Use of stem cells in the biological repair of articular cartilage

Importance of the field: Articular cartilage is avascular, aneural, and renowned for its poor capacity to repair after damage. For decades scientists and clinicians have deliberated over the potential to repair or regenerate articular cartilage and to date many techniques have been used in an attempt to create the best possible repair tissue.

Areas covered in this review: This review article summarises surgical interventions that have been developed since the late 1940's; covering conservative strategies, invasive techniques and touching upon latest advancements involving stem cells and tissue engineering.

What will the reader gain: The reader will gain a sound understanding into the history and background of strategies that have developed in attempts to reverse clinical symptoms of damaged or diseased articular cartilage. The article provides an insight into the plethora of potential repair mechanisms, and reviews future developments involving stem cells and biomaterials.

Take home message: Although work is still in its infancy, the use of stem cells in the biological repair of articular cartilage provides a promising outlook onto future developments; advancing from strategies and techniques that are already in use.     

组织工程化软骨细胞和骨髓间充质干细胞用于修复同种异体关节软骨缺损

背景:关节软骨几乎没有自身修复的能力,目前临床大多采用自体或异体软骨移植修复、软骨膜或骨膜移植修复、软骨细胞移植修复。由于自体软骨来源有限,异体软骨又存在慢性免疫排斥反应,最终可能导致预后不佳;软骨膜或骨膜移植修复的软骨易于退化,导致修复效果不佳。目的:总结组织工程化软骨细胞、骨髓间充质干细胞及两者共培养对同种异体软骨缺损修复作用的研究现状。方法:应用计算机检索PubMed数据库及中国期刊网全文数据库1994-01/2012-01有关组织工程化软骨细胞和骨髓间充质干细胞用于修复同种异体关节软骨缺损方面的文章,英文检索词为"cartilage defect,allograft,chondrocyte,mesenchymal stem cells,bone marrow mesenchymal stem cells",中文检索词为"软骨缺损,同种异体移植,软骨细胞,骨髓间充质干细胞"。排除重复性及非中英文语种研究,共保留35篇文献进行综述。结果与结论:随着体外细胞培养方法的不断改进,现已能够把软骨细胞从坚韧的软骨中分离出来,并获得大量高纯度的软骨细胞并繁殖出新生软骨细胞。软骨细胞培养增殖能力低,传代培养容易引起老化和去分化;而成体骨髓中骨髓间充质干细胞含量少,随传代次数的增多成软骨潜能明显降低。骨髓间充质干细胞和软骨细胞共培养,两种细胞相互促进增殖和分化,作为种子细胞可减少软骨细胞增殖传代次数并节省软骨细胞数量,与组织工程支架材料复合能有效修复关节软骨缺损。     

Challenges in engineering osteochondral tissue grafts with hierarchical structures

Introduction: A major hurdle in treating osteochondral (OC) defects is the different healing abilities of two types of tissues involved – articular cartilage and subchondral bone. Biomimetic approaches to OC-construct engineering, based on recapitulation of biological principles of tissue development and regeneration, have potential for providing new treatments and advancing fundamental studies of OC tissue repair.

Areas covered: This review on state of the art in hierarchical OC tissue graft engineering is focused on tissue engineering approaches designed to recapitulate the native milieu of cartilage and bone development. These biomimetic systems are discussed with relevance to bioreactor cultivation of clinically sized, anatomically shaped human cartilage/bone constructs with physiologic stratification and mechanical properties. The utility of engineered OC tissue constructs is evaluated for their use as grafts in regenerative medicine, and as high-fidelity models in biological research.

Expert opinion: A major challenge in engineering OC tissues is to generate a functionally integrated stratified cartilage–bone structure starting from one single population of mesenchymal cells, while incorporating perfusable vasculature into the bone, and in bone–cartilage interface. To this end, new generations of advanced scaffolds and bioreactors, implementation of mechanical loading regimens and harnessing of inflammatory responses of the host will likely drive the further progress.     

Stem cells for tendon tissue engineering and regeneration

Importance of the field: Tendon injuries are common especially in sports activities, but tendon is a unique connective tissue with poor self-repair capability. With advances in stem cell biology, tissue engineering is becoming increasingly powerful for tissue regeneration. Stem cells with capacity of multipotency and self-renewal are an ideal cell source for tissue engineering.

