Bone Marrow Multipotent Mesenchymal Stromal Cells as Autologous Therapy for Osteonecrosis: Effects of Age and Underlying Causes

Abstract

Bone marrow (BM) is a reliable source of multipotent mesenchymal stromal cells (MSCs), which have been successfully used for treating osteonecrosis. Considering the functional advantages of BM-MSCs as bone and cartilage reparatory cells and supporting angiogenesis, several donor-related factors are also essential to consider when autologous BM-MSCs are used for such regenerative therapies. Aging is one of several factors contributing to the donor-related variability and found to be associated with a reduction of BM-MSC numbers. However, even within the same age group, other factors affecting MSC quantity and function remain incompletely understood. For patients with osteonecrosis, several underlying factors have been linked to the decrease of the proliferation of BM-MSCs as well as the impairment of their differentiation, migration, angiogenesis-support and immunoregulatory functions. This review discusses the quality and quantity of BM-MSCs in relation to the etiological conditions of osteonecrosis such as sickle cell disease, Gaucher disease, alcohol, corticosteroids, Systemic Lupus Erythematosus, diabetes, chronic renal disease and chemotherapy. A clear understanding of the regenerative potential of BM-MSCs is essential to optimize the cellular therapy of osteonecrosis and other bone damage conditions.

The Combined Use of Platelet-Rich Plasma Clot Releasate and Allogeneic Human Umbilical Cord Mesenchymal Stem Cells Rescue Glucocorticoid-Induced Osteonecrosis of the Femoral Head

“…Furthermore, special attention should be paid to the efficiency of MSCs and PRP formulation injection. It had been proved that the combinatorial therapy of MSC core decompression played a positive role in treating ONFH [ 43 ]. In this present study, PRCR and UC-MSCs were delivered to the hip joints via ultrasound-guided intra-articular injections, which possesses many advantages, such as real-time visualization, safety, and portability [ 30 , 44 ].…”

Characterization and miRNA Profiling of Extracellular Vesicles from Human Osteoarthritic Subchondral Bone Multipotential Stromal Cells (MSCs)

“…In contrast, our study is uniquely focused on the cross-talk between cartilage and SB in OA and investigated EV production from a specific type of SB cells, SB MSCs, which are directly implicated in SB OA pathology and cartilage destruction “from below” [ 60 – 62 ]. Although SB MSCs from healthy amputees would be a better control than the MSCs from bone marrow used in this work, these samples are difficult to access while MSCs from amputated knees from diabetics could carry underlying negative effects such as described previously [ 63 – 65 ].…”

Polymer Scaffolds-Enhanced Bone Regeneration in Osteonecrosis Therapy

“…Mesenchymal stem cells can differentiate into a variety of cell lines (such as bone cells, osteoblasts, and endothelial cells) (Fan et al, 2015;Hernigou et al, 2015;Sui et al, 2019). Bone marrow mesenchymal stem cells are accessible to culture and expand in vitro and accelerate bone regeneration by differentiating into osteoblasts (Le et al, 2020;Song et al, 2020;Zhu et al, 2020;El-Jawhari et al, 2021). Previous studies have shown that bone marrow mesenchymal stem cells secrete a variety of growth factors, cytokines, and other biologically active molecules to regulate the damage and repair process of ischemic tissue after transplantation (Herrmann et al, 2011).…”