人工生物材料在关节软骨损伤修复中的应用

Application of synthetic and biological materials in articular cartilage repair

背景:关节软骨损伤修复是临床上亟待解决的难题,利用人工生物组织工程材料促进软骨再生修复是目前的研究热点之一。目的:对人工生物材料在关节软骨损伤修复中应用的研究进展进行综述。方法:应用计算机检索PubMed数据库和中国知网收录的有关人工生物材料在关节软骨损伤修复中应用的研究,英文检索词为“collagen,gelatin,silk,chitosan,alginate,PEG,PCL,PLA,cartilage tissue engineering,cartilage tissue engineering materials”,中文检索词为“胶原,明胶,丝素蛋白,壳聚糖,海藻酸,聚乙二醇,聚己内酯,聚乳酸,软骨组织工程,软骨组织工程材料”。根据纳入与排除标准对所有文章进行初筛后,保留质量和相关性较高的98篇文献进行综述。结果与结论:天然材料包括胶原、明胶、丝素蛋白、壳聚糖、海藻酸等,具有良好的生物相容性、降解性;合成材料包括聚乙二醇、聚己内酯、聚乳酸等,具有良好的机械性能。材料的改性与复合能够弥补材料本身的缺陷,表现出更优秀的软骨修复能力。基于分层结构合成的多层支架在研究中相对少见,且该支架更多针对骨软骨损伤修复而非单纯的软骨损伤修复。目前支架研究集中在合成研发阶段,相应的临床试验较少,未来需要注重临床应用转化。

BACKGROUND:The repair of articular cartilage injury remains a difficult problem to be solved urgently in clinical practice.Utilizing synthetic or biological materials to promote cartilage regeneration has been a research hotspot.OBJECTIVE:To review the research progress of synthetic and biological materials in articular cartilage repair.METHODS:PubMed and CNKI databases were searched for articles about the progress of synthetic and biological materials utilized in articular cartilage repair.“Collagen,gelatin,silk,chitosan,alginate,PEG,PCL,PLA,cartilage tissue engineering,cartilage tissue engineering materials”were used as English and Chinese search terms,respectively.After preliminary screening based on the inclusion and exclusion criteria,98 articles with high quality and relevance were retained for review.RESULTS AND CONCLUSION:Natural materials,including collagen,gelatin,silk,chitosan,and alginate,have good biocompatibility and degradability.Synthetic materials,containing polyethylene glycol,polycaprolactone,and polylactic acid,have good mechanical properties.Modification and composition of materials can overcome the inherent defects in materials and show better cartilage repair ability.Studies about multi-layer scaffolds based on hierarchical structure are rare,and it is more targeted at osteochondral injury repair rather than simple cartilage injury repair.At present,scaffold research is focused on the synthetic research and development stage,and the corresponding clinical trials are few,so it is necessary to pay attention to clinical transformation in the future.