The structural organization of cells and their associated extracellular matrix (ECM) is critical to overall tissue function. Recapitulating the complex, highly organized structure of a target tissue is a key to achieve the unique functional characteristics of native tissue. However, achieving this goal requires a system in which substrate physicochemical properties such as modulus, topology and surface chemistry can be modulated. Here, we developed a cell sheet-based harvest & transfer system that can rapidly produce patterned 2D cell sheets in any physiologically relevant size and shape for various cell types. We further show that these cell sheets can be stacked one on top of the other with high cell viability while preserving the patterns, and that they remain sufficiently intact in vivo to allow neovascularization. We can thus use this system to mimic both the 2D and 3D structure of native tissue structure. A further advantage of our system is its substrate modulus tuning capability, which allows us to provide an optimal biomechanical environment for the differentiation and phenotypic stabilization of specific cell types. Because hydrogels theoretically have no limit in 2D shape and size, this system is scalable for producing quality controlled multiple cell sheets in a short period of time. Our model should also aid in understanding the mechanisms that underlie cell-cell and cell-ECM communication in 3D environments, which will be imperative to improving engineered tissue design. We thus ultimately envision that our system could allow the rapid fabrication of functionalized three dimensional thick tissues from multiple stacks of cell sheets derived from autologous cells, which would be an important step forward in both tissue modeling and regenerative medicine in general. Finally, this system can also potentially serve as a powerful model to study in vivo tissue formation and growth as well as cancer cell behavior.

<strong>Osteoarthritis</strong>, the most prevalent joint disease in the United Kingdom, is a progressive condition that results in end-stage full-thickness cartilage loss and has important social and economic impacts on society. Since cartilage lacks regenerative capabilities, it is essential to develop approaches to initiate and enhance cartilage regeneration. In this context, tissue engineering is emerging as an attractive approach for the regeneration of cartilage tissue damaged due to disease or trauma. A scaffold-free cartilage construct, analogous to those found during embryonic precartilage condensation, has received much attention as an alternative novel modality for cartilage <strong>tissue engineering</strong>. Cartilage repair with <strong>scaffold-free</strong> tissue more closely resembles the natural situation and mimics the features of the original tissue. Moreover, scaffold-free cartilage implants can overcome the complications caused by the use of suboptimal scaffolds by avoiding the need for a foreign scaffold at all. Culturing cells into tissue patches without the requirement for a scaffold can be achieved through <strong>cell sheet engineering</strong>, which uses thermo-responsive culture dishes. However, the high costs of the tissue culture consumables, and the relatively low cellular yield, makes this process less attractive. This thesis presents a novel method for generating shape-, size- and thickness-adjustable 3-dimensional scaffold-free cell pellet sheets for use as implantable biological cell patches for cartilage tissue engineering. This new technique of bioengineering scaffold-free cell pellet sheets proves to be reproducible, easily applicable, sizable and thickness adjustable. <strong>Stem cells</strong> have added a new thrust to tissue engineering. Their distinctive self-renewal and plasticity have not only optimized many tissue engineering developments, but also rendered feasible some applications which would otherwise be unattainable with somatic cells. Human mesenchymal stem cells (HMSCs) were used to examine the optimal condition for generating cell pellet sheets with this new method. Furthermore, the resultant differentiated pellet sheets were compared directly with HMSCs, human chondrocytes and human fibroblasts alone to evaluate the feasibility of using this cell pellet sheet for clinical applications in terms of their biological and mechanical properties. The results of this thesis suggest that the engineered scaffold-free, chondrogenic, differentiated MSC pellet sheet not only exhibits desirable biologic features similar to chondrocytes, but also demonstrates good integrative and viscoelastic potential that might offer exciting possibilities for the development of novel biologically-based clinical therapies. In summary the data presented herein indicate the following points: <table><ul style="list-style-type:square"><li>The differentiation of human MSCs into chondrogenic cells was achieved.</li> <li>A novel approach of centrifugal seeding on a PDMS surface was shown to effectively generate chondrogenic-differentiated cell pellet sheets without impairing the biological functions of chondrocytes.</li> <li>Various cell types such as human MSCs, human chondrocytes and human fibroblasts were found to respond well to the novel methodology and generated viable, cohesive, less shrinkable, and readily-detachable cell pellet sheets, the size and thickness of which could be adapted as required. The results obtained were superior to those obtained using the conventional thermo-responsive culture dish method.</li></table> This new methodology developed in this thesis provides an approach to in vitro cell pellet sheet generation which is closer to the physiological process of cartilage development and which proved valuable for the study of in vitro generation of scaffold-free cell patches as an important adjunct to many traditional cartilage restorative procedures. Future research on in vivo assessment of the cell sheet and the functional role of these sheets in repairing damaged cartilage is recommended.

