In vitro modulation of the differentiation status of mesenchymal stem cells (MSCs) is important for their application to regenerative medicine. We suggested that the morphology and differentiation states of MSCs could be modulated by controlling the cell affinity of a substrate. The objective of this study was to investigate the effects of surface bio-adhesive signals on self-renewal and osteogenic differentiation of MSCs using a low-fouling platform. Cell-resistant poly(carboxybetaine) hydrogel was conjugated with 5 μM or 5 mM of cell-adhesive arginine-glycine-aspartic acid (RGD) peptides in order to control the cells' affinity to the substrate. Human mesenchymal stem cells (hMSCs) were cultured on the RGD-modified poly(carboxybetaine) hydrogel and then the cells' states of stemness and osteogenic differentiation were evaluated using reverse-transcriptase polymerase chain reaction. The hMSCs formed three-dimensional spheroids on the 5 μM RGD substrate, while cells on the 5 mM RGD substrate exhibited spreading morphology. Furthermore, cells on the 5 μM RGD hydrogel maintained a better stemness phenotype, while the hMSCs on the 5 mM RGD hydrogel proliferated faster and underwent osteogenic differentiation. In conclusion, the stemness of hMSCs was best maintained on a low RGD surface, while osteogenic differentiation of hMSCs was enhanced on a high RGD surface. monolayer culture [13][14], while MSCs with spheroid morphology tend to sustain pluripotent ability during extended culturing [14][15][16]. Cell adhesion to the extracellular matrix (ECM) in a native tissue is initiated by the binding of cell membrane receptors (e.g. integrins) to ECM adhesion proteins such as fibronectin and laminin [17]. Similarly, cell attachment to artificial substrates is usually mediated by surfacebound adhesion proteins. On the other hand, cell-cell attachment is mediated by other types of cell receptors such as cadherins [18]. We suggest that cell morphology during in vitro culture could be determined by the relative affinity between cell-substrate and cell-cell interactions. When the cell-substrate interaction is stronger than the cell-cell interaction, cells attach to and spread on the substrate. Conversely, when the cell-substrate interaction is weaker than the cell-cell interaction, cells tend to form spheroids on the surface [19].We suggested that by controlling the cell affinity of a substrate the morphology and differentiation status of MSCs could be modulated. To this end, surface conjugation of ECM adhesion proteins such as fibronectin, collagen, and laminin, is a common strategy. Alternatively, conjugation of peptides containing cell-binding domains of ECM adhesion proteins is another popular approach. The advantages of peptides compared to intact proteins include cost effectiveness and reduced vulnerability to denaturation. Among the peptides that mediate cell adhesion, arginine-glycine-aspartic acid (RGD), as found in fibronectin and laminin, is the most commonly applied cell-binding peptide for substrate modification in ...