Mesenchymal or Maintenance Stem Cell & Understanding Their Role in Osteoarthritis of the Knee Joint: A Review Article

Abstract

Mesenchymal Stem Cell (MSC) therapy in osteoarthritis has been hailed as a promising treatment for osteoarthritis due<br />to their unlimited potential of healing and regeneration. Existing literature regarding their proper name, optimal sources,<br />mechanisms of action, dosage, and route of administration, efficacy, and safety is debatable. This index review article<br />has tried to connect these puzzling pieces of available information and brought clarity on some of these crucial issues.<br />The author believes that Maintenance Stem Cells (MSC) may be a more suitable term than mesenchymal stem cell or<br />medicinal signaling cells as their origin might not be limited to mesodermal tissue. Also, they have been shown capable<br />of self-renewal, differentiation, and maintaining a cascade of healing & possibly regeneration at the implanted site. Only<br />a small percentage of implanted MSC survive and rest undergo apoptosis after releasing growth factors, cytokines, and<br />extracellular vesicles. These surviving MSC become active due to conformational changes induced by anti-environment<br />stimuli and undergo limited self-renewal, proliferation, and differentiation, but only a few of them might incorporate into the<br />host tissues. These cells generate & maintain a momentum of series of regenerative activities to improve the function of<br />joint, stabilize or possibly enhance the cartilage quality. More randomized studies with long term follow-up are required to<br />bring clarity on their ideal source, expansion, culture technique, optimum dosage, and route of administration and longterm<br />safety issues.<br />Level of evidence: V