Identification and function of periosteal skeletal stem cells in skeletal development, homeostasis, and disease

Periosteum-resident skeletal stem cells (SSCs) are essential for the growth, maintenance, and repair of the skeletal system. These cells exhibit self-renewal ability and clonal pluripotency. Compared to the diverse bone marrow mesenchymal stem cells (BMSCs), periosteal skeletal stem cells (P-SSCs) represent a purified stem cell population and are preferable for bone tissue engineering.

This review covers the histological structure of the periosteum, process of isolating and characterising P-SSCs, and spatiotemporal distribution and characteristics of P-SSCs from different lineages. Additionally, the roles of P-SSCs in bone injury, disease, and periosteal niche regulation are discussed.

Intramembrane and intraconal ossification of P-SSCs exhibits favourable therapeutic potential. Osteogenesis using P-SSCs is an ideal process for bone repair.

P-SSCs are vital for bone formation, maintenance, and repair. P-SSCs are essential components of the periosteal microenvironment. Therefore, it is essential to investigate their critical clinical applications and translational functions. By targeting and inducing endogenous stem cells, the in situ repair of bone defects can be facilitated, leading to the development of more effective novel therapies.

To enhance our understanding of the function of P-SSCs in bone repair and skeleton-related diseases, it is imperative to elucidate the current research status of P-SSCs and ascertain the prospective trajectory for their advancement and refinement in bone tissue engineering. P-SSCs are expected to play an expanded role in treating bone abnormalities, leading to the optimisation of bone tissue treatment.