Li-Na Gao

The effect of aging on the pluripotential capacity and regenerative potential of human periodontal ligament stem cells

Multipotent postnatal stem cells can be isolated from human periodontal ligaments (PDLs) and have the potential for large-scale expansion, offering a reliable cell source for clinical use in periodontal regenerative therapies. However, the effects of aging on the mesenchymal stem cell (MSC) properties of these cells remain undefined. The aims of this study were to isolate and characterize the periodontal ligament stem cells (PDLSCs) derived from human impacted third molars of donors of different ages and to compare their pluripotential capacity and regenerative potential. PDL tissues were obtained from 90 surgically extracted third molars and divided into four groups according to the donors age. For each group, the colony-forming ability, proliferative capacity, migratory potential, cell surface antigens, differentiation ability, alkaline phosphatase activity, and gene expression of the PDLSCs were contrastively evaluated and quantified for statistical analysis. The in vivo tissue regenerative potential of PDLSCs was assessed by an in vivo ectopic transplantation model. It was found that human PDLSCs were successfully isolated and characterized as MSCs in all 90 teeth. PDLSCs derived from donors of different ages were successfully differentiated under an osteogenic and adipogenic microenvironment. The proliferative and migratory potential and the differentiation capacity of PDLSCs decreased as age increased (p < 0.05). PDLSCs derived from donors whose age is 62.6 ± 6.8 have a statistically significant decrease in pluripotential capacity compared with those derived from relatively young donors (p < 0.01). There is no identified cementum and PDL-like tissue formation in vivo among the two aging groups. We conclude that human PDLSCs could be successfully isolated from PDL tissue derived from donors of different ages, but the age-related changes of the MSC properties should be taken into account whenever they are intended for use in research or cytotherapy.

Mesenchymal stem cell characteristics of dental pulp and periodontal ligament stem cells after in vivo transplantation

Mesenchymal stem cells (MSCs) isolated from human postnatal dental pulp and periodontal ligament (PDL) tissues can give rise to multilineage differentiation in vitro and generate related dental tissues in vivo. However, the cell properties of human dental pulp stem cells (DPSCs) and PDL stem cells (PDLSCs) after in vivo implantation remain largely unidentified. In this study, cells were re-isolated from in vivo-generated dental pulp-like and PDL-like tissues (termed re-DPCs and re-PDLCs, respectively) as a result of ectopic transplantation of human DPSC and PDLSC sheets. The cell characteristics in terms of colony-forming ability, cell surface antigens and multi-differentiation potentials were all evaluated before and after implantation. It was found that re-DPCs and re-PDLCs were of human and mesenchymal origin and positive for MSC markers such as STRO-1, CD146, CD29, CD90 and CD105; and, to some extent, re-DPCs could maintain their colony forming abilities. Moreover, both cell types were able to form mineral deposits and differentiate into adipocytes and chondrocytes; however, quantitative analysis and related gene expression determination showed that the osteo-/chondro-differentiation capabilities of re-DPCs and re-PDLCs were significantly reduced compared to those of DPSCs and PDLSCs, respectively (P < 0.05); re-PDLCs showed a greater reduction potential than re-DPCs. We conclude that DPSCs and PDLSCs may maintain their MSC characteristics after in vivo implantation and, compared to PDLSCs, DPSCs appear much more stable under in vivo conditions. These findings provide additional cellular and molecular evidence that supports expanding the use of dental tissue-derived stem cells in cell therapy and tissue engineering.

Treatment of periodontal intrabony defects using autologous periodontal ligament stem cells: a randomized clinical trial

BackgroundPeriodontitis, which progressively destroys tooth-supporting structures, is one of the most widespread infectious diseases and the leading cause of tooth loss in adults. Evidence from preclinical trials and small-scale pilot clinical studies indicates that stem cells derived from periodontal ligament tissues are a promising therapy for the regeneration of lost/damaged periodontal tissue. This study assessed the safety and feasibility of using autologous periodontal ligament stem cells (PDLSCs) as an adjuvant to grafting materials in guided tissue regeneration (GTR) to treat periodontal intrabony defects. Our data provide primary clinical evidence for the efficacy of cell transplantation in regenerative dentistry.MethodsWe conducted a single-center, randomized trial that used autologous PDLSCs in combination with bovine-derived bone mineral materials to treat periodontal intrabony defects. Enrolled patients were randomly assigned to either the Cell group (treatment with GTR and PDLSC sheets in combination with Bio-oss®) or the Control group (treatment with GTR and Bio-oss® without stem cells). During a 12-month follow-up study, we evaluated the frequency and extent of adverse events. For the assessment of treatment efficacy, the primary outcome was based on the magnitude of alveolar bone regeneration following the surgical procedure.ResultsA total of 30 periodontitis patients aged 18 to 65 years (48 testing teeth with periodontal intrabony defects) who satisfied our inclusion and exclusion criteria were enrolled in the study and randomly assigned to the Cell group or the Control group. A total of 21 teeth were treated in the Control group and 20 teeth were treated in the Cell group. All patients received surgery and a clinical evaluation. No clinical safety problems that could be attributed to the investigational PDLSCs were identified. Each group showed a significant increase in the alveolar bone height (decrease in the bone-defect depth) over time (p < 0.001). However, no statistically significant differences were detected between the Cell group and the Control group (p > 0.05).ConclusionsThis study demonstrates that using autologous PDLSCs to treat periodontal intrabony defects is safe and does not produce significant adverse effects. The efficacy of cell-based periodontal therapy requires further validation by multicenter, randomized controlled studies with an increased sample size.Trial RegistrationNCT01357785 Date registered: 18 May 2011.

