Osteogenic potential of gingival stromal progenitor cells cultured in platelet rich fibrin is predicted by core-binding factor subunit-α1/Sox9 expression ratio (<i>in vitro</i>)

Alexander Patera Nugraha; Ida Bagus Narmada; Diah Savitri Ernawati; Aristika Dinaryanti; Eryk Hendrianto; Igo Syaiful Ihsan; Wibi Riawan; Fedik Abdul Rantam

doi:10.12688/f1000research.15423.1

Home Browse Osteogenic potential of gingival stromal progenitor cells cultured...

ALL Metrics

-

Views

-

Downloads

Get PDF

Get XML

Export

▬

✚

Research Article

Osteogenic potential of gingival stromal progenitor cells cultured in platelet rich fibrin is predicted by core-binding factor subunit-α1/Sox9 expression ratio (in vitro)

[version 1; peer review: 1 approved, 2 approved with reservations]

Alexander Patera Nugraha^1-3, Ida Bagus Narmada², Diah Savitri Ernawati⁴, [...] Aristika Dinaryanti³, Eryk Hendrianto³, Igo Syaiful Ihsan³, Wibi Riawan⁵, Fedik Abdul Rantam ^3,6

Alexander Patera Nugraha^1-3, Ida Bagus Narmada², [...] Diah Savitri Ernawati⁴, Aristika Dinaryanti³, Eryk Hendrianto³, Igo Syaiful Ihsan³, Wibi Riawan⁵, Fedik Abdul Rantam ^3,6

PUBLISHED 25 Jul 2018

Author details Author details

¹ Graduate School of Immunology, Postgraduate School, Universitas Airlangga, Surabaya, 60132, Indonesia
² Orthodontic Department, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia
³ Stem Cell Research and Development Center, Universitas Airlangga,, Surabaya, 60132, Indonesia
⁴ Oral Medicine Department, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia
⁵ Biochemistry Biomolecular Laboratory, Faculty of Medicine, Universitas Brawijaya, Malang, 65145, Indonesia
⁶ Virology and Immunology Laboratory, Microbiology Department, Faculty of Veterinary Medicine, Faculty of Veterinary Medicine, Universitas Airlangga., Surabaya, 60132, Indonesia

Alexander Patera Nugraha
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Ida Bagus Narmada
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Diah Savitri Ernawati
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Aristika Dinaryanti
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Eryk Hendrianto
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Igo Syaiful Ihsan
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Wibi Riawan
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Fedik Abdul Rantam
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Background: Alveolar bone defect regeneration has long been problematic in the field of dentistry. Gingival stromal progenitor cells (GSPCs) offer a promising solution for alveolar bone regeneration. In order to optimally differentiate and proliferate progenitor cells, growth factors (GFs) are required. Platelet rich fibrin (PRF) has many GFs and can be easily manufactured. Core-binding factor subunit-α1 (CBF-α1) constitutes a well-known osteogenic differentiation transcription factor in SPCs. Sox9, as a chondrogenic transcription factor, interacts and inhibits CBF-α1, but its precise role in direct in vitro osteogenesis remains unknown. GSPCs cultured in vitro in PRF to optimally stimulate osteogenic differentiation has been largely overlooked. The aim of this study was to analyze GSPCs cultured in PRF osteogenic differentiation predicted by CBF-α1/Sox9.
Methods: This study used a true experimental with post-test only control group design and random sampling. GPSCs isolated from the lower gingiva of four healthy, 250-gram, 1-month old, male Wistar rats (Rattus Novergicus) were cultured for two weeks, passaged every 4-5 days. GSPCs in passage 3-5 were cultured in five M24 plates (N=108; n=6/group) for Day 7, Day 14, and Day 21 in three different mediums (control negative group: αModified Eagle Medium; control positive group: High Glucose-Dulbecco’s Modified Eagle Medium (DMEM-HG) + osteogenic medium; Treatment group: DMEM-HG + osteogenic medium + PRF). CBF-α1 and Sox9 were examined with ICC monoclonal antibody. A one-way ANOVA continued with Tukey HSD test (p<0.05) based on Kolmogorov–Smirnov and Levene's tests (p>0.05) was performed.
Results: The treatment group showed the highest CBF-α1/Sox9 ratio (16.00±3.000/14.33±2.517) on Day 7, while the lowest CBF-α1/Sox9 ratio (3.33±1.528/3.67±1.155) occurred in the control negative group on Day 21, with significant difference between the groups (p<0.05).
Conclusion: GSPCs cultured in PRF had potential osteogenic differentiation ability predicted by the CBF-α1/sox9 ratio.