Areas covered in this review: This review focus on discussing the potential strategies including inductive growth factors, bio-scaffolds, mechanical stimulation, genetic modification and co-culture techniques to direct tendon-lineage differentiation of stem cells for complete tendon regeneration. Attempting to use embryonic stem cells as seed cells for tendon tissue engineering have achieved encouraging results. The combination of chemical and physical signals in stem cell microenvironment could be regulated to induce differentiation of the embryonic stem cells into tendon.

What the reader will gain: We summarize fundamental questions, as well as future directions in tendon biology and tissue engineering.

Take home message: Multifaceted technologies are increasingly required to control stem cell differentiation, to develop novel stem cell-based therapy, and, ultimately, to achieve more effective repair or regeneration of injured tendons.     

聚乙酸-聚乙醇酸共聚物复合同种异体细胞修复软骨缺损

背景:以自体骨髓间充质干细胞和软骨细胞作为种子细胞修复软骨缺损可达到理想效果,但存在细胞数量不足及二次创伤等问题。目的:观察同种异体骨髓间充质干细胞和软骨细胞与聚乙酸-聚乙醇酸共聚物复合修复关节软骨的可行性。方法:将15只新西兰大白兔随机分为实验组、对照组、空白组,制作关节软骨缺损模型,分别于骨缺损处植入同种异体骨髓间充质干细胞和同种异体软骨细胞与聚乙酸-聚乙醇酸共聚物复合体、自体骨髓间充质干细胞和自体软骨细胞与聚乙酸-聚乙醇酸共聚物复合体、聚乙酸-聚乙醇酸共聚物材料。结果与结论:术后12周苏木精-伊红及Masson三色染色显示,实验组软骨缺损处可见软骨细胞,呈圆形或多角形,柱状排列,软骨陷窝形成明显,可见大量细胞外基质沉积,修复组织显示出透明软骨样,与周围软骨结合好,与底层骨结合紧密;对照组与实验组无明显差别;空白组软骨缺损处可见纤维样细胞。说明同种异体骨髓间充质干细胞和软骨细胞与聚乙酸-聚乙醇酸共聚物复合可修复关节软骨缺损。     

Biomaterials and stem cells for tissue engineering

Introduction: Organ failure and tissue loss are challenging health issues due to widespread injury, the lack of organs for transplantation and limitations of conventional artificial implants. The field of tissue engineering aims to provide alternative living substitutes that restore, maintain or improve tissue function.

Areas covered: In this paper, a wide range of porous scaffolds are reviewed, with an emphasis on phase-separation techniques that generate advantageous nanofibrous 3D scaffolds for stem cell-based tissue engineering applications. In addition, methods for presentation and delivery of bioactive molecules to mimic the properties of stem cell niches are summarized. Recent progress in using these bioinstructive scaffolds to support stem cell differentiation and tissue regeneration is also presented.

Expert opinion: Stem cells have great clinical potential because of their capability to differentiate into multiple cell types. Biomaterials have served as artificial extracellular environments to regulate stem cell behavior. Biomaterials with various physical, mechanical and chemical properties can be designed to control stem cell development for regeneration.

Conclusion: The research at the interface of stem cell biology and biomaterials has made and will continue to make exciting advances in tissue engineering.     

Tissue engineering and microRNAs: future perspectives in regenerative medicine

Introduction: Tissue engineering is a growing area of biomedical research, holding great promise for a broad range of potential applications in the field of regenerative medicine. In recent decades, multiple tissue engineering strategies have been adopted to mimic and improve specific biological functions of tissues and organs, including biomimetic materials, drug-releasing scaffolds, stem cells, and dynamic culture systems. MicroRNAs (miRNAs), noncoding small RNAs that negatively regulate the expression of downstream target mRNAs, are considered a novel class of molecular targets and therapeutics that may play an important role in tissue engineering.

Areas covered: Herein, we highlight the latest achievements in regenerative medicine, focusing on the role of miRNAs as key modulators of gene expression, stem cell self-renewal, proliferation and differentiation, and eventually in driving cell fate decisions. Finally, we will discuss the contribution of miRNAs in regulating the rearrangement of the tissue microenvironment and angiogenesis, and the range of strategies for miRNA delivery into target cells and tissues.

Expert opinion: Manipulation of miRNAs is an alternative approach and an attractive strategy for controlling several aspects of tissue engineering, although some issues concerning their in vivo effects and optimal delivery methods still remain uncovered.     

