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

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.

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Correspondence to Kivanc Atesok or Emil Schemitsch.

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Atesok, K., Matsumoto, T., Karlsson, J. et al. An emerging cell-based strategy in orthopaedics: endothelial progenitor cells. Knee Surg Sports Traumatol Arthrosc 20, 1366–1377 (2012). https://doi.org/10.1007/s00167-012-1940-7

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Keywords

  • Endothelial progenitor cell (EPC)
  • Bone tissue engineering
  • Cell-based therapy
  • Fracture healing