间充质干细胞在鼓膜再生组织工程中的应用进展

Progress in application of mesenchymal stem cells in tissue engineering of tympanic membrane regeneration

鼓膜是听力传导的重要结构和中耳的保护屏障,鼓膜穿孔可致听力功能减退、耳溢夜甚至严重的并发症。外伤、中耳感染和鼓膜置管遗留造口是鼓膜穿孔的主要原因。耳鼻喉科医生可以采用外科手术来闭合穿孔的鼓膜,但由于手术技术要求、费用昂贵及手术并发症等限制,需要有更好的替代外科手术的方法。为解决这一问题,组织工程学已应用于实验和临床研究,包括使用一系列生物相容性支架、生长因子和干细胞来恢复和改善鼓膜的功能。间充质干细胞(MSCs)是一种能够分化为多种细胞类型的前体细胞,可从多种组织中分离出来,且易于体外培养。由于其生物学特性,目前MSCs在许多疾病的治疗中备受关注。研究表明单独使用MSCs或将其与生物材料联合应用于鼓膜破裂部位都可能会促进角质形成细胞的迁移和增殖,从而促进穿孔鼓膜闭合。本文就MSCs在鼓膜再生中的应用以及其可能作用机制作一综述,同时探讨MSCs应用中现存的问题。

Eardrum is an important structure of hearing conduction and a protective barrier of the middle ear.Perforation may causes hearing loss,otorrhea and even serious complications.Trauma,middle ear infection and tympanostomy are the main causes of tympanic membrane perforation.Otolaryngologists will close the perforated eardrum via a surgery intervention.However,due to the limitations of surgical technical requirements,high costs,and surgical complications,it is necessary to find out a better alternative to surgical methed.With respect to this issue,the tissue engineering has been applied in experimental and clinical studies,including the biocompatible scaffolds,growth factors and stem cells to restore and improve the function of the eardrum.Mesenchymal stem cells(MSCs)are progenitors that can differentiate into a variety of cell types,can be isolated from a variety of tissues,and facilitiy to be cultured in vitro.Due to its biological characteristics,MSCs have attracted much attention in the treatment of many diseases.Studies have shown that the application of MSCs alone or in combination with biomaterials at the site of tympanic membrane rupture may promote the migration and proliferation of keratinocytes and thereby promote the closure of perforated tympanic membrane.This paper reviews the application of MSCs in tympanic membrane regeneration and its potential mechanism,and discusses the existing problems in the application of MSCs.