Endogenous repair theory enriches construction strategies for orthopaedic biomaterials: a narrative review

Biomater Transl. 2021 Dec 28;2(4):343-360. doi: 10.12336/biomatertransl.2021.04.008. eCollection 2021.

Abstract

The development of tissue engineering has led to new strategies for mitigating clinical problems; however, the design of the tissue engineering materials remains a challenge. The limited sources and inadequate function, potential risk of microbial or pathogen contamination, and high cost of cell expansion impair the efficacy and limit the application of exogenous cells in tissue engineering. However, endogenous cells in native tissues have been reported to be capable of spontaneous repair of the damaged tissue. These cells exhibit remarkable plasticity, and thus can differentiate or be reprogrammed to alter their phenotype and function after stimulation. After a comprehensive review, we found that the plasticity of these cells plays a major role in establishing the cell source in the mechanism involved in tissue regeneration. Tissue engineering materials that focus on assisting and promoting the natural self-repair function of endogenous cells may break through the limitations of exogenous seed cells and further expand the applications of tissue engineering materials in tissue repair. This review discusses the effects of endogenous cells, especially stem cells, on injured tissue repairing, and highlights the potential utilisation of endogenous repair in orthopaedic biomaterial constructions for bone, cartilage, and intervertebral disc regeneration.

Keywords: biomaterials; cell plasticity; endogenous repair; stem cells; tissue engineering.

Publication types

  • Review

Grants and funding

This work was supported by the National Key Research and Development Program of China (No. 2016YFC1100100), the Major Research Plan of the National Natural Science Foundation of China (No. 91649204), China Postdoctoral Science Foundation (No. 2021M701331) and the Scientific Research Training Program for Young Talents from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.