An emerging cell-based strategy in orthopaedics: endothelial progenitor cells

Knee Surg Sports Traumatol Arthrosc. 2012 Jul;20(7):1366-77. doi: 10.1007/s00167-012-1940-7. Epub 2012 Mar 9.

Abstract

Purpose: The purpose of this article was to analyze the results of studies in the literature, which evaluated the use of endothelial progenitor cells (EPCs) as a cell-based tissue engineering strategy.

Methods: EPCs have been successfully used in regenerative medicine to augment neovascularization in patients after myocardial infarction and limb ischemia. EPCs' important role as vasculogenic progenitors presents them as a potential source for cell-based therapies to promote bone healing.

Results: EPCs have been shown to have prominent effects in promoting bone regeneration in several animal models. Evidence indicates that EPCs promote bone regeneration by stimulating both angiogenesis and osteogenesis through a differentiation process toward endothelial cell lineage and formation of osteoblasts. Moreover, EPCs increase vascularization and osteogenesis by increased secretion of growth factors and cytokines through paracrine mechanisms.

Conclusion: EPCs offer the potential to emerge as a new strategy among other cell-based therapies to promote bone regeneration. Further investigations and human trials are required to address current questions with regard to biology and mechanisms of action of EPCs in bone tissue engineering.

MeSH terms

  • Animals
  • Bone Regeneration*
  • Bone and Bones / blood supply
  • Cell Differentiation
  • Cell Movement
  • Cell Proliferation
  • Endothelial Cells / cytology*
  • Erythropoietin / physiology
  • Fracture Healing*
  • Humans
  • Mesenchymal Stem Cells
  • Neovascularization, Physiologic
  • Nitric Oxide / physiology
  • Osteoblasts
  • Osteogenesis
  • Stem Cell Transplantation*
  • Stem Cells / cytology*
  • Tissue Engineering*
  • Vascular Endothelial Growth Factors / physiology

Substances

  • Vascular Endothelial Growth Factors
  • Erythropoietin
  • Nitric Oxide