Potential therapeutic applications of muscle-derived mesenchymal stem and progenitor cells

Importance of the field: Mesenchymal adult stem cells have properties that make them attractive for use in tissue engineering and regenerative medicine. They are inherently plastic, enabling them to differentiate along different lineages, and promote wound healing and regeneration of surrounding tissues by modulating immune and inflammatory responses, promoting angiogenesis and secreting other trophic factors. Unlike embryonic stem cells, clinical uses of mesenchymal stem cells are not encumbered by ethical considerations or legal restrictions.

Areas covered in this review: We discuss skeletal muscle as a source of mesenchymal stem and progenitor cells by reviewing their biology and current applications in tissue engineering and regenerative medicine. This paper covers literature from the last 5 – 10 years.

What the reader will gain: Skeletal muscle is a plentiful source of mesenchymal stem and progenitor cells. This tissue may be obtained via routine biopsy or collection after surgical debridement. We describe the biology of these cells and provide an overview of therapeutic applications currently being developed to take advantage of their regenerative properties.

Take home message: There is potential for stem and progenitor cells derived from skeletal muscle to be incorporated in clinical interventions, either as a cellular therapy to modify the natural history of disease or as a component of engineered tissue constructs that can replace diseased or damaged tissues.     

自体骨髓间充质干细胞和同种异体软骨细胞共培养优化软骨组织工程种子的细胞源

背景：至今尚无一种细胞能完全满足组织工程对种子细胞的要求。目的：探讨自体骨髓间充质干细胞和同种异体软骨细胞共培养的可行性。方法：酶消化分离法获得兔软骨细胞,使用密度梯度离心和贴壁筛选的方法获得骨髓间充质干细胞。取细胞浓度为3×108L-1的第2代骨髓间充质干细胞和软骨细胞,随机分为3组,共培养组：将骨髓间充质干细胞和软骨细胞按2：1比例混匀;实验组：取同代同浓度的软骨细胞（浓度与共培养细胞的终浓度相同）;对照组：取低浓度软骨细胞1×108L-1（与共培养组中软骨细胞终浓度相同）。结果与结论：共培养组、实验组及对照组细胞平均群体倍增时间分别为3,7,8d;共培养组共培养细胞增殖比其他2组明显增快（P〈0.05）;糖胺多糖水平明显多于其他2组（P〈0.05）;自体骨髓间充质干细胞与同种异体软骨细胞共培养未见明显排异反应,提示自体骨髓间充质干细胞与同种异体软骨细胞为种子细胞共培养,骨髓间充质干细胞能促进软骨细胞的增殖和细胞外基质合成,缩短软骨细胞培养时间和减少传代次数,同时软骨细胞可促进骨髓间充质干细胞向软骨细胞的定向转化,节省大量软骨细胞。     

基因修饰骨髓间充质干细胞修复关节软骨损伤

背景：随着生物技术的发展,通过转基因技术修饰细胞,从而获得长期稳定表达的生物活性因子以治疗关节软骨损伤逐渐引起重视。目的：就基因修饰的骨髓间充质干细胞在修复关节软骨损伤中的应用作一综述。方法：由第一作者检索1990至2011年PubMed数据库（http：／／www．ncbi．nlm．nih.gov／PubMed）有关基因修饰骨髓间充质干细胞修复关节软骨损伤的文献,英文检索词为“cartilage,genetherapy,mesenchymalstemcells,tissueengineering,bioactivefactor,vector”。共纳入15篇文献归纳总结。结果与结论：骨髓间充质干细胞已被广泛应用于修复关节软骨损伤。通过转基因技术将特定外源基因导入骨髓间充质干细胞,联合细胞治疗和基因治疗可达到更好的治疗效果,在关节软骨损伤的治疗中有广阔的应用前景。     

与软骨细胞共培养和条件培养液诱导骨髓间充质干细胞向软骨细胞分化的比较

背景：骨髓间充质干细胞体外转化很大程度上依赖于合适的培养条件。目的：比较与软骨细胞共培养和条件培养液2种不同的诱导方案诱导骨髓间充质干细胞向软骨细胞分化的特点。方法：分离培养大鼠骨髓间充质干细胞和耳软骨细胞,采用骨髓间充质干细胞与软骨细胞共培养及条件培养液诱导成软骨的方法,诱导骨髓间充质干细胞向软骨细胞分化。以MTT法及流式细胞仪检测细胞活性及周期,糖胺多糖、甲苯胺蓝以及免疫组化染色检测细胞生物学特性,以RT-PCR法检测诱导后的软骨细胞Ⅱ型胶原RNA表达情况。结果与结论：采用共培养方式诱导的软骨细胞,其生物学特性与采用条件培养液诱导的软骨细胞相比,前者优于后者,如分泌糖胺多糖的能力以及基质分泌量均较高。提示共培养方式诱导的软骨细胞更接近正常软骨细胞,更有利于作为组织工程软骨的种子细胞。     