Keywords

Core-Binding Factor Subunit-α, Gingival Stromal Progenitor Cells, Osteogenic Differentiation, Platelet Rich Fibrin, Sox9.

Corresponding author: Fedik Abdul Rantam

Competing interests: No competing interests were disclosed.

Grant information: The research was funded by the Progam Menuju Doktor Sarjana Unggul (PMDSU) Batch III of the Ministry of Research, Technology and Higher Education of the Republic of Indonesia (Kemenristekdikti RI) (letter of appointment agreement number, 1035/D3/PG/2017; grant number 2146/D3/PG/2017).
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2018 Nugraha AP et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Data associated with the article are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication).

How to cite: Nugraha AP, Narmada IB, Ernawati DS et al. Osteogenic potential of gingival stromal progenitor cells cultured in platelet rich fibrin is predicted by core-binding factor subunit-α1/Sox9 expression ratio (in vitro) [version 1; peer review: 1 approved, 2 approved with reservations]. F1000Research 2018, 7:1134 (https://doi.org/10.12688/f1000research.15423.1) First published: 25 Jul 2018, 7:1134 (https://doi.org/10.12688/f1000research.15423.1) Latest published: 25 Jul 2018, 7:1134 (https://doi.org/10.12688/f1000research.15423.1)

Introduction

Dental caries represents a major global dental public health problem because of their high prevalence. The World Health Organization reported that almost 90% of people worldwide suffered from caries¹. Basic Health Research of National Health (RISKESDAS) in 2013 reported that 93,998,727 Indonesians, 53.2% of the population, suffered from active caries². Dental caries must be treated appropriately because, if neglected, they become so severe that the affected teeth must be extracted. Indeed, the most common cause of tooth loss is dental caries³. Populations experiencing low socioeconomic conditions demonstrate higher prevalence and extent of tooth loss because of extremely limited access to dental treatment⁴.

Tooth extraction has been the most common form of dental treatment performed in Indonesia that can lead to bone defects. RISKESDAS statistics dating from 2014 indicated that treatment involving tooth extraction reached as high as 79.6% of cases⁵. A previous study of tooth extraction-related complications revealed the prevalence of fractures (31.82%), bleeding (4.54%) and swelling (2.27%)⁶. Tooth extraction can lead to alveolar bone resorption and the destruction of alveolar bone components. Moreover, it may lead to resorption of the jawbone⁷. Tooth extraction followed by buccolingual and apicocoronal dimension reduction of the alveolar ridge at the edentulous site might be performed due to bone defects⁸.

Alveolar bone defect regeneration has long represented a challenge in the field of dentistry. Various efforts have been made to accelerate bone regeneration, such as using bone grafts. The most current treatment performed in relation to the alveolar bone involves the use of platelet rich fibrin (PRF). PRF materials encouraging bone regeneration therapy have significantly improved the clinical outcomes stemming from the treatment of infrabony defects. PRF has achieved this through the maintaining of space for tissue regeneration by inducing an osteoinductive and osteoconductive effect in the alveolar bone defect area⁹.

Nowadays, alveolar bone defect treatment involving PRF using stromal progenitor cells (SPCs) is becoming increasingly widespread. SPCs have the advantage of being able to repair and regenerate various organs and tissue, and have been considerably used in bone tissue engineering, which offers encouraging solutions for bone regeneration^10,11. SPCs are non-hematopoietic stromal cells. They have multipotent capabilities, including immunomodulators and immunoregulators, paracrine, autocrine action, and migrate directly to the tissue initiating healing and regeneration making SPCs particularly suitable for regenerative medicine development^12–14.

The orofacial region is a unique and rich source of SPCs. Those contained in the oral cavity and tooth tissue represent an emerging interesting and topical object for investigation because isolating progenitor cells from the oral tissues can be achieved with minimal invasive procedures compared to bone marrow mesenchymal stem cell (BMSC) obtainment. The utilization of progenitor cells from the oral cavity is still rarely studied and applied. However, it is potentially advantageous for tissue regeneration and, therefore, merits further investigation¹⁵.

The SPCs that are potentially useful as part of regenerative alveolar bone therapy are gingival stromal progenitor cells (GSPCs) derived from hyperplastic gingival tissue (gum overgrowth) by means of a gingivectomy. GSPCs have phenotypic characteristics and abilities similar to those of BMSCs. GSPCs possess self-renewal capabilities and also demonstrate the specific ability to regenerate into alveolar bone when transplanted into immunocompromised mice. GSPCs also specifically induce bone matrix formation in lamellar structures by recruiting host cells^11,15–17. The osteogenic ability of GSPCs needs to be explored for further application and therapy.

