Oryan Ahmad, Kamali Amir, Moshiri Ali, Baghaban Eslaminejad Mohamadreza
Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
Cells Tissues Organs. 2017;204(2):59-83. doi: 10.1159/000469704. Epub 2017 Jun 24.
Healing and regeneration of bone injuries, particularly those that are associated with large bone defects, are a complicated process. There is growing interest in the application of osteoinductive and osteogenic growth factors and mesenchymal stem cells (MSCs) in order to significantly improve bone repair and regeneration. MSCs are multipotent stromal stem cells that can be harvested from many different sources and differentiated into a variety of cell types, such as preosteogenic chondroblasts and osteoblasts. The effectiveness of MSC therapy is dependent on several factors, including the differentiating state of the MSCs at the time of application, the method of their delivery, the concentration of MSCs per injection, the vehicle used, and the nature and extent of injury, for example. Tissue engineering and regenerative medicine, together with genetic engineering and gene therapy, are advanced options that may have the potential to improve the outcome of cell therapy. Although several in vitro and in vivo investigations have suggested the potential roles of MSCs in bone repair and regeneration, the mechanism of MSC therapy in bone repair has not been fully elucidated, the efficacy of MSC therapy has not been strongly proven in clinical trials, and several controversies exist, making it difficult to draw conclusions from the results. In this review, we update the recent advances in the mechanisms of MSC action and the delivery approaches in bone regenerative medicine. We will also review the most recent clinical trials to find out how MSCs may be beneficial for treating bone defects.
骨损伤的愈合与再生，尤其是那些伴有大的骨缺损的损伤，是一个复杂的过程。人们越来越关注骨诱导和骨生成生长因子以及间充质干细胞（MSCs）的应用，以便显著改善骨修复和再生。间充质干细胞是多能基质干细胞，可以从许多不同来源获取，并分化为多种细胞类型，如前成骨软骨细胞和成骨细胞。间充质干细胞治疗的有效性取决于几个因素，例如，包括应用时间充质干细胞的分化状态、其递送方法、每次注射中间充质干细胞的浓度、所用载体以及损伤的性质和程度。组织工程和再生医学，连同基因工程和基因治疗，是可能有潜力改善细胞治疗结果的先进选择。尽管一些体外和体内研究表明间充质干细胞在骨修复和再生中具有潜在作用，但间充质干细胞治疗骨修复的机制尚未完全阐明，间充质干细胞治疗的疗效在临床试验中尚未得到有力证明，并且存在一些争议，这使得难以从结果中得出结论。在本综述中，我们更新了间充质干细胞作用机制和骨再生医学中递送方法的最新进展。我们还将综述最新的临床试验，以了解间充质干细胞如何可能有益于治疗骨缺损。
