RESUMO
BACKGROUND: Given the limitations of current therapies for the reconstruction of bone defects, regenerative medicine has arisen as a new therapeutic strategy along with mesenchymal stem cells (MSCs), which, because of their osteogenic potential and immunomodulatory properties, have emerged as a promising alternative for the treatment of bone injuries. In vivo studies have demonstrated that MSCs have a positive effect on regeneration due to their secretion of cytokines and growth factors that, when collected in conditioned medium (MSC-CM) and applied to an injured tissue, can modulate and promote the formation of new tissue. OBJECTIVE: To evaluate the effectiveness of application of conditioned medium derived from mesenchymal stem cells in bone regeneration in animal and human models. METHODS: We conducted a systematic review with a comprehensive search through February of 2018 using several electronic databases (MEDLINE, EMBASE, SCOPUS, CENTRAL (Ovid), and LILACS), and we also used the "snowballing technique". Articles that met the inclusion criteria were selected through abstract review and subsequent assessment of the full text. We assessed the risk of bias with the SYRCLE and Cochrane tools, and three meta-analyses were performed. RESULTS: We included 21 articles, 19 of which used animal models and 2 of which used human models. In animal models, the application of MSC-CM significantly increased the regeneration of bone defects in comparison with control groups. Human studies reported early mineralization in regenerated bones, and no bone resorption, inflammation, nor local or systemic alterations were observed in any case. The meta-analysis showed an overall favorable effect of the application of MSC-CM. CONCLUSIONS: The application of MSC-CM to bone defects has a positive and favorable effect on the repair and regeneration of bone tissue, particularly in animal models. It is necessary to perform additional studies to support the application of MSC-CM in clinical practice.
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Mesenchymal stem cell (MSC) transplantation has proved to be a promising strategy in cell therapy and regenerative medicine. Although their mechanism of action is not completely clear, it has been suggested that their therapeutic activity may be mediated by a paracrine effect. The main goal of this study was to evaluate by radiographic, morphometric and histological analysis the ability of mesenchymal stem cells derived from human adipose tissue (Ad-MSC) and their conditioned medium (CM), to repair surgical bone lesions using an in vivo model (rabbit mandibles). The results demonstrated that both, Ad-MSC and CM, induce bone regeneration in surgically created lesions in rabbit's jaws, suggesting that Ad-MSC improve the process of bone regeneration mainly by releasing paracrine factors. The evidence of the paracrine effect of MSC on bone regeneration has a major impact on regenerative medicine, and the use of their CM can address some issues and difficulties related to cell transplants. In particular, CM can be easily stored and transported, and is easier to handle by medical personnel during clinical procedures.
Assuntos
Tecido Adiposo/citologia , Regeneração Óssea/efeitos dos fármacos , Meios de Cultivo Condicionados/farmacologia , Arcada Osseodentária/citologia , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Comunicação Parácrina , Medicina Regenerativa , Tecido Adiposo/efeitos dos fármacos , Adulto , Animais , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Feminino , Humanos , Hidrogéis , Técnicas Imunoenzimáticas , Arcada Osseodentária/efeitos dos fármacos , Masculino , Células-Tronco Mesenquimais/efeitos dos fármacos , Procedimentos Cirúrgicos Ortognáticos , Coelhos , Cicatrização , Adulto JovemRESUMO
INTRODUCTION: The use of mesenchymal stem cells in clinical practice has increased considerably in the last decade because they play a supporting role in the processes of tissue repair and regeneration, becoming the main tool of cell therapy for the treatment of diseases functionally affecting bone and cartilage tissue . OBJECTIVE: To evaluate in vitro the proliferative and osteogenic differentiation ability of mesenchymal stem cells derived from human adipose tissue in a blood plasma hydrogel. MATERIALS AND METHODS: Mesenchymal stem cells were obtained from human adipose tissue explants and characterized by flow cytometry. Their multipotentiality was demonstrated by their ability to differentiate to adipogenic and osteogenic lineages. Cell proliferation and osteogenic differentiation ability of the cells cultured in blood plasma hydrogels were also evaluated. RESULTS: Mesenchymal stem cells derived from human adipose tissue growing in human blood plasma hydrogels showed a pattern of proliferation similar to that of the cells cultured in monolayer and also maintained their ability to differentiate to osteogenic lineage. CONCLUSIONS: Human blood plasma hydrogels are a suitable support for proliferation and osteogenic differentiation of mesenchymal stem cells derived from human adipose tissue and provides a substrate that is autologous, biocompatible, reabsorbable, easy to use, potentially injectable and economic, which could be used as a successful strategy for the management and clinical application of cell therapy in regenerative medicine.
Assuntos
Diferenciação Celular , Proliferação de Células , Células-Tronco Mesenquimais/fisiologia , Osteogênese , Tecido Adiposo/citologia , Sangue , Células Cultivadas , Meios de Cultura , Humanos , HidrogéisRESUMO
Introducción. La utilización de las células madre mesenquimales en la práctica clínica ha aumentado considerablemente en la última década, ya que juegan un papel favorable en los procesos de reparación y regeneración tisular, siendo la principal herramienta de la terapia celular para el tratamiento de enfermedades que afectan funcionalmente el tejido óseo y cartilaginoso. Objetivo. Evaluar la proliferación y capacidad de diferenciación osteogénica in vitro de células madre mesenquimales derivadas de tejido adiposo humano en un hidrogel de plasma sanguíneo. Materiales y métodos. Se obtuvieron células madre mesenquimales a partir de explantes de tejido adiposo humano y se caracterizaron por citometría de flujo; se buscó demostrar su multipotencialidad por su capacidad de diferenciación osteogénica y adipogénica. Se evaluó la proliferación celular y la capacidad de diferenciación osteogénica de las células cultivadas en hidrogeles de plasma sanguíneo. Resultados. Las células madre mesenquimales derivadas de tejido adiposo cultivadas en el hidrogel de plasma sanguíneo humano mostraron un patrón de proliferación muy similar al de las células cultivadas en monocapa y, además, mantuvieron su capacidad de diferenciación hacia el linaje osteogénico. Conclusiones. El hidrogel de plasma sanguíneo humano es un soporte adecuado para que las células madre mesenquimales derivadas de tejido adiposo humano proliferen y se diferencien hacia el linaje osteogénico y constituye un vehículo adecuado para su administración en regeneración del tejido óseo.
Introduction: The use of mesenchymal stem cells in clinical practice has increased considerably in the last decade because they play a supporting role in the processes of tissue repair and regeneration, becoming the main tool of cell therapy for the treatment of diseases functionally affecting bone and cartilage tissue . Objective: To evaluate in vitro the proliferative and osteogenic differentiation ability of mesenchymal stem cells derived from human adipose tissue in a blood plasma hydrogel. Materials and methods: Mesenchymal stem cells were obtained from human adipose tissue explants and characterized by flow cytometry. Their multipotentiality was demonstrated by their ability to differentiate to adipogenic and osteogenic lineages. Cell proliferation and osteogenic differentiation ability of the cells cultured in blood plasma hydrogels were also evaluated. Results: Mesenchymal stem cells derived from human adipose tissue growing in human blood plasma hydrogels showed a pattern of proliferation similar to that of the cells cultured in monolayer and also maintained their ability to differentiate to osteogenic lineage. Conclusions: Human blood plasma hydrogels are a suitable support for proliferation and osteogenic differentiation of mesenchymal stem cells derived from human adipose tissue and provides a substrate that is autologous, biocompatible, reabsorbable, easy to use, potentially injectable and economic, which could be used as a successful strategy for the management and clinical application of cell therapy in regenerative medicine.