The effect of the coumarin-like derivative osthole on the osteogenic properties of human periodontal ligament and jaw bone marrow mesenchymal stem cell sheets

Cell sheet engineering is a scaffold-free delivery concept that has been shown to improve mesenchymal stem cell-mediated regeneration of injured or pathologically damaged periodontal tissues in preclinical studies and several clinical trials. However, the best strategy for cell sheet production remains to be identified. The aim of this study was to investigate the biological effects of osthole, a coumarin-like derivative extracted from Chinese herbs, on the cell sheet formation and osteogenic properties of human periodontal ligament stem cells (PDLSCs) and jaw bone marrow mesenchymal stem cells (JBMMSCs). Patient-matched PDLSCs and JBMMSCs were isolated, and an appropriate concentration of osthole for cell culture was screened for both cell types in terms of cell proliferation and alkaline phosphatase (ALP) activity. Next, the best mode of osthole stimulation for inducing the formation of sheets by each cell type was selected by evaluating the amount of their extracellular matrix (ECM) protein production as well as osteogenic-related gene expression. Furthermore, both PDLSC and JBMMSC sheets obtained from each optimized technique were transplanted subcutaneously into nude mice to evaluate their capacity for ectopic bone regeneration. The results revealed that 10(-5) m/L osthole significantly enhanced the proliferation of both PDLSCs and JBMMSCs (P < 0.05), although for JBMMSCs, there was no concentration-related change among the four established osthole groups (P > 0.05). In addition, 10(-5) m/L osthole was the best concentration to promote the ALP activities of both cells (P < 0.01). Based on both the production of ECM proteins (collagen type I, integrin β1, and fibronectin) and the expression of osteogenic genes (ALP, Runt-related transcription factor 2 (RUNX2), and osteocalcin (OCN)), the provision of 10(-5) m/L osthole throughout the entire culture stage (10 days) for PDLSCs or at the early stage (first 3 days) for JBMMSCs was the most effective osthole administration mode for cell sheet formation (P < 0.05). The results of in vivo transplantation showed that osthole-mediated PDLSC and JBMMSC sheets formed more new bone than those obtained without osthole intervention (P < 0.001). Our data suggest that a suitable concentration and mode of osthole stimulation may enhance ECM production and positively affect cell behavior in cell sheet engineering.

Surface-engineering of glycidyl methacrylated dextran/gelatin microcapsules with thermo-responsive poly(N-isopropylacrylamide) gates for controlled delivery of stromal cell-derived factor-1α

In situ tissue engineering has been proposed as a promising method to address the need for the clinical regeneration of a wide variety of damaged tissues. This approach comprises the use of a cell-free instructive scaffold that incorporates and releases topical chemotactic factors to recruit host endogenous stem/progenitor cells for tissue regrowth at the locus of implantation. However, the clinical translation of this concept is hampered when repeated doses of medication must be administrated over an extended period of time. In this study, we designed a delivery platform characterized by microcapsules containing thermo-responsive poly(N-isopropylacrylamide) (PNIPAAm) gates on their outer pore surfaces for the controlled release of stromal cell-derived factor (SDF)-1α, an important chemokine for stem cell recruitment/homing. Double-phase emulsified condensation polymerization was used to prepare interconnected porous glycidyl methacrylated dextran (Dex-GMA)/gelatin microcapsules, and plasma-graft pore-filling polymerization was used to graft PNIPAAm into the surface pores of the microcapsules. The in vitro results showed that the PNIPAAm-grafted microcapsules featured thermo-responsive drug release properties due to the swollen-shrunken property of PNIPAAm gates in response to temperature changes. After subcutaneous implantation, the thermally responsive microcapsules resulted in a more sustained and long-term SDF-1α release compared with those without PNIPAAm-grafting. In the future, this delivery system may have great potential for use in cell recruiting biomaterials for various tissue engineering and regenerative medicine applications.

