Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Disease, Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China.
Cell Prolif. 2021 Jan;54(1):e12956. doi: 10.1111/cpr.12956. Epub 2020 Nov 18.
Osteoporosis is a systemic metabolic bone disease with characteristics of bone loss and microstructural degeneration. The personal and societal costs of osteoporosis are increasing year by year as the ageing of population, posing challenges to public health care. Homing disorders, impaired capability of osteogenic differentiation, senescence of mesenchymal stem cells (MSCs), an imbalanced microenvironment, and disordered immunoregulation play important roles during the pathogenesis of osteoporosis. The MSC transplantation promises to increase osteoblast differentiation and block osteoclast activation, and to rebalance bone formation and resorption. Preclinical investigations on MSC transplantation in the osteoporosis treatment provide evidences of enhancing osteogenic differentiation, increasing bone mineral density, and halting the deterioration of osteoporosis. Meanwhile, the latest techniques, such as gene modification, targeted modification and co-transplantation, are promising approaches to enhance the therapeutic effect and efficacy of MSCs. In addition, clinical trials of MSC therapy to treat osteoporosis are underway, which will fill the gap of clinical data. Although MSCs tend to be effective to treat osteoporosis, the urgent issues of safety, transplant efficiency and standardization of the manufacturing process have to be settled. Moreover, a comprehensive evaluation of clinical trials, including safety and efficacy, is still needed as an important basis for clinical translation.
骨质疏松症是一种全身性代谢性骨病，具有骨丢失和微结构退化的特征。随着人口老龄化，骨质疏松症的个人和社会成本逐年增加，对公共医疗保健构成挑战。归巢障碍、成骨分化能力受损、间充质干细胞（MSCs）衰老、微环境失衡和免疫调节紊乱在骨质疏松症发病机制中起重要作用。MSC 移植有望增加成骨细胞分化并阻断破骨细胞激活，从而重新平衡骨形成和吸收。MSC 移植治疗骨质疏松症的临床前研究为增强成骨分化、增加骨密度和阻止骨质疏松恶化提供了证据。同时，基因修饰、靶向修饰和共移植等最新技术是增强 MSC 治疗效果的有前途的方法。此外，MSC 治疗骨质疏松症的临床试验正在进行中，这将填补临床数据的空白。尽管 MSCs 治疗骨质疏松症的效果较好，但安全性、移植效率和制造过程的标准化等紧迫问题仍有待解决。此外，还需要对临床试验进行全面评估，包括安全性和疗效，作为临床转化的重要依据。
