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Raju R, Piña JO, Roth DM, Chattaraj P, Kidwai FK, Faucz FR, Iben J, Fridell G, Dale RK, D’Souza RN. Profiles of Wnt pathway gene expression during tooth morphogenesis. Front Physiol 2024; 14:1316635. [PMID: 38274045 PMCID: PMC10809389 DOI: 10.3389/fphys.2023.1316635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024] Open
Abstract
Mouse and human genetic studies indicate key roles of the Wnt10a ligand in odontogenesis. Previous studies have identified effectors and regulators of the Wnt signaling pathway actively expressed during key stages of tooth morphogenesis. However, limitations in multiplexing and spatial resolution hindered a more comprehensive analysis of these signaling molecules. Here, profiling of transcriptomes using fluorescent multiplex in situ hybridization and single-cell RNA-sequencing (scRNA-seq) provide robust insight into the synchronized expression patterns of Wnt10a, Dkk1, and Sost simultaneously during tooth development. First, we identified Wnt10a transcripts restricted to the epithelium at the stage of tooth bud morphogenesis, contrasting that of Sost and Dkk1 localization to the dental mesenchyme. By embryonic day 15.5 (E15.5), a marked shift of Wnt10a expression from dental epithelium to mesenchyme was noted, while Sost and Dkk1 expression remained enriched in the mesenchyme. By postnatal day 0 (P0), co-localization patterns of Wnt10a, Dkk1, and Sost were observed in both terminally differentiating and secreting odontoblasts of molars and incisors. Interestingly, Wnt10a exhibited robust expression in fully differentiated ameloblasts at the developing cusp tip of both molars and incisors, an observation not previously noted in prior studies. At P7 and 14, after the mineralization of dentin and enamel, Wnt10a expression was limited to odontoblasts. Meanwhile, Wnt modulators showed reduced or absent signals in molars. In contrast, strong signals persisted in ameloblasts (for Wnt10a) and odontoblasts (for Wnt10a, Sost, and Dkk1) towards the proximal end of incisors, near the cervical loop. Our scRNA-seq analysis used CellChat to further contextualize Wnt pathway-mediated communication between cells by examining ligand-receptor interactions among different clusters. The co-localization pattern of Wnt10a, Dkk1, and Sost in both terminally differentiating and secreting odontoblasts of molars and incisors potentially signifies the crucial ligand-modulator interaction along the gradient of cytodifferentiation starting from each cusp tip towards the apical region. These data provide cell type-specific insight into the role of Wnt ligands and mediators during epithelial-mesenchymal interactions in odontogenesis.
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Affiliation(s)
- Resmi Raju
- Section on Craniofacial Genetic Disorders, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Jeremie Oliver Piña
- Section on Craniofacial Genetic Disorders, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States
| | - Daniela M. Roth
- Section on Craniofacial Genetic Disorders, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Parna Chattaraj
- Section on Craniofacial Genetic Disorders, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Fahad K. Kidwai
- Section on Craniofacial Genetic Disorders, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Fabio R. Faucz
- Molecular Genomics Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - James Iben
- Molecular Genomics Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Gus Fridell
- Bioinformatics and Scientific Programming Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Ryan K. Dale
- Bioinformatics and Scientific Programming Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Rena N. D’Souza
- Section on Craniofacial Genetic Disorders, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
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Kidwai FK, Canalis E, Robey PG. Induced pluripotent stem cell technology in bone biology. Bone 2023; 172:116760. [PMID: 37028583 PMCID: PMC10228209 DOI: 10.1016/j.bone.2023.116760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/09/2023]
Abstract
Technologies on the development and differentiation of human induced pluripotent stem cells (hiPSCs) are rapidly improving, and have been applied to create cell types relevant to the bone field. Differentiation protocols to form bona fide bone-forming cells from iPSCs are available, and can be used to probe details of differentiation and function in depth. When applied to iPSCs bearing disease-causing mutations, the pathogenetic mechanisms of diseases of the skeleton can be elucidated, along with the development of novel therapeutics. These cells can also be used for development of cell therapies for cell and tissue replacement.
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Affiliation(s)
- Fahad K Kidwai
- Skeletal Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, United States of America
| | - Ernesto Canalis
- Center for Skeletal Research, Orthopedic Surgery and Medicine, UConn Musculoskeletal Institute, UConn Health, Farmington, CT 06030-4037, United States of America
| | - Pamela G Robey
- Skeletal Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, United States of America.
