Introduction

Periosteum, a highly vascularized connective tissue, plays a key role in the growth, development and regeneration of bone [39]. Fracture repair was considered to be a recapitulation of embryonic development, and members of the Wnt signaling pathway were activated [40]. Nan et al. found that Wnt signaling pathway was activated during bone regeneration [40]. The Wnt signaling pathway may play an important role in the regenerative process.

Several strategies, including gene therapy and tissue engineering together with mesenchymal stem cells (MSC), have been proposed to promote the healing of the musculoskeletal tissue. Moreover, a recent technology has revolutionized gene editing: Clustering regulatory interval short palindromic repeats (CRISPR) features simple target design, affordable, versatile and efficient, but requires more research to be the preferred platform for genome editing. Predictive genomics DNA analysis can understand which genetic advantages (if any) can be exploited and why specific rehabilitation programs are more effective in some people than others [41, 42]. Therefore, a better understanding of the genetic impact on musculoskeletal system function and disease healing is needed to plan and develop patient-specific management strategies. Currently, while some results are promising, all biological interventions are experimental and the cost/effectiveness has not been proven. In addition, the short follow-up time of most studies questioned the durability of treatment [42]. In this study, autologous periosteum was used to guide bone regeneration in vivo, and the regenerated bone was used for precise repair of the body. This technology has a promising clinical application prospect. The related differential genes and signaling pathways identified in this study can provide a rich theoretical basis for later gene and molecular intervention.

Though this in vivo study provides a better understanding in the molecular mechanisms involved in guided self-generation, it also has limitations. First, micro-CT can be conducted to evaluate the conditions of bone regeneration at different time points. The association of changes of molecules and bone regeneration can be analyzed to provide more precise explanations of the mechanisms. Besides, different parts of the regeneration may be at different stage of healing process. Immuno-histochemistry to localize the transcript and protein expression may provide deeper appreciation of the function of specific genes.

Conclusions

This study shows the guided bone regeneration involves DEGs associated with oxidation–reduction process, mitochondrion and oxidoreductase activity. The main signaling pathways includes oxidative phosphorylation, PI3K-Akt signaling pathway, osteoclast differentiation pathway and Wnt signaling. This study could deepen our understanding of the molecular mechanisms involved in the guided bone regeneration. With these findings of molecular changes at different time points, it gains the potential of regulating the specific mechanism to enhance the bone regeneration.