基于“免疫微环境调控”的屏障膜研发理念

Research and development concept of barrier membranes based on“immune microenvironment regulation”

引导骨再生技术应用于牙槽骨缺损再生的基础是屏障膜的屏障功能及空间维持作用,因此传统屏障膜的研发策略集中关注其物理屏障功能、降解性能及如何规避免疫原性提高生物相容性。屏障膜不仅能够被动地阻挡结缔组织,其作为“异己”成分植入体内后,会引发宿主持续的免疫反应即异物反应。骨免疫学理论表明免疫系统和骨骼系统联系密切,免疫细胞在骨组织相关的病理生理过程中发挥了重要作用。基于这一研究背景,笔者课题组提出基于“免疫微环境调控”的屏障膜研发理念:通过对屏障膜机械性能、表面性能及理化性能的调控,赋予屏障膜良好的免疫调控能力,诱导良好的局部免疫微环境产生,从而协调成骨与破骨以及屏障膜降解过程,提高引导骨再生中屏障膜成骨效能,满足骨缺损再生修复需求。本文述评了屏障膜的发展沿革及免疫微环境、骨再生、屏障膜三者间的紧密联系,提出基于“免疫微环境调控”的屏障膜研发理念,旨在提高屏障膜的成骨效能,解决牙槽骨缺损再生修复的科学难题。

Guided bone regeneration technology applied in alveolar bone defect regeneration is based on the barrier function and space maintenance of the barrier membrane.Therefore,traditional development strategies for barrier membranes focus on their physical barrier function,degradation characteristics and biocompatibility to avoid immunogenicity.However,not only does the barrier membrane passively block connective tissue,it is recognized as a“foreign body”that triggers a persistent host immune response,known as a foreign body reaction.The theories of osteoimmunology reveal a close relationship between the immune system and bone system and emphasize the role of immune cells in bone tissuerelated pathophysiological processes.Based on these findings,we propose a novel development strategy for barrier membranes based on immune microenvironment regulation:by manipulating mechanical properties,surface properties and physiochemical properties,barrier membranes are endowed with an improved immunomodulation ability,which helps to regulate immune cell reactions to induce a favorable local immune microenvironment,thus coordinating osteogenesis and osteoclastogenesis as well as barrier membrane degradation to increase the efficiency of barrier membranes in GBR applications.In this paper,we review the development of barrier membranes and their close relationship to the immune microenvironment concerning bone regeneration and membrane degradation.Additionally,the outcomes of research on barrier membranes based on the regulation of the immune microenvironment have been summarized to improve the osteogenesis efficiency of barrier membranes and solve the problem of the regeneration and repair of bone defects,especially alveolar bone defects.