The regeneration of damaged connective tissue: wishful thinking or reality?
This review provides a clinical and biological analysis/overview of publications that have identified injectable therapeutics including mesenchymal stem cells (MSCs), platelet-rich plasma (PrP) and Gold-induced cytokines (GOLDIC), in the regeneration and repair of tissue based on various clinical use, in vitro studies and with evidence provided by MRI or other imaging techniques. The review describes the advantages of micro-fragmented adipose tissue and its medicinal properties created through release of blood vessel-derived pericytes or MSCs and the work goes on to specify some of the critical growth factors and cytokines involved in tissue regeneration and repair including fibroblast growth factor, platelet derived growth factor, transforming growth factor-β, vascular endothelial growth factor and various cytokines. Evidence is provided on the mechanism through which adipose-derived MSCs can re-establish an optimal tissue micro-environment through paracrine signalling mechanisms allowing a natural promotion of healing and regeneration. There is some promising early evidence that gold-activated plasma may also benefit and enhance recovery through increased anti-inflammatory activities through production of gelsolin-although this is not clinically proven to date.