STROMALab, Toulouse, France; Université de Toulouse, Toulouse, France; INSERM, Toulouse, France; Etablissement Français du Sang Pyrénées-Méditerranée, Toulouse, France; Departments of Public Health and Biology, Toulouse Faculty of Dentistry, Paul Sabatier University and Toulouse University Hospital, CHU de Toulouse, Toulouse, France; Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, California, USA.
STROMALab, Toulouse, France; Université de Toulouse, Toulouse, France; INSERM, Toulouse, France; Etablissement Français du Sang Pyrénées-Méditerranée, Toulouse, France; Departments of Public Health and Biology, Toulouse Faculty of Dentistry, Paul Sabatier University and Toulouse University Hospital, CHU de Toulouse, Toulouse, France; Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, California, USA
Stem Cells Transl Med. 2014 Jun;3(6):768-74. doi: 10.5966/sctm.2013-0183. Epub 2014 Apr 17.
Periodontitis is a chronic infectious disease of the soft and hard tissues supporting the teeth. Recent advances in regenerative medicine and stem cell biology have paved the way for periodontal tissue engineering. Mesenchymal stromal cells (MSCs) delivered in situ to periodontal defects may exert their effects at multiple levels, including neovascularization, immunomodulation, and tissue regeneration. This systematic review had two goals: (a) to objectively quantify key elements for efficacy and safety of MSCs used for periodontal regeneration and (b) to identify patterns in the existing literature to explain differences between studies and suggest recommendations for future research. This systematic review provided good evidence of the capacity of MSCs to regenerate periodontal tissues in animals; however, experimentally generated defects used in animal studies do not sufficiently mimic the pathophysiology of periodontitis in humans. Moreover, the safety of such interventions in humans still needs to be studied. There were marked differences between experimental and control groups that may be influenced by characteristics that are crucial to address before translation to human clinical trials. We suggest that the appropriate combination of cell source, carrier type, and biomolecules, as well as the inclusion of critical path issues for a given clinical case, should be further explored and refined before transitioning to clinical trials. Future studies should investigate periodontal regenerative procedures in animal models, including rodents, in which the defects generated are designed to more accurately reflect the inflammatory status of the host and the shift in their pathogenic microflora.
牙周炎是一种支持牙齿的软组织和硬组织的慢性感染性疾病。再生医学和干细胞生物学的最新进展为牙周组织工程铺平了道路。原位递送至牙周缺损部位的间充质基质细胞（MSCs）可能在多个层面发挥作用，包括血管生成、免疫调节和组织再生。本系统评价有两个目标：（a）客观量化用于牙周再生的 MSCs 的功效和安全性的关键要素；（b）确定现有文献中的模式，以解释研究之间的差异，并为未来的研究提出建议。本系统评价提供了充分的证据证明 MSCs 有能力在动物中再生牙周组织；然而，在动物研究中使用的实验性生成的缺损并不能充分模拟人类牙周炎的病理生理学。此外，此类干预措施在人类中的安全性仍需研究。实验组和对照组之间存在显著差异，这些差异可能受到在转化为人类临床试验之前必须解决的关键特征的影响。我们建议在过渡到临床试验之前，进一步探索和完善细胞来源、载体类型和生物分子的适当组合，以及针对特定临床病例的关键路径问题的纳入。未来的研究应在包括啮齿动物在内的动物模型中研究牙周再生程序，其中生成的缺损旨在更准确地反映宿主的炎症状态及其致病微生物群的转变。