During skeletal formation, master transcription genes such core-binding factor subunit-α (CBF-α1) and Osterix have been identified¹⁸. However, their specific and distinct roles in various tissue types are still unclear. Sox9 is well known as a master gene regulator during chondrogenic differentiation, while CBF-α1 plays an important role during osteogenic differentiation. GSPCs, as osteoprogenitors and chondroprogenitors, express Sox9 and Runx2 during skeletal formation condensation. There is also a direct interaction between Sox9 and CBF-α1, which inhibits Sox9 activity¹⁸. Sox9 inhibitory effect on osteoblast maturation through CBF-α1 is an essential mechanism for osteo-chondroprogenitor fate determination¹⁹.

In order for GSPCs to differentiate and proliferate optimally they require growth factors (GFs), various varieties of which are shown to promote osteogenic differentiation of SPCs in vitro. PRF is predicted to be combined to promote SPCs osteogenic differentiation and ensure mineralization in vitro¹⁹. PRF can be easily produced by centrifuging without anticoagulants. PRF is rich in GFs consisting of platelet derived growth factor-β (PDGF-β), transforming growth factor-β1 (TGFβ-1), vascular endothelial growth factor (VEGF) and insulin growth factor (IGF-I). PRF provides an effective scaffold to facilitate osteogenic differentiation of GSPCs^20–23.

The osteogenic differentiation of GSPCs can be detected by various osteogenic marker expressions, such as CBF-α1 expression. The observed osteogenic markers of GSPCs are CBF subunit-α1 (CBF-α1) and Sox9^24,25. Nonetheless, there is insufficient information regarding Sox9’s role in osteogenesis of GPSCs in vitro. A study conducted by Stockl et al. mentioned that Sox9 plays a positive proliferative role in inhibiting and delaying osteogenic differentiation in rat SPCs²⁶.

The hypothesis of the current study is that GSPCs cultured in PRF can increase the CBF-α1/Sox9 expression ratio during osteogenic differentiation. Furthermore, a second objective was to analyze GSPCs cultured in PRF osteogenic differentiation predicted by CBF-α1/Sox9 expression ratio.

Methods

Ethical clearance

This study received ethical clearance relating to animal subjects from the Ethics Research Committee, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia (number 289/HRECC.FODM/XII/2017). The research was conducted at an experimental laboratory within the Stem Cell and Tissue Engineering Development Centre, Universitas Airlangga.

Research design and experimental animals

The research was fully experimental with a post-test only control group design. Sample groups were selected by means of simple random number sampling. Each animal was assigned a unique number, which were picked out of a hat by a blindfolded researcher.

The subjects consisted of male Wistar rats (Rattus norvegicus; n=4), who were adapted to the environment for 7 days. Wistar rats were obtained and cared for at the Stem Cell Animal Laboratory, Universitas Airlangga. All animals were housed in polycarbonate cages, subjected to a 12-hour light-dark cycle at the constant temperature of 23°C, and fed a standard pellet diet (expanded pellets; Stepfield, UK) with tap water ad libitum at a temperature of 22°C±2°C.

GPSCs were isolated from the lower gingival tissue of four 1-month old, healthy, mean weight = 250g, male rats through a gingivectomy, before the rats were euthanized with doses 60mg/body weight of ketamine and xylazine. Animal suffering was reduced when removing the GPSCs using rodent’s anesthesia (intramuscular injection at 0.05–0.1ml/10g body weight rodent anesthesia: ketamine, xylazine, acepromazine, and sterile isotonic saline; Sigma Aldrich, USA) following Duan et al’s method²³.

GPSCs was passaged every 4–5 days following Rantam et al’s SPCs culture method²⁷. GSPCs in passage 3–5 were cultured in five M24 plates (Sigma-Aldrich) (N=108; n=6/group) until Day 7, Day 14 and Day 21 in three different culture mediums (control negative group, control positive group and treatment group; see below for details).

Sample size (n=4 for GPSCs isolation; n=36 for PRF isolation) was based on Lemeshow's formula to determine minimum sample size

Platelet rich fibrin isolation

A different population of rats were used for PRF isolation (n=36; 36 month old; mean weight = 250g). These male Wistar rats were maintained as above. Blood was aspirated through the left ventricle of each animals’ heart, after anesthesia had been administered by injection using a 60mg/body weight dose of ketamine and a 3mg/body weight dose of xylazine (Sigma Aldrich). 1.5ml of blood was aspirated using a 3ml disposable syringe and then inserted in a vacutainer tube without an anticoagulant before being centrifuged at 3000 rpm/min for 10min (Kubota, Tokyo, Japan). The centrifuging was performed by inserting two balance tubes containing water with the same weight as the tube of blood. When the tube is removed from the centrifuge, three layers will appear that are divided into three sections; the lower section consists of red blood cells, the middle section contains PRF and the upper section is formed of acellular plasma. The PRF was then isolated after which the PRF was cut into small pieces using sterile scissors and inserted into each culture plate of the treatment group^22,28,29.