The relationship between cells and their environment is one of dynamic reciprocity, whereby cells can influence their surrounding and the surroundings can influence the cells. One example of this relationship arises from the effect of the mechanical properties of an environment on a cell and of a cell on its environment. Inspired by this relationship, we investigate 1) the local environment of biological materials, both native and synthetic, and 2) the forces that cell sheets exert on surfaces. We do this by developing techniques that focus on local mechanical properties and experimental strategies that provide insight into intercellular mechanics. We first focus on determining local mechanical properties of hydrogel materials by developing the Cavitation Rheology technique. This process involves inducing a cavitation event at the tip of a syringe needle. We develop theory to show that the critical pressure to cavitate can be directly related to the modulus of the material (Chapter 2). This allows us to experimentally determine the mechanical properties at arbitrary locations throughout a material scaffold over a range of length scales defined by the needle radius (Chapter 3). We then demonstrate that we can viturally elminate the energy contribution from the creation of new surface area to the critical pressure by cavitating with a media of lower surface energy (Chapter 4). In chapter 5, we show that Cavitation Rheology can be used on native biological tissues and we go on to demonstrate the importance of measuring the mechanical properties in vivo. We then focus on understanding the force development of cells as they grow to confluency on a dynamic substrate (Chapter 6). We demonstrate the method of living microlenses to measure the collective strains cell sheets attain by growing cells on a thin polystyrene film supported by a surface of microwells. The cells cause the film to buckle and the resultant buckling can be directly related to the strain. We use this technique to study the strains exerted by various cell types and to determine the importance of the cell-cell junctions on the strain development.

No description available.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23084号 / 医博第4711号 / 新制||医||1049(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 木村 剛, 教授 森本 尚樹, 教授 山下 潤 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

No description available.

Membranas celulares (MCs; Cell Sheets), constituídas por células-tronco (CTs), são autodestacáveis da placa de cultivo, e sem subcultivos geram grande quantidade de células que podem ser transplantadas de maneira mais próxima da fisiologia celular, mantendo-se as ligações celulares e a matriz extracelular produzidas em cultura. O ácido ascórbico ou vitamina C (VC) tem efeito indutor da formação destas MCs, aumentando a longevidade e tempo de indiferenciação das CTs. A similaridade observada entre respostas biológicas da VC em MCs e aquelas da Laserfototerapia (LFT) sobre células e tecidos, nos levou à hipótese de que estas terapias poderiam se complementar melhorando o prognóstico de futura aplicação clínica dessas MCs em regenerações de tecidos de interesse odontológico. Para testar essa hipótese, LFT e VC foram aplicadas associadas ou não na indução de MCs de células-tronco da polpa dentária humana (hDPSCs). Para tanto, hDPSCs descongeladas, que expressaram níveis típicos de marcadores de superfície de células-tronco mesenquimais, foram plaqueadas em placas de 6 poços (5x104 células por poço). Vinte e quatro horas depois do plaqueamento as culturas foram submetidas aos tratamentos dos grupos experimentais: Controle: hDPSCs em P3 cultivadas com meio clonogênico; Senescente: hDPSCs em P27 cultivadas com meio clonogênico; VC: P3 cultivadas com meio clonogênico acrescido de VC (20 ?g/ml); Laser: P3 cultivadas com meio clonogênico e submetido à LFT (contato e pontual - 5 pontos / poço, 660 nm, 20 mW, 0,028 cm², 0,71 W/cm², 7 segundos, 5 J/cm², 0,14 J por ponto, 48 horas de intervalo) e Laser+VC: P3 cultivadas com meio clonogênico acrescido de VC e submetido à LFT. Em 24 horas, 7 e 13 dias as hDPSCs dos diferentes grupos experimentais foram observadas macro e microscopicamente, e atividade da enzima telomerase foi avaliada por PCR-TRAP, complementado por ELISA. Para a avaliação da expressão de genes relacionados à natureza e indiferenciação (Mitofilina e Oct 4) e à longevidade (fase catalítica da enzima telomerase - hTERT); bem como à senescência das células do grupo senescente (?