Photobiomodulation and Stem Cell on Repair of Osteoporotic Bones

<b><i>Objective:</i></b> This study examined the use of photobiomodulation (PBM) plus adipose-derived stem cells (ASCs) to enhance the osteogenic properties of demineralized bone matrix (DBM) scaffold in a critical size femoral defect (CSFD) of ovariectomy-induced osteoporotic (OVX) rats. <b><i>Background:</i></b> PBM could be used as a unique strategy to enhance the osteogenic potential of DBMs seeded with ASCs. <b><i>Materials and methods:</i></b> The OVX rats with a CSFD were divided into six groups: (1) Control (C); (2) DBM scaffold alone (S); (3) S+PBM; (4) S+alendronate; (5) S+ASC; (6) S+PBM+ASC. Stereological analysis, real-time polymerase chain reaction (RT-PCR), and cone-beam computed tomography (CBCT) were performed after euthanization at 4 and 8 weeks postimplantation surgery. <b><i>Results:</i></b> In the 8th week, Groups 4 and 6 showed a greatly high new trabecular bone volume than the scaffold group (all, <i>p</i> = 0.009). The CBCT data demonstrated that the CSFD was significantly smaller in the two, three, and six groups relative to the control group (<i>p</i> = 0.01, <i>p</i> = 0.000, and <i>p</i> = 0.000, respectively). RT-PCR revealed that Groups 3 and 6 had higher messenger RNA levels of osteocalcin (OC) and osteoprotegerin (OPG) compared with the control group (<i>p</i> = 0.05). Group 6 had significantly lower expression of receptor activator of nuclear factor-κB ligand (RANKL) compared with the control group (<i>p</i> = 0.02). <b><i>Conclusions:</i></b> The combination of DBM plus PBM plus ASC, as well as DBM plus PBM significantly improved the healing of CSFD in OVX rats, and affected the expression of OPG, OC, and RANKL genes.