Stem cells for tendon tissue engineering and regeneration

Skeletal tissue regeneration: current approaches, challenges, and novel reconstructive strategies for an aging population

Loss of skeletal tissue as a consequence of trauma, injury, or disease is a significant cause of morbidity with often wide-ranging socioeconomic impacts. Current approaches to replace or restore significant quantities of lost bone come with substantial limitations and inherent disadvantages that may in themselves cause further disability. In addition, the spontaneous repair capacity of articular cartilage is limited; thus, investigation into new cartilage replacement and regeneration techniques are warranted. Along with the challenges of an increasingly aging demographic, changing clinical scenarios and rising functional expectations provide the imperative for new, more reliable skeletal regeneration strategies. The science of tissue engineering has expanded dramatically in recent years, notably in orthopedic applications, and it is clear that new approaches for de novo skeletal tissue formation offer exciting opportunities to improve the quality of life for many, particularly in the face of increasing patient expectations. However, significant scientific, financial, industrial, and regulatory challenges should be overcome before the successful development of an emergent tissue engineering strategy can be realized. We outline current practice for replacement of lost skeletal tissue and the innovative approaches in tissue regeneration that have so far been translated to clinical use, along with a discussion of the significant hurdles that are presented in the process of translating research strategies to the clinic.

The effects of mechanical loading on mesenchymal stem cell differentiation and matrix production

Mesenchymal stem cells or stromal cells (MSCs) have the potential to be used therapeutically in tissue engineering and regenerative medicine to replace or restore the function of damaged tissues. Therefore, considerable effort has been ongoing in the research community to optimize culture conditions for predifferentiation of MSCs. All mesenchymal tissues are subjected to mechanical forces in vivo and all fully differentiated mesenchymal lineage cells respond to mechanical stimulation in vivo and in vitro. Therefore, it is not surprising that MSCs are highly mechanosensitive. We present a summary of current methods of mechanical stimulation of MSCs and an overview of the outcomes of the different mechanical culture techniques tested. Tissue engineers and stem cell researchers should be able to harness this mechanosensitivity to modulate MSC differentiation and matrix production; however, more research needs to be undertaken to understand the complex interactions between the mechanosensitive and biochemically stimulated differentiation pathways.