POSSIBILITIES OF CURRENT CELLULAR TECHNOLOGIES FOR ARTICULAR CARTILAGE REPAIR (ANALYTICAL REVIEW)

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Abstract

Despite a wide variety of surgical procedures utilized in clinical practice for treatment of articular cartilage lesions, the search for other options of articular reconstruction remains a relevant and open issue at the current stage of medicine and biotechnologies development. The recent years demonstrated a strong belief in cellular methods of hyaline cartilage repair such as implantation of autologous chondrocytes (ACI) or cultures of mesenchymal stem cells (MSC) including techniques for genetic modification of cells.

The purpose of presented review is to summarize the published scientific data on up to date results of perspective cellular technologies for articular cartilage repair that are being developed. Autologous chondrocyte transplantation originally performed by Swedish researchers in 1987 is considered the first clinically applied technique for restoration of hyaline cartilage using cellular technologies. However, the transplanted cell culture featured low proliferative capacity and inability to form a regenerate resistant to high physical activity. Another generation of methods originated at the turn of the century utilized mesenchymal stem cells instead of autologous chondrocytes. Preparation of MSCs is a less invasive procedure compared to chondrocytes harvesting and the culture is featured by a higher proliferative ability. Researchers use various biodegradable carriers (matrices) to secure cell fixation. Despite good clinical mid-term outcomes the transplanted tissue-engineering structures deteriorate with time due to cellular de-differentiation. Next generation of techniques being currently under pre-clinical studies is featured by the preliminary chondrogenic modification of transplanted cell culture. Usage of various growth factors, modified cell product and gene-activated matrices allow to gain a stable regulatory and key proteins synthesis and achieve a focused influence on regenerate's chondrogenic proliferation and in result to form a good hyaline cartilage resistant to high physical load in long term period.

Thus, development of methods for articular cartilage repair has long ago went beyond the interests of clinical physicians, and only the close interdisciplinary cooperation of clinicians and specialists for cytology, molecular genetics and, probably, virology would enable replacement of a defect with a rigorous hyaline cartilage.

About the authors

M. S. Bozhokin

Vreden Russian Research Institute of Traumatology and Orthopedics, St. Petersburg

Author for correspondence.
Email: writeback@mail.ru

Bozhokin Mikhail S. - assistant researcher.

Ul. Akad. Baykova, 8, St. Petersburg, Russia, 195427, e-mail: writeback@mail.ru

Russian Federation

S. A. Bozhkova

Vreden Russian Research Institute of Traumatology and Orthopedics, St. Petersburg

Email: fake@neicon.ru

Bozhkova Svetlana A. - head of the research Department of prevention and treatment of wound infection and Department of clinical pharmacology

Russian Federation

G. I. Netylko

Vreden Russian Research Institute of Traumatology and Orthopedics, St. Petersburg

Email: fake@neicon.ru

Netylko Georgy I. - head of the research Department of experimental morphology

Russian Federation

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