Biomaterials can be endowed with biologically instructive properties by changing basic parameters such as elasticity and surface texture. However, translation from in vitro proof of concept to clinical application is largely missing. Porous calcium phosphate ceramics are used to treat small bone defects but in general do not induce stem cell differentiation, which is essential for regenerating large bone defects. Here, we prepared calcium phosphate ceramics with varying physicochemical and structural characteristics. Microporosity correlated to their propensity to stimulate osteogenic differentiation of stem cells in vitro and bone induction in vivo. Implantation in a large bone defect in sheep unequivocally demonstrated that osteoinductive ceramics are equally efficient in bone repair as autologous bone grafts. Our results provide proof of concept for the clinical application of “smart” biomaterials.

Human mesenchymal stromal cells (hMSCs) are increasingly used in regenerative medicine for restoring worn-out or damaged tissue. Newly engineered tissues need to be properly vascularized and current candidates for in vitro tissue pre-vascularization are endothelial cells and endothelial progenitor cells. However, their use in therapy is hampered by their limited expansion capacity and lack of autologous sources. Our approach to engineering large grafts is to use hMSCs both as a source of cells for regeneration of targeted tissue and at the same time as the source of endothelial cells. Here we investigate how different stimuli influence endothelial differentiation of hMSCs. Although growth supplements together with shear force were not sufficient to differentiate hMSCs with respect to expression of endothelial markers such as CD31 and KDR, these conditions did prime the cells to differentiate into cells with an endothelial gene expression profile and morphology when seeded on Matrigel. In addition, we show that endothelial-like hMSCs are able to create a capillary network in 3D culture both in vitro and in vivo conditions. The expansion phase in the presence of growth supplements was crucial for the stability of the capillaries formed in vitro. To conclude, we established a robust protocol for endothelial differentiation of hMSCs, including an immortalized MSC line (iMSCs) which allows for reproducible in vitro analysis in further studies.

Most therapeutic applications of bone marrow stromal cells (MSCs), or mesenchymal stem cells, require expansion of these cells. This study aimed to obtain more information about human MSCs regarding their expansion characteristics: growth, metabolism, and growth inhibitors. In addition, the same expansion factors were examined for (model species) goat and rat MSCs to evaluate differences between MSCs of mammalian species. MSC proliferation, nutrient consumption, and metabolite production were determined for five donors per species. In addition, the growth inhibitory concentrations of lactate and ammonia (NH₃) were established. Results showed that goat MSCs grew significantly faster than human and rat MSCs and that goat cells metabolized glucose more efficiently into energy (Y_lac/glc = 0.8) than human (Y_lac/glc = 2.0) and rat MSCs (Y_lac/glc = 1.9). In addition, human (qGlc = −9.2 pmol cell⁻¹ day⁻¹) and rat MSCs (qGlc = −5.9 pmol cell⁻¹ day⁻¹) consumed more glucose than goat MSCs (qGlc = −2.6 pmol cell⁻¹ day⁻¹). Glutamine was shown not to be important as energy source for human, goat, and rat MSCs. Regarding growth inhibition by metabolites, rat MSCs were more sensitive to lactate and NH₃ (growth inhibiting at 16 mM lactate and at 1.9 mM NH₃) than goat (lactate: 28.4 mM, NH₃: 2.9 mM) and human MSCs (lactate: 35.4 mM, NH₃: 2.4 mM). Human MSCs did not lose their differentiation potential when their growth was inhibited by lactate or NH₃.

Small extracellular vesicles (sEVs), through their natural ability to interact with biological membranes and exploit endogenous processing pathways to convey biological information, are quintessential for the delivery of therapeutically relevant compounds, such as microRNAs (miRNAs) and proteins. Here, we used a fluorescently‐labelled miRNA to quantify the efficiency of different methods to modulate the cargo of sEVs. Our results showed that, compared with electroporation, heat shock, permeation by a detergent‐based compound (saponin) or cholesterol‐modification of the miRNA, Exo‐Fect was the most efficient method with > 50% transfection efficiency. Furthermore, qRT‐PCR data showed that, compared with native sEVs, Exo‐Fect modulation led to a > 1000‐fold upregulation of the miRNA of interest. Importantly, this upregulation was observed for sEVs isolated from multiple sources. The modulated sEVs were able to delivery miR‐155‐5p into a reporter cell line, confirming the successful delivery of the miRNA to the target cell and, more importantly, its functionality. Finally, we showed that the membrane of Exo‐Fect‐loaded sEVs was altered compared with native sEVs and that enhanced the internalization of Exo‐Fect‐loaded sEVs within the target cells and decreased the interaction of those modulated sEVs with lysosomes.