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Mesenchymal Stem Cells, Bioactive Factors, and Scaffolds in Bone Repair: From Research Perspectives to Clinical Practice. Cells 2021; 10:cells10081925. [PMID: 34440694 PMCID: PMC8392210 DOI: 10.3390/cells10081925] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
Mesenchymal stem cell-based therapies are promising tools for bone tissue regeneration. However, tracking cells and maintaining them in the site of injury is difficult. A potential solution is to seed the cells onto a biocompatible scaffold. Construct development in bone tissue engineering is a complex step-by-step process with many variables to be optimized, such as stem cell source, osteogenic molecular factors, scaffold design, and an appropriate in vivo animal model. In this review, an MSC-based tissue engineering approach for bone repair is reported. Firstly, MSC role in bone formation and regeneration is detailed. Secondly, MSC-based bone tissue biomaterial design is analyzed from a research perspective. Finally, examples of animal preclinical and human clinical trials involving MSCs and scaffolds in bone repair are presented.
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Kleer-Reiter N, Julmi S, Feichtner F, Waselau AC, Klose C, Wriggers P, Maier HJ, Meyer-Lindenberg A. Biocompatibility and degradation of the open-pored magnesium scaffolds LAE442 and La2. Biomed Mater 2021; 16. [PMID: 33827052 DOI: 10.1088/1748-605x/abf5c5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 04/07/2021] [Indexed: 11/11/2022]
Abstract
Porous magnesium implants are of particular interest for application as resorbable bone substitutes, due to their mechanical strength and a Young's modulus similar to bone. The objective of the present study was to compare the biocompatibility, bone and tissue ingrowth, and the degradation behaviour of scaffolds made from the magnesium alloys LAE442 (n= 40) and Mg-La2 (n= 40)in vivo. For this purpose, cylindrical magnesium scaffolds (diameter 4 mm, length 5 mm) with defined, interconnecting pores were produced by investment casting and coated with MgF2. The scaffolds were inserted into the cancellous part of the greater trochanter ossis femoris of rabbits. After implantation periods of 6, 12, 24 and 36 weeks, the bone-scaffold compounds were evaluated usingex vivo µCT80 images, histological examinations and energy dispersive x-ray spectroscopy analysis. The La2 scaffolds showed inhomogeneous and rapid degradation, with inferior osseointegration as compared to LAE442. For the early observation times, no bone and tissue could be observed in the pores of La2. Furthermore, the excessive amount of foreign body cells and fibrous capsule formation indicates insufficient biocompatibility of the La2 scaffolds. In contrast, the LAE442 scaffolds showed slow degradation and better osseointegration. Good vascularization, a moderate cellular response, bone and osteoid-like bone matrix at all implantation periods were observed in the pores of LAE442. In summary, porous LAE442 showed promise as a degradable scaffold for bone defect repair, based on its degradation behaviour and biocompatibility. However, further studies are needed to show it would have the necessary mechanical properties required over time for weight-bearing bone defects.
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Affiliation(s)
- N Kleer-Reiter
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-Universität, Veterinärstr. 13, München 80539, Germany
| | - S Julmi
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, An der Universität 2, Garbsen 30823, Germany
| | - F Feichtner
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-Universität, Veterinärstr. 13, München 80539, Germany
| | - A-C Waselau
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-Universität, Veterinärstr. 13, München 80539, Germany
| | - C Klose
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, An der Universität 2, Garbsen 30823, Germany
| | - P Wriggers
- Institute of Continuum Mechanics, Leibniz Universität Hannover, Appelstr. 11, Hannover 30167, Germany
| | - H J Maier
- Institut für Werkstoffkunde (Materials Science), Leibniz Universität Hannover, An der Universität 2, Garbsen 30823, Germany
| | - A Meyer-Lindenberg
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-Universität, Veterinärstr. 13, München 80539, Germany
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Castro APG. Computational Challenges in Tissue Engineering for the Spine. Bioengineering (Basel) 2021; 8:25. [PMID: 33671854 PMCID: PMC7918040 DOI: 10.3390/bioengineering8020025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/04/2021] [Accepted: 02/13/2021] [Indexed: 12/17/2022] Open
Abstract
This paper deals with a brief review of the recent developments in computational modelling applied to innovative treatments of spine diseases. Additionally, it provides a perspective on the research directions expected for the forthcoming years. The spine is composed of distinct and complex tissues that require specific modelling approaches. With the advent of additive manufacturing and increasing computational power, patient-specific treatments have moved from being a research trend to a reality in clinical practice, but there are many issues to be addressed before such approaches become universal. Here, it is identified that the major setback resides in validation of these computational techniques prior to approval by regulatory agencies. Nevertheless, there are very promising indicators in terms of optimised scaffold modelling for both disc arthroplasty and vertebroplasty, powered by a decisive contribution from imaging methods.
