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This invaluable resource discusses clinical applications with effects and side-effects of applications of stem cells in bone and cartilage regeneration. Each chapter is contributed by a pre-eminent scientist in the field and covers such topics as skeletal regeneration by mesenchymal stem cells, clinical improvement of mesenchymal stem cell injection in injured cartilage and osteoarthritis, Good manufacturing practice (GMP), minimal critera of stem cells for clinical applications, future directions of the discussed therapies and much more. Bone & Cartilage Regeneration and the other books in the Stem Cells in Clinical Applications series will be invaluable to scientists, researchers, advanced students and clinicians working in stem cells, regenerative medicine or tissue engineering.
Over the past decade, significant efforts have been made to develop stem cell-based therapies for difficult to treat diseases. Multipotent mesenchymal stromal cells, also referred to as mesenchymal stem cells (MSCs), appear to hold great promise in regards to a regenerative cell-based therapy for the treatment of these diseases. Currently, more than 200 clinical trials are underway worldwide exploring the use of MSCs for the treatment of a wide range of disorders including bone, cartilage and tendon damage, myocardial infarction, graft-versus-host disease, Crohn’s disease, diabetes, multiple sclerosis, critical limb ischemia and many others. MSCs were first identified by Friendenstein and colleagues as an adherent stromal cell population within the bone marrow with the ability to form clonogenic colonies in vitro. In regards to the basic biology associated with MSCs, there has been tremendous progress towards understanding this cell population’s phenotype and function from a range of tissue sources. Despite enormous progress and an overall increased understanding of MSCs at the molecular and cellular level, several critical questions remain to be answered in regards to the use of these cells in therapeutic applications. Clinically, both autologous and allogenic approaches for the transplantation of MSCs are being explored. Several of the processing steps needed for the clinical application of MSCs, including isolation from various tissues, scalable in vitro expansion, cell banking, dose preparation, quality control parameters, delivery methods and numerous others are being extensively studied. Despite a significant number of ongoing clinical trials, none of the current therapeutic approaches have, at this point, become a standard of care treatment. Although exceptionally promising, the clinical translation of MSC-based therapies is still a work in progress. The extensive number of ongoing clinical trials is expected to provide a clearer path forward for the realization and implementation of MSCs in regenerative medicine. Towards this end, reviews of current clinical trial results and discussions of relevant topics association with the clinical application of MSCs are compiled in this book from some of the leading researchers in this exciting and rapidly advancing field. Although not absolutely all-inclusive, we hope the chapters within this book can promote and enable a better understanding of the translation of MSCs from bench-to-bedside and inspire researchers to further explore this promising and quickly evolving field.
This book presents the evidence related to the use of injectable biologics to provide faster and better healing for musculoskeletal lesions and conditions. The authors discuss approaches, such as blood derivatives and cell concentrates, applied to lesions of muscles, ligaments, tendons, bones, meniscus and cartilage, as well as osteoarthritis. Chapters are written by some of the most influential opinion leaders in the field, with up-to-date review of the current literature, where the authors explore both the potential and the limitations of these minimally invasive and promising treatments. The first section is devoted to the formulations and rationale for the use of injectable orthobiologics, while the second section reviews current treatment methods applied to specific joints and pathologies – ranging from tendinopathies through non-unions to articular degenerative processes – as well as the results of these treatment approaches. The third section explores future perspectives, such as pluripotent stem cells, gene therapy, and the stimulation of intrinsic stromal cell niches. Appealing to a broad readership, this book will be of interest to both laboratory research scientists and clinicians, including orthopedists, sports physicians, physiatrists, and regenerative medicine experts.
Articular cartilage is a highly specialized avascular connective tissue. This multidisciplinary article reviews the molecular and morphological aspects of GLUT expression and function in chondrocytes and their mesenchymal and embryonic stem cell precursors.
Osteoarthritis (OA), the most common form of arthritis, is generally characterized by a slowly progressive degeneration of articular cartilage, particularly in the weight-bearing joints. It has a stronger prevalence in women, and its incidence increases with age. OA is a major and growing health concern in developed countries, owing to steadily increasing life expectancy and the demand for better quality of life. Because of its chronic nature and nonfatal outcome, OA affects the growing population of the elderly over an increasing time span. Moreover, despite its relatively benign character, OA is one of the most disabling diseases; it is responsible for increasing financial and social burdens in terms of medical treatments, forced inactivity, loss of mobility, and dependence. Despite a growing awareness of OA as a medical problem that has yet to reach its maximum impact on society, there is a surprising absence of effective medical treatments beyond pain control and surgery. So far, only symptom-modifying drugs are available, while there remains a major demand for disease-modifying treatments of proven clinical efficacy. This demand will hopefully be met in the future by some of the drugs that have been pressed into development and are now at different stages of clinical investigation. Nevertheless, the current lack of effective treatments reflects a still insufficient knowledge of cartilage with respect to its metabolism, interactions with other joint tissues, and causes and mechanisms (possibly of very different nature) leading to failure of its turnover.