-galactosidase), as hDPSCs de todos os grupos experimentais foram submetidas ao RT-qPCR As hDPSCs foram capazes de formar MCs somente nos grupos VC e Laser+VC (100%), entre 10 e 13 dias. As MCs do grupo Laser+VC apresentaram maior facilidade na manipulação. Atividade de Telomerase nas hDPSCs foi observada somente em 24 horas (Controle e LFT) e em 7 dias (VC e Laser+VC). Os marcadores de indiferenciação (Oct 4) e mesenquimal (mitofilina), bem como a hTERT foram expressos nas hDPSCs de todos os grupos experimentais. O Oct4 e o hTERT, em 7 dias, apresentaram expressões significativamente maiores nos grupos VC e Laser+VC em comparação com os demais (p < 0,0001, p = 0,0009, respectivamente). A expressão da mitofilina foi significativamente maior no grupo Laser+VC, em 7 dias (p =0,033). A técnica de obtenção de MCs de hDPSCs por essa metodologia foi considerada adequada para ser testada em procedimentos regenerativos. A LFT quando associada à VC não interferiu na formação das MCs, nem na manutenção da longevidade e indiferenciação das hDPSCs. Adicionalmente, a LFT melhorou a manipulação das MCs. Assim sendo, a associação de VC e LFT na indução de MCs parece promissora para futura utilização de MCs na odontologia regenerativa. / Cell Sheets, consisting of stem cells (SCs) are self detachable from the cultivation plate, and with no subcultivation can generate large amount of cells. The cell sheets can be transplanted closer to cell physiology environment by keeping the cell connections and the extracellular matrix produced in culture. Ascorbic acid or Vitamin C (VC) has inductive effect on cell sheet formation, increasing the longevity and the stemness of the cell for long period of time. The similarity between biological responses of VC in cell sheets and those of Laserphototherapy (LPT, Laser) on cells and tissues led us to hypothesize that these therapies could improve the prognosis of future clinical application of these cell sheets in regeneration of dental tissues. To test this hypothesis, LPT and VC were applied, associated or not, to induce human dental pulp stem cells (hDPSCs). Therefore, hDPSCs, which expressed typical levels of mesenchymal stem cell surface markers, were plated in 6-well plates (5x104 cells per well). Twenty-four hours later they were subjected to the treatment of experimental groups: Control: hDPSCs in P3 cultured with regular medium; Senescent: hDPSCs in P27 cultured with regular medium; VC: P3 cultured with regular medium supplemented with VC (20 ?g/ml); Laser: P3 cultures with regular medium and submitted to LPT (punctual and contact mode-5 points / well, 660 nm, 20 mW, 0.028 cm², 0.71 W/cm², 7 sec, 5 J/cm², 0.14 J per point, 48 hours-intervals) and Laser+VC: P3 cultured with regular medium supplemented with VC and submitted to LPT Within 24 hours, 7 and 13 days the hDPSCs of the different experimental groups were observed macroscopically and microscopically, and the telomerase enzyme activity was assessed by PCR-TRAP, complemented by ELISA. To evaluate the expression of genes related to the nature and differentiation (Mitofilina and Oct 4), longevity (catalytic phase of telomerase-hTERT enzyme), and the senescence of the senescent group cells (?-galactosidase), the hDPSCs of all experimental groups were subjected to RT-qPCR. The RT-qPCR data were compared by ANOVA complemented by the Tukey\'s test (p <= 0.05). The hDPSCs were able to form cell sheets only in the VC and Laser+VC groups (100%). Additionally, the cell sheets of the Laser+VC group presented easier handling. Telomerase activity in hDPSCs was observed only in 24 hours (Control and Laser) and seven days (VC and Laser + VC). The undifferentiating marker (Oct 4) and mesenchymal marker (mitofilin), as well as hTERT were expressed in hDPSCs of all experimental groups. Oct4 and hTERT presented expressions significantly higher at 7 days in VC and Laser+VC groups than in all other groups (p < 0.0001, p = 0.0009, respectively). The expression of mitofilin was significantly higher in the Laser+VC group, in 7 days (p = 0.0338). The technique of obtaining cell sheets of hDPSCs by the methodology here presented was considered appropriate to be further tested in regenerative procedures. The LPT when combined with VC did not interfere with the formation of the cell sheets, neither in the maintenance of longevity and undifferentiating status of hDPSCs. Moreover, LPT improved the handling of the cell sheets. Thus, the association of VC and LPT in the induction of cell sheets seems promising for future use in regenerative dentistry.

