Stem cell homing in musculoskeletal injury

Abstract

The regenerative potential of injured adult tissue suggests the physiological existence of cells capable of participating in the reparative process. Recent studies indicate that stem-like cells residing in tissues contribute to tissue repair and are replenished by precursor bone marrowderived cells. Mesenchymal stromal cells (MSC) are among the candidates for reparative cells. These cells can potentially be mobilized into the circulation in response to injury signals and exert their reparative effects at the site of injury. Current therapies for musculoskeletal injuries pose unavoidable risks which can impede full recovery. Trafficking of MSC to the injury site and their subsequent participation in the regenerative process is thought to be a natural healing response that can be imitated or augmented by enhancing the endogenous MSC pool with exogenously administered MSC. Therefore, a promising alternative to the existing strategies employed in the treatment of musculoskeletal injuries is to reinforce the inherent reparative capacity of the body by delivering MSC harvested from the patient's own tissues to the site of injury. The aim of this review is to inform the reader of studies that have evaluated the intrinsic homing and regenerative abilities of MSC, with particular emphasis on the repair of musculoskeletal injuries. Research that supports the direct use of MSC (without in vitro differentiation into tissue-specific cells) will also be reported. Based on accruing evidence that the natural healing mechanism involves the recruitment of MSC and their subsequent reparative actions at the site of injury, as well as documented therapeutic response after the exogenous administration of MSC, the feasibility of the emerging strategy of instant stem-cell therapy will be proposed.

The effect of intra‐articular injection of autologous bone marrow stem cells on pain and knee function in patients with osteoarthritis

“…5 New treatment options include tissue engineering for tissue regeneration, which includes harvesting and transplant methods. 6,7 Tissue auto-transplant is a well-established strategy for treatment of damaged or lost tissue after a trauma, oncological resection, congenital deformities or progressing degenerative disease. 8 In this field stem cells (SC) have been studied.…”

Adult Stem Cell Mobilization Enhances Intramembranous Bone Regeneration: A Pilot Study

“…These endogenous progenitor cells can be mobilized to the PB [1,11,12,15,17,22,36,48,52]. Circulating MSCs, and perhaps other adult stem cells, home to sites of skeletal injury [14,23,29,35,45,54], and increasing the number of adult stem cells at sites of injury aids tissue regeneration [4,8,16,40,43,56] either directly or through trophic effects [5,8,17,53].…”

A Comparative Evaluation of Factors Influencing Osteoinductivity Among Scaffolds Designed for Bone Regeneration

“…19 Importantly, the interaction between CXCL12 and CXCR4 is required for the homing of MSC to the sites of bone healing. 28,29 Wynn et al observed that MSC migrate toward a CXCL12 gradient in a dose-dependent manner. 30 With such a multifactorial impact, the expression levels of both CXCL12 and CXCR4 are therefore highly relevant to osteogenesis, and increased levels would be considered a strong advantage of one scaffold over another.…”