组织工程学治疗脊髓损伤的研究进展

Tissue engineering for the treatment of spinal cord injury

脊髓损伤（spinal cord injury，SCI）的治疗一直是世界性难题。SCI后原发和继发性神经元死亡以及神经营养因子的缺乏，使脊髓缺乏自我修复的能力。胶质瘢痕被吞噬细胞吞噬后形成囊腔成为轴突再生的永久性屏障。近年来，组织工程学的发展使SCI患者有了新的希望。组织工程技术的应用已成为SCI后轴突再生和神经功能恢复的研究热点。组织工程是指应用生命科学与工程学的原理与技术，在正确认识哺乳动物正常及病理两种状态下的组织结构与功能关系的基础上，研究、开发用于修复、维护和促进人体各种组织或器官损伤后功能和形态的生物替代物的一门新兴学科。早期的组织工程，如皮肤和软骨的移植已成功应用于大面积烧伤和严重软骨退变和损伤的患者。随着科学的进展，已有研究显示，非细胞支架、脱细胞脊髓支架以及纳米材料等移植可以促进大鼠SCI的恢复。这些支架材料可以使种植在其上的细胞定居、维持表型和传递生化递质及营养，可以较为一致地引导神经细胞生长以及轴突延长与重塑，从而重建神经网络。然而，SCI的研究还需组织工程学、数学建模和发育生物学等多学科领域研究人员协作，以取得更加深入和精细化的进展。利用生物体自组织的过程，给予最小的干预来引导组织修复过程向期望的结果发展。本文着重对组织工程学的发展以及其在SCI治疗中的作用进行综述。

The treatment of spinal cord injury （SCI） has been a worldwide problem. After spinal cord injury, primary and secondary spinal cord neuronal death and lack of neurotrophins will damage the self-repair ability of the injured spinal cord, Glial scar or the cavity formed by the phagocytic cells has become the permanent barrier of axonal regeneration. In recent years, the de- velopment of tissue engineering has become a new hope for patients with spinal cord injury. The application of tissue engineering technology has become a hot research topic in axonal regeneration and functional recovery after spinal cord injury. Tissue engi- neering is a new subject which applies the principle and technology of life science and engineering, based on the correct under- standing of normal and pathological state of organizational structure and function relationship, to research and develop biological substitutes for repair, maintenance and promotion of function and morphology of human tissue or organ after damage. In early days, skin and cartilage grafts have been successfully used in patients with large area burns and severe cartilage degeneration or injury. Studies have shown that non-cell scaffold, acellnlar spinal cord scaffold and nano materials, can promote the recovery of spinal cord injury in rats. These scaffolds let implanted ceils settled, maintaining the phenotype and delivery of biochemical factors and nutrition. It can provide guidance for nerve cell growth and axon extension in the favorable direction, thereby reconstructing the neural network. However, in order to gain more deep and meticulous study progress of spinal cord injury, we need to continue to collaborate with researchers in the field of engineering, mathematical modeling and developmental biology. The use of minimal engineering interventions to guide the process to the desired result should be developed by using the process of biological self-organi- zation. This paper focused on the development of tissue engineering and its role in the treatment of spinal cord injury.