Orthopedic cellular therapy: An overview with focus on clinical trials

In this editorial,the authors tried to evaluate the present state of cellular therapy in orthopedic field.The topics the authors try to cover include not only the clinical trials but the various research areas as well.Both the target diseases for cellular therapy and the target cells were reviewed.New methods to activate the cells were interesting to review.Most advanced clinical trials were also included because several of them have advanced to phase Ⅲ clinical trials.In the orthopedic field,there are many diseases with a definite treatment gap at this time.Because cellular therapies can regenerate damaged tissues,there is a possibility for cellular therapies to become disease modifying drugs.It is not clear whether cellular therapies will become the standard of care in any of the orthopedic disorders,however the amount of research being performed and the number of clinical trials that are on-going make the authors believe that cellular therapies will become important treatment modalities within several years.

Cell mediated gene therapy: A guide for doctors in the clinic

The recent approval of gene therapy products in Europe and Asia and the upsurge of gene therapy products in clinical trials signal the rebound of this technology not only for many orphan diseases but also for non-life threatening diseases. Following the success of induced pluripotent stem （iPS） cells in research, other modifed ex vivo gene therapies are also knocking on the door of the clinic. Historically, gene therapy has experienced many ups and downs and still faces many challenges.During the past 10 years, many new ideas have been tried, and the goal of making this technology a more effective treatment modality through greater safety and control is coming within reach. The frst clinical trial of iPS cells has begun, and cell mediated gene therapy products have reached phase Ⅲ in some countries. The potential for tumorigenicity and immunogenicity are still concerns with these products, so physicians should understand the biological aspects of engineered cells in the clinic. In this review article, we attempted to provide a summary update of the current state of knowledge regarding this technology： that is, we reviewed products that have fnished clinical trials, are still in clinical trials and/or are at the research stage. We also focused on the challenges, future directions, and strategies for making this technology available in the clinic. In addition, the available measures for making gene therapy products safer are within the scope of this article. It is also important to understand the manufacturing process for gene therapy products, because cell characteristics can change during the cell expansion process. When physicians use gene therapy products in the clinic, they should be aware of the viability, temperature sensitivity and stability of these cells because biologic products are different from chemical products. Although we may not be able to answer all possible questions and concerns, we believe that this is the right time for physicians to increase their interest in and understanding of this evolving technology.