Current applications of adipose-derived mesenchymal stem cells in bone repair and regeneration: A review of cell experiments, animal models, and clinical trials

Abstract

In the field of orthopaedics, bone defects caused by severe trauma, infection, tumor resection, and skeletal abnormalities are very common. However, due to the lengthy and painful process of related surgery, people intend to shorten the recovery period and reduce the risk of rejection; as a result, more attention is being paid to bone regeneration with mesenchymal stromal cells, one of which is the adipose-derived mesenchymal stem cells (ASCs) from adipose tissue. After continuous subculture and cryopreservation, ASCs still have the potential for multidirectional differentiation. They can be implanted in the human body to promote bone repair after induction in vitro, solve the problems of scarce sources and large damage, and are expected to be used in the treatment of bone defects and non-union fractures. However, the diversity of its differentiation lineage and the lack of bone formation potential limit its current applications in bone disease. Here, we concluded the current applications of ASCs in bone repair, especially with the combination and use of physical and biological methods. ASCs alone have been proved to contribute to the repair of bone damage in vivo and in vitro. Attaching to bone scaffolds or adding bioactive molecules can enhance the formation of the bone matrix. Moreover, we further evaluated the efficiency of ASC-committed differentiation in the bone in conditions of cell experiments, animal models, and clinical trials. The results show that ASCs in combination with synthetic bone grafts and biomaterials may affect the regeneration, augmentation, and vascularization of bone defects on bone healing. The specific conclusion of different materials applied with ASCs may vary. It has been confirmed to benefit osteogenesis by regulating osteogenic signaling pathways and gene transduction. Exosomes secreted by ASCs also play an important role in osteogenesis. This review will illustrate the understanding of scientists and clinicians of the enormous promise of ASCs’ current applications and future development in bone repair and regeneration, and provide an incentive for superior employment of such strategies.

Implication of Cellular Senescence in Osteoarthritis: A Study on Equine Synovial Fluid Mesenchymal Stromal Cells

“…Widely studied for their immunomodulatory proprieties and their abilities to self-renew and to differentiate towards several lineages, including chondrocytes, no successful application based on the MSCs approach and the derived secretome has been developed for cartilage regeneration. However, most of the current research has been focused on the application of MSCs derived from bone marrow [ 25 , 26 ], adipose [ 27 ], and fetal-derived tissues [ 28 , 29 ], and just a few studies have investigated the potential therapeutic proprieties of sf-MSCs. Although sf-MSCs have demonstrated higher chondrogenic capabilities than other types of MSCs [ 30 ], their accumulation as senescent cells in synovial fluid and their correlation with OA progression have never been investigated.…”

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

“…The transplantation of autologous human ADSCs did not result in major adverse events, the focal bone formation was good, and a few patients achieved excellent clinical results. However, problems surrounding graft loosening, infection, and tumor recurrence were observed [ 102 ]. A 6-year follow-up study of cranioplasty based on ADSCs, β-TCP, and a supporting mesh illustrated unsatisfactory results, such as marked graft resorption, late infection (7.3 years postoperatively), or meningioma recurrence (2.2 years postoperatively).…”

Adipose-Derived Mesenchymal Stromal Cells: A Tool for Bone and Cartilage Repair

“…On the other hand, many more nonmetallic scaffolds have been designed, each of them characterized by different advantages and disadvantages. Examples of these scaffolds include the acellular matrix, coralline scaffolds, natural or synthetic polymers and hybrid scaffolds [20,58,59]. Ideal scaffolds should be degradable and biocompatible and mimic as closely as possible the physiological microenvironment of the target tissue.…”

“…Natural ECMs can be advantageously prepared in the form of hydrogels [58], which are considered a promising cell-supporting alternative material [63]. Hydrogels are characterized by a 3D polymeric network that, retaining a large amount of water, more closely resembles soft tissues, thus providing a wider range of scaffold applications.…”