Applications of Chondrocyte-Based Cartilage Engineering: An Overview

Table 1

Advantage and disadvantages associated with the cells sources used in tissue engineering for cartilage repair.

Cell type	Advantage	Disadvantage/limitations
(i) Chondrocytes	(i) Promising cell source for cartilage repair; (ii) More abundant than progenitor cells; (iii) No severe clinical safety issues have been associated with the ACI technique; (iv) Restricted to chondrogenic lineage	(i) Donor-site morbidity caused by cartilage harvest; (ii) Chondrocyte dedifferentiation during cellular expansion; (iii) Limited cells available and multiple surgical procedures involved are the hurdles of using chondrocytes; (iv) Requires autologous cartilage
(ii) Adult mesenchymal stem cells (MSCs); (a) Adipose tissue-derived MSCs; (AD-MSCs); (b) Bone marrow-derived MSCs; (BM-MSCs)	(i) Easily obtained from tissues such as adipose tissue, bone marrow, and synovial membrane; (ii) These cells have higher chondrodifferentiation capacity and proliferation rate; (iii) Resistant to senescence; (iv) Autologous cartilage is not required to obtained these cells	(i) Potential risks of induction or stimulation of tumorigenesis, colonization of nontarget tissues, transmission of infection, use of human (allogeneic) or animal serum-derived agents during cell expansion; (ii) Reduced potentiality with age and disease; (iii) Production of fibrocartilage instead of hyaline cartilage in the lesion and of terminal differentiation with cell hypertrophy and mineralization leading to the replacement of cartilage by bone; (iv) Not restricted to chondrogenic lineage; (v) AD-MSCs possess limited chondrogenic potential
(iii) Induced pluripotent stem cells (iPSCs)	(i) iPSCs have showed promising result in cartilage repair; (ii) Cell amount is not issue and can be stimulated to obtained require amount; (iii) Autologous cartilage is not required to obtain these cells	(i) Chondrogenic efficacy of iPSCs; (ii) Ex vivo purification of calls; (iii) Genetic modification associated with reprogramming protocols; (iv) Teratogenesis perspective and in vivo tissue malformations
(iv) Embryonic stem cells (ESCs)	(i) Coculture with mature chondrocytes stimulates ESC chondrogenesis	(i) Teratoma formation; (ii) Host immunorejection for clinical transplant