干细胞外泌体修复肌腱及腱骨止点的作用及机制研究进展

Research progress in the effect and mechanism of stem cell-derived exosomes in tendon and enthesis repair

肌腱和腱骨止点损伤是常见的运动损伤,严重影响患者日常活动和生活质量。手术重建是肌腱和腱骨止点损伤的主要治疗手段。但由于修复后的肌腱及腱骨止点结构与原生组织差异较大,手术效果常不理想,易再次撕裂。外泌体是一种内含多种活性物质的脂质双层小囊泡,在细胞间通信中发挥重要作用。其中干细胞外泌体作为一种新兴的无细胞治疗手段,在药物递送、组织工程、退行性疾病等领域中得到广泛研究,但其在肌腱及腱骨止点修复中的作用关注较少。因此,笔者就肌腱及腱骨止点的组织学特点和修复过程、干细胞外泌体对肌腱和腱骨止点的修复作用及机制研究进展进行综述,旨在为肌腱及腱骨止点损伤的基础研究及临床治疗提供新思路。

Tendon and enthesis injuries are common sports injuries that seriously impair patients′daily activities and quality of life.Surgical reconstruction is the main treatment for tendon and enthesis injuries.However,the surgical effect is often unsatisfactory due to the structure of repaired tendon and enthesis remaining different from those of the native ones,and re-rupture is prone to occur.Exosomes are lipid bilayer vesicles containing varieties of active substances,which play a crucial role in the communication of different cells.As a new cell-free therapy,stem cell-derived exosomes have been widely studied in the fields of drug delivery,tissue engineering and degenerative diseases,but their role in tendon and enthesis repair is rarely concerned.Therefore,the authors review tendon and enthesis injuries from aspects of histological features,repair process,and repair effect and mechanism of action of stem cells-derived exosomes,aiming to provide new insights into the basic research and clinical treatment of tendon and enthesis injuries.