Histological Evaluation of Mesenchymal Stem Cell Treatment Effectiveness in Osteoarthritis: A Scoping Review

Abstract

Background: Osteoarthritis (OA) is a chronic degenerative joint disease characterised by pain, stiffness and a loss of joint function. Emerging research has reported on the therapeutic potential of mesenchymal stem cell (MSC) therapy in OA therapy symptomatically. This review aims to evaluate the effectiveness of MSC therapy in the treatment of OA on a histological basis. Method: This scoping review was conducted following the PRISMA-ScR guidelines. The identification and screening process lasted for a month between November and December 2024. Six electronic databases were utilised to obtain data articles including ScienceDirect, SpringerLink, ProQuest, EBSCO, Medline, and Cochrane. The keywords used to identify the data in these databases were determined using the PICO framework and then organised using the Boolean system to generate the following search terms; (“Osteoarthritis” OR “Degenerative arthritis”) AND “Mesenchymal stem cell” AND (“Cartilage repair” OR “Cartilage regeneration”). Result: Twenty-six of 3,184 original articles met the inclusion criteria with a majority reporting significantly improved cartilage repair after MSC therapy. Of those of twenty-six articles, twenty-one reported improved cartilage density, specifically increased chondrocyte volume, while six articles reported an improved chondrocyte characteristic with a decrease of apoptosis and hypertrophic chondrocytes. Fourteen articles reported improvements in extracellular matrix composition by increased COL2 and decreased COL1 levels. Additionally, seven articles reported on the immunomodulatory properties of MSCs, either by decreasing pro-inflammatory cytokines or increasing anti-inflammatory cytokines. Only one of twenty-six studies reported an insignificant outcome between the MSC therapy group and the control group. Conclusion: MSC therapy displayed promising histological benefits for cartilage repair in OA through various mechanisms. Further studies are recommended to optimise administration methods, especially in multifactorial conditions such as systemic inflammation.