Bone regeneration strategies: Engineered scaffolds, bioactive molecules and stem cells current stage and future perspectives

Bone fractures are the most common traumatic injuries in humans. The repair of bone fractures is a regenerative process that recapitulates many of the biological events of embryonic skeletal development. Most of the time it leads to successful healing and the recovery of the damaged bone. Unfortunat...

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Bibliographic Details
Published in:Biomaterials Vol. 180; pp. 143 - 162
Main Authors: Ho-Shui-Ling, Antalya, Bolander, Johanna, Rustom, Laurence E., Johnson, Amy Wagoner, Luyten, Frank P., Picart, Catherine
Format: Journal Article
Language:English
Published: Netherlands Elsevier Ltd 01.10.2018
Elsevier
Subjects:
active ingredients
adults
animal models
Animals
Bioactive
bioactive compounds
Biocompatible Materials - chemistry
Biomaterial
bone formation
bone fractures
bone marrow
Bone Regeneration - physiology
cell lines
Chemical Sciences
clinical trials
diabetes
Fracture
growth factors
Humans
in vitro studies
Material chemistry
metabolism
Nonunion
peptides
periosteum
Scaffold
skeletal development
Stem cells
Stem Cells - cytology
Stem Cells - physiology
stromal cells
Tissue Engineering - methods
Biomaterial
Fracture
Nonunion
Scaffold
Bioactive
Stem cells
ISSN:0142-9612, 1878-5905, 1878-5905
Online Access:Get full text
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Summary:Bone fractures are the most common traumatic injuries in humans. The repair of bone fractures is a regenerative process that recapitulates many of the biological events of embryonic skeletal development. Most of the time it leads to successful healing and the recovery of the damaged bone. Unfortunately, about 5–10% of fractures will lead to delayed healing or non-union, more so in the case of co-morbidities such as diabetes. In this article, we review the different strategies to heal bone defects using synthetic bone graft substitutes, biologically active substances and stem cells. The majority of currently available reviews focus on strategies that are still at the early stages of development and use mostly in vitro experiments with cell lines or stem cells. Here, we focus on what is already implemented in the clinics, what is currently in clinical trials, and what has been tested in animal models. Treatment approaches can be classified in three major categories: i) synthetic bone graft substitutes (BGS) whose architecture and surface can be optimized; ii) BGS combined with bioactive molecules such as growth factors, peptides or small molecules targeting bone precursor cells, bone formation and metabolism; iii) cell-based strategies with progenitor cells combined or not with active molecules that can be injected or seeded on BGS for improved delivery. We review the major types of adult stromal cells (bone marrow, adipose and periosteum derived) that have been used and compare their properties. Finally, we discuss the remaining challenges that need to be addressed to significantly improve the healing of bone defects.
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PMCID: PMC6710094
First co-authors
ISSN:0142-9612
1878-5905
1878-5905
DOI:10.1016/j.biomaterials.2018.07.017