Regenerative approaches for the treatment of early OA.
The diagnosis and the prompt treatment of early osteoarthritis (OA) represent vital steps for delaying the onset and progression of fully blown OA, which is the most common form of arthritis, involving more than 10 % of the world's population older than 60 years of age. Nonsurgical treatments such as physiotherapy, anti-inflammatory medications, and other disease-modifying drugs all have modest and short-lasting effect. In this context, the biological approaches have recently gained more and more attention. Growth factors, blood derivatives, such as platelet concentrates, and mesenchymal adult stem cells, either expanded or freshly isolated, are advocated amongst the most promising tool for the treatment of OA, especially in the early phases. Primarily targeted towards focal cartilage defects, these biological agents have indeed recently showed promising results to relieve pain and reduce inflammation in patients with more advanced OA as well, with the final aim to halt the progression of the disease and the need for joint replacement. However, despite of a number of satisfactory in vitro and pre-clinical studies, the evidences are still limited to support their clinical efficacy in OA setting.
Orthopaedic Biotechnology Laboratory, Galeazzi Orthopaedic Institute, Milan, Italy. laura.degirolamo@grupposandonato.it.
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de Girolamo
II Orthopedic Division and NanoBiotechnology Lab, Rizzoli Orthopedic Institute, Bologna, Italy.
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Kon
II Orthopedic Division and NanoBiotechnology Lab, Rizzoli Orthopedic Institute, Bologna, Italy.
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Filardo
Department of Orthopaedics and Traumatology, University of Torino, Turin, Italy.|Molecular Biotechnology Center, University of Torino, Turin, Italy.
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Marmotti
ITRT Centro Médico Teknon, Barcelona, Spain.
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Soler
Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.|Galeazzi Orthopaedic Institute, Milan, Italy.
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Peretti
I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy.
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Vannini
Center of Experimental Orthopaedics, Saarland University, Homburg/Saar, Germany.|Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg/Saar, Germany.
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Madry
Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA.
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Chubinskaya
D000273:Adipose Tissue / Q000166:cytology; D002358:Cartilage, Articular; D018450:Disease Progression; D061345:Early Medical Intervention; D006801:Humans; D007249:Inflammation; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use*; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D059630:Mesenchymal Stem Cells; D010003:Osteoarthritis / Q000628:therapy; D020370:Osteoarthritis, Knee / Q000628:therapy*; D010146:Pain; D053657:Platelet-Rich Plasma; D012038:Regeneration
D036341:Intercellular Signaling Peptides and Proteins
Cartilage; Growth factors; Mesenchymal stem cells; Molecular therapy; Osteoarthritis