Ikanke-abasi James

 Introduction.  Sports injuries, accidental trauma, genetic defects, and aging are the most common causes of damage to articular cartilage and bony tissue. The incidence of hospitalized patient bone fractures is estimated to be 1 million in the United States. Surgery is the leading form of treatment. However, the risks associated with surgery include: include pain, swelling, nerve injury, rejection of bone graft, extended hospitalization, multiple donor sites leading to increased morbidity and significant graft resorption. Mesenchymal stem cell (MSC) therapy is an alternative and has proven to be effective for osteochondral defects, osteogenesis imperfecta, and non-union bone fractures. Methods.  Studies have shown the beneficial use of bone marrow derived mesenchymal stem cells (MSCs), however, emerging research shows that Wharton jelly derived MSCs (WJ-MSCs) are best suited for cartilage regeneration. Bone morphogenic protein (BMP), fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF), and Transforming growth factor (TGF) are all important players in angiogenesis and cartilage regeneration. The role of bone morphogenic protein was evaluated using a rat model to determine how it impacts fracture healing. The immunogenicity of WJ-MSCs were compared with those from adult bone marrow in a rabbit’s knee to determine which has better immunosuppressive activity. Results.    BMPs are members of the transforming growth factor-β (TGF-β) protein superfamily and play a Crucial role in proliferation and differentiation of resident mesodermal progenitors. They upregulate growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor and insulin-like growth factor 1 (IGF1). As a result, they enhance chondrogenic differentiation and cartilage formation significantly. WJ-MSCs proved to be more hypoimmunogenic when compared to bone marrow MSCs and thus elicited a smaller immune response when engrafted into a rabbit’s knee. WJMSCs are non-invasive as they originate from an umbilical cord that loses purpose after birth. These MSCs displayed faster proliferation rates and lacked teratomas found with engrafting other mesenchymal stem cells. This is in large part due to the hypoimmunogenic ability of WJ-MSCs. MSCs isolated from Wharton jelly express significantly lower HLA-I, produce cytokines (TGFb and IL-10) that tolerate allogenic tissue. Conclusions.  Mesenchymal stem cells are a great alternative option for cartilage and bone repair. Wharton jelly-derived mesenchymal stem cells are better suited because of their immunosuppressive activity. Lack of teratomas, painless collection procedure, faster proliferation rates and hypoimmunogenicity make WJ-MSCs safe & effective for cartilage regeneration.

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