Bone graft technologies currently available to treat large segmental defects typically generate replacement tissue with poor vascularity and poor host integration that leads to clinical failures associated with osteonecrosis or dislodgement. As a result, there is a significant unmet need to improve the clinical outcome in procedures treating trauma, fracture non-unions, spinal fusion, osteonecrosis, and segmental bone osteotomies such as those created upon tumor removal. Tissue engineering is a promising strategy to promote bone regeneration. However, the general approach in bone tissue engineering to directly stimulate bone formation through osteogenesis has been largely unsuccessful. In this proposal we approach bone regeneration through a cartilage intermediate. This process, called endochondral ossification, is the normal developmental mechanism for formation of long bones, and is the pathway through which the majority of fractures heal. I hypothesize that bone regeneration through a chondrogenic intermediate will produce a neotissue that resembles the native bone in both form and function. To test this hypothesis I will compare bone regeneration from a cartilage graft to the gold-standard bone graft technique in a critically sized murine bone defect. In support of this approach, I have preliminary data demonstrating that a cartilage graft containing hypertrophic chondrocytes promotes a well-vascularized and integrated bone regenerate. In addition to evaluating the quality of bone regenerated by a cartilage graft versus bone graft, I will determine the mechanism through which repair occurs. According to my hypothesis, bone regeneration will occur through the process of endochondral ossification, resulting in apoptosis of hypertrophic chondrocytes and producing a bone regenerate that is host derived. However, preliminary data indicate that donor cartilage is contributing to the bone regenerate through an unresolved mechanism. I will use genetic and cell labeling techniques to trace the cell phenotype throughout this repair process to evaluate how the cartilage heals large bone defects.
The second aim of this research proposal is to translate the concept of promoting bone regeneration through endochondral ossification into a clinically viable technology. To accomplish this I will design biologically modified synthetic scaffolds that promote formation of hypertrophic cartilage from mesenchymal stem cells (MSCs). Scaffold will be designed with variable degradation rates tuned to the process of endochondral ossification to optimize bone regeneration in vivo. In earlier studies I have characterized hypertrophic maturation of MSCs in tissue-engineered scaffolds and developed a MMP-7 bioresponsive system tuned to chondrogenesis. Together these aims address an important clinical problem with a translatable technology capable of improving current bone regeneration techniques. Furthermore this project was specifically designed to meet my long-term career objective related to musculoskeletal regeneration by utilizing multipotent progenitor cells and bioresponsive scaffolds to recapitulate normal development and/or repair mechanisms in clinically relevant in vivo models.

Public Health Relevance

Presently there is no adequate bone graft technology that allows for correction of large segmental defects that occur in response to trauma, gunshot and artillery wounds, and that occur upon tumor removal. The success of this project may have widespread and immediate impact on human health by developing a cartilage template that will promote bone regeneration through the process of endochondral ossification. This project will investigate the in vivo molecular mechanism and quality of bone regeneration from a cartilage graft in the first aim, and then develop a tissue engineering strategy that uses a biologically modified scaffold to promote cartilage formation from mesenchymal stem cells in the second aim.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Postdoctoral Individual National Research Service Award (F32)
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Special Emphasis Panel (ZRG1-F10B-S (20))
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Wang, Fei
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University of California San Francisco
Schools of Medicine
San Francisco
United States
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Hu, Diane P; Ferro, Federico; Yang, Frank et al. (2017) Cartilage to bone transformation during fracture healing is coordinated by the invading vasculature and induction of the core pluripotency genes. Development 144:221-234
Almubarak, Sarah; Nethercott, Hubert; Freeberg, Marie et al. (2016) Tissue engineering strategies for promoting vascularized bone regeneration. Bone 83:197-209
Bahney, Chelsea S; Jacobs, Linsey; Tamai, Robert et al. (2016) Promoting Endochondral Bone Repair Using Human Osteoarthritic Articular Chondrocytes. Tissue Eng Part A 22:427-35
Marcucio, Ralph S; Nauth, Aaron; Giannoudis, Peter V et al. (2015) Stem Cell Therapies in Orthopaedic Trauma. J Orthop Trauma 29 Suppl 12:S24-7
Bahney, Chelsea S; Hu, Diane P; Taylor, Aaron J et al. (2014) Stem cell-derived endochondral cartilage stimulates bone healing by tissue transformation. J Bone Miner Res 29:1269-82
Yu, Yan-yiu; Bahney, Chelsea; Hu, Diane et al. (2012) Creating rigidly stabilized fractures for assessing intramembranous ossification, distraction osteogenesis, or healing of critical sized defects. J Vis Exp :