Preconditioning Methods to Improve Mesenchymal Stromal Cell-Derived Extracellular Vesicles in Bone Regeneration—A Systematic Review
Hertel, Fernanda Campos, Aline Silvestrini da Silva, Adriano de Paula Sabino, Fabrício Luciani Valente, and Emily Correna Carlo Reis. 2022. “Preconditioning Methods to Improve Mesenchymal Stromal Cell-Derived Extracellular Vesicles in Bone Regeneration—a Systematic Review.” Biology 11 (5): 733. https://doi.org/10.3390/biology11050733.
Mesenchymal stromal cells (MSCs) have long been used in research for bone regeneration, with evidence of their beneficial properties. In the segmental area ofMSC-based therapies,MSC-derived extracellular vesicles (EVs) have also shown great therapeutic effects in several diseases, including bone healing. This study aimed to assess whether the conditioning ofMSCs improves the therapeutic effects of their derived extracellular vesicles for bone egeneration. Electronic research was performed until February 2021 to recover the studies in the following databases: PubMed, Scopus, andWeb of Science. The studies were screened based on the inclusion criteria. Relevant information was extracted, including in vitro and in vivo experiments, and the animal studies were evaluated for risk of bias by the SYRCLE tool. A total of 463 studies were retrieved, and 18 studies met the inclusion criteria (10 studies for their in vitro analysis, and 8 studies for their in vitro and in vivo analysis). The conditioning methods reported included: osteogenic medium; dimethyloxalylglycine; dexamethasone; strontium-substituted calcium silicate; hypoxia; 3D mechanical microenvironment; and the overexpression of miR-375, bone morphogenetic protein-2, and mutant hypoxia-inducible factor-1. The conditioning methods ofMSCs in the reported studies generate exosomes able to significantly promote bone regeneration. However, heterogeneity regarding cell source, conditioning method, EV isolation and concentration, and defect model was observed among the studies. The different conditioning methods reported in this review do improve the therapeutic effects ofMSC-derived EVs for bone regeneration, but they still need to be addressed in larger animal models for further clinical application.