Periosteum Derived Cells in Skeletal Tissue Regeneration

Abstract

The field of skeletal tissue engineering has in recent years been transformed by the identification of specific skeletal progenitor cell populations and their role in bone fracture healing. Specifically, progenitor cells residing within the periosteum have been shown to be crucial for bone regeneration. Importantly, this is not a phenomenon performed by one common progenitor cell, instead, distinct skeletal progenitor cell populations have been identified within the periosteum, shown to also contribute to different aspects of tissue repair. These findings represent major steps in the field of regenerative medicine, since there is currently no reliable treatment for patients with a failing endogenous repair system. Therefore, insights regarding the specific cell populations and factors that steer their homing and differentiation in vivo can aid in the development of optimized and personalized engineered treatment strategies. In this chapter, we highlight the crucial role of periosteum-derived cells in bone development, homeostasis, and repair. We next provide an overview of the periosteum-residing skeletal progenitor cells identified so far and their role in bone regeneration. Subsequently, we discuss the required steps to isolate and expand periosteal cells in vitro, and the current state of the art in the use of periosteum-derived cells for bone formation and regeneration following the intramembranous, endochondral, or osteochondral tissue repair route. Finally, we present an overview of periosteal cells in the preclinical and clinical setting and discuss their future potential.