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Journal of Translational Medicine logoLink to Journal of Translational Medicine
. 2024 May 15;22:459. doi: 10.1186/s12967-024-05294-5

Unveiling heterogeneity in MSCs: exploring marker-based strategies for defining MSC subpopulations

Si Chen 1,#, Bowei Liang 1,#, Jianyong Xu 2,3,
PMCID: PMC11094970  PMID: 38750573

Abstract

Mesenchymal stem/stromal cells (MSCs) represent a heterogeneous cell population distributed throughout various tissues, demonstrating remarkable adaptability to microenvironmental cues and holding immense promise for disease treatment. However, the inherent diversity within MSCs often leads to variability in therapeutic outcomes, posing challenges for clinical applications. To address this heterogeneity, purification of MSC subpopulations through marker-based isolation has emerged as a promising approach to ensure consistent therapeutic efficacy. In this review, we discussed the reported markers of MSCs, encompassing those developed through candidate marker strategies and high-throughput approaches, with the aim of explore viable strategies for addressing the heterogeneity of MSCs and illuminate prospective research directions in this field.

Keywords: Mesenchymal stem/stromal cells, MSCs, Subpopulation, Cell markers, Identity

Introduction

MSCs (mesenchymal stem/stromal cells) are heterogenous cell populations, residing in various tissues (such as bone marrow, umbilical cord, teeth, adipose, and so on). Differing from other types of adult stem cells or terminal differentiated cells, the main function of MSCs is sensing and responding to micro-environmental disturbances. Due to their innate characteristics and functions, they have multiple ways to respond to micro-environmental changes, such as extracellular matrix modification, recruiting other cells (the immune cells, for example), secreting small factors with various functions (immune modulation and regeneration, for example) [1]. It is well-known that many diseases are resulting from micro-environment dysfunctions. Therefore, the MSCs have been intensively and extensively applied in treating different kinds of diseases. Both pre-clinical and clinical investigations have shown that the MSCs hold great promise in developing one new therapeutic approach for treating many kinds of diseases [15].

Soon after the first demonstration of MSCs, its therapeutic applications have been investigated for decades. Unfortunately, in contrast to the rapid growth of clinical trials, few of them eventually have been developed as applicable therapeutic products. In addition to other factors inducing the therapeutic inconsistency of MSCs, cell heterogeneity is one tough challenge in their way to achieve the expected clinical outcomes [1, 2, 4, 6, 7].

The heterogeneity of MSCs is reflected in different levels, such as the molecular levels (transcriptomics, proteomics, secretomics, and epigenomics), and the function levels (tri-lineage differentiation potentials, immunomodulatory capabilities, and regenerative activities) [2, 7, 8]. The heterogeneity of MSCs could be induced by various factors including the donor conditions (age, gender, health condition, genetic background, and so on), tissue origin, and the strategies to isolate and expand the MSCs (digestion enzyme, matrix protein, cell culture medium, passage number, and so on) [2, 6, 7, 912] (Fig. 1). The causes of MSC heterogeneity have been extensively described in the preceding reviews, and we will not delve into them further. Pluripotent stem cell derived MSC, which can avoid the heterogeneity induced by the aforementioned factors, is also an important category of MSCs [13, 14]. However, we will focus exclusively on MSCs derived from somatic cells under natural conditions in this review.

Fig. 1.

Fig. 1

Illustration of factors inducing MSC heterogeneity and potential solutions. The MSC heterogeneity results from various factors, including donor conditions (age, gender, health conditions), tissue origin (bone, fat, placenta/umbilical cord, teeth), and the methods employed for isolating (plastic adherence, MACS, FACS) and expanding MSCs (2D, 3D bioreactor, 3D matrix). To address MSC heterogeneity and enhance their therapeutic stability, three primary strategies are currently employed. These strategies encompass standardizing the MSC production procedures and purifying MSC subpopulations by markers. MSC mesenchymal stem/stromal cell, MACS magnetic-activated cell sorting, FACS fluorescence-activated cell sorting, 2D 2 dimensional, 3D 3 dimensional

Among different strategies to reduce the heterogeneity and improve the therapeutic consistency of MSCs, purifying the homogenous MSC subpopulations is suggested to yield more consistent clinical outcomes [6]. MSC subpopulations refer to distinct groups or subsets within the broader MSC population that are identified based on specific characteristics or markers. These characteristics can include surface protein expressions, functional properties, gene expression profiles, or responsiveness to different environmental cues. According to the minimal criteria for defining MSCs, stated by the International Society for Cellular Therapy in 2006 [15], 55 MSC markers have been identified so far from different tissues and species (Fig. 2, Table 1).

Fig. 2.

Fig. 2

Timeline of MSC marker identification

Table 1.

Basic information for MSC markers

Name Gene ID Aliases Full name Year published Positive (%) Tissue Species References
STRO-1 Antibody recogniziing unknown target 1991 5–66.5 Bone marrow Human 2070060
2004 6 Bone marrow Human 14715641
2009 6 Bone marrow Human 19143868
2010 13.3 Bone marrow Human 20162565
2011 n.d Adipose tissue Rat 21903091
2011 n.d Bone marrow Rat 21208041
2011 n.d Heart Rat 21208041
2011 n.d Leg muscle Rat 21208041
2011 n.d Aorta Rat 21208041
2011 n.d Rectum Rat 21208041
2011 n.d Adipose tissue Human 21208041
2011 n.d Prostate tissue Human 21208041
2017 11 Tooth germ Human 28686984
2019 1.0–9.6 Gingiva Human 30260000
2021 10 Dental follicle Human 33278647
2021 15 Periodontal ligament Human 33278647
2021 20 Dental pulp Human 33278647
CD34 947 CD34 molecule 1991 n.d Bone marrow Human 1720038
2007 1.8 Bone marrow Human 17786605
2016 n.d Placental amnion membrane Human 27405780
NT5E 4907

NT;

eN;

NT5;

NTE;

eNT;

CD73;

E5NT;

CALJA;

5'-nucleotidase ecto 1992 n.d Bone marrow Human 1316137
2006 n.d Chondrocyte Murine 16443378
2006 n.d Osteoblast precursors Human 16418778
2008 n.d Bone marrow Human 18086871
2017 44.8–69.1 Bone marrow Murine 28684854
2018 n.d Bone marrow Murine 29451855
2019 n.d Bone marrow Murine 31279774
2021 n.d Adipose tissue Human 33407847
NGFR 4804

CD271;

p75NTR;

TNFRSF16;

p75(NTR);

Gp80-LNGFR;

Nerve growth factor receptor 1993 n.d Bone marrow Human 7681701
2006 n.d Bone marrow Human 16977637
2007 n.d Bone marrow Human 17395729
2010 0.2–2.5 Bone marrow Human 20179086
2012 n.d Bone marrow Human 22268519
2012 n.d Bone marrow Human 22048731
2012 5.5 Adherent dermal Human 22048731
2012 31.4 Embryonic face Rat 22982680
2015 10.6 Dental pulp Human 26674422
2018 0.1–1.1 Bone marrow Human 29482445
2018 3.8–13 Bone marrow Human 29915318
2018 1.5–5.9 Adipose tissue Human 29915318
2018 0–0.5 Amniotic fluid Human 29915318
2018 0–0.5 Cord blood Human 29915318
2019 n.d Adipose tissue Human 30816233
2021 19.1–22.1 Adipose tissue Human 33653407
ENG 2022

END;

HHT1;

ORW1;

Endoglin 1996 n.d Bone marrow Human 8652367
2000 98 Bone marrow Human 10942523
2005 33.7–46.5 Bone marrow from young Human 16507351
2005 36.7–43.9 Bone marrow from old Human 16507351
2006 1.9–2.8 Bone marrow Human 16601078
2010 1.2–82.0 Adipose tissue Human 20153525
2011 n.d Synovium Rat 21205995
ALCAM 214

MEMD;

CD166;

Activated leukocyte cell adhesion 1997 n.d Bone marrow Human 9276087
1998 n.d Bone marrow Rat 9556065
1998 n.d Bone marrow Rabbit 9556065
1998 n.d Bone marrow Canine 9556065
1998 n.d Bone marrow Human 9556065
2002 5.7–91.4 Bone marrow Murine 12070283
2011 11.5–72.2 Cartilage Human 21787134
2011 n.d Bone marrow Horse 21782255
2011 n.d Adipose tissue Horse 21782255
2015 n.d Amniotic membrane Porcine 26540004
2020 n.d Bone marrow Human 34493362
2020 n.d Umbilical cord Human 34493362
MCAM 4162

CD146;

MUC18; HEMCAM; METCAM; MelCAM;

Melanoma cell adhesion molecule 1998 n.d Bone marrow Human 9529137
2003 n.d Bone marrow Human 12674330
2003 n.d Dental pulp Human 12674330
2007 n.d Bone marrow Human 17332507
2007 n.d Dental pulp Human 17332507
2007 1.3–1.7 Endometrial tissue Human 17872908
2011 n.d Bone marrow Human 21415267
2016 n.d Bone marrow Human 26753846
2016 12–25 Umbilical cord Human 26841872
2016 14.7–99.4 Bone marrow Human 26941359
2016 39.5 Periapical cyst Human 27406247
2019 60–90 Bone marrow Human 31002939
2020 34.6–65.6 Bone marrow Human 32379908
2021 11 Gingival tissue Human 33777147
2021 n.d Dental pulp Human 34461987
2022 70–80 Umbilical cord Human 35729643
THY1 7070

CD90;

CDw90;

Thy-1 cell surface antigen 1999 n.d Bone marrow Human 10102814
2009 n.d Bone marrow Murine 19841085
2009 95–100 Bone marrow Human 18985728
2009 32–75 Bone marrow Human 18985728
2009 38–96 Amnion Human 18985728
2009 63–91 Chorion Human 18985728
2014 n.d Incisor tooth Murine 25079316
2016 98 Dental pulp Human 27465541
2016 98 Adipose tissue Human 27465541
2016 98 Amniotic fluid Human 27465541
2018 30 Incisor pulp Murine 29371677
2018 8.8–10.2 Arterie Human 30008326
2019 n.d Cardiac Murine 31353772
ITGA1 3672

