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World J Stem Cells. Jul 26, 2014; 6(3): 266-277
Published online Jul 26, 2014. doi: 10.4252/wjsc.v6.i3.266
Periosteum derived stem cells for regenerative medicine proposals: Boosting current knowledge
Concetta Ferretti, Monica Mattioli-Belmonte
Concetta Ferretti, Monica Mattioli-Belmonte, Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, 60126 Ancona, Italy
Author contributions: Ferretti C and Mattioli-Belmonte M equally contributed to conception and acquisition of data as well as to article drafting and revising.
Supported by Italian FIRB and PRIN project grants, No. 2010J8RYS7 and No. RBAP10MLK7
Correspondence to: Dr. Monica Mattioli-Belmonte, Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Via Tronto 10/A, 60126 Ancona, Italy. m.mattioli@univpm.it
Telephone: +39-71-2206077 Fax: +39-71-2206073
Received: October 25, 2013
Revised: January 9, 2014
Accepted: April 25, 2014
Published online: July 26, 2014
Processing time: 267 Days and 3.5 Hours
Abstract

Periosteum is a thin fibrous layer that covers most bones. It resides in a dynamic mechanically loaded environment and provides a niche for pluripotent cells and a source for molecular factors that modulate cell behaviour. Elucidating periosteum regenerative potential has become a hot topic in orthopaedics. This review discusses the state of the art of osteochondral tissue engineering rested on periosteum derived progenitor cells (PDPCs) and suggests upcoming research directions. Periosteal cells isolation, characterization and migration in the site of injury, as well as their differentiation, are analysed. Moreover, the role of cell mechanosensing and its contribution to matrix organization, bone microarchitecture and bone stenght is examined. In this regard the role of periostin and its upregulation under mechanical stress in order to preserve PDPC survival and bone tissue integrity is contemplated. The review also summarized the role of the periosteum in the field of dentistry and maxillofacial reconstruction. The involvement of microRNAs in osteoblast differentiation and in endogenous tissue repair is explored as well. Finally the novel concept of a guided bone regeneration based on the use of periosteum itself as a smart material and the realization of constructs able to mimic the extracellular matrix features is talked out. Additionally, since periosteum can differentiate into insulin producing cells it could be a suitable source in allogenic transplantations. That innovative applications would take advantage from investigations aimed to assess PDPC immune privilege.

Keywords: Periosteum; Mesenchymal stem cells; MicroRNA; Bone tissue engineering; Bone turn-over

Core tip: Periosteum provides a niche for pluripotent cells. Elucidating periosteum regenerative potential is a hot topic in orthopaedics. This review discusses the state of the art of osteochondral tissue engineering rested on periosteum derived cells and suggests upcoming research directions aimed to the development of new standards of care for the maintenance of bone mass both in post-trauma healing process and in physiological turn-over.