组织工程窦房结构建及血管化的最新研究与应用进展

Construction and vascularization of tissue-engineered sinus node in cardiac tissue engineering

背景:理论上组织工程窦房结移植入体内可以建立新的起搏点,并且可以随着机体发育,达到治疗窦房结综合征的目的,但目前仍处于最初级的阶段,需要进行不断的探索。目的:总结综述现阶段组织工程窦房结构建的不同方法及心脏组织工程血管化的研究进展。方法:由第一作者检索Pub Med数据库及CNKI全文数据库1984年至2016年的相关文献,并进行筛选,归纳和总结。英文检索词为"Vascularize,Tissue Engineering,Sinus Node",中文检索词为"血管化、组织工程、窦房结"。阐述组织工程窦房结的构建方法,总结归纳了各种心脏组织工程血管化的重要性及策略,分析组织工程窦房结血管化应用的方法,最后组织工程窦房结血管化进行总结和展望。结果与结论:起搏种子细胞的选择大致为窦房结原代细胞,脂肪、骨髓间充质干细胞,胚胎干细胞等。组织工程支架材料更是种类繁多,活体的窦房结本身就处于胶原支架上,因此胶原类材料更为适用于组织工程窦房结。3D打印技术、细胞膜片技术使血管化组织工程窦房结的构建和移植成为可能。移植早期的血液供应,是窦房结移植是否成功的关键,组织工程窦房结血管化的相关文献在仍处于空白状态,内皮祖细胞作为成血管能力较强的细胞已经有了巨大的进展,但是仍有一些缺陷,还面临着重大的挑战。

BACKGROUND： As in theory tissue-engineered sinus node can establish a new pacemaker in vivo when implanted into the human body, it is a promising treatment for sick sinus syndrome. But this method is immature and needs to be explored in depth. OBJECTIVE： To overview the different construction methods of tissue-engineered sinus node, and the research progress of vascularization in cardiac tissue engineering. METHODS： A computer-based retrieval in PubMed and CNKI databases was performed by the first author to search related papers published from 1984 to 2016 using the keywords of ＂vascularize, tissue engineering, sinus node＂ in English and Chinese, respectively. We summarized the construction methods of tissue-engineered sinus node and importance of vascularization in cardiac tissue engineering. RESULTS AND CONCLUSION： Sinus node cells, bone marrow mesenchymal stem cells, adipose-derived mesenchymal stem cells and embryonic stem cells can be used as seed cells. There are a variety of materials used for constructing tissue-engineered scaffolds, among which, collagen is the best choice. Three-dimensional printing technology and cell-sheet techbology make it possible to construct and transplant tissue-engineered sinus node. The early blood supply is the key for the successful sinus node transplantation. However, the vascularized tissue-engineered sinus node has not yet been reported. Endothelial progenitor cells can promote angiogenesis, but further explorations are warranted as there are some existing defects.