体外诱导人骨髓间充质干细胞分化为软骨细胞

背景:自体软骨细胞来源困难是束缚软骨细胞移植和软骨工程学发展的主要问题之一。骨髓间充质干细胞具有多向分化潜能,在不同诱导条件下,骨髓间充质干细胞能分化形成多种组织细胞,如软骨细胞、成骨细胞、成肌细胞及神经细胞等。胰岛素样生长因子-I是一种对肢体和软骨的形成及发育起重要调控作用的生长因子。目的:观察胰岛素样生长因子-I和软骨细胞培养液是否能在体外诱导骨髓间充质干细胞向软骨细胞分化。设计:开放性实验。单位:中山大学附属第二医院骨科和医学研究中心。材料:实验于2003-03/11在中山大学附属第二医院医学研究中心完成。人骨髓间充质干细胞取自因健康原因需终止妊娠的4～6月龄水囊引产的胚胎。方法:采用Percoll分离液分离培养人胚骨髓间充质干细胞,体外扩增,用流式细胞仪测定骨髓间充质干细胞的CD44,CD71,CD34,CD45表达;在第4代骨髓间充质干细胞的培养基中加入100μg/L胰岛素样生长因子-I和软骨细胞培养液,采用倒置显微镜观察、Ⅱ型胶原免疫组织化学、细胞内蛋白多糖含量测定等方法判断诱导细胞的形态变化和表达软骨基质的能力。主要观察指标:通过检测细胞CD34,CD44,CD45的表达,进行骨髓间充质干细胞表型鉴定。通过观测诱导后细胞Ⅱ型胶原免疫组织化学及细胞分泌蛋白多糖能力的变化判断其是否向软骨细胞分化。结果:①倒置显微镜观察结果:体外培养的骨髓间充质干细胞呈现成纤维细胞形态。②骨髓间充质干细胞表面抗原鉴定:流式细胞仪结果显示细胞均一性较好,第4代骨髓间充质干细胞阳性表达CD44,阴性表达CD34,CD45,说明分离获得的细胞符合骨髓间充质干细胞的特点。③光镜下观察骨髓间充质干细胞诱导为软骨细胞的形态变化:加入软骨细胞条件培养液和胰岛素样生长因子-I共培养,在培养过程中见骨髓间充质干细胞逐渐变圆,15d后可见部分细胞呈短梭形或多角形,突起短,呈现软骨细胞的特征。④Ⅱ型胶原免疫组织化学染色:胰岛素样生长因子组细胞在培养后第15天约72.5%的细胞可见棕黄色的颗粒分布于胞浆内,呈弱阳性或较强阳性。对照组骨髓间充质干细胞第15天的Ⅱ型胶原免疫组织化学为阴性。⑤蛋白多糖含量测定:胰岛素样生长因子-I和软骨细胞培养液共培养组培养15d后,细胞内蛋白多糖含量为(8.92±0.91)μg/L,高于单纯骨髓间充质干细胞培养组[(2.56±0.26)μg/L,P<0.05],但低于软骨细胞组[(13.69±1.51)μg/L,P<0.05]。结论:胰岛素样生长因子-I和软骨细胞培养液能诱导骨髓间充质干细胞向软骨细胞分化。     

The potential of amniotic fluid stem cells for cellular therapy and tissue engineering

Introduction: Foetal cells present in amniotic fluid (AF) have been used for many years to perform prenatal genetic screening. Recent reports suggested that these cells might have additional benefits. AF contains, in addition to committed and differentiated cells, a subpopulation with stem cell characteristics. AF-derived stem cells (AFS) have functions found in mesenchymal stem cells, but in addition, exhibit a potent expansion capacity and plasticity. AFS are able to undergo multi-lineage differentiation and produce progeny indicative of all three germ layers.

Areas covered: The experimental approaches available to isolate AFS and their potential for tissue engineering, the repair of organs through cell replacement and tissue regeneration.

Expert opinion: The deployment of AFS for tissue regeneration offers advantages over the use of embryonic or adult stem cells: i) AF represents a convenient and non-contested source for obtaining stem cells; ii) their derivation is relatively simple and rapid; iii) no feeder layers are required for their cultivation; iv) they display no spontaneous differentiation in culture; and v) their stem cell phenotype is not affected by long-term storage. The application of AFS for tissue replacement therapies in vivo is at a very early stage, but existing studies indicate great potential for clinical use.     