VLA1;

CD49a;

Integrin subunit alpha 1 2000 22–89 Bone marrow Human 10911362
2003 2.2–4.0 Bone marrow Human 12877680
2003 55 Bone marrow Human 12883998
2005 2.5–26.8 Bone marrow Human 15676216
2007 16.8 Bone marrow Human 17694277
2007 3.2–4.0 Bone marrow Human 17109120
2007 4–5 Bone marrow Murine 17109120
2007 1.0–1.2 Bone marrow Rat 17109120
CD9 928

MIC3;

MRP-1;

BTCC-1;

DRAP-27;

TSPAN29;

TSPAN-29;

CD9 molecule 2001 20–36 Adipose tissue Human 11573204
2007 18.4–32.6 Adipose tissue Human 17668233
Ly6a 110,454

TAP;

Sca1;

Sca-1;

Ly-6A.2;

Ly-6A/E;

Ly-6E.1;

Lymphocyte antigen 6 family member A 2003 n.d Bone marrow Murine 12732718
2003 n.d Bone marrow Murine 14616976
2008 75.0–90.6 Ear Murine 18599810
2017 n.d Bone marrow Murine 27734598
2021 20.3 Lung Murine 34341173
2022 n.d Lung Murine 35445270
CXCR4 7852

FB22;

HM89;

LAP3;

LCR1;

NPYR;

WHIM;

CD184;

LAP-3;

LESTR;

NPY3R;

NPYRL;

WHIMS;

HSY3RR;

NPYY3R;

WHIMS1;

D2S201E;

C-X-C motif chemokine receptor 2004

Cell surface: 0–1;

Intracellular: 83–98

Bone marrow Human 15251986
2006 30–56 Bone marrow Human 16253981
2006 11.5–21.6 Cord blood Human 16410389
2006 14.7–21.5 Bone marrow Human 16410389
2007 87.4–97.8 Bone marrow Human 17606439
2008 n.d Bone marrow Human 18334485
2008

Cell surface: 0.5–4.1;

Intracellular: 51–75

Bone marrow Human 18728032
2012

Cell surface: 20.9–25.1;

Intracellular: 71.8–83.2

Fetal blood Human 23197643
2014 90–100 Bone marrow Rat 24626964
2014 8.4–11.0 Umbilical cord Rat 25098450
2017 n.d Bone marrow Murine 28352314
2020 15.0–34.4 Bone marrow Murine 32418119
CD274 29,126

B7-H;

B7H1;

PDL1;

PD-L1;

hPD-L1;

PDCD1L1;

PDCD1LG1;

CD274 molecule 2005 n.d Bone marrow Murine 15827960
2008 n.d Bone marrow Murine 18607390
2020 n.d Bone marrow Murine 32509271
2020 n.d Gingiva tissue Human 32707035
CD44 960

IN;

LHR;

MC56;

MDU2;

MDU3;

MIC4;

Pgp1;

CDW44;

CSPG8;

H-CAM;

HCELL;

ECM-III;

HUTCH-1;

HUTCH-I;

ECMR-III;

Hermes-1;

CD44 molecule 2006 n.d Bone marrow Murine 16306150
2006 25.5–39.1 Ap8c3 Rat 16306150
2007 n.d Bone marrow Murine 17507906
2012 38–52 Bone marrow Murine 22654106
2013 n.d Bone marrow Human 23847000
2018 n.d Neural crest Human 29571051
GD2 2007 95 Bone marrow Human 17264296
STRO-3 Antibody recogniziing TNSALP(tissue nonspecific alkaline phosphatase, a cell-surface glycoprotein) 2007 n.d Bone marrow Human 8158854
2009 n.d Bone marrow Sheep 19231391
2010 n.d Bone marrow Sheep 20850099
2011 n.d Bone marrow Human 21155976
2012 n.d Bone marrow Sheep 22404141
2013 n.d Bone marrow Sheep 23658436
2017 n.d Bone marrow Sheep 28173831
2021 n.d Bone marrow Human 33045417
FZD9 8326

FZD3;

CD349;

Frizzled class receptor 9 2007 n.d Placenta Human 17288545
2007 n.d Bone marrow Human 17288545
2008 n.d Placenta Human 17924962
2011 n.d Placenta Human 20658518
PDGFRB 5159

IMF1;

KOGS;

IBGC4;

JTK12;

PDGFR;

PENTT;

CD140B;

PDGFR1;

PDGFR-1;

Platelet derived growth factor receptor beta 2007 69.0–74.2 Endometrial tissue Human 17872908
SSEA-4 Stage-specific embryonic antigen-4 2007 71 Bone marrow Murine 17062733
2010 33.3 Periodontal ligament Human 19945209
2012 22.7 Periodontal ligament Human 22895512
2012 45.5 Dental pulp Human 22266579
2013 11–99.6 Bone marrow Human 23330736
2014 n.d Adipose tissue Human 25123923
2017 70–86 Bone marrow Human 29078802
KIT 3815

PBT;

SCFR;

C-Kit;

CD117;

MASTC;

KIT proto-oncogene, receptor tyrosine kinase 2007 n.d Adipose tissue Human 17348807
2014 0.5 Adipose tissue Human 24713343
2014 n.d Adipose tissue Murine 24713343
ABCG2 9429

MRX;

MXR;

ABCP;

BCRP;

BMDP;

MXR1;

ABC15;

BCRP1;

CD338;

GOUT1;

MXR-1;

CDw338;

CDw388;

UAQTL1;

EST157481;

ATP binding cassette subfamily G member 2 2011 n.d Lung Murine 21312316
CD200 4345

MRC;

MOX1;

MOX2;

OX-2;

CD200 molecule 2008 n.d Bone marrow Human 18086871
2012 7.5–69.6 Bone marrow Human 22363701
2012 0.4–0.5 Umbilical cord blood Human 22363701
2012 90 Heart Human 22575528
2012 25 Bone marrow Human 22575528
2012 0–10 Adipose tissue Human 22575528
2014 70.5

Full-term placenta

(fetal origin)

Human 24721710
2014 1.8

Full-term placenta

(maternal origin)

Human 24721710
2016 23–63.4 Bone marrow Human 26773707
2017 80 Bone marrow Murine 28295880
PODXL 5420

PC;

PDX;

PCLP;

Gp200;

gp135;

PCLP-1;

PODXL1;

Podocalyxin like 2009 n.d Bone marrow Human 18818395
ITGA6 3655

JEB6;

CD49f;

VLA-6;

ITGA6A;

ITGA6B;

Integrin subunit alpha 6 2009 n.d Bone marrow Human 18818395
2012 n.d Umbilical cord blood Human 22311737
2013 n.d Bone marrow Human 23132820
2013 n.d Umbilical cord blood Human 23132820
2015 45.7–78.5 Fetal bone marrow Human 26013602
2015 11 Adult bone marrow Human 26013602
2020 n.d Aorsal skin Murine 31494092
2021 5.3–17.7 Adipose tissue Rat 33704842
STRO-4 Antibody recogniziing Hsp90β 2009 99.9 Bone marrow Human 19327008
2009 92.3 Adipose tissue Human 19327008
2009 95 Dental pulp Human 19327008
2009 86.2 Periodontal ligament Human 19327008
2009 99.9 Bone marrow Sheep 19327008
2009 91.9 Adipose tissue Sheep 19327008
2009 99.9 Dental pulp Sheep 19327008
2009 99.4 Periodontal ligament Sheep 19327008
CSPG4 1464

NG2;

MCSP;

MCSPG;

MSK16;

CSPG4A;

HMW-MAA;

MEL-CSPG;

Chondroitin sulfate proteoglycan 4 2009 13.3–89.8 Bone marrow Human 19462316
2013 n.d Bone marrow Murine 24107994
2013 95–100 Bone marrow Human 23611563
NCAM1 4684

CD56;

NCAM;

MSK39;

Neural cell adhesion molecule 1 2009 n.d Bone marrow Human 19066333
2016 22.8–95.9 Bone marrow Human 27528376
2019 1–35 Bone marrow Human 30676001
PDGFRA 5156

CD140A;

PDGFR2; PDGFR-2;

Platelet derived growth factor receptor alpha 2009 n.d Bone marrow Murine 19841085
2012 5–10 Bone marrow Murine 23154782
2013 79–85 Bone marrow Human 23776077
2014 10–73 Muscle Human 24743741
2014 n.d Bone marrow Human 25454633
2018 n.d White adipose tissue Murine 29378823
2018 n.d Bone marrow Murine 29378823
2018 6.8 Bone marrow Murine 29529192
NES 10,763 Nbla00170 Nestin 2010 n.d Bone marrow Murine 20703299
2013 n.d Bone marrow Human 23776077
2015 n.d Kidney Murine 25736496
2019 1.8–2.3 Bone marrow Murine 31029167
2020 15.3–18.5 Heart Murine 31991111
2020 3.7–4.6 Bone marrow Murine 31991111
VCAM1 7412

CD106;

INCAM-100;

Vascular cell adhesion molecule 1 2010 n.d Bone marrow Murine 20130212
2013 65 Placental chorionic villi Human 23555021
2013 32 Bone marrow Human 23555021
2013 7.4 Umbilical cord Human 23555021
2013 0.7 Adipose tissue Human 23555021
2013 n.d Bone marrow Human 24052950
2016 57.5–68.3 Placenta chorionic villi Human 27044487
2020 n.d Umbilical cord Human 32597552
2022 n.d Umbilical cord Human 35768999
ENTPD1 953

CD39;

SPG64; ATPDase; NTPDase-1;

Ectonucleoside triphosphate diphosphohydrolase 1 2011 n.d Bone marrow Murine 21176405
2013 n.d Synovial membrane Human 23804221
2014 84.3 Bone marrow Human 24043462
2017 n.d Gingiva tissue Human 28210258
2019 n.d Gingiva tissue Human 31076346
2020 n.d Gingiva tissue Human 32565049
EPHB2 2048

DRT;

EK5;

ERK;

CAPB;

Hek5;

PCBC;

EPHT3;

Tyro5;

BDPLT22;

EPH receptor B2 2011 n.d Bone marrow Human 21056708
2013 n.d Bone marrow Human 23413357
2013 n.d Bone marrow Human 23711177
MX1 4599

