Effects of hypoxic culture on bone marrow mesenchymal stem cells: From bench to bedside

Human bone marrow-derived mesenchymal stem cells (MSCs) have emerged as a promising tool for clinical applications, which require developing techniques and protocols of cell expansion to overcome cell senescence, loss of pluripotent gene expression, decrease in self-renewal and differentiation potential, low engraftment after in vivo transplantation, and rejection by allogeneic recipients. Moreover, the expanded cells should have normal karyotype and genome integrity to prevent tumorigenic transformation. Cultivation of MSCs under hypoxic conditions, the normal physiologic status of bone marrow, represents a new platform of MSC expansion for clinical applications. This article reviews the effects of hypoxic culture on MSCs, especially for translation from bench to bedside, emphasizing hypoxia as an important factor in all of the major aspects of MSC biology.