关节软骨缺损的组织工程修复

背景：软骨组织工程主要由种子细胞、生物支架、生长因子3方面组成,如何完善软骨组织工程修复一直是科研工作者研究的重点。目的：全面了解应用软骨组织工程修复软骨损伤的研究现状。方法：计算机检索PubMed和CNKI数据库中2005/2010相关文献。以＂Cartilage,tissue engineering,repair＂或＂关节软骨、组织工程、修复＂为检索词进行检索。纳入与软骨组织工程密切相关的文献,排除重复性研究。结果与结论：共检索到167篇文献,排除无关重复的文献,保留20篇文献进行综述。研究认为种子细胞是软骨组织工程最关键的方面,包括软骨细胞、骨髓间充质干细胞、胚胎干细胞和通过基因工程得到的种子细胞。目前应用最多、应用前景最好的是骨髓间充质干细胞。生物支架经历了一个漫长的过程,趋向于复合性和功能性的方向发展。各种生长因子在组织工程中必不可少。转化生长因子、胰岛素样生长因子、骨形态发生蛋白等在软骨修复中发挥了重要的功能。     

A mixed co‐culture of mesenchymal stem cells and transgenic chondrocytes in alginate hydrogel for cartilage tissue engineering

To regenerate articular cartilage tissue from degeneration and trauma, synovial mesenchymal stem cells (SMSCs) were used in this study as therapeutic progenitor cells to induce therapeutic chondrogenesis. To accomplish this, chondrocytes pre‐transduced with adenoviral vectors carrying the transforming growth factor (TGF) β3 gene were selected as transgenic companion cells and co‐cultured side‐by‐side with SMSCs in a 3D environment to provide chondrogenic growth factors in situ. We adopted a mixed co‐culture strategy for this purpose. Transgenic delivery of TGF‐β3 in chondrocytes was performed via recombinant adenoviral vectors. The mixed co‐culture of SMSCs and transgenic chondrocytes was produced in alginate gel constructs. Gene expression in both SMSCs and chondrocytes were characterized. Biochemical assays in vitro and in vivo showed that release of TGF‐ß3 from transgenic chondrocytes not only induced SMSC differentiation into chondrocytic cells but also preserved the chondrocytic phenotype of chondrocytes from suspected dedifferentiation. As a result, this mixed co‐culture strategy in conjunction with TGF‐ß3 gene delivery could be a promising approach in cartilage tissue engineering. Copyright © 2012 John Wiley & Sons, Ltd.     

软骨细胞上清液诱导滑膜间充质干细胞微团培养成软骨

背景：滑膜间充质干细胞在体外具有多向分化的能力,有望成为软骨组织工程中治疗软骨缺损的种子细胞,在其向软骨细胞分化过程中,合适的生长因子起了重要作用。 目的：利用富含生长因子的软骨细胞上清液诱导滑膜间充质干细胞向软骨细胞分化,并对其鉴定。 方法：采用消化法分别获得 SD 大鼠滑膜间充质干细胞、软骨细胞。收集软骨细胞上清液离心、过滤冻存备用。培养滑膜间充质干细胞至第3代后离心成微团,并用软骨细胞上清液进行成软骨诱导分化,通过形态学观察、免疫组织化学法、RT-PCR检测进行鉴定。 结果与结论：滑膜间充质干细胞使用软骨细胞上清液成软骨诱导21 d后,微团可见似软骨样组织。免疫组化法进行Ⅱ型胶原鉴定,基质能被Ⅱ型胶原染色,细胞染色呈现棕黄色。RT-PCR 结果显示诱导后的微团表达软骨特异性基因Ⅱ型胶原和蛋白聚糖。证实软骨细胞分泌的可溶性因子可以诱导大鼠滑膜间充质干细胞向软骨方向分化。     

In vitro chondrogenesis with lysozyme susceptible bacterial cellulose as a scaffold

