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World J Stem Cells. Nov 26, 2020; 12(11): 1341-1353
Published online Nov 26, 2020. doi: 10.4252/wjsc.v12.i11.1341
Isolation and characterization of mesenchymal stem cells in orthopaedics and the emergence of compact bone mesenchymal stem cells as a promising surgical adjunct
Albert Anastasio, Marina Gergues, Michael S Lebhar, Pranela Rameshwar, Joseph Fernandez-Moure
Albert Anastasio, Department of Orthopedic Surgery, Duke University Health System, Durham, NC 27710, United States
Marina Gergues, Department of Medicine, Hematology/Oncology, Rutgers University, New Jersey Medical School, Newark, NJ 07103, United States
Michael S Lebhar, School of Medicine, Duke University School of Medicine, Durham, NC 27710, United States
Pranela Rameshwar, Department of Medicine-Hematology/Oncology, Rutgers School of Biomedical Health Science, Newark, NJ 07103, United States
Joseph Fernandez-Moure, Department of Surgery, Division of Trauma, Acute, and Critical Care Surgery, Duke University School of Medicine, Durham, NC 27710, United States
Author contributions: Fernandez-Moure J conceived the original main idea of this review; Lebhar MS, Rameshwar P, Anastasio A, and Gergues M contributed to developing and revising the drafts.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joseph Fernandez-Moure, MD, MSc, Surgeon, Department of Surgery, Division of Trauma, Acute, and Critical Care Surgery, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC 27710, United States. joseph.fernandezmoure@duke.edu
Received: April 14, 2020
Peer-review started: April 14, 2020
First decision: September 18, 2020
Revised: September 26, 2020
Accepted: October 13, 2020
Article in press: October 13, 2020
Published online: November 26, 2020
Processing time: 222 Days and 13.6 Hours
Abstract

The potential clinical and economic impact of mesenchymal stem cell (MSC) therapy is immense. MSCs act through multiple pathways: (1) as “trophic” cells, secreting various factors that are immunomodulatory, anti-inflammatory, anti-apoptotic, proangiogenic, proliferative, and chemoattractive; (2) in conjunction with cells native to the tissue they reside in to enhance differentiation of surrounding cells to facilitate tissue regrowth. Researchers have developed methods for the extraction and expansion of MSCs from animal and human tissues. While many sources of MSCs exist, including adipose tissue and iliac crest bone graft, compact bone (CB) MSCs have shown great potential for use in orthopaedic surgery. CB MSCs exert powerful immunomodulatory effects in addition to demonstrating excellent regenerative capacity for use in filling boney defects. CB MSCs have been shown to have enhanced response to hypoxic conditions when compared with other forms of MSCs. More work is needed to continue to characterize the potential applications for CB MSCs in orthopaedic trauma.

Keywords: Compact bone; Mesenchymal stem cells; Stem cells; Trauma; Orthopedic; Regeneration

Core Tip: The use of stem cell therapies continues to emerge as available therapy for tissue engineering of orthopedic trauma. Compact bone mesenchymal stem cells (MSCs) have been studied for many years and have been found to have a greater orthopedic regenerative capacity compared to other autologous sources. Herein, we describe and review a novel source of MSCs from compact bone and their uses in orthopedic regeneration. This review is best suited for the traumatologist in search of a comprehensive review of this novel sources of MSCs and their potential uses in vitro, in vivo, and clinically.