title: Cell based advanced therapeutic medicinal products for bone repair: Keep it simple?
abstract: The development of cell based advanced therapeutic medicinal products (ATMPs) for bone repair has been expected to revolutionize the health care system for the clinical treatment of bone defects. Despite this great promise, the clinical outcomes of the few cell based ATMPs that have been translated into clinical treatments have been far from impressive. In part, the clinical outcomes have been hampered because of the simplicity of the first wave of products. In response the field has set-out and amassed a plethora of complexities to alleviate the simplicity induced limitations. Many of these potential second wave products have remained "stuck" in the development pipeline. This is due to a number of reasons including the lack of a regulatory framework that has been evolving in the last years and the shortage of enabling technologies for industrial manufacturing to deal with these novel complexities. In this review, we reflect on the current ATMPs and give special attention to novel approaches that are able to provide complexity to ATMPs in a straightforward manner. Moreover, we discuss the potential tools able to produce or predict 'goldilocks' ATMPs, which are neither too simple nor too complex.
authors.affiliation: Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Leijten
authors.affiliation: Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
authors.forename: Y C
authors.initials: YC
authors.lastname: Chai
authors.affiliation: Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Papantoniou
authors.affiliation: Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium; Biomechanics Research Unit, University of Liege, Liege, Belgium; Biomechanics Section, KU Leuven, Leuven, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Geris
authors.affiliation: Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium; Department of Materials Engineering, KU Leuven, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Schrooten
authors.affiliation: Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium. Electronic address: Frank.Luyten@uz.kuleuven.be.
authors.forename: F P
authors.initials: FP
authors.lastname: Luyten
mesh_terms: D001672:Biocompatible Materials / Q000627:therapeutic use*; D001842:Bone and Bones / Q000293:injuries* / Q000601:surgery*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D006801:Humans; D023822:Tissue Engineering / Q000379:methods*
chemical_list: D001672:Biocompatible Materials
keywords: Enabling technology; Musculoskeletal; Regenerative medicine; Stem cell; Therapy; Tissue engineering