Open AccessStem cell therapy in the management of shoulder rotator cuff disorders
Author(s) -
María Valencia Mora
Publication year - 2015
Publication title -
world journal of stem cells
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.907
H-Index - 18
ISSN - 1948-0210
DOI - 10.4252/wjsc.v7.i4.691
Subject(s) - fibrocartilage , rotator cuff , medicine , mesenchymal stem cell , stem cell , enthesis , stem cell therapy , cell therapy , tendon , paracrine signalling , regenerative medicine , bioinformatics , surgery , pathology , microbiology and biotechnology , biology , articular cartilage , osteoarthritis , alternative medicine , receptor
Rotator cuff tears are frequent shoulder problems that are usually dealt with surgical repair. Despite improved surgical techniques, the tendon-to-bone healing rate is unsatisfactory due to difficulties in restoring the delicate transitional tissue between bone and tendon. It is essential to understand the molecular mechanisms that determine this failure. The study of the molecular environment during embryogenesis and during normal healing after injury is key in devising strategies to get a successful repair. Mesenchymal stem cells (MSC) can differentiate into different mesodermal tissues and have a strong paracrine, anti-inflammatory, immunoregulatory and angiogenic potential. Stem cell therapy is thus a potentially effective therapy to enhance rotator cuff healing. Promising results have been reported with the use of autologous MSC of different origins in animal studies: they have shown to have better healing properties, increasing the amount of fibrocartilage formation and improving the orientation of fibrocartilage fibers with less immunologic response and reduced lymphocyte infiltration. All these changes lead to an increase in biomechanical strength. However, animal research is still inconclusive and more experimental studies are needed before human application. Future directions include expanded stem cell therapy in combination with growth factors or different scaffolds as well as new stem cell types and gene therapy.