Stem cell therapy in the management of shoulder rotatorcuff disorders

• 作者: Maria Valencia Mora, Miguel A Ruiz Ib #x000e1 n, Jorge D #x000ed az Heredia, Raul Barco Laakso, Ricardo Cu #x000e9 llar, and Mariano Garc a Arranz
• 来源期刊: 世界干细胞杂志：英文版（电子版）
• 学科: 医学
• 关键词: ROTATOR CUFF Enthesis BIOLOGIC STEM cells
• 年，卷（期）: 2015,（4）
• 页码范围: 691-699
• 页数: 9页
• 分类号: R

摘要

Rotator cuff tears are frequent shoulder problems thatare usually dealt with surgical repair. Despite improvedsurgical techniques, the tendon-to-bone healing rateis unsatisfactory due to difficulties in restoring thedelicate transitional tissue between bone and tendon.It is essential to understand the molecular mechanismsthat determine this failure. The study of the molecularenvironment during embryogenesis and during normalhealing after injury is key in devising strategies to geta successful repair. Mesenchymal stem cells （MSC） candifferentiate into different mesodermal tissues and havea strong paracrine, anti-inflammatory, immunoregulatoryand angiogenic potential. Stem cell therapy is thus apotentially effective therapy to enhance rotator cuffhealing. Promising results have been reported with theuse of autologous MSC of different origins in animalstudies they have shown to have better healing properties,increasing the amount of fibrocartilage formationand improving the orientation of fibrocartilage fibers withless immunologic response and reduced lymphocyteinfiltration. All these changes lead to an increase inbiomechanical strength. However, animal research is stillinconclusive and more experimental studies are neededbefore human application. Future directions includeexpanded stem cell therapy in combination with growthfactors or different scaffolds as well as new stem celltypes and gene therapy.