MX;

MxA;

IFI78;

IFI-78 K;

lncMX1-215;

MX dynamin like GTPase 1 2012 n.d Compact bone Murine 22385654
SUSD2 56,241

W5C5;

BK65A6.2;

Sushi domain containing 2 2012 3.6–4.8 Endometrial tissue Human 22469435
2013 n.d Bone marrow Human 23406305
2021 5.1 Placenta Human 33961124
ITGAV 3685

CD51;

MSK8;

VNRA;

VTNR;

Integrin subunit alpha V 2013 16 Bone marrow Human 23776077
2013 76–82 Bone marrow Murine 23776077
2015 2.4–24 Periodontal ligament Human 26674423
2019 1.4 Bone marrow Murine 31747966
2021 13.4 Heart Murine 33968928
TNFAIP6 7130

TSG6;

TSG-6;

TNF alpha induced protein 6 2014 n.d Bone marrow Human 25385603
2022 13.7–92.3 Bone marrow Murine 36153571
2022 n.d Placenta Murine 36153571
2022 n.d Adipose tissue Murine 36153571
GLI1 2735

GLI;

PPD1;

PAPA8;

GLI family zinc finger 1 2014 79.9–80.1 Incisor pulp Murine 24506883
2015 n.d Craniofacial bone Murine 25799059
2015 32 Bone marrow Murine 25465115
2017 n.d Bone marrow Human 28457748
2017 n.d Bone marrow Murine 28457748
2020 n.d Periodontal ligament Murine 32652075
2020 n.d Pulp tissue Murine 32783935
2020 n.d Lung Human 33046884
2022 n.d Bone marrow Murine 36092701
LEPR 3953

OBR;

OB-R;

CD295;

LEP-R;

LEPRD;

Leptin receptor 2014 0.3 Bone marrow Murine 24953181
2016 0.2–0.4 Bone marrow Murine 27053299
2018 n.d Bone marrow Murine 33221380
EPHA2 1969

ECK;

CTPA;

ARCC2;

CTPP1;

CTRCT6;

EPH receptor A2 2015 n.d Bone marrow Human 25684225
2015 n.d Adipose tissue Human 25684225
2018 n.d Bone marrow Human 29941036
2015 45.0–80.7 Placenta Human 26700997
2015 n.d Umbilical cord Human 26700997
2018 n.d Umbilical cord Human 30342659
2020 n.d Wharton's Jelly Human 32899389
BST2 684

CD317;

HM1.24; TETHERIN;

Bone marrow stromal cell antigen 2 2015 1–3 Bone marrow Human 26070611
2022 n.d Bone marrow Human 35734183
ISLR 3671

Meflin;

HsT17563;

Immunoglobulin superfamily containing leucine rich repeat 2016 n.d Bone marrow Murine 26924503
TLX1 3195

TCL3;

HOX11;

T cell leukemia homeobox 1 2016 n.d Bone marrow Murine 27939685
2019 n.d Bone marrow Murine 31320650
ALDH1A1 216

ALDC;

ALDH1;

HEL-9;

HEL12;

PUMB1;

ALDH11;

RALDH1;

ALDH-E1;

HEL-S-53e;

Aldehyde dehydrogenase 1 family member A1 2017 n.d Adipose tissue Human 28233376
2023 n.d Adipose tissue Human 37261440
TNFRSF10D 8793

DCR2;

CD264; TRUNDD; TRAILR4; TRAIL-R4;

TNF receptor superfamily member 10d 2017 20–35 Bone marrow Human 28962588
LGR6 59,352

GPCR;

VTS20631;

Leucine rich repeat containing G protein-coupled receptor 6 2017 n.d Lung Murine 28886383
LGR5 8549

FEX;

HG38;

GPR49;

GPR67;

GRP49;

Leucine rich repeat containing G protein-coupled receptor 5 2017 n.d Lung Murine 28886383
ROR2 4920

BDB;

BDB1;

NTRKR2;

Receptor tyrosine kinase like orphan receptor 2 2017 6.7–40.9 Bone marrow Human 28833807
CMKLR1 1240

DEZ;

ERV1;

RVER1;

ChemR23;

CHEMERINR;

Chemerin chemokine-like receptor 1 2017 n.d Bone marrow Murine 27733019
2022 n.d Bone marrow Human 35365767
2022 n.d Bone marrow Human 35723360
SDC2 6383

HSPG;

CD362;

HSPG1;

SYND2;

Syndecan 2 2018 0.1–0.2 Bone marrow Human 29979191
2020 n.d Umbilical cord Human 32169108
2020 n.d Umbilical cord Human 33158246
HMMR 3161

CD168;

IHABP;

RHAMM;

Hyaluronan mediated motility receptor 2019 1.3–1.8 Umbilical cord Human 31068579
F3 2152

TF;

TFA;

CD142;

Coagulation factor III; tissue factor 2020 20 Umbilical cord Human 32252818
2023 9.5 Wharton's Jelly Human 36504438
EPHA7 2045

EHK3;

EK11;

EHK-3;

HEK11;

EPH receptor A7 2020 5–20 Peripheral tissues Murine 31471947
SERPINF1 5176

OI6;

OI12;

PEDF;

EPC-1;

PIG35;

Serpin family F member 1 2022 n.d Lung Murine 35445270
S100A9 6280

MIF;

NIF;

P14;

CAGB;

CFAG;

CGLB;

L1AG;

LIAG;

MRP14;

60B8AG;

MAC387;

S100-A9;

S100 calcium binding protein A9provided 2023 9.5 Wharton's Jelly Human 36504438
LRRC75A 388,341

FAM211A;

C17orf76;

Leucine rich repeat containing 75A 2023 n.d Bone marrow Human 37263619

''n.d.' indicates 'not determined'

Function enrichment by GO (Gene Ontology) analysis indicates that these MSC markers mainly regulate the process of leukocyte migration, wound healing, cell chemotaxis, and so on (Fig. 3A). Although some markers are involved in multiple functions, some of them are also cross-interacted in a network way (Fig. 3B). KEGG (Kyoto Encyclopedia of Genes and Genomes) also indicates that these MSC markers are mainly involved in the signal pathways in PI3K-AKT, adhesion, and so on (Fig. 4A). Similar to the GO analysis, some markers regulated multiple pathways (Fig. 4B) and they are cross-interacted (Fig. 4C). Most of these MSC markers are localized on the cell membrane, which is suitable for cell purification with FACS (fluorescence-activated cell sorting) and MACS (magnetic-activated cell sorting), while some of them are also intracellularly or extracellularly localized (Table 2). Normally, MSCs enriched with specific makers have functional advantages (Table 2). However, in some cases, these enriched MSCs also have some disadvantages (Table 2).

Fig. 3.

Fig. 3

GO analysis of MSC markers. The bioinformatic analysis of GO enrichment of MSC markers was performed with Dotplotting (A), Cnetplotting (B). GO, gene ontology. MSC mesenchymal stem/stromal cell

Fig. 4.

Fig. 4

KEGG analysis of MSC markers. The bioinformatic analysis of KEGG enrichment of MSC markers was performed with Dotplotting (A), Cnetplotting (B), and Emapplotting (C). Bioinformatic analysis was conducted with package ‘enrichplot’ in R. KEGG, kyoto encyclopedia of genes and genomes. MSC mesenchymal stem/stromal cell

Table 2.

Pros and cons of MSC markers

Markers Cellular localization Generation Pros Cons Refs
TNFAIP6 Extracellular (Secreted) 1st Efficacy predictor of MSCs in treating inflammation Low purfiying efficiency

25385603

36153571

Higher immune suppression activities improved therapeutic effects
Improved therapeutic effects
ALDH1A1 Intracellular (Cytosol) 1st More primitive cell proliferation and tri-differentiation capabilites 37261440
STRO-1 Antibody recognizing unknown target 1st Multilineage differentiation capabilities Heterogenous

19143868

14715641

33278647

21903091

28686984

30260000

Higher level of colony-forming activities Expression level declines during passaging
Higher level of proliferative rate Not specific,also expressed in endothelium
Higher level of immune suppression
Better homing activities
Expression level increases significantly during osteogenic differentiation
ALCAM Membrane 1st Purify human MSCs from fibroblasts Not specific, expressed in other types of cells

7535342

7760007

21787134

23280653

34493362

More prone to differentiate into chondrocytes
NT5E Membrane 1st Identify the MSCs in different organs in vivo Expression level decreases during the differentiation process

16443378

16418778

18086871

29451855

31279774

28684854

33407847

34055772

Higher level of colony-forming capabilities
Higher immune suppression activities
Much higher tri-differentiation abilities
Higher level of regeneration cytokines
Improved therapeutic effects
Much more smaller with spindle and rod-like shapes
ITGA1 Membrane 1st Stronger colony-forming activity Expression levels upregulated during osteogenic differentiation

10911362

12877680

17694277

17109120

12883998

Stronger differentiation capabilities Not specific, also expressed in myofibroblasts
Higher expression levels of THY-1 and ENG
CXCR4 Membrane 1st Contributes to MSCs homing Expression level is low on the cell surface

15251986

17606439

12357350

15837815

18728032

23197643

11283404

15153618

24626964

25098450

16410389

32418119

Enhanced homing activities Expression level decreases during passaging
Expression level decreases during aging
CD9 Membrane 1st Higher NOS (nitric oxide synthase) expression Expression level declines during in vitro expansion

17668233

30356731

Higher proliferation rate Not specific,also expressed in lymphocytes
Higher colony formation ratio
Stronger cell adhesion capability
Better engraftment
Improved therapeutic effect
CD44 Membrane 1st Contributes to the MSC recruitment Gradually up-regulated during cell expansion

16306150

17507906

29571051

22654106

23847000

Contributes to migration and adhesion of MSCs Widely expressed in multiple types of cells
Enhanced colony-forming capacity Very low level in bone marrow MSCs
Enhanced in vitro differentiation abilities
GD2 Membrane 1st Much higher proliferation 17264296
Higher colony formation capabilities
Better differentiation abilities
MCAM Membrane 1st Enhanced colony formation capabilities Expression declines during in vitro expansion