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Affiliation(s)
- André P G Castro
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
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Zhang N, Zhao D, Liu N, Wu Y, Yang J, Wang Y, Xie H, Ji Y, Zhou C, Zhuang J, Wang Y, Yan J. Assessment of the degradation rates and effectiveness of different coated Mg-Zn-Ca alloy scaffolds for in vivo repair of critical-size bone defects. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:138. [PMID: 30120628 PMCID: PMC6105203 DOI: 10.1007/s10856-018-6145-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 08/01/2018] [Indexed: 05/24/2023]
Abstract
Surgical repair of bone defects remains challenging, and the search for alternative procedures is ongoing. Devices made of Mg for bone repair have received much attention owing to their good biocompatibility and mechanical properties. We developed a new type of scaffold made of a Mg-Zn-Ca alloy with a shape that mimics cortical bone and can be filled with morselized bone. We evaluated its durability and efficacy in a rabbit ulna-defect model. Three types of scaffold-surface coating were evaluated: group A, no coating; group B, a 10-μm microarc oxidation coating; group C, a hydrothermal duplex composite coating; and group D, an empty-defect control. X-ray and micro-computed tomography(micro-CT) images were acquired over 12 weeks to assess ulnar repair. A mechanical stress test indicated that bone repair within each group improved significantly over time (P < 0.01). The degradation behavior of the different scaffolds was assessed by micro-CT and quantified according to the amount of hydrogen gas generated; these measurements indicated that the group C scaffold better resisted corrosion than did the other scaffold types (P < 0.05). Calcein fluorescence and histology revealed that greater mineral densities and better bone responses were achieved for groups B and C than for group A, with group C providing the best response. In conclusion, our Mg-Zn-Ca-alloy scaffold effectively aided bone repair. The group C scaffold exhibited the best corrosion resistance and osteogenesis properties, making it a candidate scaffold for repair of bone defects.
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Affiliation(s)
- Nan Zhang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
- The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang, People's Republic of China
| | - Dewei Zhao
- The Affiliated Zhongshan hospital of Dalian University, Dalian, Liaoning, People's Republic of China
| | - Na Liu
- The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang, People's Republic of China
| | - Yunfeng Wu
- Harbin Institute of Technology, Harbin, Heilongjiang, People's Republic of China
| | - Jiahui Yang
- The Affiliated Zhongshan hospital of Dalian University, Dalian, Liaoning, People's Republic of China
| | - Yuefei Wang
- Qiqihar Medical College, Qiqihar, Heilongjiang, People's Republic of China
| | - Huanxin Xie
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Ye Ji
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Changlong Zhou
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Jinpeng Zhuang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Yaming Wang
- Harbin Institute of Technology, Harbin, Heilongjiang, People's Republic of China
| | - Jinglong Yan
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China.
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Shapiro G, Bez M, Tawackoli W, Gazit Z, Gazit D, Pelled G. Semiautomated Longitudinal Microcomputed Tomography-based Quantitative Structural Analysis of a Nude Rat Osteoporosis-related Vertebral Fracture Model. J Vis Exp 2017. [PMID: 28994771 DOI: 10.3791/55928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Osteoporosis-related vertebral compression fractures (OVCFs) are a common and clinically unmet need with increasing prevalence as the world population ages. Animal OVCF models are essential to the preclinical development of translational tissue engineering strategies. While a number of models currently exist, this protocol describes an optimized method for inducing multiple highly reproducible vertebral defects in a single nude rat. A novel longitudinal semiautomated microcomputed tomography (µCT)-based quantitative structural analysis of the vertebral defects is also detailed. Briefly, rats were imaged at multiple time points post-op. The day 1 scan was reoriented to a standard position, and a standard volume of interest was defined. Subsequent µCT scans of each rat were automatically registered to the day 1 scan so the same volume of interest was then analyzed to assess for new bone formation. This versatile approach can be adapted to a variety of other models where longitudinal imaging-based analysis could benefit from precise 3D semiautomated alignment. Taken together, this protocol describes a readily quantifiable and easily reproducible system for osteoporosis and bone research. The suggested protocol takes 4 months to induce osteoporosis in nude ovariectomized rats and between 2.7 and 4 h to generate, image, and analyze two vertebral defects, depending on tissue size and equipment.
