声带再生医学的研究进展

Research progress in regenerative medicine of vocal ford

声带是发声器官的主要组成部分,声带的振动是人们日常生活工作中语音交流的基础。声带萎缩、声带瘢痕、声带损伤等破坏了声带独特的分层结构,是导致发音障碍的重要原因。声带固有层细胞外基质的紊乱,如胶原蛋白沉积、透明质酸减少,致使声带黏弹性下降,继而影响其有效振动。现今治疗手段,如脂肪组织、透明质酸等材料的声带局部注射,不能恢复声带组织细胞外基质,达不到声带再生的效果。目前有以细胞因子为代表的分子技术和以干细胞为代表的细胞学技术,重建细胞外基质,恢复声带正常结构,从而达到声带再生的目的。但这些技术还在研究阶段,尚未确定为常规临床治疗方法。本文介绍声带的生理结构和发音原理,并从支架、干细胞、细胞因子三个方面,综述声带再生医学的研究进展,以及研究中所存在的挑战。

Vocal fold is the major component of the vocal organ,the oscillation within which is the basis of verbal communication in daily life and work of people.Vocal ford atrophy,scar,and injury are the main causes of dysphonia,principally due to the damage of the unique layered structure of the vocal fold.Disorganized extracellular matrix of the lamina propria-excessive collagen composition and reduction in hyaluronic acid-lead to a loss of viscoelasticity of vocal fold and destroy its capacity to vibrate.The current therapeutic methods are limited,such as intracordal injection of adipose tissue,hyaluronic acid,and other materials since they cannot recover the abnormal distribution of extracellular matrix components.At present,there are molecular technology represented by cytokines and cytological technology represented by stem cells,to reconstruct the extracellular matrix and restore the normal structure of vocal ford,to achieve the purpose of vocal ford regeneration.However,these techniques are still in research and have not been established as routine clinical procedures.This review not only introduces the physiological structure and pronunciation principle of vocal ford,but also describes the research progress of regenerative medicine of vocal fold from three aspects:scaffolds,stem cells,and cytokines.We also identify some obstacles to advance in research.