神经生长因子对骨折修复的作用

Role of nerve growth factor on fracture repair

学术背景:近来研究发现,在正常骨组织和骨折骨痂中有神经生长因子及其受体的表达,局部给予外源性神经生长因子对骨折修复具有促进作用。目的:对神经生长因子在骨折修复中的表达、作用及可能的作用机制进行总结分析。检索策略:应用计算机检索PubMed 1951-01/2007-06期间的相关文章,检索词为"nerve growth factor,bone fracture,repair,osteogenesis"。同时应用计算机检索中文CNKI全文数据库1990-01/2007-06期间的相关文章,检索词"神经生长因子,骨折,修复"。对资料进行初审,纳入标准:①神经生长因子的生物学特性。②骨折修复的过程。③神经生长因子对骨折修复作用的实验或临床研究。排除标准:重复研究、Meta分析或综述类文章。文献评价:共收集到59篇相关文献,28篇符合纳入标准,排除的31篇为内容陈旧或重复文章。符合纳入标准的28篇文章中,分别涉及神经生长因子的发现发展、生物学特性9篇,神经生长因子的作用5篇,骨折修复过程中参与的因子及各方面因素的影响4篇,神经生长因子对骨折的修复作用10篇。资料综合:①正常骨组织和骨折骨痂中均有神经生长因子及其受体的表达。②神经生长因子主要由来源于神经嵴的神经元支配的靶组织产生,其被这些神经元轴突摄取后逆行运输至胞体,通过多种途径调节神经细胞的基因转录而发挥生物效应,维持神经元的存活、刺激轴突的生长,并对外周神经的发育、营养起重要的作用。神经生长因子主要是通过促进骨折部位神经的再生参与骨折修复。③骨折愈合的机制十分复杂,神经生长因子对骨组织的作用也是多方面、多层次和相互交叉的,其机制尚未完全探明。结论:虽然神经生长因子促进骨折修复作用的研究已经取得一些进展,但仍处于初级阶段,其作用机制尚不清楚。

BACKGROUND： Recent researches find that the nerve growth factor and its receptor express in normal bone tissue and bone fracture callus, local application of foreign-derived nerve growth factor can promote the fracture repair. OBJECTIVE： To analyze and summarize the expression, role and possible mechanism of nerve growth factor in fracture repair. RETRIEVAL STRATEGY： The articles between January 1951 and June 2007 were retried from PubMed by using the key words of ＂nerve growth factor, bone fracture, repair, osteogenesis＂ by computer. Meanwhile, the relevant articles were searched between January 1990 and June 2007 from database of Chinese National Knowledge Infrastructure by imputing the key words of ＂nerve growth factor, bone fracture, repair, osteogenesis＂ into computer. The data were selected primarily, inclusion criteria：①the biological characteristics of nerve growth factor, ②the fracture healing process, ③the effect of nerve growth factor on fracture healing in experimental or clinical research. Exclusion criteria： duplicate research, Meta-analysis or reviewed articles. LITERATURE EVALUATION： A total of 59 literatures were retrieved, 28 met the inclusion criteria and 31 were excluded due to obsolete or duplicate contents. Among 28 selected articles, 9 ones involved in the development and biological characteristics of nerve growth factor, 5 ones included the role of nerve growth factor, 4 ones referred to the factors in fracture healing process, and 10 ones were related with nerve growth factor on fracture repair. DATA SYNTHESIS： ①Nerve growth factor and its receptor express in both normal bone tissue and bone fracture callus.②Nerve growth factor derives from the target tissue, which is dominant by the neurons in neural crest, and retrogrades axonal transport to cell body by the neuron uptake. Through various channels in regulating gene transcription of nerve cells, nerve growth factor can play biological effects, maintain neuronal survivals and stimulate axonal growth, moreover it is important for the development and nutrition of peripheral nerve. Nerve growth factor participates fracture healing mainly through promoting nerve regeneration in fracture sites.③Fracture healing is a complex mechanism, the role of nerve growth factor on bone tissue is multifaceted, multi-level and cross-cutting, its mechanism have not yet been fully proved. CONCLUSION： Although some research progress have been achieved about the nerve growth factor on promoting fracture healing, it is still at the preliminary stage and its mechanism is unclear.