Page 35 - Exosomes - wound healing power

Journal name: Open Access Journal of Sports Medicine
Article Designation: REVIEW
Year: 2017
Volume: 8
Open Access Journal of Sports Medicine Dovepress Running head verso: Pak et al
Running head recto: Clinical use of mesenchymal stem cells in meniscal repair
open access to scientific and medical research
DOI: http://dx.doi.org/10.2147/OAJSM.S113018
Open Access Full Text Article REVIEW
Potential use of mesenchymal stem cells in human

meniscal repair: current insights

This article was published in the following Dove Press journal:
Open Access Journal of Sports Medicine
23 March 2017
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Jaewoo Pak 1–3* Abstract: The menisci of the human knee play an important role in maintaining normal func-
Jung Hun Lee 1,4* tions to provide stability and nutrition to the articular cartilage, and to absorb shock. Once
Kwang Seung Park 4 injured, these important structures have very limited natural healing potential. Unfortunately, the
Jeong Ho Jeon 4 4 traditional arthroscopic meniscectomy performed on these damaged menisci may predispose the
For personal use only. Open Access Journal of Sports Medicine downloaded from https://www.dovepress.com/ by 68.175.65.102 on 25-Mar-2017 1 Seoul, Republic of Korea; available, mesenchymal stem cells (MSCs) have been investigated as an alternative therapeutic
joint toward early development of osteoarthritis. Although a very limited number of studies are
Sang Hee Lee
Stems Medical Clinic, Gangnamgu,
modality to repair human knee meniscal tears. This review summarizes the results of published
applications of MSCs in human patients, which showed that the patients who received MSCs
TEDA‑Puhua International Hospital,
2
Tianjin, People’s Republic of China;
Life Science Institute, Komplek
3
cells) presented symptomatic improvements, along with magnetic resonance imaging evidences
Permata Senayan, Jalan Tentara (autologous adipose tissue-derived stem cells or culture-expanded bone marrow-derived stem
Pelajar, Jakarta Selatan, Indonesia; of the meniscal repair.
4 National Leading Research Keywords: adipose tissue-derived stem cells, bone marrow-derived stem cells, human knee,
Laboratory, Department of Biological
Sciences, Myongji University, Yongin, meniscal tear, articular cartilage, therapeutic modality
Gyeonggido, Republic of Korea
*These authors contributed equally to Introduction
this work
The menisci of a human knee are a pair of fibrocartilaginous structures that function to
provide stability and nutrition to the articular cartilage, and to absorb shock. Remov-
1–3
ing these structures, by either full or partial meniscectomy, disrupts the homeostasis
of the knee and predisposes the joint to an early development of osteoarthritis (OA). 4–7
The human meniscus has very limited vascularity. The inner one-third of the menis-
cus (also known as the white zone due to its lack of vascularity) has lesser natural healing
potential than the middle (the red–white zone, with moderate vascularity), which in turn
has lesser natural healing potential than the peripheral one-third (called the red zone due
to relatively abundant vascularity). Due to its lack of vascularity, symptomatic injury
8,9
in the inner one-third of the meniscus may require a partial meniscectomy, even though
a partial meniscectomy may result in an early development of OA of the treated knee. 10,11
As an alternative treatment to the surgical repair of meniscal tears, mesenchymal
stem cells (MSCs) have been investigated. MSCs are of special interest because of
their multilineage plasticity, with potential induction toward both fibrocartilage and
Correspondence: Sang Hee Lee
National Leading Research Laboratory, articular cartilage. 12,13 Numerous human studies have been published in the field of
Department of Biological Sciences, regenerative medicine regarding the regenerative potential of MSCs in articular carti-
Myongji University, 116 Myongjiro, 14–18
Yongin, Gyeonggido 17058, Republic of lage. Some of these studies have demonstrated the increased volume of meniscal
Korea fibrocartilage resulting in its regeneration. 15–17
Tel +82 31 330 6195
Fax +82 31 335 8249 For example, Centeno et al first published a case study, in which culture-expanded,
Email sangheelee@mju.ac.kr autologous bone marrow-derived MSCs were administrated via a percutaneous and

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