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      Human Migratory Meniscus Progenitor Cells Are Controlled via the TGF-β Pathway

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          Summary

          Degeneration of the knee joint during osteoarthritis often begins with meniscal lesions. Meniscectomy, previously performed extensively after meniscal injury, is now obsolete because of the inevitable osteoarthritis that occurs following this procedure. Clinically, meniscus self-renewal is well documented as long as the outer, vascularized meniscal ring remains intact. In contrast, regeneration of the inner, avascular meniscus does not occur. Here, we show that cartilage tissue harvested from the avascular inner human meniscus during the late stages of osteoarthritis harbors a unique progenitor cell population. These meniscus progenitor cells (MPCs) are clonogenic and multipotent and exhibit migratory activity. We also determined that MPCs are likely to be controlled by canonical transforming growth factor β (TGF-β) signaling that leads to an increase in SOX9 and a decrease in RUNX2, thereby enhancing the chondrogenic potential of MPC. Therefore, our work is relevant for the development of novel cell biological, regenerative therapies for meniscus repair.

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          Highlights

          • Progenitor cells are found in the inner avascular part of human osteoarthritic menisci

          • These meniscus progenitor cells (MPCs) are clonogenic, migratory, and multipotent

          • MPCs are governed via the canonical TGF-β pathway

          • TGF-β3 via Smad2 reduces Runx2 to enhance the chondrogenic potential of MPCs

          Abstract

          Degeneration of knee joints during osteoarthritis often begins with meniscal lesions and regeneration of the inner, avascular meniscus does not occur. In this article, Miosge and colleagues show that cartilage tissue harvested from the inner human meniscus harbors unique meniscus progenitor cells (MPCs). These cells are controlled by canonical TGF-β signaling that leads to an increase in their chondrogenic potential.

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          Most cited references35

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          Osteoarthritis cartilage histopathology: grading and staging.

          Current osteoarthritis (OA) histopathology assessment methods have difficulties in their utility for early disease, as well as their reproducibility and validity. Our objective was to devise a more useful method to assess OA histopathology that would have wide application for clinical and experimental OA assessment and would become recognized as the standard method. An OARSI Working Group deliberated on principles, standards and features for an OA cartilage pathology assessment system. Using current knowledge of the pathophysiology of OA morphologic features, a proposed system was presented at OARSI 2000. Subsequently, this was widely circulated for comments amongst experts in OA pathology. An OA cartilage pathology assessment system based on six grades, which reflect depth of the lesion and four stages reflecting extent of OA over the joint surface was developed. The OARSI cartilage OA histopathology grading system appears consistent and simple to apply. Further studies are required to confirm the system's utility.
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            Meniscus pathology, osteoarthritis and the treatment controversy.

            The menisci are internal structures that are of central importance for a healthy knee joint; they have a key role in the structural progression of knee osteoarthritis (OA), and the risk of the disease dramatically increases if they are damaged by injury or degenerative processes. Meniscus damage might be considered a signifying feature of incipient OA in middle-aged and elderly people. As approximately every third knee of people in these groups has a damaged meniscus, tears are common incidental findings of knee MRI. However, as most tears do not cause symptoms, careful clinical evaluation is required to determine if a damaged meniscus is likely to directly impact a patient's symptoms. Conservative management of patients with knee pain and a degenerative meniscal tear should be considered as a first-line therapy before surgical treatment is contemplated. Patients with mechanical interference of joint movements, such as painful catching or locking, might need surgical treatment with meniscal repair if possible. In a subset of patients, meniscal resection might relieve pain and other symptoms that potentially originate directly from the torn meniscus. However, the possibility of an increased risk of OA if functional meniscal tissue is removed cannot be overlooked.
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              Migratory chondrogenic progenitor cells from repair tissue during the later stages of human osteoarthritis.

              The regeneration of diseased hyaline cartilage continues to be a great challenge, mainly because degeneration--caused either by major injury or by age-related processes--can overextend the tissue's self-renewal capacity. We show that repair tissue from human articular cartilage during the late stages of osteoarthritis harbors a unique progenitor cell population, termed chondrogenic progenitor cells (CPCs). These exhibit stem cell characteristics such as clonogenicity, multipotency, and migratory activity. The isolated CPCs, which exhibit a high chondrogenic potential, were shown to populate diseased tissue ex vivo. Moreover, downregulation of the osteogenic transcription factor runx-2 enhanced the expression of the chondrogenic transcription factor sox-9. This, in turn, increased the matrix synthesis potential of the CPCs without altering their migratory capacity. Our results offer new insights into the biology of progenitor cells in the context of diseased cartilage tissue. Our work may be relevant in the development of novel therapeutics for the later stages of osteoarthritis.
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                Author and article information

                Contributors
                Journal
                Stem Cell Reports
                Stem Cell Reports
                Stem Cell Reports
                Elsevier
                2213-6711
                25 September 2014
                25 September 2014
                11 November 2014
                : 3
                : 5
                : 789-803
                Affiliations
                [1 ]Tissue Regeneration Work Group, Department of Prosthodontics, Medical Faculty, Georg-August-University, 37075 Goettingen, Germany
                [2 ]Institute of Medical Statistics, Medical Faculty, Georg-August-University, 37075 Goettingen, Germany
                [3 ]Developmental Biology, Harvard School of Dental Medicine, Boston, MA 02115, USA
                Author notes
                []Corresponding author nmiosge@ 123456gwdg.de
                [4]

                Co-first author

                Article
                S2213-6711(14)00264-1
                10.1016/j.stemcr.2014.08.010
                4235742
                25418724
                cd04c026-b08d-423d-8dbb-d83a5531832b
                © 2014 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

                History
                : 2 April 2014
                : 19 August 2014
                : 20 August 2014
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