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Embryonic stem cells (ES) have the potential of long-term viability, selfrenewal and pluripotency which makes them interesting candidates for tissue engineering and gene therapy applications. On the other hand ethical and political issues arise while using theses cells and severe problems such as their tumorgenicity have not been solved yet. In the last couple of month a new source of cells with stem cell character was developed, the induced pluripotent stem cells (iPS). These cells are derived from differentiated adult cells via transduction of three transcription factors and show features similar to embryonic stem cells. Unfortunately, this includes the tumorgenicity which is even higher in those cells since the transcription factor transduction needed until now, is performed with retrovial vectors, which have a tumor potential on their own. Thus, adult stem cells are investigated extensively as alternative source of self-renewing cells. Human mesenchymal stem cells (HMSCs), which have in addition the advantage of potential autologous transplantation, can be found in various differentiated tissues since they are needed for maintenance and repair. They can be differentiated in chondrogenic, osteogenic, adipogenic and myogenic lineages which makes them an excellent tool for future tissue replacement strategies.
One of the most common problems in Regenerative Medicine is the regeneration of damaged bone with the aim of repairing or replacing lost or damaged bone tissue by stimulating the natural regenerative process. Particularly in the fields of orthopedic, plastic, reconstructive, maxillofacial and craniofacial surgery there is need for successful methods to restore bone. From a regenerative point of view two different bone replacement problems can be distinguished: large bone defects and small bone defects. Currently, no perfect system exists for the treatment of large bone defects.
Bone regeneration and replacement is a major focus in regenerative medicine since degenerative diseases and tumor surgery as well as accidents or dangerous recreational behavior is leading to an increasing need for bone reconstruction strategies. Especially for critical size bone defects, tissue engineering with mesenchymal stem cells is extensively studied because these cells are functioning as precursors for osteoblast in vivo. Nevertheless to reproduce the complex interaction of various factors in vitro is not an easy approach and further investigations have to be done. The status quo is summarized. A variety of growth and transcription factors are known to be involved in osteogenesis with bone morphogenetic proteins (BMPs) and the transcription factor Runx2 being the most extensively studied ones. But also PPAR γ and Osterix are generally regarded as the master regulators of osteoblast differentiation. Recently the large family of purinergic receptors has proven to be essential molecules in osteogenesis as well. In addition, scaffolding is needed to create a three-dimensional tissue. Recent developments in scaffold design are summarized, including natural and synthetic materials with or without the use of bioactive molecules constructed to mimic the natural environment. The status quo of scaffold fabrication methods such as 3D nanoprinting and their influence on cell-scaffold interactions is discussed. In this review we summarize the most interesting results and our related work focusing on two joined approaches: 1) the complex interaction of the most promising factors improving or accelerating osteogenic differentiation and ii) the development of scaffold materials with osteoconductive and osteoinductive properties.
Mesenchymal Stem Cells
(2020)