Other potential mechanisms
synovitis, bone marrow lesions, fibrosis
CRITICAL LIMB ISCHEMIA, SYNOVITIS, DISEASE, FIBROSIS, PATHOPHYSIOLOGY, IDIOPATHIC PULMONARY FIBROSIS, OSTEOPHYTE
In addition to having immunomodulatory and chondroprotective effects in OA, MSCs may act through a variety of other mechanisms that target multiple tissues within the joint. These mechanisms include antifibrotic and angiogenic effects, which are interrelated with immunomodulation. In particular, the pro-angiogenic mechanisms of MSCs have been widely documented and are of clinical relevance to a variety of conditions, such as critical limb ischemia [There is a complex interplay between inflammatory and angiogenic processes, with immune cells playing a critical role in the temporal regulation of vessel remodeling through both pro- and anti-angiogenic mechanisms [Antifibrotic effects of MSC therapies have been documented in several clinical indications for which fibrosis is a disease hallmark, including for idiopathic pulmonary fibrosis [In addition to the immunomodulatory, angiogenic, and antifibrotic properties of MSCs that may impact multiple tissues within the joint, MSCs may have tissue-specific effects on the subchondral bone, menisci, and ligaments. MRI data on these tissues from clinical studies involving MSCs in OA are sparse and limited by the sensitivity of the technique. However, Chen et al. have shown that autologous MSC(AT) injection significantly reduced the MOAKS for bone marrow lesions and cysts, meniscus pathology, and periarticular features at 48 weeks relative to baseline, while no significant differences were observed for osteophyte, synovitis, ligament tears or tendon abnormality scores [The menisci and ligaments of the joint play important roles in mechanical support, and damage to these tissues can precede radiographic OA; however, their roles in OA progression and pathophysiology are poorly understood [