骨免疫调制(osteoimmunomodulation)在成骨中的研究进展

Research updates of osteoimmunomodulation in osteogenesis

大节段骨缺损的治疗金标准仍然是自体骨移植,合成生物材料由于植入引起的炎症反应、降解特性、生物相容性等导致难以替代自体骨移植。鉴于此,近年来,骨免疫研究及具有免疫调节功能的生物材料的开发越来越受到重视。免疫系统通过调节细胞的炎症表型向抗炎表型的转换及炎症因子反应对骨愈合起着重要作用。在骨缺损部位炎症反应的发生包括免疫细胞的浸润(如巨噬细胞、中性粒细胞、 T细胞、 B细胞)和炎症因子的释放,如白细胞介素1β(IL-1β)、 IL-6、肿瘤坏死因子α(TNF-α)等,影响骨愈合的进程和结局。如何开发具有免疫调节功能的生物材料对骨缺损,尤其是大节段骨缺损的治疗具有重要意义。为此,深入了解免疫系统中重要细胞和因子在骨缺损中的重要作用,有助于先进的具有免疫调节作用的功能性生物材料的开发。但免疫系统对骨愈合影响的机制尚不完全清楚,还需要更多的研究和探索。

The gold-standard for bone substitution of large bone defects continues to be autogenous bone graft.Artificial bone substitutes are difficult to replace the autogenous bone grafting due to excessive immune response,fast biodegradation characteristics and inappropriate biocompatibility.Given these drawbacks,osteoimmunology and its advanced functional biomaterials have gained growing attention in recent years.Immune system plays an essential role during bone healing via regulating the shift from inflammatory to anti-inflammation phenotype,and inflammatory cytokines response.The inflammatory reaction mainly include infitration of immune cells(such as macrophages,neutrophils,T cells,B cells,etc)and release of inflammatory factors(such as IL-1β,IL-6,TNF-α,etc.)at the bone defects,which subsequently affect the step-wised process of bone healing rejuvenation.Hence,advanced bone biomaterials with immunomodulatory properties is of great significance for the treatment of patients with recalcitrant bone defects,especially for delayed healing or non-union.The reciprocal mechanism of immuno-modulated bone healing,however,is not fully understood and more research is required in the future.