Review Article

The Crosstalk between Mesenchymal Stem Cells and Macrophages in Bone Regeneration: A Systematic Review

Table 1

Immunoregulatory potential of MSCs on macrophages in bone regeneration.

AuthorCell sourceStudy typeCell managementImmunoregulatory potential of MSCs on MφsProposed mechanisms

Tasso R 2013C57BL/6 mice—BMSCs; C57BL/6 mice—MφsIn vitro & in vivoIn vitro: Mφs cultured in the IL-1a-stimulated BMSC-CM
In vivo: BMSCs seeded on bioceramic scaffolds are transplanted
In vitro: the percentage of M2 Mφs significantly increases after Mφs cultured in the CM from BMSCs
In vivo: implanted BMSCs induce Mφ switching to a proresolving phenotype and recruit vasculogenic and osteogenic progenitors from BM
PGE2 secreted from BMSCs activates the NF-κB pathway to affect M2 Mφ polarization
Seebach E 2014SD rats—BMSCs; SD rats—MφsIn vivoBMSCs embedded in a fibrin carrier are implanted into femoral bone defectsBMSC composites attract proinflammatory M1 Mφs and endothelial progenitors and then promote implant integration, angiogenesis, and tissue maturation/
Tour G 2014Lewis GFP transgenic rat—BMSCs; SD rats—MφsIn vivoBMSCs with HA-ECM are implanted into calvarial bone defectsM1 Mφs were prevalent than M2 Mφs in the calvarial defects at 2 weeks after surgery/
Lin T 2017C57BL/6 mice—BMSCs; C57BL/6 mice—MφsIn vitroMφs are treated with the CM from LPS-exposed MSCNF-κBREIL4CM from MSCNF-κBREIL4 modulates inflammatory M1 Mφs into an anti-inflammatory M2 MφsNF-κB-sensing MSCNF-κBREIL4 produces excessive IL-4 for immunomodulation
Lin T 2017C57BL/6 mice—BMSCs; C57BL/6 mice—MφsIn vitroPreconditioned BMSCs with LPS plus TNF-α culture with M1 MφsPreconditioned BMSCs modulate M1 Mφs into an anti-inflammatory phenotype and increase PGE2 production but not affect mineralizationPreconditioned BMSC-secreted PGE2 can be stimulated by TNF-α through the NF-κB/COX2-dependent pathway
Saldana L 2017Human—BMSCs; THP-1—MφsIn vitroBMSCs undergo osteogenic differentiation with the CM from the cocultures of BMSCs, Mφs, and 1,25D31,25D3 promotes the switching of cocultured Mφs toward the M2 phenotype secreting anti-inflammatory factors (IL-10, PGE2) to enhance matrix maturation and mineralization of BMSCs/
Li T 2018SD rats—BMSCs; RAW 264.7—MφsIn vitro & in vivoIn vitro: Lap/Mφ CM with osteogenic components is applied to stimulate BMSCs
In vivo: Lap+BMSCs are injected into the bone defect
In vitro: BMSCs reversed M1 Mφs induced by Lap into M2 Mφs and promoted osteogenesis
In vivo: the Lap+BMSC group shows obvious new bone formation with a significant increase in M2 Mφs
Activation of the OSM pathway is likely involved in the enhanced osteogenesis by BMSCs
He Y 2019SD rats—BMSCs; RAW 264.7—MφsIn vitro & in vivoIn vitro: CM from BMSCs seeded on Ti-SF/LL-37 is applied on Mφ culturing
In vivo: LL-37-loaded SFNPs of Ti rods are inserted into the bone defect
In vitro: M2 phenotype switching of Mφs is induced by the BMSCs seeded on Ti-SF/LL-37
In vivo: demonstrated in Table 2
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Wei F 2019Human—BMSCs; RAW 264.7—MφsIn vitroLPS-induced Mφs are treated with exosomes first isolating from osteogenically differentiating BMSCsThe uptake of exosomes significantly decreases the M1 phenotypic marker of LPS-induced Mφs/

BMSCs: bone marrow stem cells; Mφs: macrophages; CM: conditioned medium; PGE2: prostaglandin E2; NF-κB: nuclear factor-kappa B; GFP: green fluorescent protein; HA-ECM: hydroxyapatite-extracellular matrix; LPS: lipopolysaccharide; TNF-α: tumor necrosis factor-alpha; COX2: cyclooxygenase 2; 1,25D3: 1,25-dihydroxyvitamin D3; Lap: laponite; OSM: oncostatin M; Ti-SF: titanium-silk fibroin; SFNPs: silk fibroin nanoparticles.