Membranas celulares (MCs; Cell Sheets), constituídas por células-tronco (CTs), são autodestacáveis da placa de cultivo, e sem subcultivos geram grande quantidade de células que podem ser transplantadas de maneira mais próxima da fisiologia celular, mantendo-se as ligações celulares e a matriz extracelular produzidas em cultura. O ácido ascórbico ou vitamina C (VC) tem efeito indutor da formação destas MCs, aumentando a longevidade e tempo de indiferenciação das CTs. A similaridade observada entre respostas biológicas da VC em MCs e aquelas da Laserfototerapia (LFT) sobre células e tecidos, nos levou à hipótese de que estas terapias poderiam se complementar melhorando o prognóstico de futura aplicação clínica dessas MCs em regenerações de tecidos de interesse odontológico. Para testar essa hipótese, LFT e VC foram aplicadas associadas ou não na indução de MCs de células-tronco da polpa dentária humana (hDPSCs). Para tanto, hDPSCs descongeladas, que expressaram níveis típicos de marcadores de superfície de células-tronco mesenquimais, foram plaqueadas em placas de 6 poços (5x104 células por poço). Vinte e quatro horas depois do plaqueamento as culturas foram submetidas aos tratamentos dos grupos experimentais: Controle: hDPSCs em P3 cultivadas com meio clonogênico; Senescente: hDPSCs em P27 cultivadas com meio clonogênico; VC: P3 cultivadas com meio clonogênico acrescido de VC (20 ?g/ml); Laser: P3 cultivadas com meio clonogênico e submetido à LFT (contato e pontual - 5 pontos / poço, 660 nm, 20 mW, 0,028 cm², 0,71 W/cm², 7 segundos, 5 J/cm², 0,14 J por ponto, 48 horas de intervalo) e Laser+VC: P3 cultivadas com meio clonogênico acrescido de VC e submetido à LFT. Em 24 horas, 7 e 13 dias as hDPSCs dos diferentes grupos experimentais foram observadas macro e microscopicamente, e atividade da enzima telomerase foi avaliada por PCR-TRAP, complementado por ELISA. Para a avaliação da expressão de genes relacionados à natureza e indiferenciação (Mitofilina e Oct 4) e à longevidade (fase catalítica da enzima telomerase - hTERT); bem como à senescência das células do grupo senescente (?-galactosidase), as hDPSCs de todos os grupos experimentais foram submetidas ao RT-qPCR As hDPSCs foram capazes de formar MCs somente nos grupos VC e Laser+VC (100%), entre 10 e 13 dias. As MCs do grupo Laser+VC apresentaram maior facilidade na manipulação. Atividade de Telomerase nas hDPSCs foi observada somente em 24 horas (Controle e LFT) e em 7 dias (VC e Laser+VC). Os marcadores de indiferenciação (Oct 4) e mesenquimal (mitofilina), bem como a hTERT foram expressos nas hDPSCs de todos os grupos experimentais. O Oct4 e o hTERT, em 7 dias, apresentaram expressões significativamente maiores nos grupos VC e Laser+VC em comparação com os demais (p < 0,0001, p = 0,0009, respectivamente). A expressão da mitofilina foi significativamente maior no grupo Laser+VC, em 7 dias (p =0,033). A técnica de obtenção de MCs de hDPSCs por essa metodologia foi considerada adequada para ser testada em procedimentos regenerativos. A LFT quando associada à VC não interferiu na formação das MCs, nem na manutenção da longevidade e indiferenciação das hDPSCs. Adicionalmente, a LFT melhorou a manipulação das MCs. Assim sendo, a associação de VC e LFT na indução de MCs parece promissora para futura utilização de MCs na odontologia regenerativa. / Cell Sheets, consisting of stem cells (SCs) are self detachable from the cultivation plate, and with no subcultivation can generate large amount of cells. The cell sheets can be transplanted closer to cell physiology environment by keeping the cell connections and the extracellular matrix produced in culture. Ascorbic acid or Vitamin C (VC) has inductive effect on cell sheet formation, increasing the longevity and the stemness of the cell for long period of time. The similarity between biological responses of VC in cell sheets and those of Laserphototherapy (LPT, Laser) on cells and tissues led us to hypothesize that these therapies could improve the prognosis of future clinical application of these cell sheets in regeneration of dental tissues. To test this hypothesis, LPT and VC were applied, associated or not, to