生长板损伤修复的研究进展

Research advances in repair of growth plate injury

生长板是软骨内成骨的发育中心,在形态和功能上可分为静息带、增殖带、前肥大带与肥大带。生长板损伤常导致儿童肢体长度差异和成角畸形等骨骼生长缺陷。目前的矫形手术损伤较大且效果有限,尚缺乏有效的生物疗法。动物模型的生长板损伤后修复的细胞与分子事件可分为4个阶段:炎症期、成纤维期、成骨期与重塑期。现有研究表明,参与上述过程调控的相关分子,如炎症细胞因子肿瘤坏死因子α、促有丝分裂的血小板衍生生长因子以及调节成骨的血管内皮生长因子、骨形态蛋白均参与生长板损伤修复的调节。对生长板损伤修复机制的探究可能为生物疗法的研发提供新的靶标。此外,软骨组织工程的发展,尤其是间充质细胞的应用也为生长板损伤修复提供潜在的干预措施。

Growth plate,the developmental center of endochondral osteogenesis,can be divided morphologically and functionally into a resting zone,a proliferative zone,a prehypertrophic zone and a hypertrophic zone.Injuries to growth plate often lead to bone growth defects including limb length discrepancy and angulation deformity in children.Currently,their orthopedic corrective surgeries are invasive and limitedly effective and no effective biotherapy has been available.Previous studies on animal models of growth plate damage have investigated the related cellular and molecular events in the repair of damaged growth plates in the 4 distinct inflammatory,fibrogenic,osteogenic and remodeling phases.Related molecules involved in the regulation of the above processes,such as inflammatory cytokines tumor necrosis factor alpha,mitogenic platelet-derived growth factor and bone morphogenetic protein,are found to participate in the regulation of growth plate injury.Exploration of the mechanisms may provide new targets for biotherapy.In addition,development of cartilage tissue engineering,especially application of mesenchymal stem cells,also provides potential interventions for growth plate injury.