Osteogenic differentiation in a combination of platelet rich fibrin and gingival stromal progenitor cells

The analysis was conducted on three groups, consisting of two control groups and one experimental group.

GSPC treatment group: GSPCs were cultured with PRF and containing ITS plus, 2mM L-glutamine, 100μg/ml sodium pyruvate, 0.2mM ascorbic acid-2 phosphate, dexamethasone 10-7 M (GeneTex, Taiwan), 10ng/ml TGF-β3 and high-dose glucose-Dulbecco's Modified Eagle Medium (DMEM-HG) (Sigma Aldrich).

Positive control group: GSPCs were placed on an osteogenic medium culture plate of ITS plus, 2 mM L-glutamine, 100μg/ml sodium pyruvate 0.2mM ascorbic acid-2 phosphate, dexamethasone 10-7 M (GeneTex).

Negative control group: GSPCs were cultured with αModified Eagle Medium (αMEM) (Sigma Aldrich).

Every three days, every group cell medium was replaced. Osteogenic differentiation was evaluated on Day 7, 14, 21 culture cells groups¹⁶.

GSPCs cultured cells were coated with coverslips and, after incubation at 37°C for 1 - 2 hours, were fixed using 10% formaldehyde for 15 min. The coverslips were then rinsed four times with PBS and dried for several minutes. The cells were blocked with PBS and FBS 1% for 15–30 minutes and washed with PBS four times. The samples were then examined following immunocytochemical staining by indirect technique using a 3.3'-diaminobenzidine stain kit (Pierce DAB Substrate Paint Kit 34002, Thermofisher^TM, Waltham, MA, USA) and monoclonal antibodies (Santa Cruz Biotechnology, Dallas, TX, USA): anti-CBF-α1 (mouse monoclonal; sc-101145) and anti-Sox9 (mouse monoclonal; sc-166505). CBF-α1 and Sox9 expression was read using a light microscope (CX22 Binocular, Olympus) at 200x magnification. Every cell expressing CBF1-α or Sox9 in one field was examined three times by three experts (WR, EH and FAR) and the mean was then calculated^27,30,31.

Data analysis

The data obtained was analyzed using ANOVA continued with Tukey HSD test (p<0.05) based on a Saphiro-Wilk normality test and a Levene's variance of homogeneity test (p>0.05). Data were analyzed using SPSS version 20.0 (IBM SPSS, Chicago, USA).

The experiments were replicated 3 times (n=54). The data was then duplicated (n=108) using an estimation formula and SPSS (see Supplementary File 1 and Supplementary File 2)³².

Results

The highest average CBF-α1 expression was in the treatment group on Day 7, whereas the lowest was in the control (-) group on Day 21 (Figure 1 and Figure 2). Sox9 expression had the highest mean value in the treatment group on Day 7, while its lowest value was in the negative control group on Day 21 (Figure 3 and Figure 4).

Figure 1. Core-binding factor subunit-α1 (CBF-α1) expression in gingival stromal progenitor cells (GSPCs) of Wistar rats (Rattus Novergicus).

(A-C) CBF-α1 expression in the negative control group; (D-F) CBF-α1 expression in the positive control group; (G-I) CBF-α1 expression in the treatment group. CBF-α1 expression in GSPCs was observed on Days 7, 14 and 21. Positive CBF-α1 expression is highlighted in brown (red arrow) following an examination at 200x magnification (n=1).

Figure 2. Mean core-binding factor subunit-α1 (CBF-α1) expression on Days 7, 14, 21 in each treatment group (n=6).

Figure 3. Sox9 expression in gingival stromal progenitor cells (GSPCs) of Wistar rats (Rattus Novergicus).

(A-C) Sox9 expression in the negative control group; (D-F) Sox9 expression in the positive control group; (G-I) Sox9 expression in the treatment group. Sox9 expression in GSPCs was observed on Days 7, 14 and 21. Positive Sox9 expression is highlighted in brown (red arrow) following examination at 200x magnification (n=1).

Figure 4. Mean Sox9 expression on Days 7, 14, 21 in each treatment group (n=6).

