Are Osteoblasts Multiple Cell Types? A New Diversity in Skeletal Stem Cells and Their Derivatives.

Only in the past decade have the stem cells in the skeleton been identified. Here, we discuss a pair of recent reports that identify that skeletal stem cells are actually a family of related cells that each have distinct locations and functions. These site-specific skeletal stem cells account for the signature diseases occurring in different regions of the skeleton. Specifically, one of these stem cells forms the spine and establishes that this stem cell drives the high rate of breast cancer metastasis to the spine over other skeletal sites. There are also at least two skeletal stem cells in the flat bones of the skull, with mutations alerting how these two stem cells "talk" to each other serving as a cause for disorders of premature skull fusion. Despite displaying differences in their function, these stem cells are each united by shared features including a partially shared series marker genes. We also here propose that this diversity at the level of skeletal stem cells translates into a similar diversity in mature skeletal cell types, including osteoblasts. In this model, osteoblasts are not a single cell type, but rather a family of related cells each with distinct functions.