17956733

17872908

26753846

31002939

33777147

26841872

34461987

35729643

32379908

24188055

26941359

31070478

Much higher colony-forming Expressed in many cell type
Much stronger chemotactic attraction
Enhanced immune suppression activities
Enhanced immune suppression and secretory capacities
More prone to differentiate into vascular smooth muscle cell
Less senescent phenotypes
Faster proliferation rate
Stronger stemness characteristics
CD200 Membrane 1st Much higher level of colony-forming activity Down-regulated during differentiation

18086871

24721710

28295880

26773707

Enhanced immune suppression activities Low level of CD200 expression in MSCs derived from adipose
Contributes to immune suppression Expression is not induced by IFN-γ in AD and UC derived MSCs
Contributes to myeloid differentiation inhibition
Prone to differentiate into the osteocytes
Ly6a Membrane 1st Contributes to maintain the stem cell state of MSCs Heterogenous

12732718

18599810

34341173

35445270

17379763

Higher proliferation rate Not specific,expressed in multiple types of stem cells
Better immune suppression abilities
THY1 Membrane 1st Contributes to regulate the balance between osteoblasts and adipocytes differentiation Not specific,expressed in the fibroblasts

30089635

18985728

26718647

29371677

25739049

Predict the immune suppressive function
Proliferate faster and better differentiation capabilities
ITGA6 Membrane 1st Higher colony-forming activities Not specific,expressed in multiple types of cells

18818395

22311737

23132820

26013602

31494092

33704842

29720266

Higher differentiation abilities
Smaller size
Better homing activities
Better regeneration activity
Better anti-apoptotic activities
STRO-4 Antibody recognizing the Hsp90β 1st Higher colony-forming activities 19327008
Higher proliferation rate
Higher multiple differentiation abilities
ENTPD1 Membrane 1st Contributes to suppress T cell proliferation

21176405

24043462

28210258

32565049

23804221

31076346

Contributes to suppress activation of B cells
Better efficiency of chondrogenic and osteogenic differentiation
Prevent osteoclastogenesis
CSPG4 Membrane 1st Enhanced proliferation abilities Not specific, expressed in fibroblast and endothelial cells

23611563

19462316

Enhanced colony-forming abilities
Enhanced differentiation abilities
MX1 Intracellular (cytosol, nuclear membrane) 1st Prone to differentiate into osteoblasts and regenerate the bone 22385654
ITGAV Membrane 1st Faster proliferating rate

31747966

33968928

Better abilities of colony-forming
Better homing ability
Better anti-inflammatory effects
Therapeutic effects in the mouse model of myocardial infarction
STRO-3 Antibody recognizing the TNSALP 1st Higher proliferation and differentiation potencies

18158854

19231391

20850099

21155976

22404141

23658436

26799116

28173831

33045417

Have been applied in treating disease models
GLI1 Intracellular (nucleoplasm, cytosol) 1st Responsible for tissue regeneration after injury Prone to differentiate into osteochondrogenic lineages

24506883

27618218

29230039

33046884

36092701

25799059

25465115

28457748

32783935

Contributes to tissue fibrosis
Heterogenous
ISLR Extracellular (secreted) 1st Predict differentiation efficiency Expression in fibroblast

26924503

34676218

Enhanced anti-fibrosis functions
TNFRSF10D Membrane 1st Reduced proliferation rate and differentiation efficiency 28962588
Increased senescence phenotype
EPHA7 Membrane 1st Proliferate faster 31471947
Higher level of colony-formation
Higher level of differentiation capabilities
SDC2 Membrane 1st Enhanced colony forming

29979191

32169108

33158246

34746723

Enhanced immune suppression
Enhanced regeneration activities
Safe, feasible, and effective in clinics
ENG Membrane 1st Reduced adipogenic differentiation efficiency

20153525

21205995

23069852

33800564

Contravercy on the osteogenic and chondrogenic differentiation efficiency
Not specific,expressed in activated ECs and immune cells
NGFR Membrane 1st Higher colony forming activity

12135677

16977637

17395729

22268519

29482445

29915318

22048731

22982680

30816233

33653407

Proliferate faster
Enhanced immune suppression activity
Higher tri-differentiation efficiency
Improved therapeutic effects
NES Intracellular (intermediate filaments) 1st A MSC subpopulation constituting the niche for HSCs

20703299

31029167

Improved therapeutic effects
FZD9 Membrane 1st CD349 MSCs have better neovascularization abilities 20658518
CD34 Membrane 1st Higher colony forming activity A marker of endothelial cells

1720038

17786605

PDGFRB Membrane 1st Contributes to maintain MSC functions

14766732

16210003

17872908

Higher colony-forming activities
SSEA-4 Membrane 1st Enrich MSC populations 17062733
NCAM1 Membrane 1st Enhanced chondrogenic differentiation potentials Not specific

19066333

30676001

Supporting long-term hematopoiesis
VCAM1 Membrane 1st Contributes to immune suppression function of MSCs Colony-forming ability varies among different MSCs

20130212

23555021

32597552

24052950

27044487

35768999

Stronger ability to suppress immune responses Expression level decreases during expansion
Enhanced homing capacity CD106 expression varies among MSCs derived from different tissues
Better pro-angiogenic activity
LEPR Membrane 1st Much higher colony-forming activities

24953181

27053299

Promotes adipose differentiation of MSCs while inhibit osteogenesis
PDGFRA Membrane 1st Enhanced differentiation activities Expressed in human skeletal muscle

19841085

23776077

29529192

Enhanced differentiation activities Species differences
SUSD2 Membrane 1st Higher clonogenicity 22469435
EPHB2 Membrane 1st Improves intestinal homing abilities 23413357
Promotes the intestinal stem cell regeneration
KIT Membrane 1st Better cell proliferative

17348807

24713343

Enhanced clonogenic activities
EPHA2 Membrane 1st Distinguish MSCs from fibroblasts Not specific,expressed in epithelial cells

26700997

30342659

32899389

28171762

32811512

BST2 Membrane 1st Up-regulated mRNA levels of immunosuppressive genes The fresh CD317 BM-MSCs have better immune suppression activities

26070611

35734183

unpublished data

Better regeneration capabilities
Better immune suppression capabilities of UC-MSCs in CDM
TLX1 Intracellular 1st Better colony forming potentials

27939685

31320650

Better tri-lineage differentiation
ROR2 Membrane 1st Enhanced chondrogenic differentiation efficiency 28833807
CD274 Membrane 1st Enchanced immune suppression activities Widely expressed on multiple types of cells, such as lymphocytes 32707035
Improved therapeutic effects
ABCG2 Membrane 1st Higher telomerase activity 21312316
Better anti-inflammatory effects
PODXL Membrane 1st Higher colony-forming activities

18818395

22311737

23132820

26013602

31494092

33704842

Higher differentiation abilities
Smaller size
Better homing activities
Better regeneration activity
Better anti-apoptotic activities
S100A9 Extracellular (secreted) 2st Enhanced wound repair capabilities 36504438
F3 Membrane 2st Better regeneration abilities Lower proliferation

32252818

36504438

LRRC75A Intracellular (nucleoplasm) 2st Better VEGF production 37263619
SERPINF1 Extracellular (secreted) 2st Stable 35445270
CMKLR1 Membrane 2st Stronger immune suppression activities Slower proliferation rate 35365767
Better osteogenic differentiation potential Weaker adipogenic differentiation potentials
HMMR Membrane 2st Related to cell cycle status 31068579
LGR5 Membrane 2st Promote alveolar differentiation A marker for epithelial stem cells

26460010

28886383

LGR6 Membrane 2st Supports the airway differentiation A marker for epithelial stem cells

26460010

28886383

Supports the Lgr5 + epithelial stem cells turnover

There are various strategies available for biomarker discovery, and among them, two classic approaches stand out: the candidate biomarker strategy and the high-throughput screening strategy. The candidate biomarker strategy is based on existing biological knowledge, where one or more molecules or features possibly related to a specific disease or biological process are selected as candidate biomarkers. These candidates are then experimentally validated for their expression levels or variations under different conditions. This strategy relies heavily on a profound comprehensive understanding of medical domains and relevant biological processes [16]. In contrast, the high-throughput screening strategy employs techniques like genomics, transcriptomics, proteomics, lipidomics, and metabolomics to simultaneously analyze a large number of molecules and features. Through these techniques, it becomes feasible to detect thousands of molecules, facilitating the comparison of differences between heterogenous cell populations. Notably, this approach allows for the identification of biomarkers associated with specific functions without being reliant on prior knowledge [1620]. It's worth noting that these strategies can be combined to enhance the comprehensive development of potential biomarkers. This integrated approach harnesses the biological knowledge of the candidate biomarker strategy while utilizing the technical capabilities of the high-throughput strategy to discover biomarkers associated with distinct functional subgroups in a more comprehensive and precise manner [16, 2124]. In the realm of MSCs, with the use of prior knowledge and high-throughput technologies such as single-cell RNA sequencing (scRNA-seq), specific markers related to different functional subsets of mesenchymal stem cells can be more comprehensively and accurately mined [1724].

Therefore, in the current review, we would discuss the MSC markers that have been identified so far. Furthermore, based on the identification approaches, these markers have been categorized into two groups: the 1st generation of MSC markers, which has been identified by the candidate biomarker strategy; and the 2nd generation of MSC makers, which has been identified by high-throughput screening approaches (Table 2).

Techniques of identifying mesenchymal stem cell subpopulations

In most studies reviewed in this paper, Flow cytometry and fluorescence-activated cell sorting (FACS) is predominantly utilized for sorting MSC subpopulations. FACS are the primary methods for identifying MSC subpopulations, celebrated for their precision and versatility in scientific research. These technologies use fluorescently labeled antibodies to target specific surface markers, allowing researchers to conduct multiparameter analyses [25, 26]. This facilitates simultaneous assessment of various markers and functional properties within MSC populations, aiding in the identification and isolation of distinct subpopulations based on differential expression of markers. Such detailed analysis provides crucial insights into MSC heterogeneity.