The treatment group recorded the highest CBF-α1/Sox9 ratio (16.00±3.000/14.33±2.517/) on Day 7 while the lowest CBF-α1/Sox9 ratio (3.33±1.528/3.67±1.155) was registered by the control negative group on Day 21 (Table 1). The data obtained was normal with homogeneous distribution (p>0.05). There was significant difference between CBF-α1 and Sox9 expression in each group (p<0.05) (Supplementary Table 1 and Supplementary Table 2).

Table 1. CBF-α1/Sox9 expression ratio between groups.

Day	CBF-α1 expression			Sox9 expression			P-value*
	Negative control group	Positive control group	Treatment group	Negative control group	Positive control group	Treatment group
7	9.00±2.000	11.33±1.528	16.00±3.000	5.67±1.155	11.00±1.00	14.33±2.517	0.00
14	7.33±1.528	9.33±0.577	11.67±2.082	2.67±0.577	7.33±1.528	11.33±1.528	0.00
21	3.33±1.528	8.33±1.155	10.67±1.528	2.33±1.155	6.00±1.000	9.00±2.000	0.00

Results are presented as the mean ± standard deviation. *One-way ANOVA, significant at p<0.05.

CBF-α1: core-binding factor subunit-α1.

Dataset 1.Raw results for CBF-α1 and Sox9 expression for all time points for all treatment groups (N=108; n=6/group).

Dataset 2.Raw image data.

Discussion

GSPCs cultured in PRF expressed CBF-α1 strongly. In this study, the highest CBF-α1 expression was recorded by the treatment group on Day 7, with significant difference between groups. The CBF-α1 expression declined between Day 14 and Day 21. The results of this study were in line with the research by Zou et al., which suggested that CBF-α1 expression is used to detect the osteogenic ability of SPCs using yellow fluorescent protein³³.

CBF-α1 is a master key gene transcription factor associated with osteoblast differentiation, which initiates temporally and spatially controlled osteogenesis. Disturbances to CBF-α1 result in obstacles to bone formation because osteoblast differentiation cannot occur. Loss of CBF-α1 expression gene function in the early stages will interfere with osteogenic differentiation and homeostasis in bone development. CBF-α1 is often expressed strongly between Day 7 and Day 14^23,25. Osterix and CBF-α1 periodically regulate osteoblast differentiation processes^34,35. A study conducted by Loebel et al. showed that CBF-α1 expression increased on Day 7, while Duan et al.’s study demonstrated that CBF-α1 expression increased on Day 12 as detected by RT-PCR^19,23. Such findings differed from the results of this study due to the contrasting methods and samples employed, but there were similarities in that CBF-α1 was an early marker of osteogenic differentiation.

CBF-α1 plays an important role in the early stages of BMSCs differentiation into preosteoblasts. CBF-α1 is generally a preliminary regulator and Osterix is a regulator activator during osteoblast differentiation. Both of these osteoblastogenic coding genes are stimulated and regulated by various signaling pathways, such as the canonical Wnt signaling pathway and bone morphogenetic protein (BMP). Wnt/Cytosolic β-catenin stimulates osteoblastogenesis through the activation of osteogenic transcription factors CBF-α1 and Osterix³⁶. CBF-α1 is known as an important regulatory gene during osteogenic development by enhancing specific osteoblastic differentiation by inducing osteogenic extracellular matrix gene expression during osteoblast maturation, such as collagen-Iα, alkaline phosphatase, and osteocalcin³³.

In the present study, the GSPCs cultured in PRF stimulates CBF-α1 expression because PRF is rich in various GFs, such as TGFβ-1, PDGF, IGF, VEGF, FGF, EGF, and HGF. PRF promotes migration, proliferation and differentiation of mesenchmymal stem cells as well as neovascularization and collagen synthesis. PRF also promotes, accelerates and improves the quality of soft and bone tissue regeneration²³. According to Li et al., PRF significantly promotes the induction of mineralization of progenitor cells in alveolar bone, and endogenous stem cells present in the dental tissue that increases exclusively in CBF-α1 expression^37,38.

Interestingly, GSPCs cultured PRF in this study increased Sox9 even in an osteogenic culture medium with significant difference with the control groups. In this study, the highest Sox9 expression occurred in the treatment group on Day 7. The results of this study were supported by those of a study by Sumarta et al., which stated that SPCs cultured in PRF stimulate Sox9 expression²². Sox9 expression showed a positive expression, thereby establishing the role of Sox9 during bone formation. In a knockout Sox9 animal model, osteogenic differentiation was also delayed³⁹. Significantly, recent genetics studies stated that Sox9 in SPCs could eventually differentiate into osteoblasts⁴⁰. Therefore, the inhibitory effect of Sox9 on osteoblastic and chondrocyte maturation via repression of CBF-alpha1 function is an essential mechanism for osteo-chondroprogenitor cell fate determination⁴¹.