induce human dental pulp stem cells (hDPSCs). Therefore, hDPSCs, which expressed typical levels of mesenchymal stem cell surface markers, were plated in 6-well plates (5x104 cells per well). Twenty-four hours later they were subjected to the treatment of experimental groups: Control: hDPSCs in P3 cultured with regular medium; Senescent: hDPSCs in P27 cultured with regular medium; VC: P3 cultured with regular medium supplemented with VC (20 ?g/ml); Laser: P3 cultures with regular medium and submitted to LPT (punctual and contact mode-5 points / well, 660 nm, 20 mW, 0.028 cm², 0.71 W/cm², 7 sec, 5 J/cm², 0.14 J per point, 48 hours-intervals) and Laser+VC: P3 cultured with regular medium supplemented with VC and submitted to LPT Within 24 hours, 7 and 13 days the hDPSCs of the different experimental groups were observed macroscopically and microscopically, and the telomerase enzyme activity was assessed by PCR-TRAP, complemented by ELISA. To evaluate the expression of genes related to the nature and differentiation (Mitofilina and Oct 4), longevity (catalytic phase of telomerase-hTERT enzyme), and the senescence of the senescent group cells (?-galactosidase), the hDPSCs of all experimental groups were subjected to RT-qPCR. The RT-qPCR data were compared by ANOVA complemented by the Tukey\'s test (p <= 0.05). The hDPSCs were able to form cell sheets only in the VC and Laser+VC groups (100%). Additionally, the cell sheets of the Laser+VC group presented easier handling. Telomerase activity in hDPSCs was observed only in 24 hours (Control and Laser) and seven days (VC and Laser + VC). The undifferentiating marker (Oct 4) and mesenchymal marker (mitofilin), as well as hTERT were expressed in hDPSCs of all experimental groups. Oct4 and hTERT presented expressions significantly higher at 7 days in VC and Laser+VC groups than in all other groups (p < 0.0001, p = 0.0009, respectively). The expression of mitofilin was significantly higher in the Laser+VC group, in 7 days (p = 0.0338). The technique of obtaining cell sheets of hDPSCs by the methodology here presented was considered appropriate to be further tested in regenerative procedures. The LPT when combined with VC did not interfere with the formation of the cell sheets, neither in the maintenance of longevity and undifferentiating status of hDPSCs. Moreover, LPT improved the handling of the cell sheets. Thus, the association of VC and LPT in the induction of cell sheets seems promising for future use in regenerative dentistry.

No description available.

A terapia de fotobiomodulação (PBMT do inglês photobiomodulation therapy) exerce efeitos benéficos em processos relevantes para a regeneração tecidual. A técnica de membranas celulares (CSs; cell sheets) pode gerar grande quantidade de células organizadas em uma matriz extracelular (MEC) produzida por essas células. A constituição de MEC das CSs pode ser de importância para a regeneração de tecidos. O colágeno tipo I, a fibronectina e a tenascina são proteínas da MEC já detectadas em CSs de células-tronco da polpa dentária humana. O objetivo deste estudo foi investigar os efeitos de diferentes parâmetros de PBMT sobre a arquitetura (histologia), composição proteica (Western blotting e imunoistoquímica) e ultraestrutura (MEV e MET) da MEC de CSs de células-tronco da polpa dental humana. As células-tronco foram descongeladas e recaracterizadas através da análise de seu perfil imunofenotípico avaliado pela expressão de moléculas de superfície utilizando citometria de fluxo para marcadores associados a células-tronco mesenquimais (MSC do inglês mesenchymal stem cells; CD105, CD146 e CD44) e não associados (CD45, CD34 e CD14). As CSs foram formadas em placas de cultivo celular após 15 dias em cultura em meio clonogênico suplementado com vitamina C (20 ?g/ml). As culturas celulares foram alocadas em 3 grupos experimentais diferentes, como segue: Controle: nenhum tratamento adicional; PBMT1 e PBMT2. A PBMT foi realizada com um laser diodo vermelho contínuo, aplicando-se os seguintes parâmetros gerais: 660nm, 20mW, 0,028cm2 e 0,71W/cm2. Os parâmetros do PBMT1 foram: 4s, 3J/cm2 e 0,08J por ponto, e o PBMT2: 7s, 5J/cm2 e 