Induced pluripotent stem cells (iPSCs) as a new source of bone in reconstructive surgery: A systematic review and meta-analysis of preclinical studies

Abstract

It is now well established that regenerative medicine and stem cell therapy are the most promising approach to obtain full tissue regeneration by using various cell types including stem cells isolated from adult tissues, embryonic stem cells, and induced pluripotent stem cells (iPSCs). Recently, iPSCs have been successfully differentiated into osteoprogenitors to facilitate repair and regeneration of bone defects. Thus, the purpose of this systematic review and meta-analysis is to summarize the articles published that assess the osteogenic potential of iPSCs in vitro and their ability to heal bone defects in reconstructive surgery. PICO questions were subjected to literature search in four different databases. Methodological and risk of bias assessment of the included in vitro and in vivo articles were performed. Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the quality of evidence for each outcome variable included in the systematic review. In vivo bone formation was selected as the primary outcome for meta-analysis, and publication bias was explored using funnel plots. Initial literature search retrieved 4,772 studies, whereas only 70 articles included in the review. Yamanaka set was the commonly used reprogramming factor introduced with different vectors into the somatic cells. Several somatic cell sources have been used to successfully produce the iPSCs. iPSCs have osteogenic differentiation capacities and would be considered as a new source of stem cells that can be used in reconstructive surgery for bone regeneration.

Investigating the Therapeutics Effects of Oral Cavity Derived Stem Cells on Neurodegenerative Diseases: A Systematic Review

“…The risk of bias evaluation was made by considering previous studies and modifying related parameters from these studies (Fliefel, Ehrenfeld, & Otto, 2018;Zhang, Ge, Hao, & Dong, 2018). The assessment was based on the description of the following parameters for the quality assessment of the study for in vivo studies: (1) published in a peer-reviewed journal; (2) random allocation to group; (3) treatment allocation concealment; (4) pretreatment behavioral assessment; (5) blinded assessment of outcome (or computerized); (6) reporting of a sample size calculation; (7) assessment of ≥2 outcomes; (8) compliance with animal welfare regulations; (9) ethics committee approval; (10) statement of a potential conflict of interest.…”

“…For in-vitro studies, the risk of bias was assessed via a modified 6-point-item checklist from previous studies (Fliefel, Ehrenfeld, & Otto, 2018;Malinowski, Musiała, & Wiciński, 2020), including: (1) published in a peer-reviewed journal; (2) blinded assessment of outcome (detection bias); (3) reporting sample size calculation, (4) assessment of ≥2 outcomes (performance bias), (5) ethics committee approval and (6) statement of potential conflict of interest (funding bias). Articles reporting 1-2, 3-4, and 5-6 parameters were classified as having high, medium, and low risk of bias, respectively.…”

Use of stem cells in bone regeneration in cleft palate patients: review and recommendations

“…MDSCs seem to be a better option than muscle precursor cells as the latter needs BMP-2 for in vitro osteogenic differentiation 59 . In addition, application of induced pluripotent stem cells is a new opportunity for bone regeneration 60 . However, more studies need to be conducted to accurately confirm the efficacy of this new treatment.…”

Cell-Based and Scaffold-Based Therapies for Joint Preservation in Early-Stage Osteonecrosis of the Femoral Head

“…Cell-free therapies involving the use of exosomes and microRNAs may provide a novel therapeutic paradigm. Furthermore, iPSCs have osteogenic differentiation capacities 106,107 , and iPSCs are expected for another source of MSCs to be used in the cell-based therapy on the treatment of osteonecrosis of the femoral head.…”