In this study, GSPCs-cultured PRF regulated and stimulated both CBF-α1/Sox9 expression ratio on Day 7 with significant difference between groups. The interaction and cooperation between CBF-α1/Sox9 is a mandatory master transcription gene for cartilage and bone development¹⁸. As Sox9 inhibited and downregulated CBF-α1 on Day 7, it may be even more sensitive to predict osteogenic differentiation ability of SPCs. Furthermore, while Sox9 expression was downregulated, osteogenic differentiation ability was stimulated during early osteogenic differentiation in vitro. Nevertheless, CBF-α1/Sox9 expression ratio on Day 7 could be used to predict the osteogenic differentiation ability of GMSCs, suggesting a balance between CBF-α1/Sox9 in the earlier regulatory bone formation and regeneration^19,41.

Conclusion

GSPCs cultured in PRF increased CBF-α1/Sox9 expression on Day 7. GSPCs cultured in PRF possessed potential osteogenic differentiation ability as predicted by the CBF-α1/sox9 expression ratio. CBF-α1/Sox9 expression constitutes a promising future in vitro screening method employed to detect the earliest osteogenic differentiation of SPCs. Further study is required to analyze any association with CBF-α1/Sox9 expression ratio in vivo.

Data availability

Dataset 1: Raw results for CBF-α1 and Sox9 expression for all time points for all treatment groups (N=108; n=6/group). DOI, 10.5256/f1000research.15423.d210638⁴²

Dataset 2: Raw image data. DOI, 10.5256/f1000research.15423.d210639⁴³

Competing interests

No competing interests were disclosed.

Grant information

The research was funded by the Progam Menuju Doktor Sarjana Unggul (PMDSU) Batch III of the Ministry of Research, Technology and Higher Education of the Republic of Indonesia (Kemenristekdikti RI) (letter of appointment agreement number, 1035/D3/PG/2017; grant number 2146/D3/PG/2017).

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Acknowledgments

The authors would like to thank the Postgraduate School, Department of Dental Medicine, Faculty of Medicine, Stem Cell Research and Development Centre, Universitas Airlangga for its support of the research reported here.

Supplementary material

Supplementary Table 1. Tukey HSD multiple comparison between groups of CBF-α1.

Click here to access the data.

Supplementary Table 2. Tukey HSD multiple comparison between groups of Sox9 expression.

Click here to access the data.

Supplementary File 1: Estimation resume of CBF-α1 expression.

Click here to access the data.

Supplementary File 2: Estimation resume of Sox9 expression.

Click here to access the data.

