心脏脱细胞基质支架的制备及临床应用前景

Preparation and application of cardiac decellularized matrix scaffolds

背景:全天然的心脏脱细胞支架材料可提供与受体类似的宏观及微观结构、基质成分和血管网分布,是较理想的心脏生物组织工程材料。目的:综述心脏脱细胞基质支架材料的制备方法、成分特征、生物学特性及其在心脏再植方面的最新研究进展。方法:应用计算机检索Pub Med数据库、万方数据库2008年1月至2017年4月有关心脏脱细胞基质的文献,检索词为"heart,cardiac muscle,myocardial tissue,decellularized matrix;心脏,心肌,脱细胞基质",去除与心脏瓣膜有关的文章,最终选取代表性的英文文献44篇、中文文献6篇。结果与结论:目前制备心脏脱细胞基质支架的方法有:物理处理、化学方法和生物学处理(酶解法)法。心脏的细胞外基质支架主要含有Ⅰ、Ⅲ和Ⅳ型胶原、糖氨聚糖、纤连蛋白、层粘连蛋白及少量生长因子。目前,脱细胞基质在心肌组织工程上的应用主要分为3个方向:基于脱细胞基质片层的"创可贴"心肌组织工程研究;基于脱细胞基质的可注射性心肌组织工程研究;基于心脏全器官脱细胞-再细胞化的人工心脏再造研究。尽管心脏脱细胞基质支架方面已取得了一些成功的经验,但用于心脏再植的临床应用还有许多问题亟待解决。

BACKGROUND:All-natural cardiac decellularized scaffold material has macroscopic and microstructure,matrix components and vascular network distribution similar to the receptor,which is an ideal material for heart tissue engineering.OBJECTIVE:To summarize the preparation methods,composition characteristics,biological characteristics and the latest research progress of cardiac decellularized matrix scaffold.METHODS:Relevant articles published from January 2008 to April 2017 were searched in PubMed and Wanfang databases using the keywords of“heart,cardiac muscle,myocardial tissue,decellularized matrix”in English and Chinese,respectively.Finally,50 representative articles(44 in English and 6 in Chinese)were included with the exception of the articles that were associated with cardiac valves.RESULTS AND CONCLUSION:Currently,the methods of preparing cardiac decellular matrix scaffolds include physical processing,chemical method and biological treatment(enzymatic method).Cardiac extracellular matrix scaffolds mainly contain I,III and IV collagen,glycosaminoglycans,fibronectin,laminin and a small amount of growth factors.At present,the application of the decellular matrix in myocardial tissue engineering includes three directions:the"band-aid"myocardial tissue engineering study based on decellular matrix lamella;the study of the myocardial tissue engineering on injectable myocardial tissue engineering based on the decellular matrix;and the study of decellularized-recellularized artificial cardiac reengineering based on the cardiac all-organ.Although some successful experience has been achieved in the stents,their use in the cardiac replantation still has many problems to be solved.