组织工程化肌腱的构建与运动性肌腱损伤

Construction of tissue-engineered tendon and exercise-induced tendon injury

目的:总结评价构建组织工程化肌腱生物支架材料的性能及作用,以寻找合理的肌腱替代物。方法:以"组织工程;肌腱修复;生物材料支架;运动性肌腱损伤"为中文关键词,"tissue engineering,tendon repairing,biological material scaffold,sport injury of tendon"为英文关键词,采用计算机检索1994-01/2009-12相关文章。纳入与有关运动性肌腱损伤与组织工程肌腱相关的文章;排除重复研究或Meta分析类文章。以16篇文献为主,重点对一下5个问题进行了讨论:①肌腱的组织学特征?②肌腱移植材料种类及组织工程肌腱种子细胞的来源?③如何解决同种异体肌腱细胞的免疫学反应?④如何制备与筛选特殊力学强度的支架材料?⑤伦理学问题。结果:与传统肌腱修复比较,组织工程化肌腱具有许多优点:解决了供体肌腱来源问题;组织工程化肌腱具有活力和功能,植入后可与受体肌腱愈合,永久性替换缺损肌腱;可根据缺损肌腱任意塑型,在重建功能的同时达到形态修复的目的。但是构建组织工程化肌腱,还有许多问题有待研究和解决。如何提高支架材料应用性,研制具有与正常人体肌腱组织相接近的力学性能的支架材料是其中的关键性问题。结论:模拟体内环境,解决组织工程肌腱构建的生物材料、种子细胞,以及在体外成功构建肌腱组织是未来组织工程肌腱构建过程中的研究的重点。

BACKGROUND：To summarize the features and roles of tissue-engineered tendon and to explore an ideal substitute for tendon.METHODS：Documents published between January 1994 and December 2009 was searched by computer using Keywords of ＂tissue engineering,tendon repairing,biological material scaffold,and sport injury of tendon＂.Papers related to exercise-induced tendon injury and tissue-engineered tendon were included,repetitive research or Meta analysis was excluded.A total of 16 documents were discussed around the following five questions：① What are the histologic characteristics of tendon？ ② Where does seed cells for tissue-engineered tendon from and what is the category of tendon materials？ ③ How to solve the immunological reaction？ ④ How to prepare and select scaffold materials？ ⑤Ethical issues.RESULTS：Compared with the conventional tendon repair,the tissue-engineered tendons are characterized by sufficient resources,fully healing with recipient tendon,permanently replaced the defected tendon,and easily molding.However,there still problem needs to be solved in the construction of tissue-engineered tendons.The key problem is how to prepare a scaffold material that has similar mechanical property as normal human tendon.CONCLUSION：How to simulating in vivo environment,solving biomaterials and seed cells selection,and in vitro construction of tissue-engineered tendon are the research focus of tissue-engineered tendons.