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We hypothesized that allogeneic ABCB5\u207a mesenchymal stem cells (MSCs) can serve as a biologic cell source to augment bone marrow-derived MSC (BM-MSC) populations without impairing osteogenesis. Primary human BM-MSCs from five donors were combined with GMP-manufactured ABCB5\u207a MSCs at graded replacement ratios (0\u201395%) and cultured under osteogenic conditions for 21 days. Osteogenic potential was evaluated using complementary assays of mineralization, biochemical activity, and matrix composition. Robust osteogenesis was maintained across all groups, with cultures containing 50% ABCB5\u207a MSCs demonstrating comparable functional osteogenic activity to BM-MSC controls, including similar\n                    <jats:sup>99m<\/jats:sup>\n                    Tc-HDP uptake (2.96 vs. 2.68 MBq) and calcium\u2013phosphate ratios (1.2 vs. 1.1). Higher substitution levels showed a progressive decline in osteogenic output, consistent with dilution of BM-MSC-driven effects. 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The study was conducted in accordance with the ethical principles for medical research involving human participants as outlined in the Declaration of Helsinki (revised at the 75th WMA General Assembly, Helsinki, Finland, October 2024). All patients provided informed written consent to participate in the study. A consent for publication is not applicable as our manuscript does not include any identifying images or other personal or clinical details of participants.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"M.H.F declares the following competing financial and professional interests: M.H.F is the primary inventor of the foundational intellectual property (IP) related to the isolated cells characterized in this study, which has been legally licensed from Boston Children\u2019s Hospital to RHEACELL GmbH & Co. KG (Heidelberg, Germany). Consequently, M.H.F. is eligible to receive potential downstream milestone payments or future royalties managed under institutional IP distribution policies. Furthermore, M.H.F. serves as an official scientific advisor to RHEACELL GmbH & Co. KG and holds equity\/stock ownership in the company. This conflict of interest was formally disclosed to, and is actively managed by, the Conflict-of-Interest Review Committee at Boston Children\u2019s Hospital.All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"283"}}