$$\rightleftharpoonup{xx}$$
$$\longleftharp{xx}$$,
$$\longrightharp{xx}$$,
Mesenchymal stem cells (MSCs) are an attractive candidate for cell-based therapies in regenerative medicine1,2. They can be harvested from a variety of tissue sources such as bone marrow, umbilical cord, placenta, dental pulp, and subcutaneous adipose tissue3. However, as the availability of stem cells in adults is limited and their isolation procedure is often invasive (resulting in donor site morbidity), it is desirable to have an alternative stem cell source that could circumvent these challenges.
The knee joint is a depot of various cell types, such as infrapatellar fat pad-derived MSCs, synovial membrane-derived MSCs, synovial fluid-derived MSCs, ligament fibroblasts, articular chondrocytes, etc4,5,6. These cells have the potential to be widely explored in musculoskeletal tissue engineering-based research. Therefore, the knee joint could be a possible and reliable source of multiple types of MSCs. Adipose depot located in the knee joint, known as the infrapatellar fat pad (IFP) or Hoffa's fat pad, is a promising and alternative choice of MSC depot. The IFP is a relatively easily accessible and clinically obtainable source of MSCs, as it is routinely resected and discarded as surgical waste during knee arthroscopy or open knee surgery. Removal of the IFP is associated with minimal donor-site morbidity, which also makes it an attractive tissue source. While having a similar phenotypic profile, MSCs from IFP (IFP-MSCs) have enhanced clonogenic potential when compared with bone marrow-derived mesenchymal stem cells (BM-MSCs)6 and better proliferative capacity compared to subcutaneous adipose-derived stem cells (ADSCs)7. Interestingly, compared to synovial fluid-derived MSCs (SF-MSCs), IFP-MSCs do not lose their proliferative capacity at late passages, nor does doubling time increase at late passages. This suggests that, during cell expansion, IFP-MSCs can achieve a sufficiently large number of cells for in vitro tissue engineering applications without compromising their proliferation rate8. Recent studies have also suggested that IFP-MSCs possess superior chondrogenic differentiation potential compared to bone marrow-derived MSCs (BMSCs) and adipose-derived MSCs (ADSCs), probably due to their anatomical proximity to articular cartilage, indicating their suitability for cartilage tissue engineering6,7,9,10. Moreover, they also possess age-independent osteogenic differentiation potential11. Intra-articular injection of IFP-MSCs has been shown to reduce pain and improve knee joint functions in patients with osteoarthritis (OA)12,13. Further, strong immunosuppressive responses and improved immunomodulatory properties of IFP-MSCs in the presence of inflammatory cytokines during pathological conditions have also been reported6.
IFP-MSCs are a promising and alternate source of MSCs; however, their therapeutic benefit in tissue engineering and regenerative medicine is relatively less explored. The existing studies on IFP-MSCs have majorly utilized cells from human donors. Amongst these, a few recent studies have investigated IFP-MSCs from healthy human donors (non-arthritic patients, aged 17-60 years)6,14, whereas most of the studies have used IFP-MSCs from aged patients undergoing total knee replacement surgery (diseased patients, age 70-80 years). As both age and disease are known to alter the normal functioning of stem cells (reduced number and loss of functional potential), this could potentially lead to inconsistencies in the outcome of the MSC-based studies7,15,16,17. In addition to that, the use of IFP-MSCs from patients with pathophysiological conditions (e.g., arthritis and obesity) also poses difficulty for understanding the basic characteristics of healthy cells in vitro, thereby acting as a limiting factor in the development of MSCs-based therapies. To overcome these issues, the use of IFP-MSCs from healthy donors is vital. As access to a healthy human donor is challenging, animal models could be a better alternative. In this regard, there are a few studies where IFP has been isolated from mice18. However, owing to the small size of the fat pad in normal mice, fat tissues from multiple animals have been combined to get enough tissue to execute elaborate experimental procedures19. Hence, there is a need for a large animal model, which could fulfill the requirement for the higher number of cells and simultaneously comply with the 3R principles (refine, replace, and reduce) in animal research20. The usage of large animals has significant implications in translational research. Specifically, in musculoskeletal tissue engineering, a range of large animals such as dogs, pigs, sheep, goats, and horses have been investigated21. Goat (Capra aegagrus hircus) is an excellent choice of large animal since its stifle joint has the closest anatomy to the human knee joint22,23,24. The subchondral bone trabecular structure and subchondral bone thickness of goats are similar to humans, and the proportion of the cartilage to bone is also reported to be close to humans21. In addition, goats have been widely domesticated throughout the world, making them easily available when they are skeletally mature. Further, low maintenance costs and easy handling have made them an attractive animal model for research22.
In the present study, a simple protocol for the isolation of IFP-MSCs from the stifle joint of Capra aegagrus hircus (goat) and in vitro culture conditions for their expansion and differentiation are demonstrated. The isolated cells are adherent, have MSC-like morphology, form CFU-F (colony-forming unit-fibroblast) colonies, and possess adipogenic, chondrogenic, and osteogenic differentiation potential. Therefore, IFP-MSCs show potential as an alternative source of MSCs for biomedical applications.