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However, the complexity and specificity of the \u201clive\u201d cells have posed challenges for MSC-based drug development and the concomitant scale-up preparation from laboratory to industrialization. For instance, despite the considerable progress in ex vivo  cell culture technology for fulfilling the robust development of drug conversion and clinical trials, yet significant challenges remain in obtaining regulatory approvals. Thus, there\u2019s an urgent need for the research and development of MSC drugs for KOA. In this review, we provide alternative solution strategies for the preparation of MSC drugs on the basis of the principle of quality by design, including designing the cell production processes, quality control, and clinical applications. In detail, we mainly focus on the quality by design method for MSC manufacturing in standard cell-culturing factories for the treatment of KOA by using the Quality Target Product Profile as a starting point to determine potential critical quality attributes and to establish relationships between critical material attributes and critical process parameters. Collectively, this review aims to meet product performance and robust process design, and should help to reduce the gap between compliant products and the production of compliant good manufacturing practice.<\/jats:p>","DOI":"10.4252\/wjsc.v17.i5.106547","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T02:35:28Z","timestamp":1747967728000},"source":"Crossref","is-referenced-by-count":8,"title":["Quality by design strategy of human mesenchymal stem\/stromal cell drug products for the treatment of knee osteoarthritis"],"prefix":"10.4252","volume":"17","author":[{"given":"Hao","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chen","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei-Sheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100587"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3873098"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61879-0"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-019-1478-4"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-021-02444-0"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1186\/s13578-020-00516-x"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/cpr.12862"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-020-1577-2"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s11064-023-03968-y"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1038\/nri2395"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/cbin.11976"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s12015-020-10053-2"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1186\/s42826-022-00125-4"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2022.109408"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2174\/1574888X17666220520155212"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1093\/stcltm\/szae094"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.62347\/DRAE5818"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.2174\/1574888X16666210712212421"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.4252\/wjsc.v13.i8.1058"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/ni.3002"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2017.09.068"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10061278"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1002\/stem.1634"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcyt.2018.10.014"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0005846"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.reth.2024.12.016"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e15946"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1038\/nbt0109-26"},{"key":"B29","unstructured":"Mitchell M. 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