Bone marrow stem cells rejuvenation using lentivirus SATB-2 for alveolar bone loss prevention in postmenopausal osteoporosis: A review

Ministry of Health Republic of Indonesia in 2006 found that 2 out of 5 Indonesian population was at risk of osteoporosis. This finding was higher than global osteoporosis risk which was only 1 to 3 ratios. Mean national prevalence of osteoporosis reaches 41.75%, among which 53% is dominated by women in 70-80 years of age. Women are 4 times more likely to develop osteoporosis than men due to post-menopausal estrogen deficiency. Low estrogen level shifts dynamic bone metabolism to bone catabolic process. Furthermore, the aging of Bone Marrow Stem Cells (BMSCs) also progressively have reduced stemness to regenerate new bone. Consequently, alveolar bone becomes less dense and prones to fracture and gingival recession.BMSCs are multipotent cells that can proliferate and differentiate into other cell types, such as osteoblasts. Postmenopausal women, not only experienced bone loss due to low estrogen level, yet also suffer impaired BMSCs ability to generate new bone. SATB-2 is a transcription factor that can upregulate anti-aging regulator Nanog activity as well as induce osteoblastogenesis. Insertion of SATB-2 gene to BMSCs by lentivirus vector results in sustainable BMSCs SATB-2 overexpression thus preventing alveolar bone resorption. In conclusion, SATB2 gene transfection to aging-BMSCs can rejuvenate these cells and prevent alveolar bone loss in post-menopausal women.