# Osteoarthritis--The Role of Mesenchymal Stem Cells in Cartilage Regeneration
## 4 MSC-Based Therapy for OA  
### General Characteristics  
The origins of MSCs date to 1960 when [PERSON] revealed that those cells, isolated from bone marrow (BM), could produce ectopic bone in vivo. It was revealed that fibrobl-tic non-hematopoietic colony cells maintained hematopoietic stem cells in the perivascular niche [110]. Multipotent plasticity was demonstrated by the cells' ability to differentiate in vitro into osteocytes, chondrocytes, and adipocytes [111]. After successfully detecting MSCs grown from human bone marrow, [PERSON] developed the term \"mesenchymal stem cells\" in 1991 [112]. MSCs are pluripotent cells that can differentiate into a wide variety of cell types [111; 112; 113; 114; 115]. These cell types include chondrocytes, adipocytes, osteoblasts, myogenic, and neuronal cells [116; 117]. MSCs have been discovered in a variety of tissues, including BM [118], umbilical cord (UC) blood [119], UC tissue [120], placenta [121; 122], periosteum [123; 124], trabecular bone [124; 125], adipose tissue [126], synovium [127], and skeletal muscle [128]. According to [127], the principal sources of therapeutic MSCs are found in adipose tissue and bone marrow. They are distinguished from other cells by their fibrobl appearance and the particular markers, CD11b+, CD14+, CD34+, CD45+, HLA-DR+, CD73+, CD90+, and CD105+, that they express [128]. In contrast to chondrocytes, MSCs are easier to cultivate and have the ability to develop into cartilage [129]. Important cartilage-specific markers, such as type II collagen, aggregate proteoglycans, and sulfate proteoglycans, are expressed by differentiated cells. Inducers, similar to those employed in other tissue engineering methods, may be put to use to bring about chondrogenic growth. Bone morphogenetic proteins (BMP) [130] and IGF-1 [131] are two of the different inducers that have been discovered, although TGF-\(\beta\)[129] is the most well-known inducer. Figure 1 illustrates the MSCs' sources and differentiation possibilities. \begin{table}
\begin{tabular}{l l l} \hline \hline \multicolumn{1}{c}{**Treatment**} & \multicolumn{1}{c}{**Administration**} & \multicolumn{1}{c}{**Therapeutic Effect in OA**} \\ \hline Physical measures & lifestyle change, weight loss, adapted exercise, braces \\ \hline Pharmacological options & & \\ Acetaminophen & systemic & \(\downarrow\) pain \\ NSAIDs & systemic, topical & \(\downarrow\) pain, \(\downarrow\) inflammation \\ Opioids & systemic & \(\downarrow\) pain \\ Glucocorticoids & intra-articular injection & \(\downarrow\) pain, \(\downarrow\) inflammation \\ Duloxetine & systemic & \(\downarrow\) pain \\ \hline Capsaicin & topical & \(\downarrow\) pain \\ \hline PRP & intra-articular injection & \(\downarrow\) pain, \(\downarrow\) inflammation, \(\uparrow\) tissue \\  & & regeneration, \(\uparrow\) function \\ \hline Hyaluronic acid & intra-articular injection & \(\downarrow\) pain, \(\uparrow\) function \\ \hline Glucosamine and chondro sulfate & systemic & \(\uparrow\) function \\ \hline MSCs & intra-articular injection & \(\uparrow\) bone and cartilage regeneration, \(\downarrow\) pain, \\  & & \(\uparrow\) function \\ \hline Surgical intervention & & \\ Joint debridement & arthrotomy, arthroscopy & \(\downarrow\) pain, \(\uparrow\) function \\  & & \(\uparrow\) cartilage repair \\  & & \(\downarrow\) pain, \(\downarrow\) degenerative process \\  & & \(\downarrow\) pain, \(\downarrow\) inflammation \\  & & \(\downarrow\) pain \\  & & \(\downarrow\) pain, \(\uparrow\) cartilage repair \\  & & \(\downarrow\) pain, \(\uparrow\) function \\ \hline \hline \end{tabular} OA = osteoarthritis, NSAIDs = non-steroidal anti-inflammatory drugs, PRP = platelet-rich plasma, MSCs = mesenchymal stem cells, \(\downarrow\) = decrease; \(\uparrow\) = increase.  
\end{table} 
Table 1: Treatment options and their effect in OA. There are several concerns that need to be addressed regarding the quantity and quality of MSCs, even though an OA treatment based on MSC shows promise [132].