基因活化材料在骨科组织损伤修复中的应用

Application of gene-activated-matrix in the repair of orthopaedic tissue injury

背景:基因活化材料是新型的专为组织工程设计的转基因材料。目前基因活化材料技术在骨科主要用于骨折不愈合、软骨以及肌腱韧带损伤的修复。目的:分析目前基因活化材料在骨科组织损伤修复中的应用,为临床应用提供参考。方法:以"Gene-Activated-Matrix,GAM"英文检索词及"基因活化材料,组织工程,骨与软骨损伤修复,肌腱韧带损伤修复"中文检索词,检索CNKI中国知网数据库和PubMed数据库1999-01/2010-09相关文献128篇。纳入与骨组织工程及基因活化材料有关的基础性、前瞻性及临床性研究,排除标准重复性研究,保留其中的26篇进行分析。结果与结论:目前基因活化材料技术在骨科主要用于骨折、软骨以及肌腱韧带损伤的修复。随着分子生物学和基因工程技术的发展,可利用基因活化材料修复关节软骨损伤,通过转基因的靶细胞持续大量分泌生长因子来修复损伤的关节软骨。目前,基因治疗存在的主要问题是基因转染的安全性、基因表达的可控性、以及寻找合适的基因载体。同时,基因活化材料治疗为韧带和肌腱损伤愈合也提供了新的治疗途径。大量研究表明利用基因活化材料治疗在组织损伤修复方面具有有效性和可行性,但仍面临许多问题需要解决。

BACKGROUND：Gene-activated-matrix（GAM） is a new kind of transgenic matrix designed for tissue engineering. At present GAM is used for repairing of nonunion,cartilaginous injury,ligament and tendon injury in orthopaedics. OBJECTIVE：To analyze the application of GAM in the repair of orthopaedic tissue injury,and to provide reference for further clinical application of GAM in orthopedics METHODS：＂Gene-Activated-Matrix,GAM＂ in English and ＂gene-Activated-Matrix,GAM,tissue engineering,bone and cartilage injury repair,ligament and tendon injury repair＂ in Chinese were utilized as search terms to retrieve 128 literatures from CNKI database and PubMed database（1999-01/2010-09） . The researches related to basic,prospective,and clinical study of bone tissue engineering and GAM were included,standard duplicate researches were excluded,26 of them were involved for analysis. RESULTS AND CONCLUSION：GAM is currently mainly used for the repair of fractures,cartilage,and tendon and ligament injury. With the development of molecular biology and genetic engineering technology,GAM can be used to repair articular cartilage injury,the target cells by transgenic continued high secretion of growth factors to repair articular cartilage injury. Currently,the main problems of gene therapy are the safety of gene transfer,the controllability of gene expression,and appropriate gene vector. Meanwhile,GAM treatment also provides a new therapeutic approach for the healing of ligament and tendon injuries. Numerous studies showed that GAM treatment has efficacy and feasibility in tissue injury repair,but still faces many problems to be solved.