Mesenchymal stem cell-derived exosomes are at the forefront of research in two of the most high profile and funded scientific areas – cardiovascular research and stem cells. Mesenchymal Stem Cell Derived Exosomes provides insight into the biofunction and molecular mechanisms, practical tools for research, and a look toward the clinical applications of this exciting phenomenon which is emerging as an effective diagnostic. Primarily focused on the cardiovascular applications where there have been the greatest advancements toward the clinic, this is the first compendium for clinical and biomedical researchers who are interested in integrating MSC-derived exosomes as a diagnostic and therapeutic tool. - Introduces the MSC-exosome mediated cell-cell communication - Covers the major functional benefits in current MSC-derived exosome studies - Discusses strategies for the use of MSC-derived exosomes in cardiovascular therapies
This work is the result of a partnership that began in 2011, when I received for the first time the invitation to be the scientific editor of a book on bone grafting, by the still little publisher known as InTech. Now six years later, InTech has grown and thrived. My respect and warm approval for the quality of the publisher's work only increased. The hyaline cartilage is a tissue that challenges tissue engineering and regenerative medicine because of its avascular nature. In the 11 chapters of this book, the reader will find texts written by researchers working on advanced topics related to basic laboratory research, as well as excellent reviews on the clinical use of currently available therapies.
“Cell and Tissue Engineering” introduces the principles and new approaches in cell and tissue engineering. It includes both the fundamentals and the current trends in cell and tissue engineering, in a way useful both to a novice and an expert in the field. The book is composed of 13 chapters all of which are written by the leading experts. It is organized to gradually assemble an insight in cell and tissue function starting form a molecular nano-level, extending to a cellular micro-level and finishing at the tissue macro-level. In specific, biological, physiological, biophysical, biochemical, medical, and engineering aspects are covered from the standpoint of the development of functional substitutes of biological tissues for potential clinical use. Topics in the area of cell engineering include cell membrane biophysics, structure and function of the cytoskeleton, cell-extracellular matrix interactions, and mechanotransduction. In the area of tissue engineering the focus is on the in vitro cultivation of functional tissue equivalents based on the integrated use of isolated cells, biomaterials, and bioreactors. The book also reviews novel techniques for cell and tissue imaging and characterization, some of which are described in detail such as atomic force microscopy. Finally, mathematical modeling methods are presented as valuable and indispensable tools in cell and tissue engineering. Numerous illustrations enhance the quality and ease of use of the presented material.
Fully updated with recent technologies, current scientific knowledge, and the latest techniques, A Primer in Cartilage Repair and Joint Preservation of the Knee, 2nd Edition, presents the full range of treatment options for a changing, increasingly younger patient population. Using an easy-to-follow, step-by-step approach, Dr. Thomas Minas clearly teaches how to meet the new challenges of cartilage repair by utilizing the latest techniques and technologies, including advances in orthobiologics. Surgical photographs, abundant illustrations, and procedural videos provide detailed visual guidance. - Details the systematic approach to diagnosis, patient management, surgical techniques, and rehabilitation for a variety of problems. - Covers current scientific knowledge of cartilage properties, the etiology of damage and the intrinsic repair and regeneration processes. - Helps you select the best treatment course for each patient through extensive coverage of options from non-surgical to mini-incision total knee arthroplasty. - Discusses the latest evidence, research and challenges associated with new techniques such as MACI, ACI, HTO, DFO, and more. - Features new and expanded coverage of the latest advances in orthobiologics including platelet-rich plasma, bone marrow stem cells, fat stem cells, scaffolds and much more. - Includes key topics such as printed 3-D cartilage structures and the management of secondary cartilage lesions. - Contains high-quality illustrations and surgical photos, as well as new videos that provide clear instructions on how to perform key procedures. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Cartilage injuries in children and adolescents are increasingly observed, with roughly 20% of knee injuries in adolescents requiring surgery. In the US alone, costs of osteoarthritis (OA) are in excess of $65 billion per year (both medical costs and lost wages). Comorbidities are common with OA and are also costly to manage. Articular cartilage's low friction and high capacity to bear load makes it critical in the movement of one bone against another, and its lack of a sustained natural healing response has necessitated a plethora of therapies. Tissue engineering is an emerging technology at the threshold of translation to clinical use. Replacement cartilage can be constructed in the laboratory to recapitulate the functional requirements of native tissues. This book outlines the biomechanical and biochemical characteristics of articular cartilage in both normal and pathological states, through development and aging. It also provides a historical perspective of past and current cartilage treatments and previous tissue engineering efforts. Methods and standards for evaluating the function of engineered tissues are discussed, and current cartilage products are presented with an analysis on the United States Food and Drug Administration regulatory pathways that products must follow to market. This book was written to serve as a reference for researchers seeking to learn about articular cartilage, for undergraduate and graduate level courses, and as a compendium of articular cartilage tissue engineering design criteria. Table of Contents: Hyaline Articular Cartilage / Cartilage Aging and Pathology / In Vitro / Bioreactors / Future Directions