Tissue Eng Regen Med.  2019 Aug;16(4):327-334. 10.1007/s13770-019-00204-z.

The Interaction between Joint Inflammation and Cartilage Repair

Affiliations
  • 1Experimental Rheumatology, Department of Rheumatology, Radboudumc, Radboud Institute for Molecular Life Sciences (RIMLS), Geert Grooteplein 26, 6525 GA Nijmegen, The Netherlands. Peter.vanderkraan@radboudumc.nl

Abstract

BACKGROUND
Articular cartilage lesions occur frequently but unfortunately damaged cartilage has a very limited intrinsic repair capacity. Therefore, there is a high need to develop technology that makes cartilage repair possible. Since joint damage will lead to (sterile) inflammation, development of this technology has to take into account the effects of inflammation on cartilage repair.
METHODS
A literature search has been performed including combinations of the following keywords; cartilage repair, fracture repair, chondrogenesis, (sterile) inflammation, inflammatory factors, macrophage, innate immunity, and a number of individual cytokines. Papers were selected that described how inflammation or inflammatory factors affect chondrogenesis and tissue repair. A narrative review is written based on these papers focusing on the role of inflammation in cartilage repair and what we can learn from findings in other organs, especially fracture repair.
RESULTS
The relationship between inflammation and tissue repair is not straightforward. Acute, local inflammation stimulates fracture repair but appears to be deleterious for chondrogenesis and cartilage repair. Systemic inflammation has a negative effect on all sorts of tissue repair.
CONCLUSION
Findings on the role of inflammation in fracture repair and cartilage repair are not in line. The currently widely used models of chondrogenesis, using high differentiation factor concentrations and corticosteroid levels, are not optimal. To make it possible to draw more valid conclusions about the role of inflammation and inflammatory factors on cartilage repair, model systems must be developed that better mimic the real conditions in a joint with damaged cartilage.

Keyword

Cartilage repair; Fracture repair; Chondrogenesis; Inflammation; Innate immunity

MeSH Terms

Cartilage*
Cartilage, Articular
Chondrogenesis
Cytokines
Immunity, Innate
Inflammation*
Joints*
Macrophages
Cytokines
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