Mesenchymal stem cells (MSCs) have been widely exploited as promising candidates in clinical settings for bone repair and regeneration in view of their self-renewal capacity and multipotentiality. However, little is known about the mechanisms underlying their fate determination, which would illustrate their effectiveness in regenerative medicine. Recent evidence has shed light on a fundamental biological role of autophagy in the maintenance of the regenerative capability of MSCs and bone homeostasis. Autophagy has been implicated in provoking an immediately available cytoprotective mechanism in MSCs against stress, while dysfunction of autophagy impairs the function of MSCs, leading to imbalances of bone remodeling and a wide range of aging and degenerative bone diseases. This review aims to summarize the up-to-date knowledge about the effects of autophagy on MSC fate determination and its role as a stress adaptation response. Meanwhile, we highlight autophagy as a dynamic process and a double-edged sword to account for some discrepancies in the current research. We also discuss the contribution of autophagy to the regulation of bone cells and bone remodeling and emphasize its potential involvement in bone disease.

中文翻译：

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自噬在确定间充质干细胞和骨重塑中的命运。

考虑到它们的自我更新能力和多能性，间充质干细胞（MSCs）已广泛用作临床修复和再生骨中有希望的候选者。然而，对其命运决定的潜在机制知之甚少，这将说明它们在再生医学中的有效性。最近的证据阐明了自噬在维持MSCs再生能力和骨骼稳态方面的基本生物学作用。自噬已经被认为可以激发MSC中立即可用的细胞保护机制来抵抗压力，而自噬功能障碍会损害MSC的功能，从而导致骨骼重塑失衡以及各种老化和退化性骨疾病。这篇综述旨在总结有关自噬对MSC命运决定的影响及其作为应激适应反应的作用的最新知识。同时，我们强调自噬是一个动态过程和一把双刃剑，以弥补当前研究中的一些差异。我们还讨论了自噬在调节骨细胞和骨重塑中的作用，并强调了其在骨病中的潜在作用。