title: Regenerative potential of the cartilaginous tissue in mesenchymal stem cells: update, limitations, and challenges.
abstract: Advances in the studies with adult mesenchymal stem cells (MSCs) have turned tissue regenerative therapy into a promising tool in many areas of medicine. In orthopedics, one of the main challenges has been the regeneration of cartilage tissue, mainly in diarthroses. In the induction of the MSCs, in addition to cytodifferentiation, the microenvironmental context of the tissue to be regenerated and an appropriate spatial arrangement are extremely important factors. Furthermore, it is known that MSC differentiation is fundamentally determined by mechanisms such as cell proliferation (mitosis), biochemical-molecular interactions, movement, cell adhesion, and apoptosis. Although the use of MSCs for cartilage regeneration remains at a research level, there are important questions to be resolved in order to make this therapy efficient and safe. It is known, for instance, that the expansion of chondrocytes in cultivation, needed to increase the number of cells, could end up producing fibrocartilage instead of hyaline cartilage. However, the latest results are promising. In 2014, the first stage I/II clinical trial to evaluate the efficacy and safety of the intra-articular injection of MSCs in femorotibial cartilage regeneration was published, indicating a decrease in injured areas. One issue to be explored is how many modifications in the articulate inflammatory environment could induce differentiation of MSCs already allocated in that region. Such issue arose from studies that suggested that the suppression of the inflammation may increase the efficiency of tissue regeneration. Considering the complexity of the events related to the chondrogenesis and cartilage repair, it can be concluded that the road ahead is still long, and that further studies are needed.
authors.affiliation: Universidade Federal de Santa Maria (UFSM), Centro de Ciências da Saúde, Santa Maria, RS, Brazil; Universidade Federal de Santa Maria (UFSM), Laboratório de Biogenômica, Santa Maria, RS, Brazil.
authors.forename: Ivana Beatrice Mânica da
authors.initials: IB
authors.lastname: Cruz
authors.affiliation: Universidade Federal da Fronteira Sul (UFFS), Hospital São Vicente de Paulo, Instituto de Ortopedia e Traumatologia, Passo Fundo, RS, Brazil.
authors.forename: Antônio Lourenço
authors.initials: AL
authors.lastname: Severo
authors.affiliation: Universidade Federal de Santa Maria (UFSM), Laboratório de Biogenômica, Santa Maria, RS, Brazil.
authors.forename: Verônica Farina
authors.initials: VF
authors.lastname: Azzolin
authors.affiliation: Universidade Federal de Santa Maria (UFSM), Laboratório de Biogenômica, Santa Maria, RS, Brazil.
authors.forename: Luiz Filipe Machado
authors.initials: LF
authors.lastname: Garcia
authors.affiliation: Universidade Federal da Fronteira Sul (UFFS), Hospital São Vicente de Paulo, Instituto de Ortopedia e Traumatologia, Passo Fundo, RS, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Kuhn
authors.affiliation: Universidade Federal da Fronteira Sul (UFFS), Hospital São Vicente de Paulo, Instituto de Ortopedia e Traumatologia, Passo Fundo, RS, Brazil.
authors.forename: Osvandré
authors.initials: O
authors.lastname: Lech
keywords: Cartilaginous tissue; Regenerative potential; Stem cells