钛种植体表面改性对巨噬细胞极化和诱导成骨的影响

Effects of titanium implant surface modification on macrophage polarization and osteogenesis

背景:单纯采用骨形成细胞评价钛种植体材料的生物学性能已不能满足获得早期和长期稳定的骨结合的要求。为实现上述目标,必须深入理解种植体与机体界面相互作用,同时考量包括巨噬细胞在内的体内免疫因素对种植材料的重要影响,指导种植体表面改性。目的:综述近年来钛种植体表面物理、化学性质和生物改性对巨噬细胞极化和诱导成骨影响的研究现状。方法:第一作者应用计算机检索PubM ed、Springerlink、Web of Science、ScienceD irect、CNKI、维普、万方数据库2010年1月至2017年12月发表的文献,选择有关钛种植体、巨噬细胞极化、诱导成骨的文献。结果与结论:巨噬细胞作为固有免疫反应的主要效应细胞,是种植体植入机体后首先到达种植体-组织界面、含量最丰富的一种细胞。种植体表面的不同物理化学和生物改性可通过激活巨噬细胞的M1炎症极化方向或者M2组织愈合方向,进而在种植体骨结合中发挥关键性作用。同时,种植体表面改性还对巨噬细胞诱导成骨有着重要的影响。未来发展方向是从免疫学角度解释种植体-宿主相互作用的愈合机制,研发新型钛种植体,通过巨噬细胞的免疫调节作用诱导骨形成并获得骨偶联的内稳态平衡,实现早期和长期稳定的骨结合。

BACKGROUND:A single use of bone-forming cells to evaluate the biological properties of titanium implant materials cannot meet the demands of early and long-term stable osseointegration.In order to fulfill the objective mentioned above,it is necessary to understand the interaction between implant and body at the interface of implantation.It is also urgent to consider the invaluable function of immunological factors including macrophage,so as to guide the implant surface modification.OBJECTIVE:To review the influence of physical,chemical and biological surface modifications of implants on the macrophage polarization and osteogenesis.METHODS:The first author conducted a computer-based retrieval of PubMed,Springerlink,Web of Science,ScienceDirect,CNKI,CqVip and WanFang databases for relevant articles published from January 2010 to December 2017.The key words were“titanium,implant,macrophage,polarization,osteogenesis”in English and Chinese,respectively.RESULTS AND CONCLUSION:Macrophages represent the first and the most abundant cells in contact with these implant materials and act as main effector cells in the intrinsic immune response.Surface modifications of implants play an important role in osseintegration by a M1“tissue-inflammatory”polarization or M2“wound-healing”activation.Furthermore,implant surface modification also affects the osteoinductive ability of macrophage.Future research intends to explain the bone healing mechanism between implant and host tissues from the immunological aspect and develop new-type titanium implants.New surface modification methods of implants,which could induce osteogenesis and acquire bone coupling and homeostasis,will be developed to fulfill early-and long-term stable osseointegration.