Another vital technique, immunomagnetic cell sorting, utilizes magnetic beads tagged with antibodies targeting specific surface markers for selective isolation of MSC subpopulations [27, 28]. This method ensures high specificity and efficiency, essential for distinguishing and harvesting functionally diverse MSC subsets.

Additionally, functional assays are integral for understanding the biological characteristics of MSC subpopulations. Immunomodulatory assays, for instance, involve co-culture setups with immune cells to evaluate MSCs' effects on immune cell proliferation, activation, and cytokine production [2933]. These studies highlight the potential therapeutic uses of distinct MSC subsets in treating immune-related conditions. Differentiation assays, including those for osteogenic, adipogenic, and chondrogenic pathways, further elucidate the multilineage potential of MSC subpopulations, critical for identifying suitable cell sources for tissue engineering and regenerative medicine.

Gene expression profiling, through techniques such as RNA sequencing, provides deep insights into the transcriptomic landscapes that define specific functional states or lineage commitments within MSC populations [1719, 23, 34]. These analyses help pinpoint molecular signatures characteristic of unique MSC subsets, enhancing our understanding of their heterogeneity.

Together, these techniques not only facilitate a comprehensive analysis of MSC heterogeneity but also specialize in pinpointing distinct MSC subpopulations. By employing these advanced methodologies, researchers can effectively characterize the diverse functional capacities and biological properties inherent to each subpopulation, significantly enhancing the precision of mesenchymal stem cell-based therapeutic strategies and the development of personalized regenerative medicine.

1st generation of MSC markers

Immune suppression related markers

Although the MSCs have been widely investigated in the animal models of different diseases, the only approved clinical product of MSCs is for GVHD (Graft Versus Host Disease) treatment in clinics [35, 36], because of their immune suppression capabilities. The immune modulation activity is one of those important contributors to the therapeutic effects of MSCs [1].

Extracellular secreted modulators

It has been demonstrated that TNFAIP6 (Tumor Necrosis Factor Alpha-Induced Protein 6) is a potential cell marker for mouse MSCs, irrespective of tissue origin and laboratory origin, with higher immune suppression activities and improved therapeutic effects [12]. However, the membrane expression level of TNFAIP6 is significantly lower than its cytoplasm level [12]. Indeed, TNFAIP6, also known as TSG6, is a small secreted protein with extracellular matrix remodeling and immunomodulation functions [37]. On the other hand, the importance of these secreted modulators, such as the TNFAIP6 having been characterized as one efficacy predictor of MSCs in treating inflammation in vivo [38], makes it necessary to develop novel strategies to purifying these MSC subpopulations for improving their therapeutic effects.

Extracellular ATP clearance

Dying or stressed cells could release ATP (Adenosine 5'-triphosphate) to the extracellular spaces and induce the pro-inflammatory cascade [39, 40]. The immune regulatory cells, such as Treg and MSCs, could express genes, such as ENTPD1 (Ecto-Nucleoside Triphosphate Diphosphohydrolase 1, also known as CD39) and NT5E (Ecto-5′-AMP-nucleotidase, also known as CD73), responsible for clearing these extracellular ATP [39, 41]. CD39 could hydrolyze the extracellular ATP, into ADP and then AMP; while CD73 converts AMP into adenosine [39, 40]. The extracellular adenosine has strong immune suppression activities via binding to the corresponding P1 receptors (including A1R, A2AR, A2BR, and A3R), and activating the downstream pathways (such as PKA, NF-κB, CREB, AKT, PI3K, ERK, JNK, and p38) [42]. Furthermore, the extracellular adenosine also regulates other cell functions, such as cell proliferation, adhesion, migration, invasion, tight junction formation, and vascular remodeling [39, 40, 42, 43].

The expression levels of CD39, CD73, and adenosine receptors could be induced by tissue damage, remodeling, and also the conditions of hypoxia and inflammation [4143]. It has been demonstrated that MSCs express both CD73 and CD39 and could convert ATP into adenosine, resulting in suppressing T cell proliferation [4447], and the activation of B cells [48]. The expression levels of CD73 modulate the proliferation and differentiation capabilities of MSCs [49, 50]. Its expression level decreases during the differentiation process [51].

The purified CD73+ MSCs have higher levels of colony-forming capabilities [52], even higher than the ENG+ and THY1+ MSCs [51]. In addition, CD73+ MSCs have much higher tri-differentiation abilities (adipocytes, osteoblasts, and chondrocytes) and higher immune suppression activities [52, 53]. Through EGFP reporter analysis in mice, CD73 could identify the MSCs in different organs in vivo [54, 55]. Furthermore, CD73+ MSCs are much more smaller with spindle and rod-like shapes, while CD73 MSCs are more polygonal larger cells [33]. CD73+ MSCs secrete higher levels of regeneration cytokines, such as VEGF, SDF-1α, and HGF than CD73 MSCs, and show improved therapeutic effects on the rat model of myocardial infarction [33]. Furthermore, CD73+CD39+ MSCs have great potential in bone regeneration, including better efficiency in chondrogenic and osteogenic differentiation [56], preventing osteoclastogenesis [57], and promoting bone formation via the Wnt/β-catenin pathway[58].

Other immune regulators

CD200 is an immune suppressor and promotes peripheral immune tolerance [59, 60]. Its immune suppression function works through binding to its receptor CD200R, which then activates multiple pathways, such as MAPK-ERK, p38 MAPK, and JNK, via Dok and p120-RasGAP [61], resulting in upregulating the downstream effectors including IDO (indoleamine-2,3-dioxygenase), TGF-β, and IL-10 [59]. A higher expression level of CD200 in MSCs correlates with enhanced immune suppression activities in vitro and in vivo [62]. CD200 expressed on MSCs recognizes and binds to its receptor CD200R, which is expressed on myeloid progenitors, resulting in myeloid differentiation inhibition and immune suppression [63]. CD200+ MSCs have much higher levels of colony-forming activity [51]. However, it has been demonstrated that the expression of CD200 is undetectable in MSCs derived from umbilical cord blood [64], or very low in MSCs derived from adipose [65]. In contrast, MSCs derived from the umbilical cord express higher levels of CD200 [65]. Interestingly, the pro-inflammatory cytokine IFN-γ upregulates the expression of CD200 in MSCs derived from bone marrow but not adipose or umbilical cord [65].

BST2 (bone marrow stromal cell antigen 2), also known as CD317, is a type of transmembrane glycoprotein involved in virus reproduction suppression and immune regulation [66]. Using the hTERT immortalized human bone marrow MSC colonies, it has been demonstrated that the MSCs from the CD317+ colony have increased cell areas and up-regulated mRNA levels of immunosuppressive genes than the CD317 MSCs in vitro [67]. Furthermore, CD317+ bone marrow-derived MSCs have better regeneration capabilities than the CD317 MSCs [68]. However, fresh CD317 MSCs isolated from human bone marrow have better immune suppression activities but not CD317+ MSCs [68]. However, our unpublished data show that CD317+ MSCs isolated from the human umbilical cord and expanded with chemically defined media have better immune suppression capabilities (unpublished data).

CD274, also known as PD-L1 (programmed death ligand 1), is a type I transmembrane protein and is widely expressed on multiple types of cells, such as lymphocytes [69]. Its expression can be induced by pro-inflammatory cytokines, such as interferon-γ (IFN-γ), TNF-α, and IL-17 [69, 70]. And it has strong immune suppression activities through binding to its receptor PD-1 [71]. It has been demonstrated that PD-L1 is expressed in MSCs [70, 72, 73]. PD-L1+ MSCs have enhanced immune suppression activities and improved therapeutic effects on the collagen-induced mouse model of arthritis [74].

MX1, for ‘myxovirus resistance’, is the gene responsible for virus immunity and an important component of interferon pathway [75]. It has been demonstrated that Mx1+ MSCs are clonogenic at the single-cell level and have tri-differentiation abilities [32]. Although its antivirus mechanism remains unsolved, the Mx1+ MSCs might also have immune regulatory functions.

Cell adhesion related markers

In addition to the important role of MSCs in modulating immune responses [1], another critical function is regulating cell adhesion, including both the cell adhesion and migration of MSCs, as well as the recruitment and adhesion of other types of cells, such as lymphocytes.

Mediating cell migration

CD44 is an important adhesion molecule involved in recruiting immune cells or stem cells into the inflammatory or injured tissues, via interacting with hyaluronic acid (HA), which is expressed in the injured/inflammatory sites [76, 77].Their interactions induce conformational changes of CD44, recruit adaptor proteins, and lead to cytoskeletal rearrangement, resulting in the activation of various signaling pathways that involve cell growth, adhesion, and migration [76, 77]. In addition, CD44 also functions as a co-receptor to regulate the activities of other receptors, such as VEGFR, EGFR, FGFR and PDGFR [78]. CD44 is widely expressed in multiple types of cells, including MSCs, and it also contributes to MSC recruitment [79, 80]. Its expression level is further induced by PDGF [79]. The migration and adhesion of MSCs depend on CD44-HA (hyaluronic acid) interaction [79, 80]. Therefore, CD44 is a potentially important cell surface marker for MSC purification [81]. However, later investigations indicate that freshly isolated mouse/human MSCs derived from bone marrow express very low levels of CD44 [82, 83]. MSCs show enrichment in the CD44 fractions, as evidenced by their marker expression, colony-forming capacity, and in vitro differentiation abilities [82, 83]. Interestingly, CD44 is gradually up-regulated during cell expansion, even for the CD44 fractions of MSCs [82, 83]. Thus, the CD44 expression levels after in vitro expansion, may not reflect their original cell identity [82]. The CD44+ MSCs have enhanced colony-forming capacity and differentiation abilities [84].

