组织工程气管临床应用的研究与进展

Clinical application and progress of tissue-engineered trachea

背景:以组织工程气管作为移植气管,不但能降低抗原细胞的表达,抑制免疫反应,还能够预先在体外进行气管的血管化以及相关组织细胞的再生培养。目的:总结归纳常用的气管移植的方法,介绍组织工程气管的最新临床移植方式,为开展该类手术提供参考依据。方法:以tissue engineering,trachea,transplantation为检索词,检索Pubmed数据库(1990-01/2009-05),ScienceDirect数据库(1990-01/2009-05),Springer数据库(1990-01/2009-05);以组织工程学,气管,移植为检索词,检索CNKI数据库(1990-01/2009-05)。文献检索语种限制为英文和中文。纳入与气管移植相关的临床研究和动物实验;排除重复文献。结果与结论:计算机初检得到270篇文献,根据纳入排除标准,对其中32篇文献进行分析。由于各种原因引起的气管不可逆性损伤且需移植置换的情况在临床工作中日趋增多,而移植气管的材料来源一直是制约临床气管移植的主要问题。体外构建组织工程气管用于移植被视为气管修复的有效途径。文章对气管移植及组织工程气管的起源与发展进行回顾,且对近年来较常用的同种异体移植,自体组织移植及生物材料移植等方法,生物支架材料的构建研究,种子细胞的选取研究,组织工程气管的临床应用进展等进行简要叙述,并对最新的利用同种异体气管与剔除供者免疫细胞进行种子细胞培养相结合的方法,成功完成全球首例人造气管移植的案例进行着重的介绍。

BACKGROUND：Tissue-engineered trachea serving as a tracheal transplant,can not only reduce the expression of antigen cells,suppress immunoreaction,but also in advance conduct vascularization of blood vessels and regeneration culture of tissue cells in vitro. OBJECTIVE：To summarize the commonly used methods for tracheal transplantation,to introduce the latest clinical transplantation method of tissue-engineered trachea,and to provide reference evidence for carrying out such operations. METHODS：Taking tissue engineering,trachea,transplantation in English as search terms,Pubmed database from January 1990 to May 2009,ScienceDirect database from January 1990 to May 2009,Springer database from January 1990 to May 2009 was retrieved; Taking tissue engineering,trachea,transplantation in Chinese as search terms,CNKI database from January 1990 to May 2009 was researched. Literatures were limited to English and Chinese languages. Inclusive criteria：clinical studies and animal experiments related to the tracheal transplantation; exclusive criteria：duplicate documents. RESULTS AND CONCLUSION：Totally 270 literatures were screened out by computer,according to inclusion and exclusion criteria,32 documents of which were involved for analysis. There is an increasing cases with irreversible injury of tracheal resulted from various reasons and in need of transplantation during clinical work,and the material source of tracheal transplantation is always the main problem to limited the clinical use. Constructing tissue-engineered trachea in vitro is considered to be a good way for repairing trachea. This paper will review the origin and development of tracheal transplantation and tissue-engineered trachea,summarize the common method of allotransplantation,autotransplantation and biomaterial transplantation,as well as the research of constructing bio-scaffold,choosing seed cells and clinical applied development of tissue-engineered trachea,and emphatically introduce the first case of successful artificial tracheal transplantation by combining the method of allotransplantation and culturing the seed cell without the immune cells of donor.