外泌体在骨不连治疗中的作用机制及进展

Mechanism and progress of exosomes in the treatment of nonunion

背景:骨不连是骨折术后常见的并发症,给患者带来了极大的困扰。随着外泌体技术的不断研发,外泌体在骨不连的治疗中逐渐显露优势,成为医疗工作新的研究方向。目的:从国内外研究中归纳总结,探讨外泌体在骨不连治疗中的作用。方法:中文以"外泌体,骨不连,骨重塑,骨再生,血管损伤,成骨细胞,破骨细胞"检索万方、中国知网、维普文献数据2003至2019年的相关文献,英文以"exosomes,nonunion,boneremodelling",检索Pub Med数据库2003至2019年的相关文献,根据纳入及排除标准摘选50篇文章。结果与结论:(1)近年来,外泌体作用于骨不连的研究得到越来越多的重视,外泌体中的mi RNA及蛋白质可以通过影响骨细胞的分化作用于骨不连;(2)随着进一步的研究发现,外泌体可通过调节骨重塑,促进血管修复,改善系统性疾病等方面治疗骨不连;(3)但是目前对于外泌体的研究仍处于实验阶段,如何将其更好地应用于临床治疗还需进一步的探究。

BACKGROUND: Bone nonunion is a common complication after fracture, which brings great distress to patients. With the continuous development of exosomal technology, exosomes gradually show their advantages in the treatment of nonunion, which has become a new research direction in medical work. OBJECTIVE: To summarize the researches in and outside China and explore the role of exosomes in the treatment of nonunion.METHODS: The authors retrieved related Chinese articles published from 2003 to 2019 in Wanfang database, CNKI and VIP database with the key words of "exosomes, nonunion, bone remodeling, bone regeneration, vascular injury, osteoblasts, osteoclasts" and related English articles published from 2003 to 2019 in Pub Med with the key words of "exosomes, nonunion, bone remodeling". Totally 50 articles were selected based on inclusion and exclusion criteria. RESULTS AND CONCLUSION:(1) In recent years, more and more attention has been paid to the study of exosomes on bone nonunion. Mi RNAs and proteins in exosomes can affect bone nonunion by affecting the differentiation of osteocytes.(2) Studies have found that exosomes can treat bone nonunion by regulating bone remodeling, promoting vascular repair, and improving systemic diseases.(3) However, the current research on exosomes is still in the experimental stage. The specific method of how to better apply it to clinical treatment needs further exploration.