MCAM (melanoma cell adhesion molecule), also known as CD146, is involved in cell-ECM (extracellular matrix) interactions [85, 86]. Upregulation of CD146 could switch cell–cell adhesion to cell-ECM adhesion by interacting with its ligands in the ECM, preparing cells for migration and invasion by secreting related cytokines and proteins [85, 86]. CD146 is expressed in many cell types, especially in those cells constituting blood vessels, such as endothelial cells [86] and MSCs [8791]. And it has been proposed that CD146 is an MSC marker of multipotency [9093]. CD146+ MSCs have a much stronger chemotactic attraction [9497], and enhanced immune suppression activities in vitro and in vivo [27, 9799]. Higher levels of CD146 expression correlate with a faster proliferation rate, enhanced multilineage differentiation potentials, stronger stemness characteristics, and less senescent phenotypes [98100]. However, Tormin et al. have demonstrated that the colony-forming cells are exclusively enriched in the CD271+ population of MSCs in human bone marrow, regardless of the expression level of CD146 [101]. Within the CD271+ MSCs, both CD146+ and CD146 share similar genotypes and phenotypes [101]. Furthermore, other studies have also demonstrated that CD146+ and CD146 share similar levels of MSC marker expression, colony-forming, proliferation and differentiation capabilities [94, 96, 102, 103]. And the CD146 MSCs even proliferate significantly faster than the CD146+ population [103]. Higher expression of CD146 also indicates more prone to differentiate into vascular smooth muscle cells [103]. In MSCs derived from human dental cysts, CD146Low MSCs have higher levels of cell proliferation, colony-formation, and osteogenesis [102].

SDC2 (Syndecan-2), also known as CD362, is a type of transmembrane heparan sulfate proteoglycan, involved in modulating cell adhesion, proliferation, migration, and apoptosis through its interactions with the extracellular matrix and various proteins, such as proteases and cytokines. These interactions induce downstream pathway activations through intracellular protein partners [104]. CD362 is mainly expressed in MSCs [104]. CD362+ MSCs have enhanced colony forming, immune suppression and regeneration activities [105107]. Furthermore, both Phase 1 and Phase 2 clinical studies show that CD362+ MSCs are safe, feasible, and effective in treating COVID-19 infections [108].

Mediating lymphocyte adhesion

VCAM1 (vascular cell adhesion molecule 1), also known as CD106, mediates cell–cell adhesion and plays an important role in mediating the rolling, adhesion, and migration of circulating lymphocytes on the endothelium under inflammatory conditions [109111]. The CD106 is induced by pro-inflammatory cytokines in MSCs [112], and is involved in the immune suppression function of MSCs [113]. CD106+ MSCs derived from placenta and umbilical cord have stronger abilities to suppress immune responses [112, 114] and better pro-angiogenic activity, with enhanced promoting endothelial cell proliferation and migration [28, 115]. Furthermore, CD106+ MSCs have enhanced homing capacity [28, 112].

ITGA1 (integrin subunit alpha 1) is identified in the very late stage of activated T cells. ITGA1 is the major component of the ECM by binding to collagens (mainly collagen I and IV) and laminin, supporting the migration and activation of leukocytes, such as T cells, NK cells, NKT cells, and monocytes, especially the long-term activated or resident T cells [116, 117]. The ITGA1 has been proposed as an MSC marker for human bone marrow [118120]. The ITGA1+ MSCs have stronger colony-forming activity [118, 119].

CD9, also known as MRP1 (motility related protein-1), is widely expressed in many cell types, including MSCs and lymphocytes, and is involved in regulating cell migration and invasion through integrin receptors [121, 122]. It has been demonstrated that CD9 is involved in the recognition and binding between MSCs and lymphocytes [123]. CD9+ human MSCs have higher NOS (nitric oxide synthase) expression, proliferation rate, colony formation ratio, and stronger cell adhesion capability, resulting in better engraftment and improved therapeutic effects in the mouse model of hindlimb ischemia [124, 125].

Other adhesion molecules

THY1, also known as CD90, is a small membrane protein located in the lipid raft [126]. Although CD90 does not have an intracellular domain, it is involved in cell adhesion, migration, proliferation, and apoptosis through modulating the cell–cell and cell–matrix interactions via binding to its ligands, such as integrins, syndecan, CD90 and CD97 [126, 127]. CD90 has been identified as an important marker for MSCs from different species and tissues [128132], and could be a potential marker for predicting the immune suppressive function of MSCs [133, 134]. Later studies also indicate that CD90+ MSCs have a faster proliferation rate and better differentiation capabilities [135137]. However, CD90 is also expressed in the fibroblasts, which might induce fibrosis [138].

Other adhesion genes also have been demonstrated as potential MSC makers, such as the SUSD2 [139141], ALCAM [142, 143], NCAM1 [144149], CD51 (also known as ITGAV) [150, 151], and ITGA6 (also known as CD49f) [152] (Tables 1, 2).

Regeneration related markers

Ephrin receptors

The Ephrin receptors (EphA and EphB), which can be recognized by ephrin ligands, play an important role in modulating multiple cellular functions, such as the self-renewal and differentiation of stem cells [153158]. Proteomics studies indicate that EphA2 is expressed in the MSCs from human bone marrow and umbilical cord, and regulates the functions of MSCs [159, 160]. Follow-up studies showed that EphA2 could be a cell surface marker to distinguish MSCs from fibroblasts [161]. Furthermore, EphA7+ MSCs proliferate faster and have higher levels of colony formation and differentiation capabilities [162]. And EphB2+ MSCs have improved intestinal homing abilities and promoted the intestinal stem cell regeneration [31]. It has been demonstrated that Eph/ephrin pathway is also involved in the cell migration of MSCs [163166], and is essential for suppressing the proliferation of activated T cells by MSCs [167].

PDGFR

PDGFR (platelet-derived growth factor receptor), including PDGFRA and PDGFRB (also known as CD140α and CD140β, respectively), plays an important role in embryonic development and organogenesis, particularly in regulating the proliferation, migration, and differentiation of MSCs in various organs [168171]. Although both CD140α and CD140β have been identified as MSC markers [91, 168, 169], their investigation also indicates that CD140α is the negative selection marker for human MSCs derived from bone marrow, which differs from mouse MSCs [172].

Wnt pathway

FZD9, also known as CD349, is a receptor for Wnt ligands and activates β-catenin signaling pathway, which is involved in embryonic development and stem cell renewal [173, 174]. It has been demonstrated that CD349 is expressed in MSCs from both bone marrow and placenta, and proposed as a feasible marker for MSC isolation [175, 176]. Although both CD349+ and CD349 MSCs show similar levels of MSC marker expression and differentiation abilities, the CD349 MSCs have better neovascularization abilities than the CD349+ MSCs [177].

ROR2 is a tyrosine kinase-like orphan receptor, which can be activated by Wnt5a and regulate the tissue polarity and cell movement through downstream WNT/PCP (planar cell polarity) signaling pathway [178, 179]. It has been demonstrated that ROR2+ MSCs derived from human bone marrow have enhanced chondrogenic differentiation efficiency [30].

Others

ALDH (aldehyde dehydrogenase) belongs to the metabolic enzyme family, which is involved in regulating glycolysis/gluconeogenesis and the detoxification of aldehydes via oxidation [180, 181]. It plays an important role in cell survival, proliferation, differentiation, and has been characterized as a classical stem cell marker [180, 181]. In human adipose tissues, the ALDHHigh MSCs represent a more primitive subpopulation than the ALDHLow MSCs, from the perspectives of cell proliferation and tri-differentiation capabilities [182, 183].

STRO-1 can bind to an uncharacterized cell surface antigen, and identify around 10% of mononuclear cells in the human bone marrow [184]. Purified STRO-1+ cells from human bone marrow have higher levels of colony-forming activity, proliferative rate, multilineage differentiation capabilities, and immune suppression activities by expressing higher levels of immune inhibitory factors (IL-8, LIF, IDO, HLA-G, VCAM1, TGF-β, and IL-10) [185], suggesting that STRO-1 is a potential MSC marker [184, 186]. Later study showed that STRO-1+ MSCs have better homing activities than STRO-1 MSCs in the bone marrow, spleen, muscle, liver and kidney, while STRO-1 MSCs are more prone to be trapped in the lung [187].

STRO-3, which recognizes TNSALP (tissue nonspecific alkaline phosphatase, a cell-surface glycoprotein), also identifies a MSC subpopulation with higher proliferation and differentiation potencies [188, 189]. The STRO-3+ MSCs have been identified in various species and tissues and applied in treating various disease models [189196].

STRO-4 is a monoclonal antibody recognizing the cell surface expressed chaperone protein, Hsp90β. STRO-4+ MSCs have higher colony-forming activities, proliferation rates, and multiple differentiation abilities [29].

TLX1, also known as Hoxa11, belongs to Hox gene family which is essential for patterning during embryonic development. It has been demonstrated that the Hoxa11-lineage marked (Hoxa11-eGFP) could identify the multi-potent MSCs in the mouse bone marrow [197]. Hoxa11+ MSCs have better colony forming potentials and tri-lineage differentiation abilities [198, 199].

Transcription factor GLI1, the effector of the Hh signaling pathway, which regulates tissue development and homeostasis, has been used to mark MSCs in vivo [24, 200202]. These Gli1+ MSCs are responsible for tissue regeneration after injury [200, 203206]. However, the Gli1+ MSCs have the tendency to differentiate into osteochondrogenic lineages [201, 204]. Furthermore, the Gli1+ MSCs also contribute to tissue fibrosis [205, 207, 208].

ISLR, also known as Meflin, is a glycoprotein (cell membrane located or secreted) with anti-fibrosis functions through interacting with BMP7 (bone morphogenetic protein 7) and inhibiting TGF-β pathway and myofibroblast differentiation [209]. It has been demonstrated that Meflin is one MSC marker, and its expression positively correlates with its differentiation efficiency [210, 211].

Sca-1 (stem cell antigen-1) has been characterized as a common marker in multiple types of stem cells, such as hematopoietic stem cells and MSCs [212, 213]. It has been demonstrated that mouse MSCs derived from bone marrow and ear express high levels of Sca-1 [214216]. The expression of Sca-1 is fundamental for maintaining the stem cell state of MSCs [22, 213, 215, 217]. Furthermore, they have higher proliferation rates and better immune suppression abilities [22, 217]. Other common stem cell markers, such as SSEA-4 (stage-specific embryonic antigen-4), KIT, and ABCG2, have also been identified as MSC markers [218227].

Neuron related markers

Interestingly, the MSCs express some neural development related genes and some of them have been identified as MSC markers, such as CSPG4 (chondroitin sulfate proteoglycan 4) [228230], GD2 (Disialoganglioside) [231], CD271 [232238], and Nestin [239243]. Whether the expression of neuron related genes indicates the dedifferentiated state of MSCs or potential interactions between MSCs and neurons remains unclear and needs further investigation.

