Adipose-derived stem cell sheet encapsulated construct of micro-porous decellularized cartilage debris and hydrogel for cartilage defect repair.

Challenges of repairing injuries and damage to the cartilage still remain in orthopedics. The characteristics of cartilage structure, especially avascular, make it a limited capacity of self-renewal. Articular cartilage defect or damage result from various causes will lead to degenerative osteoarthritis (OA). Surgical treatment and non-surgical treatment can temporarily alleviate symptoms to some extent but can't fundamentally restore the normal structure and function of cartilage, and therefore give rise to progressive degeneration. Autologous or allogeneic cartilage transplantation has been employed to the treatment of osteoarthritis for years. Nevertheless, the major deficiency of cartilage grafting is the inability and insufficiency to repair large cartilage defect. Implants are also unable to integrate with native tissue well. Adipose-derived stem cells (ASCs) can be easily isolated from subcutaneous fat tissues and harvest as intact cell sheets containing extracellular matrix (ECM), intercellular connect, ion channel, growth factor receptors, nexin and other important cell surface proteins by means of temperature-responsive culture dish (TCD). A cell sheet can provide a large amount of extracellular matrix, fibronectin, and cells contributing to the integration of cartilage. Decellularized extracellular matrix (DECM) of cartilage debris with excellent cell affinity and signal transduction is capable of driving cartilage homeostasis and regeneration. Appropriate decellularization process would remove cellular remnants of cartilage debris, keep the mechanical properties, and avoid the adverse immune response of allografts effectively. Micro-porous cartilage debris conduces to cell migration and angiogenesis. The cell-round shape of adipose-derived stem cells cultured in the three-dimensional (3D) system provided by hydrogel is more susceptible to chondrogenic stimulation and prevents it from fibroblast-like phenotypic conversion. We hypothesize that adipose-derived stem cell sheet encapsulated construct of micro-porous decellularized cartilage debris and hydrogel can effectively promote regeneration of cartilage defect. The construct of decellularized cartilage debris and hydrogel provide a favorable microenvironment for stem cells. Adipose-derived stem cells sheet supply fibronectin, collagen, and cells contributing to integration and regeneration of cartilage restore. Moreover, the constructs can be shaped and fabricated according to the configuration of target defect, especially in osteoarthritis, which is promising for clinical application.