Mesenchymal stem cells (MSCs) are multipotent stromal cells with a strong potential in human regenerative medicine due to their ability to renew themselves and differentiate into various specialized cell types under certain physiological or experimental conditions. MSCs secrete a broad spectrum of autocrine and paracrine factors (MSCs’ secretome) that could exert significant effects on cells in their vicinity. MSCs have been clinically tested and have displayed a great potential in the treatment of bone/cartilage fractures and disorders, diabetes, cardiovascular diseases and immune, neurodegenerative and inflammatory diseases. The therapeutic efficacy of MSCs was initially attributed to their multipotent character and ability to engraft and differentiate at the site of injury. However, in recent years, it has been revealed that either undifferentiated or differentiated MSCs’ secretome plays an important role in the therapeutic potential of MSCs. The deciphering of the composition of MSCs’ secretome through proteomic and metabolic analyses and implementation of certain advanced analytical (nuclear magnetic resonance (NMR) spectroscopy, mass spectrometry (MS), chromatography, etc.) and immunological methods could contribute to the understanding of the mechanisms underlying the therapeutic effects of MSCs.
Part of the book: Metabolomics
The peripheral nerve injury after trauma is a common occurrence in both human and veterinary medicine and has severe consequences for the survival and quality of life of the patients. Despite the continuous efforts and the creation of diverse medical and surgical techniques, the harmful effects of this type of injury are far from being overcome. Regenerative medicine has been growing in the scientific milieu as a new therapeutic approach for different situations. Among the cell-based therapies explored, the mesenchymal stem cells are evidenced by their features, versatility and potential applications. The olfactory mucosa mesenchymal stem cells, components of the olfactory system and identified in the lamina propria, were newly identified and are still undergoing characterization, appearing as a new promise in the regenerative therapy of several tissues but with special emphasis on the nervous system in general and the peripheral nervous system in particular, for which they appear to have special regenerative aptitude.
Part of the book: Mesenchymal Stem Cells
Human adult peripheral nerve injuries are a high incidence clinical problem that greatly affects patients’ quality of life. Although peripheral nervous system has intrinsic regenerative capacity, this occurs in an incomplete or poorly functional manner. When a nerve fiber loses its continuity with consequent damage of the basal lamina tubes, axon spontaneous regeneration is disorganized and mismatched. These phenomena translate in an inadequate nerve functional recovery and consequent musculoskeletal incapacity. Nerve grafts still remain the gold standard in peripheral injuries treatment. However, this approach contains its disadvantages such as the necessity of primary surgery to harvest the autografts, loss of a functional nerve, donor site morbidity and longer surgery procedures. Therefore, biomaterials and tissue engineering can provide efficient resources and alternatives to nerve injury repair not only by the development of biocompatible structures but also, introducing neurotrophic factors and cellular systems to stimulate optimum clinical outcome. In this chapter, a comprehensive state-of-the art picture of tissue-engineered nerve grafts scaffolds, their application in nerve regeneration along with latest advances in peripheral nerve repair and future perspectives will be discussed, including our own large experience in this field of knowledge.
Part of the book: Materials, Technologies and Clinical Applications
Autogenous cancellous bone is the most effective material in promoting rapid healing and still considered the “gold standard” for evaluation of bone graft substitutes. The harvesting process to collect autologous bone is associated with complications and its availability is limited. Allogenic bone is another alternative with osteoconductive properties, and it act as a structural graft when applied in defects of long bones, but some disadvantages are also associated. The development of the bone grafts substitutes has gained tremendous popularity over the last two decades. Osteoconductive materials act as scaffolds were cells from the surrounding tissues with osteogenic capacities can lay new bone, and may be produced using different types of agents, such as bone products, ceramics, bioactive glasses, collagen, polymers, and composites. Bonelike® is produced by the incorporation of P2O5–CaO glass-based system within a hydroxyapatite matrix. Bonelike® Poro consists of polygonal granules with 2000–2800 μm and 4000–5600 μm of diameter with pore sizes range from 100 to 400 μm. This chapter will focus on the different techniques were this ceramic synthetic bone substitute was used to promote bone regeneration with special attention in both experimental and clinical cases of veterinary orthopaedics in dogs and cats, horses and ruminants, including results obtained with Bonelike®.
Part of the book: Materials, Technologies and Clinical Applications
Musculoskeletal injuries impact millions of people globally and affect their health and well-being as well as of their companion and athletic animals. Soft-tissue injuries represent almost half of these and are associated with unorganized scar tissue formation and long time-depending healing processes. Cell-based therapeutic strategies have been developed in the past decades aiming at the treatment and reversion of such disorders. Stem cells are fairly appealing in the field, being a responsive undifferentiated population, with ability to self-renew and differentiate into different lineages. Mesenchymal stem cells (MSCs) can be obtained from several adult tissues, including the synovial membrane. Synovia-derived MSCs can be found in individuals of any age and are associated to intrinsic regenerative processes, through both paracrine and cell-to-cell interactions, thus, contributing to hosts’ healing capacity. Studies have demonstrated the potential benefit of synovia-derived MSCs in these regenerative processes in both human and veterinary medicine. The purpose of this chapter is to review the literature regarding SM-MSC therapies applied to musculoskeletal disorders, in both human and veterinary medicine.
Part of the book: Tissue Regeneration
Peripheral nerve injuries remain a common clinical complication, and currently available therapies present significant limitations, often resulting in poor and suboptimal outcomes. Despite significant developments in microsurgical approaches in the last decades, no effective treatment options have been disclosed. Current research focuses on the optimization of such microsurgical techniques and on their combination with other pro-regenerative factors, such as mesenchymal stem cells or biomaterials. Mesenchymal stem cells present a remarkable capacity for bioactive molecule production that modulates inflammatory and regenerative processes, stimulating peripheral nerve regeneration. In parallel, efforts have been directed towards the development of biomaterial nerve guidance channels and nerve conduits. These biomaterials have been optimized in terms of biodegradability, ability to release bioactive factors, incorporation of cellular agents, and internal matrix architecture (to enable cellular migration and mimic native tissue morphology and to generate and bear specific electrical activity). The current literature review presents relevant advances in the development of mesenchymal stem cell and biomaterial-based therapeutic approaches aiming at the peripheral nerve tissue regeneration in diverse lesion scenarios, also exploring the advances achieved by our research group in this field in recent years.
Part of the book: Peripheral Nerve Disorders and Treatment