Therapeutic Potential of Adipose Mesenchymal Stem Cells for Synovial Regeneration: from In-Vitro Studies to Clinical Applications

Synovial joint disorders affect a substantial proportion of the global population, posing a significant challenge to the individual patient and global healthcare systems. Novel therapeutic strategies for resolving cartilage and synovial damage have recently been investigated. Adipose-derived mesenchymal stem cells (AD-MSCs) emerged as a potential cell-based therapy approach due to their accessibility, abundance, low immunogenicity, immunomodulatory effect, and tissue repair capability. The translation of AD-MSCs-based therapies from bench to clinical practice has shown promising results; with extensive evidence supporting their feasibility and efficacy for treating joint disorders. Despite their considerable potential, however, few AD-MSCs-based therapies have been approved for clinical application, primarily due to a lack of standardization and a poorly understood mechanism of action in vivo. The characterization of AD-MSCs from in vitro to in vivo models and eventually to clinical trials enables a comprehensive assessment of their therapeutic potential in synovial regeneration, bridging the gap between basic research and clinical application. The advantages and limitations collected from studies that delineate the effect of AD-MSCs on synovial cells will help researchers translate this cell-therapy approach from bench to clinical application. This review examines current models and applications of their therapeutic potential for synovial regeneration from in vitro studies to clinical trials. We also discuss the potential of cell-free therapy for joint disorders by means of extracellular vesicles.