Other markers

Since the first demonstration of MSCs, the ENG (Endoglin), also known as CD105, has been identified as a classical MSC marker [15, 128]. Using CD105 to purify MSCs is feasible and efficient in human bone marrow and adipose [244248]. Furthermore, CD105+ MSCs have increased osteogenic and chondrogenic differentiation efficiency, and reduced adipogenic differentiation efficiency [248, 249]. However, controversial results also show that a low expression level of CD105 is correlated with increased osteogenic and chondrogenic differentiation [250]. Indeed, as a coreceptor of the TGF-β superfamily, CD105 is involved in regulating osteogenic differentiation [251253].

The SDF1-CXCR4 is the major pathway responsible for cell recruitment and retention [254, 255]. CXCR4 is expressed in human MSCs and contributes to the MSCs homing process [256260]. For example, in the mouse model of osteogenesis imperfecta, the human MSCs migrate into the bone marrow through the SDF1-CXCR4 pathway and reduce the fracture rate [261]. Furthermore, in the rat model of ischemic brain injuries, rat MSCs migrate into the injured sites of the brain and show therapeutic effects via the SDF1-CXCR4 pathway [262, 263]. Although the expression level of CXCR4 is high in MSCs, few the on the cell surface [256, 261]. However, Honczarenko et al. have demonstrated that the surface expression of CXCR4 is up to around 43% [264], indicating that some factors might induce the cell surface expression of CXCR4, such as culture conditions, stimuli, and passage numbers [265]. Indeed, the expression level of CXCR4 decreases during passaging [264, 266] and aging [267]. The cell membrane localization of CXCR4 is induced by cytokine stimulation (such as SDF-1) [256, 261, 268] or 3D culture conditions [269].

Some other MSC markers have also been demonstrated, such as LepR (Leptin receptor) [270273], CD34 [274276], and TNFRSF10D [277]. However, their functions in MSCs remain unclear. Purifying MSC subpopulation with one single maker has many disadvantages (Table 2). Therefore, the combination of multiple markers is a promising strategy to improve the efficiency and efficacy of MSC subpopulation purification. It has been demonstrated that the PODXLhi/ITGA6hi MSCs have better activities of colony formation, differentiation, proliferation, homing activities, regeneration activity, and anti-apoptotic activities [152, 278282]. The PDGFR+Sca-1+ MSCs could differentiate into both mesenchymal and endothelial at single-cell level with enhanced self-renewal and multipotency abilities [129], and the CD146+PDGFRβ+ MSCs have higher levels of colony-forming activities [91]. Combining PDGFRα and other markers, such as Ly6a, Sca-1, and CD51, would further enrich the MSC subpopulation with enhanced colony-forming and differentiation activities [129, 243, 283, 284]. On the other hand, identifying novel MSC markers with novel high-throughput technologies is also critical for both MSC subpopulation purification and understanding the heterogeneity of MSCs.

2nd generation of MSC maker identification-high-throughput approach

The emergence and development of high-throughput technologies (genomics, transcriptomics, proteomics, lipidomics, metabolomics, and so on) have revolutionized various fields of life sciences [285287]. These high-throughput technologies have not only expedited the pace of research but also transformed our understanding of life itself by providing a comprehensive and intricate view of biological systems. Since the introduction of Illumina's Solexa sequencing technology in 2005, a new era has been heralded by paving the way for high-throughput technologies [288]. This pioneering approach, built upon parallel sequencing principles, enables the simultaneous analysis of millions of DNA fragments, dramatically boosting sequencing efficiency. Notably, this breakthrough laid the foundation for subsequent advancements, with other platforms such as 454 Life Sciences, Ion Torrent, and PacBio also contributing to the progress of high-throughput technologies [285].

The impact of high-throughput technology extends far beyond genomics, reverberating profoundly across various domains of omics research. In the realm of transcriptomics, we can now unravel intricate gene regulatory networks by simultaneously analyzing the expression of thousands of genes. Technologies like RNA-Seq have empowered scientists to assess gene expression patterns across different conditions, tissues, or developmental stages, shedding light on cellular processes and signaling pathways [286]. High-throughput mass spectrometry techniques in proteomics offer a swift and comprehensive understanding of protein–protein interactions, modifications, and functions within cells. These methods allow researchers to identify and quantify proteins in complex samples, revealing insights into cellular processes, biomarker discovery, and disease mechanisms [287]. In lipidomics, mass spectrometry-based methods have enabled the comprehensive analysis of lipid molecules in biological samples, uncovering lipid profiles associated with health and disease [289]. Similarly, metabolomics, utilizing high-throughput mass spectrometry and nuclear magnetic resonance (NMR) techniques, offers insights into the global metabolite composition of cells or organisms, contributing to our understanding of metabolic pathways and disease biomarkers [290]. Epigenomics, focusing on epigenetic modifications like DNA methylation and histone modifications, benefits from high-throughput techniques such as DNA methylation arrays and next-generation sequencing. These tools provide a genome-wide view of epigenetic modifications, aiding in deciphering their roles in gene regulation, development, and disease [291].

Among these high-throughput technologies, single-cell RNA sequencing technology (scRNA-seq) is a significant innovation in the field of MSCs that has sparked widespread interest in recent years [1724]. By deciphering the gene expression of each individual cell within a cell population, this technique reveals the astonishing complexity of cellular diversity and heterogeneity, bringing about a revolutionary breakthrough in cellular biology research [292, 293]. Distinct from traditional bulk RNA sequencing methods, scRNA-seq can precisely analyze cell function and types, regardless of sample heterogeneity [293295].

Several novel MSC markers have been discovered since the application of scRNA-seq technology in the MSC field, such as the LRRC75A+ MSCs with enhanced VEGF production [23]; the CMKLR1+ MSCs with improved immune suppression capabilities [19]; the F3+ and S100A9+ MSCs with better regenerative activities [17, 18, 34].

Among these novel MSC markers identified by scRNA-seq, the CMKLR1+ subpopulation with enhanced immune suppression capabilities [19] has been investigated in detail. The CMKLR1 (Chemokine-like receptor 1), also known as CCRL2 (chemokine C–C motif receptor-like 2), is the transmembrane receptor for chemoattractant chemerin, involved in recruiting and migrating of lymphocytes and immune suppression via its ligand resolvin E1, an important anti-inflammatory mediator [296]. Furthermore, it has been demonstrated that the CMKLR1+ MSCs have better osteogenic differentiation potential and weaker adipogenic differentiation potentials than the CMKLR1 MSCs [19]. Indeed, the CMKLR1 pathway regulates the differentiation balance between the osteoblastogenic and adipogenic MSCs [297]. However, their data also indicate that inhibiting the CMKLR1 pathway promotes the osteoblastogenic differentiation of MSCs and suppresses the adipogenic differentiation of the mouse MSCs [297]. Whether the controversial data resulting from species differences needs further investigation [298300].

The applications of scRNA-seq not only promote the identification of novel MSC markers, but also uncover new potential functions of MSCs. The MSC marker F3 [17, 18], also known as CD142 or thromboplastin, is a transmembrane glycoprotein and a receptor for coagulation factors, which is involved in platelet activation and coagulation development after tissue injury [301, 302]. The discovery of F3 in MSCs might indicate that MSCs play an important role in blood clot formation at the site of injury.

The extracellular matrix modification function of MSCs is well-known [303, 304]. However, the extracellular matrix microenvironment is a highly complex and dynamic biological component and is critical for the functions of MSCs, including the immune modulation function and stem cell characteristics [3, 305, 306]. Identifying new extracellular matrix-related MSC markers, such as Serpinf1 [22] and HMMR [20], would enhance our understanding of MSC biology in greater depth and breadth..

In addition, scRNA-seq is a powerful strategy for investigating the heterogeneity of MSCs. Purifying a homogenous MSC subpopulation is proposed to have improved therapeutic advantages [17, 19, 23, 307]. However, it has been demonstrated that the Gli1+ MSCs are still heterogenous, as revealed by scRNA-seq [24]. Furthermore, scRNA-seq can also uncover the diversity of functions and interactions among different MSC subpopulations. Two major MSC subpopulations (Lgr5+ and Lgr6+) residing in the mouse lung have completely different functions, uncovered by scRNA-seq analysis [21]. Lgr6+ MSCs support the airway differentiation, while the Lgr5+ MSCs promote alveolar differentiation [21]. In the human umbilical cord, four different MSC subpopulations (proliferative, niche-supporting, metabolism-related, and biofunctional MSCs) have been revealed by scRNA-sequencing [17].

High-throughput techniques for purifying MSC subpopulations

Throughout the developmental trajectory of scRNA-seq, various innovative platforms have emerged, each catering to different research needs based on their unique principles and features. The 10 × Genomics Chromium system is one widely used platform. It employs droplet technology to combine individual cells with specific molecular barcode particles, enabling high-throughput cell capture and transcriptome sequencing [308]. Similarly, Drop-seq utilizes droplet technology to encapsulate cells and molecular barcode beads in droplets, providing a cost-effective option for large-scale cell sequencing [308]. For studies requiring more accurate and comprehensive gene expression information, SMART-seq2 is an ideal choice. Its principle involves introducing specific sample labels after reverse transcription of RNA, allowing individual processing and sequencing of each cell's RNA for deeper insights [309]. For large-scale sample processing, CEL-seq2 proves to be a powerful selection, utilizing cell-specific molecular barcode primers to provide unique identification for each cell [310]. Additionally, the C1 platform, also known as Fluidigm C1, is an advanced single-cell analysis technology platform. It combines microfluidics technology and real-time fluorescence PCR technology, enabling high-throughput capture, processing, and analysis of individual cells. The workflow of the C1 platform includes key steps such as cell capture, lysis, reverse transcription, and amplification, resulting in high-quality single-cell transcriptome data. The C1 platform can be applied to various types of cell analysis, offering crucial support for cellular biology research [311].

