Published online Jun 26, 2023. doi: 10.4252/wjsc.v15.i6.548
Peer-review started: March 17, 2023
First decision: April 10, 2023
Revised: April 21, 2023
Accepted: May 5, 2023
Article in press: May 5, 2023
Published online: June 26, 2023
Processing time: 101 Days and 0.8 Hours
Osteoarthritis (OA) is a common degenerative joint disease that often involves progressive cartilage degeneration and bone destruction of subchondral bone. At present, clinical treatment is mainly for pain relief, and there are no effective methods to delay the progression of the disease. When this disease progresses to the advanced stage, the only treatment option for most patients is total knee replacement surgery, which causes patients great pain and anxiety. As a type of stem cell, mesenchymal stem cells (MSCs) have multidirectional differentiation potential. The osteogenic differentiation and chondrogenic differentiation of MSCs can play vital roles in the treatment of OA, as they can relieve pain in patients and improve joint function. The differentiation direction of MSCs is accurately controlled by a variety of signaling pathways, so there are many factors that can affect the differentiation direction of MSCs by acting on these signaling pathways. When MSCs are applied to OA treatment, the microenvironment of the joints, injected drugs, scaffold materials, source of MSCs and other factors exert specific impacts on the differentiation direction of MSCs. This review aims to summarize the mechanisms by which these factors influence MSC differentiation to produce better curative effects when MSCs are applied clinically in the future.
Core Tip: Several reviews have summarized the current status of mesenchymal stem cells (MSCs) in the treatment of osteoarthritis (OA). These studies usually focus on the paracrine function of MSCs. However, the differentiation function of MSCs also plays an important role in the treatment of diseases. This is the first review to report the factors that may affect the differentiation direction of MSCs in the treatment of OA and aims to provide guidance for more accurate regulation when MSC therapy is applied in the future.