Investigation of dental pulp stem cells isolated from discarded human teeth extracted due to aggressive periodontitis

Recently, human dental pulp stem cells (DPSCs) isolated from inflamed dental pulp tissue have been demonstrated to retain some of their pluripotency and regenerative potential. However, the effects of periodontal inflammation due to periodontitis and its progression on the properties of DPSCs within periodontally compromised teeth remain unknown. In this study, DPSCs were isolated from discarded human teeth that were extracted due to aggressive periodontitis (AgP) and divided into three experimental groups (Groups A, B and C) based on the degree of inflammation-induced bone resorption approaching the apex of the tooth root before tooth extraction. DPSCs derived from impacted or non-functional third molars of matched patients were used as a control. Mesenchymal stem cell (MSC)-like characteristics, including colony-forming ability, proliferation, cell cycle, cell surface antigens, multi-lineage differentiation capability and in vivo tissue regeneration potential, were all evaluated in a patient-matched comparison. It was found that STRO-1- and CD146-positive DPSCs can be isolated from human teeth, even in very severe cases of AgP. Periodontal inflammation and its progression had an obvious impact on the characteristics of DPSCs isolated from periodontally affected teeth. Although all the isolated DPSCs in Groups A, B and C showed decreased colony-forming ability and proliferation rate (P < 0.05), the decreases were not consistent with the degree of periodontitis. Furthermore, the cells did not necessarily show significantly diminished in vitro multi-differentiation potential. Only DPSCs from Group A and the Control group formed dentin-like matrix in vivo when cell-seeded biomaterials were transplanted directly into an ectopic transplantation model. However, when cell-seeded scaffolds were placed in the root fragments of human teeth, all the cells formed significant dentin- and pulp-like tissues. The ability of DPSCs to generate dental tissues decreased when the cells were isolated from periodontally compromised teeth (P < 0.05). Again, increased periodontal destruction was not necessarily followed by a decrease in the amount of dentin- and pulp-like tissue formed. These findings provide preliminary evidence that periodontally compromised teeth might contain putative stem cells with certain MSC properties, as long as the vitality of the pulp has not been totally damaged. Whether these cells can serve as a source of autologous multipotent MSCs for clinical regenerative therapies warrants further investigation with larger sample sizes and various types of periodontitis.

Platelet lysate supports the in vitro expansion of human periodontal ligament stem cells for cytotherapeutic use

Human platelet lysate (PL) produced under optimal conditions of standardization and safety has been increasingly suggested as the future ‘gold standard’ supplement to replace fetal bovine serum (FBS) for the ex vivo propagation of mesenchymal stem cells for translational medicine and cell therapy applications. However, the multifaceted effects of PL on tissue‐specific stem cells remain largely unexplored. In the present study, we investigated the stem cell behaviours of human periodontal ligament stem cells (PDLSCs) in media with or without PL. Our data indicate that human PL, either as an adjuvant for culture media or as a substitute for FBS, supports the proliferation and expansion of human PDLSCs derived from either ‘young’ or ‘old’ donors to the same extent as FBS, without interfering with their immunomodulatory capacities. Although PL appears to inhibit the in vitro differentiation of ‘young’ or ‘old’ PDLSCs, their decreased osteogenic potential may be restored to similar or higher levels compared with FBS‐expanded cells. PL‐ and FBS‐expanded PDLSCs exhibited a similar potential to form mineralized nodules and expressed similar levels of osteogenic genes. Our data indicate that large clinically relevant quantities of PDLSCs may be yielded by the use of human PL; however, further analysis of its precise composition and function will pave the way for determining optimized, defined culture conditions. In addition to the potential increase in patient safety, our findings highlight the need for further research to develop the potential of PL‐expanded PDLSCs for clinical use. Copyright

Macrophage polarization in human gingival tissue in response to periodontal disease

OBJECTIVE Although accumulating evidence indicates that macrophages are central players in the destructive and reparative phases of periodontal disease, their polarization states at different stages of periodontal inflammation remain unclear. METHODS We collected gingival biopsies from patients with chronic periodontitis (P group), gingivitis (G group), or periodontally healthy individuals (H group). Polarized macrophages were identified through immunofluorescence. M1- and M2-related cytokines were detected by immunohistochemistry. RESULTS Compared with the H group, the P group had more M1 cells (higher M1/M2 ratio) and significantly higher TNF-α, IFN-γ, IL-6, and IL-12 levels. Although the G group also exhibited higher TNF-α and IL-12 levels than the H group, they had similar M1/M2 ratios. The M1/M2 ratio and IFN-γ and IL-6 levels were significantly higher in the P than the G group. Among M2-related cytokines, IL-4 levels were significantly higher in the G than the H group. The M1/M2 ratio was positively correlated with clinical probing depth (PD), and both were positively correlated with IFN-γ and IL-6. PD was negatively correlated with IL-4. CONCLUSION Macrophage polarization in gingival tissue may be responsible for the development and progression of inflammation-induced tissue destruction, and modulating macrophage function may be a potential strategy for periodontal disease management.