Faculty Opinions recommended

References

1. Petersen PE, Bourgeois D, Ogawa H, et al.: The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005; 83(9): 661–69. PubMed Abstract | Free Full Text
2. Ministry of Health and National Institute of Health Research and Development: National report on basic health research, RISKESDAS, 2013. Jakarta, Indonesia, 2014 (and additional analysis). Ministry of Health, Republic of Indonesia, Jakarta.
3. Lee JH, Oh JY, Choi JK, et al.: Trends in the incidence of tooth extraction due to periodontal disease: results of a 12-year longitudinal cohort study in South Korea. J Periodontal Implant Sci. 2017; 47(5): 264–272. PubMed Abstract | Publisher Full Text | Free Full Text
4. Susin C, Oppermann RV, Haugejorden O, et al.: Tooth loss and associated risk indicators in an adult urban population from south Brazil. Acta Odontol Scand. 2005; 63(2): 85–93. PubMed Abstract | Publisher Full Text
5. Ministry of Health Republic of Indonesia: Health Profile in Indonesia 2014. Ministry of Health Republic of Indonesia. Sekretaris Jenderal. Jakarta, 2015. Reference Source
6. Lande R, Kepel BJ, Siagian KV: Profile of Risk Factor and Complication of Tooth Extraction at RSGM PSPDG-FK Unsrat. Jurnal E-Gigi (Eg). 2015; 3(2): 1–6.
7. Hamzah Z, Kartikasari N: Irrational Tooth Extraction increasing structural and functional bone resorption. Stomatognatic (J. K. G Unej). 2015; 12(2): 61–6.
8. Schropp L, Wenzel A, Kostopoulos L, et al.: Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent. 2003; 23(4): 313–323. PubMed Abstract
9. Chang IC, Tsai CH, Chang YC: Platelet-rich fibrin modulates the expression of extracellular signal- regulated protein kinase and osteoprotegerin in human osteoblasts. J Biomed Mater Res A. 2010; 95: 327–32. PubMed Abstract | Publisher Full Text
10. Barzilay R, Melamed E, Offen D: Introducing transcription factors to multipotent mesenchymal stem cells: making transdifferentiation possible. Stem Cells. 2009; 27(10): 2509–2515. PubMed Abstract | Publisher Full Text
11. Egusa H, Sonoyama W, Nishimura M, et al.: Stem cells in dentistry--part I: stem cell sources. J Prosthodont Res. 2012; 56(3): 151–165. PubMed Abstract | Publisher Full Text
12. Augello A, Kurth TB, De Bari C: Mesenchymal stem cells: a perspective from in vitro cultures to in vivo migration and niches. Eur Cell Mater. 2010; 20: 121–133. PubMed Abstract | Publisher Full Text
13. Law S, Chaudhuri S: Mesenchymal stem cell and regenerative medicine: regeneration versus immunomodulatory challenges. Am J Stem Cells. 2013; 2(1): 22–38. PubMed Abstract | Free Full Text
14. Gao F, Chiu SM, Motan DA, et al.: Mesenchymal stem cells and immunomodulation: current status and future prospects. Cell Death Dis. 2016; 7: e2062. PubMed Abstract | Publisher Full Text | Free Full Text
15. Egusa H, Sonoyama W, Nishimura M, et al.: Stem cells in dentistry--Part II: Clinical applications. J Prosthodont Res. 2012; 56(4): 229–248. PubMed Abstract | Publisher Full Text
16. Niibe K, Suehiro F, Oshima M, et al.: Challenges for stem cell-based "regenerative prosthodontics". J Prosthodont Res. 2017; 61(1): 3–5. PubMed Abstract | Publisher Full Text
17. Miran S, Mitsiadis TA, Pagella P: Innovative Dental Stem Cell-Based Research Approaches: The Future of Dentistry. Stem Cells Int. 2016; 2016: 7231038. PubMed Abstract | Publisher Full Text | Free Full Text
18. Zhou G, Zheng Q, Engin F, et al.: Dominance of SOX9 function over RUNX2 during skeletogenesis. Proc Natl Acad Sci U S A. 2006; 103(50): 19004–9. PubMed Abstract | Publisher Full Text | Free Full Text
19. Loebel C, Czekanska EM, Bruderer M, et al.: In vitro osteogenic potential of human mesenchymal stem cells is predicted by Runx2/Sox9 ratio. Tissue Eng Part A. 2015; 21(1–2): 115–23. PubMed Abstract | Publisher Full Text | Free Full Text
20. Baek HS, Lee HS, Kim BJ, et al.: Effect of platelet-rich fibrin on repair of defect in the articular disc in rabbit temporomandibular joint by platelet-rich fibrin. Tissue Engineering and Regenerative Medicine. 2011; 8(6): 530–535. Reference Source
21. Kazemi D, Fakhrjou A, Dizaji VM, et al.: Effect of autologous platelet rich fibrin on the healing of experimental articular cartilage defects of the knee in an animal model. Biomed Res Int. 2014; 2014: 486436. PubMed Abstract | Publisher Full Text | Free Full Text
22. Sumarta NPM, Pramono DC, Hendrianto E, et al.: Chondrogenic Differentiation Capacity of Human Umbilical Cord Mesenchymal Stem Cells with Platelet Rich Fibrin Scaffold in Cartilage Regeneration (In Vitro Study). Bali Med J. 2016; 5(3): 420–426. Publisher Full Text
