干细胞构建软骨组织工程研究进展

Research progress in tissue- engineered cartilage construction with stem cells

[背景]创伤后软骨的再生能力是很有限的,而目前处理小的软骨缺损的方法有以下几种:(1)姑息治疗,包括关节镜下的清理和冲洗;(2)修补治疗,骨髓刺激疗法,如微骨折术;(3)修复治疗,包括骨软骨的移植和自体软骨细胞的移植。大的缺损的处理,一般使用同种异体骨软骨移植,或全关节成形术。然而软骨缺损治疗的未来,要靠软骨再生技术所提供的生物医学解决方法。[目的]探讨近年来软骨组织工程的进展,总结干细胞及其他方面进步和发展方向。[方法]检索关于干细胞构建软骨组织工程的文章,在标题和摘要中以"stem cell、tissue engineering、cartilage、bioreactor"为检索词进行检索。最终选择45篇文献进行综述。[结果与结论]实验室和临床研究都已经验证了软骨组织工程治疗大的缺损的方法。再生的软骨可以来自于软骨细胞,多能干细胞和间充质干细胞。支架材料的来源包括蛋白质,碳水化合物,合成材料,复合高分子材料等。软骨诱导生长因子的应用可以加强软骨的形成。生物反应器的发明,能加强体外组织工程软骨的营养运输,提供所需的机械刺激。多学科研究方法的运用,使得临床运用软骨再造技术有希望变为现实。

[Background]The regeneration capacity of posttraumatic cartilage is limited. Current methods for small cartilage defects include alleviative treatment by cleaning and flushing through arthroscopy,reparative therapy through microfracture techniques,restorative therapy through osteochondral grafting,and autologous chondrocyte implantation techniques. For large defects,we generally use osteochondral allografts or total joint arthroplasty. However,the treatment of cartilage defects in the future relies on biomedical technology to provide cartilage regeneration solutions. [Objective]This study aimed to review the recent progress and development in research on stem cells and cartilage tissue engineering. [Method]Articles from a database that are related to tissue- engineered cartilage construction with stem cells were retrieved through a computer by using the English search key words ＂ stem cell,＂ ＂ tissue engineering,＂ ＂ cartilage,＂ and ＂ bioreactor＂ in the title and summary. Finally,45 articles were included. [Result and Conclusion]Laboratory and clinical studies have validated a treatment method for large defects that utilizes cartilage tissue engineering. Cartilage can regenerate from chondrocytes,pluripotent stem cells,and mesenchymal stem cells. Sources of scaffold generally include proteins,carbohydrates,synthetic materials,and composite polymer materials. Application of growth factors can induce enhanced cartilage formation. The invention of bioreactors can enhance nutrient transport in vitro in tissue-engineered cartilage and provide the required mechanical stimulation. With the use of multidisciplinary research methods,clinical application of a cartilage recycling technology is expected to become a reality.