组织工程骨修复骨缺损的研究进展及临床应用

Research progress and clinical application of repairing bone defects using tissue engineered bone

背景:随着生物技术的兴起,以生物材料来制作移植替代物的组织工程学正在不断地发展,因此组织工程骨修复骨缺损也成为当前的研究热点。目的:概述国际上关于骨组织工程研究的现状及临床应用的进展。方法:应用计算机检索PubMed数据库、Springer Link数据库、Science Direct数据库2000-01/2009-03文献,检索词为"tissue engineering of bone,bone defect,clinical applications"。选择与组织工程骨修复骨缺损相关的种子细胞、支架材料、动物模型、血管化和临床应用的文章,无论观察对象为人或动物均纳入检索标准。结果与结论:骨缺损的修复是临床上的难题之一,传统吻合血管的自体骨移植是治疗局部骨缺损的金标准,但是其存在供骨区并发症及数量有限的缺点。而无活性的异体骨虽然不受数量的限制,但是存在排异和传染疾病的可能。因此利用组织工程技术构建组织工程骨是修复骨缺损的趋势。组织工程骨包含具有骨传导性的支架、释放诱导成骨的生长因子、负载具有成骨潜能的细胞及组织工程骨血管化或充足的血供4个关键元素,因此要准确地评估组织工程骨修复骨缺损的作用,需要进一步理解参与骨再生的各种因素及其相互作用,同时还要在标准化动物模型研究中衡量积极因素和可能的有害影响。骨组织工程在实验研究领域已经显示出了积极的作用和相当大的发展前景,但在进入临床应用以前还有很多问题等待解决。

BACKGROUND：With the development of biotechnology,repairing bone defects using tissue engineered bone has become a hot spot.OBJECTIVE：To overview the research progress and clinical applications of repairing bone defects with tissue engineered bone.METHODS：The databases of PubMed,Springer Link,and Science Direct were retrieved for papers published from January 2000 to March 2009 with key words of ＂tissue engineering of bone,bone defect,and clinical applications＂.The relevant papers concerning stem cell,scaffold material,animal model,vascularization during repairing bone defects with tissue engineered bone were collected.RESULTS AND CONCLUSION：Bone defect reparation has been a clinical challenge.The traditional autogenous bone transplantation was the gold standard for local bone defects,which had drawback of complication.It is an ideal technique that applying allogeneic bone scaffolds without number restrictions to repair bone defects,which had possibility of rejection reaction and infection.Therefore,the applications of tissue engineered bone are the tendency.The tissue engineered bone comprised 4 key elements：bone conductive scaffolds,releasing osteogenic growth factor,loaded osteogenic potential cells,as well as vascularization.Thus,the factors involved in osteanagenesis and its relations,as well as animal model studies should be evaluated during bone defects reparation.There have been shown positive roles and considerable development prospects of tissue engineered bone,but many issues have to be solved before the clinical applications.