Adipose tissue-derived progenitors for engineering osteogenic and vasculogenic grafts.

Scherberich A; Muller AM; Schafer DJBanfi AMartin I

摘要

The current need for bone grafts in orthopedic and reconstructive surgery cannot be satisfied by autologous tissue transplant due to its limited availability and significant associated morbidity. Tissue engineering approaches could supply sufficient amounts of bone substitutes by exploiting the ability to harvest autologous osteogenic progenitors associated with suitable porous materials. However, the generation of clinically relevant-sized constructs is critically hampered by limited vascularization, with consequent engraftment and survival only of a thin outer shell, upon in vivo implantation. To overcome this limitation, different non-mutually exclusive approaches have recently been developed to promote or accelerate graft vascularization, from angiogenic growth factor gene delivery to surgical pre-vascularization of the construct before implantation. A simple, promising strategy involves the co-culture of vasculogenic cells to form an intrinsic vascular network inside the graft in vitro, which can rapidly anastomose with the host blood vessels in vivo. Recent data have shown that adipose tissue-derived stromal vascular fraction (SVF) may provide an efficient, convenient, and autologous source for both osteogenic and endothelial cells. When SVF progenitors were cultured in appropriate bioreactor systems and ectopically implanted, a functional vascular network connected to the host was formed concomitantly to bone formation. Future studies should aim at demonstrating that this approach effectively supports survival of scaled up cell-based bone grafts at an orthotopic site. The procedure should also be adapted to become compatible with an intra-operative timeline and complemented with the definition of suitable potency markers, to facilitate its development into a simplified, reproducible, and cost-effective clinical treatment.

机译：当前需要在整形和骨移植整形外科手术不能满足自体组织移植由于其有限的可用性和显著相关发病提供足够数量的骨替代品利用收获自体的能力成骨的祖细胞与合适的关联多孔材料。临床上relevant-sized构造是严重受到有限的血管化,顺向移植和生存的一层薄薄的外壳,在体内植入。克服这个限制,non-mutually不同最近开发的独家方法促进或加速移植物血管化,从血管生成生长因子基因传递手术pre-vascularization构造在植入。涉及vasculogenic细胞的共培养形成一个内在血管网络内移植体外,可快速汇合宿主体内血管。表明,脂肪tissue-derived基质血管分数(SVF)可能提供一个高效的,为方便,自体来源成骨的内皮细胞。祖细胞在适当的培养生物反应器系统和ectopically植入,功能性血管网络连接到主机与此同时成立骨形成。未来的研究应该旨在证明这种方法有效地支持生存扩大细胞原位骨移植网站。与术中时间轴的定义和补充合适的效力标记,促进它发展成一个简化的、可再生的和有效的临床治疗。

Adipose tissue-derived progenitors for engineering osteogenic and vasculogenic grafts.

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