Tendon regeneration and repair with adipose derived stem cells

Tendon, the crucial element of the musculoskeletal system, when damaged, never restores the biological and biomechanical properties completely. Recently, tissue engineering and regenerative medicine have enabled the differentiation of postnatal somatic stem cells or mesenchymal stem cells (MSCs) to different cell lineages and tissues including tendon. In addition, the MSCs, mainly bone marrow derived stem cells (BSCs) were proven to enhance tendon healing. Adipose derived stem cells (ASCs) were shown to be as effective as the other MSCs by their multipotency and proliferative efficiency. However, neither the differentiation of ASCs to tenocytes nor the tendon regeneration using ASCs have been described in literature. Recently, we have studied the effect of ASCs on primary tendon repair in in-vivo model. In this paper, we sought to discuss tendon tissue engineering by focusing on culture of tenocytes, biomaterials, scaffolds, mechanical loading, fibroblasts and mesenchymal stem cells and mainly on adipose derived stem cells. Tendon regeneration using ASCs might be one of the clinical remedies in near future. In addition, the enhancing effect of ASCs on tendon repair and tendon defects might enable better clinical outcomes in musculoskeletal system reconstruction. Advances in biomaterial technology will improve the methodology in tendon regeneration however, up to date, ASCs present an ideal cell source for experimental and clinical research on tendon engineering.