Abstract
Craniofacial area represent a unique district of human body characterized by a very high complexity of tissues, innervation and vascularization, and being deputed to many fundamental function such as eating, speech, expression of emotions, delivery of sensations such as taste, sight, and earing. For this reasons, tissue loss in this area following trauma or for example oncologic resection, have a tremendous impact on patients' quality of life. In the last 20 years regenerative medicine has emerged as one of the most promising approach to solve problem related to trauma, tissue loss, organ failure etc. One of the most powerful tools to be used for tissue regeneration is represented by stem cells, which have been successfully implanted in different tissue/organs with exciting results. Nevertheless, both autologous and allogeneic stem cell transplantation raise many practical and ethical concerns that make this approach very difficult to apply in clinical practice. For this reason different cell free approaches have been developed aiming to the mobilization, recruitment, and activation of endogenous stem cells into the injury site avoiding exogenous cells implant but instead stimulating patients' own stem cells to repair the lesion. To this aim many strategies have been used including functionalized bioscaffold, controlled release of stem cell chemoattractants, growth factors, BMPs, Platelet–Rich-Plasma, and other new strategies such as ultrasound wave and laser are just being proposed. Here we review all the current and new strategies used for activation and mobilization of endogenous stem cells in the regeneration of craniofacial tissue.
Highlights
Regenerative medicine is the field of translational research that aims to replace and repair cells, tissues and organs to restore their normal functions (Mason and Dunnill, 2008)
Another possible approach is the use of Platelet-Rich Plasma (PRP), a concentrate of blood platelets that upon activation releases various growth factors, including Platelet-Derived Growth Factor (PDGF) and Vascular Endothelial Growth Factor (VEGF) (Fekete et al, 2012), and neurotransmitters that have been shown to be fundamental for tooth repair in animal model (Baudry et al, 2015)
Regenerative medicine is today at a crucial point: we have already developed effective methods to improve tissue regeneration for some critical districts of the human body, such as the bones of the craniofacial complex, but these methods usually require the use of cells obtained from the same individual or from another individual, that need to be processed ex vivo before the transplant takes place
Summary
Regenerative medicine is the field of translational research that aims to replace and repair cells, tissues and organs to restore their normal functions (Mason and Dunnill, 2008). The increasing understanding of the natural mechanisms involved in the development of tissues and organs has led to the creation of three-dimensional in vitro bioreactors, including nanotechnology and microfluidics-based bioreactors that recapitulate normal and pathological tissue development, structure and function (Rajan et al, 2014; Obregon et al, 2015) and pave the way to the idea of “printed organ,” a new technique used for fabrication of organ-like constructs (Choi and Kim, 2015; Ledford, 2015) These technologies have been made possible thanks to the mind-shift that has brought scientists to create synthetic matrices that recapitulate the natural properties of the extracellular matrix (ECM) of the different tissues, as a direct consequence of the evidences that the composition of the scaffold is able to influence stem cell proliferation, differentiation and angiogenesis through integrin signaling (Pittenger et al, 1999; Hynes, 2002a,b)
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