Craniofacial Fracture and Secretome: A Systematic Review

Area of Science:

• Regenerative Medicine
• Biomaterials Science
• Craniofacial Surgery

Background:

• Craniofacial fracture repair presents significant clinical challenges.
• Tissue engineering, especially cell-free secretome therapy, offers a promising strategy for bone regeneration.
• Secretome, comprising soluble proteins and extracellular vesicles, is investigated for its therapeutic potential.

Purpose of the Study:

• To evaluate the efficacy of secretome therapy in promoting craniofacial bone regeneration.
• To assess secretome's impact on bone healing in both animal models and human studies.

Main Methods:

• A systematic review of literature published up to August 2024 was conducted.
• Studies were sourced from Google Scholar, The Cochrane Library, and PubMed, with inclusion of in vitro, in vivo, and clinical data.
• Risk of bias was assessed using the Cochrane risk of bias 2.0 checklist; non-craniofacial fracture studies were excluded.

Main Results:

• Twenty articles were included, comprising 4 human studies (48 participants) and 16 animal studies (dogs, rabbits, rats).
• Secretome treatment elevated levels of critical bone-healing proteins, including VEGF, IGF, osteocalcin, and BMP-2.
• Radiographic and histological analyses confirmed accelerated bone healing in secretome-treated subjects.

Conclusions:

• Secretome therapy effectively promotes craniofacial bone healing by stimulating cytokine production and facilitating repair.
• The findings suggest secretome therapy is a viable approach for large-area craniofacial defect regeneration.
• Further high-quality research with larger cohorts and minimized bias is recommended to solidify these outcomes.