Mesenchymal stem cells (MSCs) are multipotent adult stem cells that can self-renew and differentiate into a variety of cell types including chondrocytes, osteocytes and adipocytes. MSCs reside in bone marrow, adipose tissues, cord blood, peripheral blood, placenta, Wharton's jelly, fetal liver and lung among others. MSCs represent one of the most promising stem cells for regenerative medicine due to their multipotency, immunoprivileged properties and easy expansion in vitro. So far, MSCs are already in various phases of clinical application [1][2][3][4]. Their most immediate use is in the orthopedic context due to the clear demonstration of their ability to differentiate into bone and cartilage [5][6][7][8]. It has been 5 decades since Friedenstein et al described clonal and plastic adherent stromal cells from bone marrow in the 1960s [9,10]. Although there are a handful of genes suggesting possible MSC stemness markers, the molecular basis underlying MSC stemness, especially the key transcription factor to MSC stemness, is still poorly understood.There are several reasons for poor understanding of MSC stemness. First of all, the heterogeneity of MSCs greatly hamper in-depth MSC study. Variations exist among MSCs from different sources and culture conditions, even fast and slow growing CFUderived MSCs from the same patient also display differences [11,12]. So far, the factors that affect the heterogeneity of the MSC population is still largely unknown. Secondly, the limited lifespan of MSCs increases the dif iculty to study MSCs, especially in case of large number of cells needed. Like other adult stem cells, MSCs undergo the replicative senescence after only a inite number of times in culture. At around passage 10, MSCs demonstrate morphological abnormalities, enlargement, attenuated expression of speci ic surface markers, and ultimately proliferation arrest [13,14]. In the meanwhile, MSCs reduce differentiation potential during prolonged in vitro culture [15]. The limited lifespan of MSCs also greatly compromises the therapeutic application of human MSCs due to limitation in cell number. Thirdly, little is known about MSC niche. Stem cell niche is a speci ic microenvironment, in which stem cells are able to selfrenew and maintain the undifferentiated state. So far, the MSC niche remains poorly understood.Stem cell niche provides a milieu that prolongs cellular lifespan and maintains the undifferentiated state of stem cells. Mimicking endogeneous niche of MSCs is able to delay the cell aging and maintain MSC stemness, including hypoxia [16][17][18], coating with extra-cellular matrix (ECM) [19,20], and 3D culture [21,22] among others. Hypoxic environment has been suggested as physiologic niche to maintain stemness of stem cells. MSCs resides in niche characterized by hypoxic condition. Culture of MSCs under hypoxia enhanced proliferation and preserved the expression of stemnessrelated genes [16,18]. Changed gene expression pro ile of MSCs by hypoxia included differentiation, extracellular matrix, intermediate i...