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Affiliation(s)
- Galina Shapiro
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine
| | - Maxim Bez
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine
| | - Wafa Tawackoli
- Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center
| | - Zulma Gazit
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Department of Orthopedics, Cedars-Sinai Medical Center
| | - Dan Gazit
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center; Department of Orthopedics, Cedars-Sinai Medical Center
| | - Gadi Pelled
- Skeletal Biotech Laboratory, Hebrew University-Hadassah Faculty of Dental Medicine; Department of Surgery, Cedars-Sinai Medical Center; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center;
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D'Alimonte I, Mastrangelo F, Giuliani P, Pierdomenico L, Marchisio M, Zuccarini M, Di Iorio P, Quaresima R, Caciagli F, Ciccarelli R. Osteogenic Differentiation of Mesenchymal Stromal Cells: A Comparative Analysis Between Human Subcutaneous Adipose Tissue and Dental Pulp. Stem Cells Dev 2017; 26:843-855. [DOI: 10.1089/scd.2016.0190] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Iolanda D'Alimonte
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
- Department of Aging Research Center and Translational Medicine (CeSI-MeT), University of Chieti-Pescara, Chieti, Italy
- StemTeCh Group, Chieti, Italy
| | - Filiberto Mastrangelo
- Unit of Dentistry, IRCCS San Raffaele Scientific Institute, Vita e Salute University, Milano, Italy
| | - Patricia Giuliani
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Laura Pierdomenico
- Department of Medicine and Aging Science, University of Chieti-Pescara, Chieti, Italy
- Department of Aging Research Center and Translational Medicine (CeSI-MeT), University of Chieti-Pescara, Chieti, Italy
- StemTeCh Group, Chieti, Italy
| | - Marco Marchisio
- Department of Medicine and Aging Science, University of Chieti-Pescara, Chieti, Italy
- Department of Aging Research Center and Translational Medicine (CeSI-MeT), University of Chieti-Pescara, Chieti, Italy
- StemTeCh Group, Chieti, Italy
| | - Mariachiara Zuccarini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
- Department of Aging Research Center and Translational Medicine (CeSI-MeT), University of Chieti-Pescara, Chieti, Italy
| | - Patrizia Di Iorio
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Raimondo Quaresima
- Department of Civil Engineering, Architecture and Environment, University of L'Aquila, L'Aquila, Italy
| | - Francesco Caciagli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Renata Ciccarelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
- Department of Aging Research Center and Translational Medicine (CeSI-MeT), University of Chieti-Pescara, Chieti, Italy
- StemTeCh Group, Chieti, Italy
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Roskies M, Jordan JO, Fang D, Abdallah MN, Hier MP, Mlynarek A, Tamimi F, Tran SD. Improving PEEK bioactivity for craniofacial reconstruction using a 3D printed scaffold embedded with mesenchymal stem cells. J Biomater Appl 2016; 31:132-9. [DOI: 10.1177/0885328216638636] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objective Polyetheretherketone (PEEK) is a bioinert thermoplastic that has been investigated for its potential use in craniofacial reconstruction; however, its use in clinical practice is limited by a poor integration with adjacent bone upon implantation. To improve the bone–implant interface, two strategies have been employed: to modify its surface or to impregnate PEEK with bioactive materials. This study attempts to combine and improve upon the two approaches by modifying the internal structure into a trabecular network and to impregnate PEEK with mesenchymal stem cells. Furthermore, we compare the newly designed PEEK scaffolds' interactions with both bone-derived (BMSC) and adipose (ADSC) stem cells. Design Customized PEEK scaffolds were designed to incorporate a trabecular microstructure using a computer-aided design program and then printed via selective laser sintering (SLS), a 3D-printing process with exceptional accuracy. The scaffold structure was evaluated using microCT. Scanning electron microscopy (SEM) was used to evaluate scaffold morphology with and without mesenchymal stem cells (MSCs). Adipose and bone marrow mesenchymal cells were isolated from rats and cultured on scaffolds. Cell proliferation and differentiation were assessed using alamarBlue and alkaline phosphatase assays, respectively. Cell morphology after one week of co-culturing cells with PEEK scaffolds was evaluated using SEM. Results SLS 3D printing fabricated scaffolds with a porosity of 36.38% ± 6.66 and density of 1.309 g/cm2. Cell morphology resembled viable fibroblasts attaching to the surface and micropores of the scaffold. PEEK scaffolds maintained the viability of both ADSCs and BMSCs; however, ADSCs demonstrated higher osteodifferentiation than BMSCs ( p < 0.05). Conclusions This study demonstrates for the first time that SLS 3D printing can be used to fabricate customized porous PEEK scaffolds that maintain the viability of adipose and bone marrow-derived MSCs and induce the osteodifferentiation of the adipose-derived MSCs. The combination of 3D printed PEEK scaffolds with MSCs could overcome some of the limitations using PEEK biopolymers for load-bearing bone regeneration in craniofacial reconstruction.
