Cell therapy for bone repair

Abstract

When natural bone repair mechanisms fail, autologous bone grafting is the current standard of care. The osteogenic cells and bone matrix in the graft provide the osteo-inductive and osteo-conductive properties required for successful bone repair. Bone marrow (BM) mesenchymal stem cells (MSCs) can differentiate into osteogenic cells. MSC-based cell therapy holds promise for promoting bone repair. The amount of MSCs available from iliac-crest aspirates is too small to be clinically useful, and either concentration or culture must therefore be used to expand the MSC population. MSCs can be administered alone via percutaneous injection or implanted during open surgery with a biomaterial, usually biphasic hydroxyapatite/β-calcium-triphosphate granules. Encouraging preliminary results have been obtained in patients with delayed healing of long bone fractures or avascular necrosis of the femoral head. Bone tissue engineering involves in vitro MSC culturing on biomaterials to obtain colonisation of the biomaterial and differentiation of the cells. The biomaterial-cell construct is then implanted into the zone to be treated. Few published data are available on bone tissue engineering. Much work remains to be done before determining whether this method is suitable for the routine filling of bone tissue defects. Increasing cell survival and promoting implant vascularisation are major challenges. Improved expertise with culturing techniques, together with the incorporation of regulatory requirements, will open the way to high-quality clinical trials investigating the usefulness of cell therapy as a method for achieving bone repair. Cell therapy avoids the drawbacks of autologous bone grafting, preserving the bone stock and diminishing treatment invasiveness.

Osteogenic differentiation of amniotic fluid mesenchymal stromal cells and their bone regeneration potential

“…Bone marrow harvesting requires invasive pro cedures while the MSC number and differentiation potential decline with increasing age of the donor [94] . MSCs from extraembryonic tissues are easily accessible.…”

Protective effect of berberine against oxidative stress-induced apoptosis in rat bone marrow-derived mesenchymal stem cells

“…Owing to the low immunogenicity and transplantability (32), BMSCs are an effective resource for transplantation in clinical application, with the establishment of cell banks for bone regenerative medicine (2,33). Previously, much attention has been directed towards the poor survival of transplantation in MSC-based therapy (5,9,34,35).…”

“…Fortunately, mesenchymal stem cell (MSC)-based therapy has recently emerged as an appealing and potential therapeutic strategy for the treatment of delayed union, nonunion or persistent bone defects (2). Bone marrow-derived MSCs (BMSCs), one type of MSC cell, have the properties of plasticity and the ability to differentiate into chondrocytes, osteocytes and adipocytes (3).…”

“…The transplantation of BMSCs in damaged tissues has been an innovation used in tissue engineering, particularly in the field of skeletal regenerative medicine (4,5). Cultured BMSCs have been injected or combined with biomaterials into fracture sits where the BMSCs differentiate into osteoblasts to repair the fracture (2,6,7). Therefore, multiple stem cell-based products and techniques to enhance the efficacy of local implantation of BMSCs are currently being investigated to optimize bone healing in various animal models and clinical trials (3,5).…”

The Osteogenic Potential of Human Nondifferentiated and Pre-differentiated Mesenchymal Stem Cells Combined with an Osteoconductive Scaffold – Early Stage Healing

“…To reach the research aims we compare the scaffold loaded with pre-differentiated, non-differentiated MSCs and scaffold which was not loaded with the MSCs applying the approach suggested by Rosset et al (10). A group of rats was implanted with a bone scaffold loaded with pre-differentiated osteoblasts and pre-differentiated endothelial cells, and this group was compared to a group of rats implanted with the bone scaffold loaded with undifferentiated MSCs and group of rat implanted with the scaffold alone.…”