Apart from the aforementioned platforms, other unique single-cell sequencing platforms continue to advance the field of cell analysis. For instance, inDrop, a platform similar to Drop-seq, utilizes microfluidic chips for cell capture, boasting high-throughput performance. Its distinctive design involves encapsulating cells and molecular barcode beads together in droplets, enhancing efficiency and accuracy in cell capture and analysis [308]. Moreover, sci-ATAC-seq is another notable platform that not only focuses on single-cell gene expression but also integrates transcriptome and chromatin accessibility information, providing researchers with more comprehensive data [312]. SPLiT-seq, a high-throughput single-cell sequencing technology, simultaneously captures the transcriptomes of thousands of cells. Through specialized fragmentation tags, cellular lysates are split into multiple fragments, each containing a cell-specific molecular barcode. This tag design enables the concurrent amplification of RNA fragments from multiple cells in a single reaction, achieving high-throughput cell capture and sequencing [313].

The exploration of the majority of these markers (S100A9, F3, LRRC75A, SERPINF1, CMKLR1, GL1) in the context of scRNA-seq applications has primarily relied on the 10 × Genomics Chromium system [1719, 2224], while the CD168 identification was conducted with the C1 platform [20] and the interaction between Lgr5+ and Lgr6+ MSCs were carried out by using the SMART-seq2 technology [21]. The reliability of these three platforms for developing novel MSC markers has been successfully validated. However, other single-cell sequencing platforms have yet to be applied in the MSC marker field so far. Their respective unique advantages, however, suggest they still hold immense potential for the development of new and effective MSC markers.

Beyond accelerating the pace of analysis, these technologies facilitate the simultaneous analysis of expansive datasets, laying bare the intricate network of molecular mechanisms and relationships that drive biological systems [285]. With the wide application of high-throughput technologies in biomedicine, we also had a deeper understanding of the complexity of biological systems and sought to go beyond the limitations of single omics. The rise of high-throughput technologies not only accelerated data generation but also paved the way for the emergence of multi-omics. This approach, fueled by the copious data generated, marries different omics layers (genomics, transcriptomics, proteomics, and metabolomics) into a comprehensive narrative of biological intricacies. By merging diverse omics datasets, multi-omics integration offers a more comprehensive biological context, enhancing accuracy and facilitating meaningful interpretation of findings [314, 315]. Notably, multi-omics technologies have already been applicated in MSCs [316319]. Gao et al. demonstrated the utility of multi-omics analysis in understanding the immunosuppressive efficacy of MSCs, shedding light on cellular senescence and PD-L1 expression through single-cell transcriptome and proteomic data analysis [319]. Their findings underscore the potential of multi-omics approaches in discovering new effective MSC markers. This indicates that multi-omics is a feasible strategy to find new effective MSC subpopulations.

Enhanced therapeutic efficacy of marker-sorted MSC subpopulations

Above-mentioned MSC subpopulations exhibit enhanced therapeutic efficacy in various disease models, offering tailored treatment approaches for regenerative medicine and immunotherapy. CD73+ MSCs, characterized by heightened regeneration cytokine secretion and colony-forming capabilities, have shown promising results, particularly in myocardial infarction models [33, 52]. Similarly, CD200+, CD317+, and PD-L1+ MSC subpopulations demonstrate superior colony-forming activity and immune modulation, with CD317+ MSCs exhibiting notable immune suppression capabilities [51, 68, 74]. Moreover, functional diversity is evident among MSC subpopulations. For instance, CD146+ MSCs exhibit strong chemotactic attraction and immune suppression, while CD362+ MSCs display enhanced colony formation and immune suppression, validated in COVID-19 clinical trials [27, 9499, 105108]. Additionally, CD106+ MSCs from placenta and umbilical cord tissues demonstrate potent immunomodulation and pro-angiogenic activities [28, 112, 114, 115]. Furthermore, ITGA1+ MSCs and STRO-4+ MSCs exhibit robust colony-forming and proliferation rates [29, 118, 119].

In the clinical translation of marker-based sorting, personalized therapeutic interventions are becoming increasingly feasible. However, further clinical studies are needed to validate the efficacy and safety of these approaches. Overall, leveraging the unique properties of marker-sorted MSC subpopulations holds great promise for advancing regenerative medicine and immunotherapy, offering tailored treatments for diverse medical conditions.

Conclusions and perspectives

Although the therapeutic applications of the MSCs have great promises, challenges still need to be overcome [320, 321]. And the heterogeneity of MSCs constitutes one of those important barriers before their clinical application [6, 7]. Through bioinformatic analysis of the RNA-seq data from different labs and tissues, it is shown that the isolation and expansion procedures induce more heterogeneity than the tissue origin [12]. It should be noted that purifying and expanding the MSCs in vitro is a kind of stress similar to tissue damage in vivo, which might affect the molecular pathways and functions of MSCs [322]. Indeed, the expanded MSCs in vitro are very different from their counterpart in vivo [323]. The MSC expansion strategy would select the cell population which could adapt to these stimuli and stresses [322], indicating the necessity of standardizing the MSC processing procedures and developing a full chemical defined medium [6, 1012]. Therefore, selecting the suitable MSC subpopulations with specific markers based on their functions and applications is necessary and mandatory [6, 7].

So far, the quest for identifying markers of MSCs has been incessant. The emergence of advanced high-throughput multi-omics techniques offers a promising avenue for discovering novel markers. In this review, numerous MSC subpopulations identified through marker-based sorting have demonstrated significant therapeutic efficacy in animal models. These subpopulations mainly exhibit enhanced therapeutic effects through their potent immunosuppressive capabilities, which have been validated across various animal models of inflammation [38, 68, 74, 112, 114]. Additionally, some subpopulations possess superior homing and regenerative properties, contributing to tissue repair in the rat model of myocardial infarction and the mouse model of hindlimb ischemia [31, 33, 124, 125]. These findings offer promising directions for future therapeutic applications of MSCs. Furthermore, ongoing advances in understanding and manipulating the properties of MSC subpopulations hold great promise for the development of more targeted and effective therapies in regenerative medicine and immune modulation.

However, upon evaluating the majority of currently developed markers, a trend becomes apparent: many subpopulations that are sorted tend to revert to an unsorted state after multiple generations of in vitro proliferation. For instance, during the isolation of MSCs using markers like MCAM, CD9, CXCR4, and STRO-1, their expression diminishes upon subsequent in vitro expansion and cultivation [100, 124, 264, 266, 324]. This situation might indicate that the sole reliance on biomarkers cannot purify consistent and stable subpopulations of MSCs, and eventually achieve successful applications in clinical medicine.

Under diverse physiological or pathological conditions, MSCs exhibit various forms of plasticity, including alterations in morphology, surface markers, secretion, differentiation, proliferation, migration, and apoptotic potential [325]. This plasticity is intimately linked to the microenvironment surrounding MSCs, where physical, chemical, and biological factors impact MSCs’ functions through distinct mechanisms [325]. These mechanisms might involve critical processes like signaling pathway modulation and cellular reprogramming, ultimately influencing MSCs’ capabilities [325]. Illustrating the immunomodulatory role of MSCs exemplifies this phenomenon. During the acute phase or relapse of inflammation, effector T cells secrete pro-inflammatory cytokines, including IFN-γ, TNF, IL-1, and IL-7. These pro-inflammatory cytokines stimulate MSCs to produce substantial amounts of IDO (indoleamine 2,3-dioxygenase) and chemokines. Chemokines serve to attract activated T cells toward MSCs. The elevated concentration of IDO metabolites stemming from this process directly inhibits T cells, resulting in an overall attenuation of the immune response and promotion of tissue repair [1, 326]. On the contrary, in chronic inflammation or during remission, the concentration of anti-inflammatory cytokines, such as TGF-β, increases while pro-inflammatory cytokines decline. Consequently, the production of IDO by MSCs drops below the immunosuppressive threshold. Despite the continued expression of chemokines albeit at lower levels, recruited T cells are not restricted, thus exacerbating the inflammatory immune response [1, 326].

As previously highlighted, MSCs are characterized by their exceptional plasticity. The exclusive focus on purifying MSC subpopulations could potentially impose certain limitations. A more intricate strategy revolves around carefully shaping the extracellular environment of MSCs through deliberate in vitro cultivation, a process terming ‘MSC education’. The objective of this educational initiative is to tap into the inherent variability present within the cell population, steering it towards a consistent manifestation of the intended functions. Across a spectrum of models, diverse categories of educated MSCs have unveiled a range of distinctive functionalities [327329]. For instance, when BM-MSCs are exposed to WNT5a secreted by gastric cancer cells, a noticeable upregulation of α-SMA expression and an amplified capacity for driving tumorigenesis have been observed [327]. Furthermore, the exosomes released by MSCs primed with neonatal serum have proven capable of expediting the healing of cutaneous wounds by actively stimulating angiogenesis [328]. Notably, MSCs that have undergone a process of education through exposure to chemotherapy have emerged as critical mediators in facilitating communication between MSCs and tumor-initiating cells within specific tumor contexts. This communication is achieved through the selective secretion of cytokines and/or chemokines [329]. In the realm of immune regulation, differently educated MSCs can even exhibit contrasting functionalities. Waterman et al. found that MSCs educated by T-cell signaling (referred to as MSC-I) are primarily geared toward producing pro-inflammatory factors, while MSCs educated by TLR3 signaling (referred to as MSC-II) predominantly express immune-suppressive factors [330]. Similarly, MSCs educated by immune factors such as IFN-γ and TNF-α also demonstrate enhanced immune-suppressive capabilities [1, 331].

To sum up, the development of MSC markers, bolstered by high-throughput techniques, holds substantial potential. Looking at the broader field of MSC research, in addressing the challenge of inconsistent therapeutic efficacy due to MSC heterogeneity, MSC education also presents a viable avenue alongside MSC markers.

Author contributions

Si Chen and Bowei Liang wrote the draft; Jianyong Xu revised the manuscript.

Funding

Guangdong Basic and Applied Basic Research Foundation (2021A1515012484, 2023A1515010181); The fundamental research project of the Shenzhen Science and Technology Innovation Commission (20231120113324002).

Data availability

Not applicable.

Declarations

Competing interests

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Footnotes

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Si Chen and Bowei Liang have contributed equally to this work and share first authorship.

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