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Kidwai FK, Mui BWH, Almpani K, Jani P, Keyvanfar C, Iqbal K, Paravastu SS, Arora D, Orzechowski P, Merling RK, Mallon B, Myneni VD, Ahmad M, Kruszka P, Muenke M, Woodcock J, Gilman JW, Robey PG, Lee JS. Quantitative Craniofacial Analysis and Generation of Human Induced Pluripotent Stem Cells for Muenke Syndrome: A Case Report. J Dev Biol 2021; 9:jdb9040039. [PMID: 34698187 PMCID: PMC8544470 DOI: 10.3390/jdb9040039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
In this case report, we focus on Muenke syndrome (MS), a disease caused by the p.Pro250Arg variant in fibroblast growth factor receptor 3 (FGFR3) and characterized by uni- or bilateral coronal suture synostosis, macrocephaly without craniosynostosis, dysmorphic craniofacial features, and dental malocclusion. The clinical findings of MS are further complicated by variable expression of phenotypic traits and incomplete penetrance. As such, unraveling the mechanisms behind MS will require a comprehensive and systematic way of phenotyping patients to precisely identify the impact of the mutation variant on craniofacial development. To establish this framework, we quantitatively delineated the craniofacial phenotype of an individual with MS and compared this to his unaffected parents using three-dimensional cephalometric analysis of cone beam computed tomography scans and geometric morphometric analysis, in addition to an extensive clinical evaluation. Secondly, given the utility of human induced pluripotent stem cells (hiPSCs) as a patient-specific investigative tool, we also generated the first hiPSCs derived from a family trio, the proband and his unaffected parents as controls, with detailed characterization of all cell lines. This report provides a starting point for evaluating the mechanistic underpinning of the craniofacial development in MS with the goal of linking specific clinical manifestations to molecular insights gained from hiPSC-based disease modeling.
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Affiliation(s)
- Fahad K. Kidwai
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
- Correspondence: (F.K.K.); (J.S.L.); Tel.: +1-201-685-2295 (F.K.K.); +1-301-827-1647 (J.S.L.)
| | - Byron W. H. Mui
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Konstantinia Almpani
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Priyam Jani
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Cyrus Keyvanfar
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Kulsum Iqbal
- School of Dental Medicine, Tufts University, Boston, MA 02111, USA;
| | - Sriram S. Paravastu
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Deepika Arora
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
- Biosystems and Biomaterials Division, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Pamela Orzechowski
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Randall K. Merling
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Barbara Mallon
- NIH Stem Cell Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA;
| | - Vamsee D. Myneni
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Moaz Ahmad
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Paul Kruszka
- National Human Genome Research Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (P.K.); (M.M.)
| | - Maximilian Muenke
- National Human Genome Research Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (P.K.); (M.M.)
| | - Jeremiah Woodcock
- Materials Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA; (J.W.); (J.W.G.)
| | - Jeffrey W. Gilman
- Materials Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA; (J.W.); (J.W.G.)
| | - Pamela G. Robey
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
| | - Janice S. Lee
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA; (B.W.H.M.); (K.A.); (P.J.); (C.K.); (S.S.P.); (D.A.); (P.O.); (R.K.M.); (V.D.M.); (M.A.); (P.G.R.)
- Craniofacial Anomalies & Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA
- Correspondence: (F.K.K.); (J.S.L.); Tel.: +1-201-685-2295 (F.K.K.); +1-301-827-1647 (J.S.L.)
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Mui BWH, Arora D, Mallon BS, Martinez AF, Lee JS, Muenke M, Kruszka P, Kidwai FK, Robey PG. Generation of human induced pluripotent stem cell line (NIDCRi001-A) from a Muenke syndrome patient with an FGFR3 p.Pro250Arg mutation. Stem Cell Res 2020; 46:101823. [PMID: 32505898 DOI: 10.1016/j.scr.2020.101823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/12/2020] [Indexed: 10/24/2022] Open
Abstract
Muenke syndrome is the leading genetic cause of craniosynostosis and results in a variety of disabling clinical phenotypes. To model the disease and study the pathogenic mechanisms, a human induced pluripotent stem cell (hiPSC) line was generated from a patient diagnosed with Muenke syndrome. Successful reprogramming was validated by morphological features, karyotyping, loss of reprogramming factors, expression of pluripotency markers, mutation analysis and teratoma formation.
