运动员的关节软骨损伤及其基因治疗

Articular cartilage defects and gene therapy in athletes

目的:总结和分析关节软骨损伤及其自然修复的机制,结合运动员特殊的群体,阐述基因治疗在关节软骨损伤治疗的重要性和可行性及其存在的问题与展望。资料来源:应用计算机检索Medline1991-01/2006-01关于关节软骨损伤与基因治疗的文章。检索词“genetherapy,articularcartilagedefects,athletes”并限定文章的语种类为English。同时利用计算机检索万方数据资源系统和中国期刊全文数据库1991-01/2006-01的相关文章,限定文章语言种类为中文,检索词“基因治疗,关节软骨损伤,运动员”。资料选择:对资料进行初审,纳入标准:①关于基因治疗导入方法、载体的选择和存在的问题及优点。②有关关节软骨损伤治疗方面、与运动训练结合方面的研究。排除标准:排除重复性研究。资料提炼:共收集到符合上述要求的文献39篇,排除18篇重复性研究。21篇符合纳入标准:其中15篇关于基因治疗方面的文章,6篇关于运动员关节软骨损伤方面的文章。资料综合:关节软骨损伤后常伴随关节炎、骨赘等症状的产生,导致关节功能性障碍,对于运动员来说严重者常常影响运动训练、比赛及运动寿命等。关节软骨损伤再生修复难,治疗也相对困难。结论:基因治疗方法在运动医学中的应用,将为运动员的关节软骨损伤提供一条新的治疗途径,突破一些运动医学治疗中现存的难点,最终带来运动损伤治疗的根本性变革,而运动员关节软骨损伤的治疗今后的研究将趋向于体外基因治疗与组织工程学相结合。

OBJECTIVE： This paper aims to summarize and analyze the mechanisms of articular cartilage defects and their natural repair, and expatiate the importance and feasibility of gene therapy for articular cartilage defects along with the coming problems and prospects. DATA SOURCES： An online search of Medline database in English and Wanfang database and China Journal Full-text Database （CJFD） in Chinese was undertaken by using the keywords of ＂gene therapy, articular cartilage defects, athletes＂ to identify the relevant articles to the articular cartilage defects and gene therapy published from January 1991 to January 2006. STUDY SELECTION： The literatures were selected primarily. Inclusive criteria： （1） the methods, carriers selections, existing problems and advantages of gene therapy; （2）sports training of articular cartilage. The repeated studies were excluded. DATA EXTRACTION： There were 39 literatures in accordance with the criteria, and 18 of them were excluded due to the repetition of the same research. Among 21 selected literatures, 15 were reviews of gene therapy and 6 were reviews of articular cartilage defects. DATA SYNTHESIS： Articular cartilage defects always go with many other diseases, such as osteoarthritis and osteophyma, which often induce the functional disorder of joints, and for athletes, it also influences sports training, matches and sports longevity severely. Owing to the poor repair of cartilage tissues, the traditional therapy is ineffective. CONCLUSION： The application of gene therapy in the field of sports medicine will offer a new method to cure articular cartilage defects of athletes, break through some present difficulties of sports medicine therapy. and finally call on the basic reforms of sports injury treatment. In addition, one future direction for cartilage repair in athletes is ex vivo gene therapy in combination with tissue engineering.