Published online Aug 26, 2020. doi: 10.4252/wjsc.v12.i8.776
Peer-review started: February 28, 2020
First decision: April 25, 2020
Revised: May 17, 2020
Accepted: June 20, 2020
Article in press: June 20, 2020
Published online: August 26, 2020
Mesenchymal stem cells (MSCs) have been widely exploited as promising candidates in clinical settings for bone repair and regeneration in view of their self-renewal capacity and multipotentiality. However, little is known about the mechanisms underlying their fate determination, which would illustrate their effectiveness in regenerative medicine. Recent evidence has shed light on a fundamental biological role of autophagy in the maintenance of the regenerative capability of MSCs and bone homeostasis. Autophagy has been implicated in provoking an immediately available cytoprotective mechanism in MSCs against stress, while dysfunction of autophagy impairs the function of MSCs, leading to imbalances of bone remodeling and a wide range of aging and degenerative bone diseases. This review aims to summarize the up-to-date knowledge about the effects of autophagy on MSC fate determination and its role as a stress adaptation response. Meanwhile, we highlight autophagy as a dynamic process and a double-edged sword to account for some discrepancies in the current research. We also discuss the contribution of autophagy to the regulation of bone cells and bone remodeling and emphasize its potential involvement in bone disease.
Core tip: Autophagy is a dynamic recycling mechanism that fuels cellular renovation and homeostasis. Recent studies have shed light on an essential role of autophagy in orchestrating self-renewal and the multilineage differentiation potential of mesenchymal stem cells (MSCs), thus coordinating bone homeostasis. This review outlines the effects of autophagy on MSCs fate determination and cytoprotection under different kinds of stresses. Moreover, we emphasize that the involvement of autophagy ensures balanced bone remodeling, which will be of significance in facilitating its application as a therapeutic target in bone repair and regeneration.