滑膜幹細胞移植による軟骨・半月板の再生医療

Homeostasis and Disorder of Musculoskeletal System.Transplantation of synovial mesenchymal stem cells for cartilage and meniscus regeneration.

　近年，幹細胞を用いた再生医療の臨床応用が発展している。我々は滑膜由来の間葉系幹細胞を用いた治療を行っており，関節軟骨損傷に対して軟骨欠損部への細胞移植を，半月板損傷に対して縫合術と同時に細胞移植を行っている。本法は関節鏡視下に行える低侵襲な治療である。現在，安全性が確認され，良好な臨床成績が得られている。今後さらに長期成績を検証し，なお一層発展させていきたい。

　Cartilage injury remains one of the common clinical problems due to its limited regeneration capacities. Meniscectomy commonly performed for meniscus injury leads to osteoarthritis, but the indication of meniscus repair is limited. We have identified that synovial mesenchymal stem cells（MSCs）are superior to MSCs derived from other tissues in proliferation capacity and in vitro/in vivo chondrogenic potentials. When suspension of synovial MSCs was placed on the cartilage defect for 10 minutes, 60％ of the cells attached to the defect site. Based on these basic researches, we started a clinical study for cartilage regeneration by arthroscopic transplantation of synovial MSCs. Additionally, we transplanted synovial MSCs for meniscus injury after meniscus repair. We obtained good clinical results of cartilage regeneration and meniscus healing without any serious side effects. Transplantation of synovial MSCs will be useful for cartilage or meniscus injuries.