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Affiliation(s)
- Michael Roskies
- Department of Otolaryngology – Head & Neck Surgery, McGill University, Montreal, QC, Canada
- Craniofacial Stem Cell and Tissue Engineering Laboratory, McGill University, Montreal, QC, CA
| | - Jack O Jordan
- Craniofacial Stem Cell and Tissue Engineering Laboratory, McGill University, Montreal, QC, CA
| | - Dongdong Fang
- Craniofacial Stem Cell and Tissue Engineering Laboratory, McGill University, Montreal, QC, CA
| | | | - Michael P Hier
- Department of Otolaryngology – Head & Neck Surgery, McGill University, Montreal, QC, Canada
| | - Alex Mlynarek
- Department of Otolaryngology – Head & Neck Surgery, McGill University, Montreal, QC, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Simon D Tran
- Craniofacial Stem Cell and Tissue Engineering Laboratory, McGill University, Montreal, QC, CA
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
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Strong AL, Hunter RS, Jones RB, Bowles AC, Dutreil MF, Gaupp D, Hayes DJ, Gimble JM, Levi B, McNulty MA, Bunnell BA. Obesity inhibits the osteogenic differentiation of human adipose-derived stem cells. J Transl Med 2016; 14:27. [PMID: 26818763 PMCID: PMC4730660 DOI: 10.1186/s12967-016-0776-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 01/06/2016] [Indexed: 12/25/2022] Open
Abstract
Background Craniomaxillofacial defects secondary to trauma, tumor resection, or congenital malformations are frequent unmet challenges, due to suboptimal alloplastic options and limited autologous tissues such as bone. Significant advances have been made in the application of adipose-derived stem/stromal cells (ASCs) in the pre-clinical and clinical settings as a cell source for tissue engineering approaches. To fully realize the translational potential of ASCs, the identification of optimal donors for ASCs will ensure the successful implementation of these cells for tissue engineering approaches. In the current study, the impact of obesity on the osteogenic differentiation of ASCs was investigated. Methods ASCs isolated from lean donors (body mass index <25; lnASCs) and obese donors (body mass index >30; obASCs) were induced with osteogenic differentiation medium as monolayers in an estrogen-depleted culture system and on three-dimensional scaffolds. Critical size calvarial defects were generated in male nude mice and treated with scaffolds implanted with lnASCs or obASCs. Results lnASCs demonstrated enhanced osteogenic differentiation in monolayer culture system, on three-dimensional scaffolds, and for the treatment of calvarial defects, whereas obASCs were unable to induce similar levels of osteogenic differentiation in vitro and in vivo. Gene expression analysis of lnASCs and obASCs during osteogenic differentiation demonstrated higher levels of osteogenic genes in lnASCs compared to obASCs. Conclusion Collectively, these results indicate that obesity reduces the osteogenic differentiation capacity of ASCs such that they may have a limited suitability as a cell source for tissue engineering. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0776-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amy L Strong
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA.
| | - Ryan S Hunter
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA.
| | - Robert B Jones
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA.
| | - Annie C Bowles
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA.
| | - Maria F Dutreil
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA.
| | - Dina Gaupp
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA.
| | - Daniel J Hayes
- Department of Biological and Agricultural Engineering, Louisiana State University, Baton Rouge, LA, 70803, USA.
| | - Jeffrey M Gimble
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA. .,LaCell LLC, New Orleans, LA, 70112, USA. .,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, 70112, USA.
| | - Benjamin Levi
- Department of Surgery, Division of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA.
| | - Margaret A McNulty
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, 70803, USA.
| | - Bruce A Bunnell
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA. .,Department of Pharmacology, Tulane University School of Medicine, New Orleans, LA, 70112, USA.
