Adipose-derived stem cell-based optimization strategies for musculoskeletal regeneration: recent advances and perspectives

Abstract

Musculoskeletal disorders are the leading causes of physical disabilities worldwide. The poor self-repair capacity of musculoskeletal tissues and the absence of effective therapies have driven the development of novel bioengineering-based therapeutic approaches. Adipose-derived stem cell (ADSC)-based therapies are being explored as new regenerative strategies for the repair and regeneration of bone, cartilage, and tendon owing to the accessibility, multipotency, and active paracrine activity of ADSCs. In this review, recent advances in ADSCs and their optimization strategies, including ADSC-derived exosomes (ADSC-Exos), biomaterials, and genetic modifications, are summarized. Furthermore, the preclinical and clinical applications of ADSCs and ADSC-Exos, either alone or in combination with growth factors or biomaterials or in genetically modified forms, for bone, cartilage, and tendon regeneration are reviewed. ADSC-based optimization strategies hold promise for the management of multiple types of musculoskeletal injuries. The timely summary and highlights provided here could offer guidance for further investigations to accelerate the development and clinical application of ADSC-based therapies in musculoskeletal regeneration. Graphical abstract

Tendon extracellular-matrix-derived tissue engineering micro-tissue for Achilles tendon injury regeneration in rats

“…Similar to tenocytes, uninduced ADSCs secrete collagen type I under general culture conditions [ 39 , 40 ]. Transmission electron microscopy studies have shown that the cells are rich in rough endoplasmic reticulum, indicating strong maintenance of secretion under co-culture conditions [ 41 ]. Therefore, ADSCs are an ideal source of seed cells for tendon tissue engineering due to their easy isolation, multiple differentiation potential and excellent responsiveness to microenvironmental stimuli [ 42 ].…”