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Affiliation(s)
- Byron W H Mui
- Skeletal Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Deepika Arora
- Skeletal Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Barbara S Mallon
- NIH Stem Cell Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Ariel F Martinez
- Human Development Section, National Human Genome Research Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Janice S Lee
- Dental Clinical Research Core, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Maximilian Muenke
- National Human Genome Research Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892
| | - Paul Kruszka
- National Human Genome Research Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892
| | - Fahad K Kidwai
- Skeletal Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
| | - Pamela G Robey
- Skeletal Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
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Movahednia MM, Kidwai FK, Jokhun DS, Squier CA, Toh WS, Cao T. Potential applications of keratinocytes derived from human embryonic stem cells. Biotechnol J 2015; 11:58-70. [PMID: 26663861 DOI: 10.1002/biot.201500099] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 08/13/2015] [Accepted: 10/19/2015] [Indexed: 01/03/2023]
Abstract
Although skin grafting is one of the most advanced cell therapy technique, wide application of skin substitutes is hampered by the difficulty in securing sufficient amount of epidermal substitute. Additionally, in understanding the progression of skin aging and disease, and in screening the cosmetic and pharmaceutical products, there is lack of a satisfactory human skin-specific in vitro model. Recently, human embryonic stem cells (hESCs) have been proposed as an unlimited and reliable cell source to obtain almost all cell types present in the human body. This review focuses on the potential off-the-shelf use of hESC-derived keratinocytes for future clinical applications as well as a powerful in vitro skin model to study skin function and integrity, host-pathogen interactions and disease pathogenesis. Furthermore, we discuss the industrial applications of hESC-derived keratinized multi-layer epithelium which provides a human-like test platform for understanding disease pathogenesis, evaluation of new therapeutic modalities and assessment of the safety and efficacy of skin cosmetics and therapeutics. Overall, we conclude that the hESC-derived keratinocytes have great potential for clinical, research and industrial applications.
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Affiliation(s)
| | - Fahad K Kidwai
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Doorgesh S Jokhun
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Christopher A Squier
- Department of Oral Pathology, Radiology & Medicine, and Dows, College of Dentistry, The University of Iowa, Iowa City, Iowa, USA
| | - Wei Seong Toh
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore.,Tissue Engineering Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Tong Cao
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore. .,Tissue Engineering Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore. .,National University of Singapore Graduate School for Integrative Sciences and Engineering (NGS), Singapore, Singapore.
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Abstract
For many years, cell therapies have been hampered by limited availability and inter-batch variability of primary cells. Human embryonic stem cell (hESC) can give rise to specialized cells like keratinocytes and recently emerged as a virtually unlimited source of potential therapeutic cells. However, xenogeneic components in differentiation cocktails have been limiting the clinical potential of hESC-derived keratinocytes (hESCs-Kert). Here, we demonstrated efficient differentiation of H9 human embryonic stem cells (H9-hESCs) into keratinocytes (H9-Kert(ACC)) in an autogenic co-culture system. We used activin as the main factor to induce keratinocyte differentiation. H9-Kert(ACC) expressed keratinocyte markers at mRNA and protein levels. Establishment of such animal-free microenvironment for keratinocyte differentiation will accelerate potential clinical application of hESCs.
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Affiliation(s)
- Fahad K Kidwai
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Kidwai FK, Liu H, Toh WS, Fu X, Jokhun DS, Movahednia MM, Li M, Zou Y, Squier CA, Phan TT, Cao T. Differentiation of human embryonic stem cells into clinically amenable keratinocytes in an autogenic environment. J Invest Dermatol 2012; 133:618-628. [PMID: 23235526 DOI: 10.1038/jid.2012.384] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Human embryonic stem cells (hESCs)-derived keratinocytes hold great clinical and research potential. However, the current techniques are hampered by the use of xenogenic components that limits their clinical application. Here we demonstrated an efficient differentiation of H9 hESCs (H9-hESCs) into keratinocytes (H9-Kert) with the minimum use of animal-derived materials. For differentiation, we established two microenvironment systems originated from H9-hESCs (autogenic microenvironment). These autogenic microenvironment systems consist of an autogenic coculture system (ACC) and an autogenic feeder-free system (AFF). In addition, we showed a stage-specific effect of Activin in promoting keratinocyte differentiation from H9-hESCs while repressing the expression of early neural markers in the ACC system. Furthermore, we also explained the effect of Activin in construction of the AFF system made up of extracellular matrix similar to basement membrane extracted from H9-hESC-derived fibroblasts. H9-Kert differentiated in both systems expressed keratinocyte markers at mRNA and protein levels. H9-Kert were also able to undergo terminal differentiation in high Ca(2+) medium. These findings support the transition toward the establishment of an animal-free microenvironment for successful differentiation of hESCs into keratinocytes for potential clinical application.
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Affiliation(s)
- Fahad K Kidwai
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore
| | - Hua Liu
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore; Centre for Stem Cell and Tissue Engineering, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Wei Seong Toh
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore
| | - Xin Fu
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore; Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Doorgesh S Jokhun
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Mohammad M Movahednia
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore
| | - Mingming Li
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore
| | - Yu Zou
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore
| | - Christopher A Squier
- Department of Oral Pathology, Radiology and Medicine, and Dows, College of Dentistry, The University of Iowa, Iowa City, Iowa, USA
| | - Toan T Phan
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tong Cao
- Oral Sciences Disciplines, Faculty of Dentistry, National University of Singapore, Singapore.
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