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PTH Induces Systemically Administered Mesenchymal Stem Cells to Migrate to and Regenerate Spine Injuries. Mol Ther 2015; 24:318-330. [PMID: 26585691 DOI: 10.1038/mt.2015.211] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 11/13/2015] [Indexed: 12/11/2022] Open
Abstract
Osteoporosis affects more than 200 million people worldwide leading to more than 2 million fractures in the United States alone. Unfortunately, surgical treatment is limited in patients with low bone mass. Parathyroid hormone (PTH) was shown to induce fracture repair in animals by activating mesenchymal stem cells (MSCs). However, it would be less effective in patients with fewer and/or dysfunctional MSCs due to aging and comorbidities. To address this, we evaluated the efficacy of combination i.v. MSC and PTH therapy versus monotherapy and untreated controls, in a rat model of osteoporotic vertebral bone defects. The results demonstrated that combination therapy significantly increased new bone formation versus monotherapies and no treatment by 2 weeks (P < 0.05). Mechanistically, we found that PTH significantly enhanced MSC migration to the lumbar region, where the MSCs differentiated into bone-forming cells. Finally, we used allogeneic porcine MSCs and observed similar findings in a clinically relevant minipig model of vertebral defects. Collectively, these results demonstrate that in addition to its anabolic effects, PTH functions as an adjuvant to i.v. MSC therapy by enhancing migration to heal bone loss. This systemic approach could be attractive for various fragility fractures, especially using allogeneic cells that do not require invasive tissue harvest.
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Abstract
Bone defects do not heal in 5-10% of the fractures. In order to enhance bone regeneration, drug delivery systems are needed. They comprise a scaffold with or without inducing factors and/or cells. To test these drug delivery systems before application in patients, they finally need to be tested in animal models. The choice of animal model depends on the main research question; is a functional or mechanistic evaluation needed? Furthermore, which type of bone defects are investigated: load-bearing (i.e. orthopedic) or non-load-bearing (i.e. craniomaxillofacial)? This determines the type of model and in which type of animal. The experiments need to be set-up using the 3R principle and must be reported following the ARRIVE guidelines.
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Bone marrow derived stem cells in joint and bone diseases: a concise review. INTERNATIONAL ORTHOPAEDICS 2014; 38:1787-801. [PMID: 25005462 DOI: 10.1007/s00264-014-2445-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 06/21/2014] [Indexed: 12/11/2022]
Abstract
Stem cells have huge applications in the field of tissue engineering and regenerative medicine. Their use is currently not restricted to the life-threatening diseases but also extended to disorders involving the structural tissues, which may not jeopardize the patients' life, but certainly influence their quality of life. In fact, a particularly popular line of research is represented by the regeneration of bone and cartilage tissues to treat various orthopaedic disorders. Most of these pioneering research lines that aim to create new treatments for diseases that currently have limited therapies are still in the bench of the researchers. However, in recent years, several clinical trials have been started with satisfactory and encouraging results. This article aims to review the concept of stem cells and their characterization in terms of site of residence, differentiation potential and therapeutic prospective. In fact, while only the bone marrow was initially considered as a "reservoir" of this cell population, later, adipose tissue and muscle tissue have provided a considerable amount of cells available for multiple differentiation. In reality, recently, the so-called "stem cell niche" was identified as the perivascular space, recognizing these cells as almost ubiquitous. In the field of bone and joint diseases, their potential to differentiate into multiple cell lines makes their application ideally immediate through three main modalities: (1) cells selected by withdrawal from bone marrow, subsequent culture in the laboratory, and ultimately transplant at the site of injury; (2) bone marrow aspirate, concentrated and directly implanted into the injury site; (3) systemic mobilization of stem cells and other bone marrow precursors by the use of growth factors. The use of this cell population in joint and bone disease will be addressed and discussed, analysing both the clinical outcomes but also the basic research background, which has justified their use for the treatment of bone, cartilage and meniscus tissues.
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