A current focus of tissue engineering is the use of adult human mesenchymal stem cells (hMSCs) as an alternative to autologous chondrocytes for cartilage repair. Several natural and synthetic polymers (including cellulose) have been explored as a biomaterial scaffold for cartilage tissue engineering. While bacterial cellulose (BC) has been used in tissue engineering, its lack of degradability in vivo and high crystallinity restricts widespread applications in the field. Recently we reported the formation of a novel bacterial cellulose that is lysozyme‐susceptible and ‐degradable in vivo from metabolically engineered Gluconacetobacter xylinus. Here we report the use of this modified bacterial cellulose (MBC) for cartilage tissue engineering using hMSCs. MBC's glucosaminoglycan‐like chemistry, combined with in vivo degradability, suggested opportunities to exploit this novel polymer in cartilage tissue engineering. We have observed that, like BC, MBC scaffolds support cell attachment and proliferation. Chondrogenesis of hMSCs in the MBC scaffolds was demonstrated by real‐time RT–PCR analysis for cartilage‐specific extracellular matrix (ECM) markers (collagen type II, aggrecan and SOX9) as well as histological and immunohistochemical evaluations of cartilage‐specific ECM markers. Further, the attachment, proliferation, and differentiation of hMSCs in MBC showed unique characteristics. For example, after 4 weeks of cultivation, the spatial cell arrangement and collagen type‐II and ACAN distribution resembled those in native articular cartilage tissue, suggesting promise for these novel in vivo degradable scaffolds for chondrogenesis. Copyright © 2013 John Wiley & Sons, Ltd.     

脐血间充质干细胞在软骨组织工程中的应用

背景：关节软骨修复再生能力较差,软骨缺损的修复与功能重建是关节外科的一大难题,也是近年研究热点之一,而软骨组织工程技术的发展为其提供了新的思路和方法。目的：总结和分析脐血间充质干细胞的生物学特性及其在软骨组织工程中的研究与应用。方法：通过计算机检索中国期刊全文数据库及PubMed数据库2000-01/2010-12的有关文献资料,分别以＂脐血间充质干细胞,组织工程,软骨缺损＂为中文检索词,＂umbilical cord blood mesenchymal stem cells,tissue engineering,cartilage repair＂为英文检索词,纳入脐血间充质干细胞和软骨组织工程的相关文献,排除重复性研究,共选取33篇文献做进一步分析。结果与结论：脐血间充质干细胞以其固有的取材方便、免疫原性较弱、分化能力强以及被病毒细菌污染率低等特有的优势,成为软骨组织工程理想的种子细胞,将在未来软骨组织工程的研究及应用中发挥重要的作用。     

Epigenetic approaches to regeneration of bone and cartilage from stem cells

Introduction: Embryonic stem cells (ESCs) or adult stem cells, especially mesenchymal stem cells (MSCs), have been intensively studied for skeletal tissue regeneration including bone and cartilage. Epigenetic mechanisms play essential roles in stem cell maintenance and differentiation. However, little is known about the epigenetic regulation of osteogenesis and chondrogenesis of stem cells.

Areas covered: In this review, features of ESCs and adult stem cells, epigenetics and chromatin structure, as well as epigenetic mechanisms, such as chromatin remodeling, DNA methylation and histone modifications, polycomb group (PcG) proteins and microRNAs are described. Epigenetic researches of stem cell are introduced.

Expert opinion: Epigenetic alterations of stem cell during the in vitro differentiation can be controlled for clinical applications. MSCs are effective resources for skeletal tissue regeneration in both undifferentiated and differentiated states. Understanding epigenetic signatures of MSC is crucial to maintain the stemness. In addition, investigation of epigenetic changes in the differentiation of MSCs is very important to develop methods or chemicals to promote efficient differentiation of MSCs. Inhibition of PcG protein enhancer of zeste (Ezh2) a chromatin modifier, could be a promising candidate to improve MSC differentiation by decreasing Ezh2-mediated H3K27me3.     

Perivascular cells as mesenchymal stem cells

Importance of the field: Mesenchymal stem cells are multipotent adult stem cell populations that have broad differentiation plasticity and immunosuppressive potential that render them of great importance in cell-based therapies. They are identified by in vitro characteristics based on their differentiation potential for clinical approaches while their biological properties and in vivo identities are often less understood.

Areas covered in this review: Recent research carried out in the last decade on mesenchymal stem cell biology suggests that mesenchymal stem cells from various tissues reside in a perivascular location and these can be identified as pericytes that function as mural cells in microvessels.

What the reader will gain: This review covers recent progress on understanding the link between pericytes and mesenchymal stem cells discussing specific points such as response to injury and tissue-specific functions.

Take home message: Despite a long and controversial history, there is a growing acceptance that perivascular cells are connected with mesenchymal stem cells, all that is really lacking is genetic evidence to show differentiation of pericytes into different cells types.