骨与软骨组织工程中骨形态发生蛋白的特征与临床应用

Clinical application of bone morphogenetic proteins in bone and cartilage tissue engineering

背景:自从1965年美国Urist等研究发现骨形态发生蛋白有助于骨重新生长后,在全世界范围内掀起了骨诱导研究的热潮,中国对于骨形态发生蛋白的研究近年也进入大规模的临床研究试验阶段。目的:回顾近年来骨形态发生蛋白在骨与软骨组织工程的临床应用及相关研究进展。方法:以"Bone morphogenetic protein, Bone tissue engineering, Cartilage tissue engineering,Osteoarthritis,Fracture,Nonunion,Bone defect,Osteonecrosis of femoral head,Gene therapy"或"骨形态发生蛋白,骨组织工程,软骨组织工程,关节炎,骨折,骨不连,骨缺损,股骨头坏死,基因治疗"等作为检索词,由第一作者检索2000年至2018年PubMed、Medline、Embase、中国知网、万方、维普等数据库收录的与骨形态发生蛋白在骨与软骨临床应用研究相关的文献报道,并排除重复性研究,共纳入62篇文章进行综述分析。结果与结论:通过从关节炎治疗、骨折治疗、骨不连及骨缺损治疗、股骨头坏死治疗、基因治疗等5个方面进行综述讨论,系统阐述了骨形态发生蛋白在骨与软骨组织工程中的临床应用研究及临床疗效报道。骨形态发生蛋白是一种具有强大的骨诱导活性成骨因子,具有促进骨生长作用,同时还具有软骨、肌腱及韧带等促进修复作用,因其较高的有效性和安全性近年来在界内倍受推崇。多种转化生长因子相互协同、复合一起作用于骨与软骨组织工程中的临床应用将成为今后骨科研究的热点之一,有待继续深入研究。

BACKGROUND:Since the Urist et al.from the USA found that bone morphogenetic proteins contribute to bone regrowth in 1965,bone induction has been a hot spot worldwide.In recent years,the study on bone morphogenetic proteins in China has also entered the clinical trial stage.OBJECTIVE:To review the clinical application and research progress of bone morphogenetic proteins in bone and cartilage tissue engineering.METHODS:“Bone morphogenetic protein,bone tissue engineering,cartilage tissue engineering,osteoarthritis,fracture,nonunion,bone defect,osteonecrosis of femoral head,gene therapy”in English and Chinese,respectively were used as keywords.The first author retrieved the literature concerning the clinical application of bone morphogenetic proteins in bone and cartilage in PubMed,Medline,Embase,CNKI,WanFang,and VIP databases from 2000 to 2018.A total of 62 eligible articles were included after excluding repeated studies.RESULTS AND CONCLUSION:From five aspects including arthritis,fracture,bone nonunion,bone defect;femoral head necrosis and gene therapy,clinical researches and outcomes of BMPs in bone and cartilage tissue engineering are summarized.Bone morphogenetic proteins possess strong bone-inducing active osteogenic factor,which can not only promote bone growth,but also promote the repair of cartilage,tendons and ligaments.Because of its high effectiveness and safety,it has been highly regarded in recent years.A variety of transforming growth factors mutually applied in bone and cartilage tissue engineering will become a hot spot in orthopedic research,which needs further investigation.