不同支架材料与间充质干细胞构建组织工程韧带在前交叉韧带损伤中的应用

Different scaffolds with mesenchymal stem cells to construct tissue engineered ligament in anterior cruciate ligament injury

背景:前交叉韧带是连接于股骨和胫骨之间的致密结缔组织,是能维持膝关节前向稳定性的重要结构,前交叉韧带损伤会导致膝关节前向不稳,若不及时治疗,将继发软骨、半月板等结构损伤。目的:综述间充质干细胞与不同支架材料构建组织工程韧带在前交叉韧带损伤中的应用。方法:应用计算机检索1950-01/2010-11PubMed数据库相关文章,检索词"ACL,stemcells,MSC,tendon,ligament"。共检索到文献103篇,最终纳入符合标准的文献35篇。结果与结论:应用间充质干细胞和支架构成的组织工程韧带目前已成功在动物实验中应用,间充质干细胞能明显加快韧带损伤修复,加强组织愈合的生物力学性能,但是再生组织的生物力学性能仍未达到正常肌腱水平。同时,间充质干细胞能促进移植物与骨的愈合,防止前交叉韧带重建后腱骨不愈合导致的失败。选择合适的间充质干细胞,支架,适当的机械刺激和必要的细胞因子是构建良好组织工程韧带的关键。随着组织工程科学及支架材料工程学的发展,应用间充质干细胞构建组织工程韧带不久将从实验室走向临床应用。

BACKGROUND：Anterior cruciate ligament（ACL） is a strong,dense structure connecting femur and tibia.It is important for forward stability of the knee joint.ACL injury may cause knee joint unstable.If it does not have proper treatment,cartilage,meniscus and other structural may have secondary injury.OBJECTIVE：To review the application of different scaffolds with mesenchymal stem cells（MSCs） in treating ACL injury.METHODS：PubMed database was researched by computer o search articles published from 1950-01 to 2010-11 with key words of ＂ACL,stem cells,MSC,tendon,ligament＂.Totally 103 papers were selected,and 35 articles were included in final analysis.RESULTS AND CONCLUSION：Tissue-engineered ligament constructed with mesenchymal stem cells and scaffolds is successfully used in animal experiements.MSCs can significantly speed up the repair of ligament damage and strengthen the biomechanical properties of healed tissue,but the biomechanical properties of regenerated tissue has not yet reached the level of normal tendon.At the same time,MSCs can promote the healing of the ligament-bone enthesis,prevent failure due to ligament-bone nonunion after ACL reconstruction.To select the appropriate MSCs,scaffold,mechanical stimulation and necessary cytokines is the key to construct tissue engineered ligament.With the development of tissue engineering and scaffold materials,MSCs constructed tissue engineered ligament will be soon introduced from basic research to clinical application.