dell'accio
Francesco
F
D002358:Cartilage, Articular / Q000166:cytology* / Q000601:surgery*; D018929:Cell Culture Techniques / Q000379:methods / Q000592:standards*; D019902:Chondrocytes / Q000166:cytology* / Q000637:transplantation*; D015510:Clinical Medicine / Q000379:methods / Q000592:standards; D006801:Humans; D038622:Internationality; D011785:Quality Assurance, Health Care / Q000592:standards*; D023822:Tissue Engineering / Q000379:methods / Q000592:standards*