0,14J por ponto. As irradiações foram realizadas em dias alternados durante todo o período do experimento, em modo pontual (5 pontos / poço ou 13 por placas de 100 mm de diâmetro) em contato com a base da placa. Após a formação das CSs, 15 dias após o plaqueamento, estas foram submetidas a análises histológica, imunoistoquímica, Western blotting, microscopia eletrônica de transmissão e de varredura. Comparações estatísticas foram realizadas (p <0,05). As células apresentaram perfil imunofenotípico clássico de MSCs, mostrando a expressão de marcadores associados a MSCs, enquanto a expressão dos marcadores não associados a MSCs estavam ausentes. O colágeno tipo I, colágeno tipo III e fibronectina estavam presentes no MEC das CSs. Western blotting revelou maior síntese de fibronectina nas CSs submetidas ao PBMT1. A ultraestrutura geral dos CSs foi diversa nos 3 grupos experimentais. As CSs do grupo PBMT1 apresentaram aspecto epitelióide, enquanto no grupo PBMT2 as CSs apresentaram células isoladas e fusiformes dispostas em feixes unidirecionais. MET identificou uma MEC mais madura e sinais de apoptose nos grupos submetidos à PBMT. A PBMT influenciou a composição e ultraestrutura da MEC de CSs de células-tronco da polpa dentária. Assim, a PBMT pode ser importante na determinação da qualidade mecânica das CSs, o que pode favorecer a terapia celular, facilitando o transplante das células-tronco. / Photobiomodulation therapy (PBMT) improves processes relevant to tissue regeneration. The technique of cell sheets (CSs) can generate large amount of cells organized in an extracellular matrix (ECM) produced by these cells. The constitution of the ECM of CSs could be of importance for tissue regeneration. Type I collagen, fibronectin and tenascin are ECM proteins already detected in CSs of human dental pulp stem cells. The aim of this study was to investigate the effects of different PBMT parameters on the architecture (histology), protein composition (Western blotting and immunohistochemistry) and ultrastructure (SEM and MET) of the MEC of CSs of human dental pulp stem cells. Dental pulp stem cells were thawed and recharacterized by the expression profile of the surface molecules using flow cytometry for mesenchymal stem cells (MSC) -associated (CD105, CD146 and CD44,) and non associated (CD45, CD34 and CD14) markers. The CSs were formed in cell culture plates after 15 days in culture in clonogenic medium supplemented with vitamin C (20 ?g/ml). The cell cultures were allocated in 3 different experimental groups, as follows: Control: no further treatment; PBMT1 and PBMT2. PBMT was performed with CW red diode laser applying the following general parameters: 660nm, 20mW, 0.028cm2 spot size and 0.71W/cm2. The PBMT1 parameters were: 4s, 3J/cm2 and 0.08J per point, and the PBMT2: 7s, 5J/cm2, and 0.14J per point. The irradiations were done on alternate days throughout the experimental time, in a punctual mode (5 points/well or 13 points/100mm-diameter dishes) in contact at the base of the plate. After the CSs formation, 15 days after plating, they were submitted to histology, immunohistochemistry, Western blotting, transmission electron microscopy and scanning electron microscopy analyses. Statistical comparisons were performed (p<0.05). The cells presented the classical immunoprofile of MSCs showing the expression of MSCs-associated markers, whereas the expression of the MSCs non-associated markers were absent. The type I collagen, type III collagen and fibronectin were present in the MEC of the CSs. Western blotting revealed a higher amount of fibronectin in the CSs submitted to PBMT1. The overall ultrastructure of the CSs was diverse in the 3 experimental groups. PBMT1 leads to epithelial-like CS, whereas the PBMT2 leads to a CSs with isolated fusiform cells arranged in unidirectional bundles. MET identified a more mature ECM and signs of apoptosis in the PBMT groups. PBMT may influence the composition and ultrastructure of the ECM of CSs of dental pulp stem cells. Thus, PBMT could be of importance in the determination of the mechanical quality of CSs, which may favor cell therapy by improving the CS transplantation approach.