组织工程技术在儿童下尿路重建修复中的若干问题

Problems of tissue engineering in reconstruction and repair of lower urinary tract in children.

组织工程的发展日新月异,并且在儿童下尿路重建修复的临床前研究中取得了不错的成效。但临床前研究在向临床转化时效果都不太理想。临床转化失败的原因很多,其中最重要的一点是临床前研究常使用的是健康动物模型,从而不能准确模拟病态组织的结构和功能。针对当前组织工程向临床转化的困境,很多新的研究方案也应运而生,包括使用多种来源的干细胞,改善移植物血供,应用可控释放生长因子的新型支架,探究深层次的信号通路以及细胞间相互作用等,但单用其中一种方法很难在临床应用中获得成功。本文阐述组织工程技术在儿童下尿路重建修复中已取得的研究进展及当前面临的主要问题。

Tissue engineering undergoes constant evolutions and it has achieved considerable progress in pediatric urology.However,almost all outcomes of clinical application have been unsatisfactory.Many reasons may explain a failure of clinical transformation and the most important one is that healthy animal models,employed frequently for preclinical studies,fail to accurately imitate the structures and functions of pathological tissues.For overcoming current difficulties of clinical transformation,many new research programs have emerged,including using stem cells from various sources,improving blood supply of grafts,employing new scaffolds with a controllable release of growth factors,exploring deep signaling pathways and cellular interactions.None of the methods alone can achieve final success in clinical practice.This paper reviews the progress and major dilemmas of tissue engineering in pediatric lower urinary tract and discusses their solutions.