23. Duan X, Lin Z, Lin X, et al.: Study of platelet-rich fibrin combined with rat periodontal ligament stem cells in periodontal tissue regeneration. J Cell Mol Med. 2018; 22(2): 1047–1055. PubMed Abstract | Free Full Text
24. Marie PJ, Fromigué O: Osteogenic differentiation of human marrow-derived mesenchymal stem cells. Regen Med. 2006; 1(4): 539–48. PubMed Abstract | Publisher Full Text
25. Shui C, Spelsberg TC, Riggs BL, et al.: Changes in Runx2/Cbfa1 expression and activity during osteoblastic differentiation of human bone marrow stromal cells. J Bone Miner Res. 2003; 18(2): 213–21. PubMed Abstract | Publisher Full Text
26. Stöckl S, Göttl C, Grifka J, et al.: Sox9 modulates proliferation and expression of osteogenic markers of adipose-derived stem cells (ASC). Cell Physiol Biochem. 2013; 31(4–5): 703–17. PubMed Abstract | Publisher Full Text
27. Rantam FA, Ferdiansyah P: Stem cell mesenchymal, Hematopoetic Stem Cells and Application Model. 2nd Ed. Surabaya: Airlangga University Press, 2014; 2: 38.
28. Borie E, Oliví DG, Orsi IA, et al.: Platelet-rich fibrin application in dentistry: a literature review. Int J Clin Exp Med. 2015; 8(5): 7922–7929. PubMed Abstract | Free Full Text
29. Rahmawati D, Roestamadji RI, Yuliati A, et al.: Osteogenic ability of combined hematopoetic stem cell, hydroxyapatite graft and platelet rich fibrin on rats (Rattus novergicus). Journal of Krishna Institute of Medical Sciences University. 2017; 6(4): 88–95. Reference Source
30. Kamadjaja MJK, Salim S, Rantam FA: Osteogenic Potential Differentiation of Human Amnion Mesenchymal Stem Cell with Chitosan-Carbonate Apatite scaffold (in vitro study). Bali Med J. 2016; 5(3): 427–433. Publisher Full Text
31. Ekizer A, Yalvac ME, Uysal T, et al.: Bone marrow mesenchymal stem cells enhance bone formation in orthodontically expanded maxillae in rats. Angle Orthod. 2015; 85(3): 394–399. PubMed Abstract | Publisher Full Text
32. Karangwa I, Kotze D: Using the Markov Chain Monte Carlo Method to Make Inferences on Items of Data Contaminated by Missing Values. American Journal of Theoretical and Applied Statistics. 2013; 2(3): 48–53. Publisher Full Text
33. Zou L, Kidwai FK, Kopher RA, et al.: Use of RUNX2 expression to identify osteogenic progenitor cells derived from human embryonic stem cells. Stem Cell Reports. 2015; 4(2): 190–198. PubMed Abstract | Publisher Full Text | Free Full Text
34. Brunetti G, Mori G, D’Amelio P, et al.: The crosstalk between the bone and the immune system: Osteoimmunology. Clinical and Developmental Immunology. 2013; 2013: 617319. Publisher Full Text
35. Crotti TN, Dharmapatni AA, Alias E, et al.: Osteoimmunology: Major and Costimulatory Pathway Expression Associated with Chronic Inflammatory Induced Bone Loss. J Immunol Res. 2015; 2015: 281287. PubMed Abstract | Publisher Full Text | Free Full Text
36. Graves DT, Kayal RA, Oates T: Chapter 19 - Osteoimmunology in the Oral Cavity (Periodontal Disease, Lesions of Endodontic Origin, and Orthodontic Tooth Movement). Osteoimmunology. 2016; 325–344. Publisher Full Text
38. Li Q, Pan S, Dangaria SJ, et al.: Platelet-rich fibrin promotes periodontal regeneration and enhances alveolar bone augmentation. Biomed Res Int. 2013; 2013: 638043. PubMed Abstract | Publisher Full Text | Free Full Text
38. Li Q, Reed DA, Min L, et al.: Lyophilized platelet-rich fibrin (PRF) promotes craniofacial bone regeneration through Runx2. Int J Mol Sci. 2014; 15(5): 8509–8525. PubMed Abstract | Publisher Full Text | Free Full Text
39. Akiyama H, Lyons JP, Mori-Akiyama Y, et al.: Interactions between Sox9 and beta-catenin control chondrocyte differentiation. Genes Dev. 2004; 18(9): 1072–1087. PubMed Abstract | Publisher Full Text | Free Full Text
40. Akiyama H, Kim JE, Nakashima K, et al.: Osteo-chondroprogenitor cells are derived from Sox9 expressing precursors. Proc Natl Acad Sci U S A. 2005; 102(41): 14665–14670. PubMed Abstract | Publisher Full Text | Free Full Text
41. Zhou G, Zheng Q, Engin F, et al.: Dominance of SOX9 function over RUNX2 during skeletogenesis. Proc Natl Acad Sci U S A. 2006; 103(50): 19004–19009. PubMed Abstract | Publisher Full Text | Free Full Text
42. Nugraha AP, Narmada IB, Ernawati DS, et al.: Dataset 1 in: Osteogenic potential of gingival stromal progenitor stem cells cultured in plasma rich fibrin is predicted by core-binding factor subunit-a1/Sox9 expression ratio (in vitro). F1000Research. 2018. Data Source
43. Nugraha AP, Narmada IB, Ernawati DS, et al.: Dataset 2 in: Osteogenic potential of gingival stromal progenitor stem cells cultured in plasma rich fibrin is predicted by core-binding factor subunit-a1/Sox9 expression ratio (in vitro). F1000Research. 2018. Data Source

Comments on this article Comments (0)

Version 1

VERSION 1 PUBLISHED 25 Jul 2018