细胞移植修复椎间盘的新视角与新进展

New insight into cell transplantation for repairing intervertebral discs

背景:目前对椎间盘退变的治疗仅限于姑息治疗或积极的外科干预,但均不能减缓或逆转其进程,远期疗效也不满意。近年来随着组织工程与再生医学的不断发展,运用细胞疗法修复退变椎间盘得到了越来越多的研究者关注。目的:总结目前临床上细胞移植治疗椎间盘退变的现状,为以后的研究提供一些理论基础和实验依据。方法:通过计算机在CNKI、万方数据库、PubMed数据库中检索相关文献,检索时限为2001年1月至2019年1月。检索的中文主题词为“椎间盘退变,细胞治疗,干细胞,细胞移植”;英文主题词为“stem cell,intervertebral disk degeneration”,筛选内容与干细胞治疗椎间盘退变相关的文献,着重选取最新的实验及临床研究成果。结果与结论:椎间盘退变主要以髓核细胞的活力和数量减少、蛋白多糖合成减少、髓核脱水以及代谢废物增多引起的。不断深入了解探索细胞移植促进髓核再生的治疗机制,不仅能够对椎间盘的发病及修复机制有更为详尽的认识,更能够对其他相关疾病的预防与细胞治疗提供新的思路与策略。

BACKGROUND:Current treatment of disc degeneration is limited to palliative care or active surgical intervention,but neither can it slow or reverse disease progression,nor is the long-term efficacy satisfactory.In recent years,with the continuous development of tissue engineering and regenerative medicine,the use of cell therapy to repair degenerative intervertebral discs has attracted more and more researchers’attention.OBJECTIVE:To summarize the current status of cell transplantation in the treatment of intervertebral disc degeneration,and to provide theoretical basis and experimental basis for future research.METHODS:The relevant articles were retrieved from the CNKI,WanFang and PubMed databases by computer.The search time was set from January 2001 to January 2019.The keywords were“intervertebral disc degeneration,cell therapy,stem cells,cell transplantation”in Chinese and English,respectively.Articles related to stem cell treatment of intervertebral disc degeneration,especially focusing on the latest experimental and clinical research results,were included.RESULTS AND CONCLUSION:Degeneration of the intervertebral disc is mainly caused by the decreased vitality and quantity of nucleus pulposus cells,the reduction of proteoglycan synthesis,the dehydration of nucleus pulposus and the increase of metabolic waste.Continuous explorations on the therapeutic mechanism by which cell transplantation promotes nucleus pulposus regeneration cannot only provide a more detailed understanding of the pathogenesis and repair mechanism of intervertebral disc degeneration,but also give new strategies for the prevention and cell therapy of other related diseases.