再生医学之组织工程耳廓软骨再生与功能重建

Regenerative medicine of tissue engineering: auricular cartilage regeneration and functional reconstruction

对于人类来说,耳廓收集声波的功能意义远低于其外观价值,因此,耳廓外形或位置的任何异常都是难以接受的。耳廓组织缺损的常见原因包括四类:先天畸形、炎症、外伤或手术(医源性)。支撑耳廓外形的软骨属于弹力软骨,维持着耳廓独特的外形与功能,相对于软骨表面的皮肤组织,软骨再生能力弱,而且来源有限,因此耳廓缺损重建的重点在于如何恢复其弹性软骨支架。另外,与其他部位的软骨修复不同,耳廓软骨重建不仅要考虑其功能,而且对外观的要求更高。

Deformity of the auricle can result from congenital defects,oncologic resection,or traumatic injury.Current clinical strategy is to utilize autologous costal cartilage for reconstructing auricular scaffolds with long-term stability.However,this method is limited by donor-site morbidity,a complex surgical sculpting process,and differing mechanical properties compared to elastic auricular cartilage.Alternatively,alloplastic implants can offer precise shape and avoid donor-site surgery,but suffer from poor biocompatibility and high rates of infection and extrusion.A tissue engineering approach to auricular reconstructions would overcome the limitations of both autologous and alloplastic transplants.In this review we focus on tissue engineering auricular cartilage reconstruction,including auricular seed cells culture and their differentiated control strategy,scaffolds choices and design technique.Many studies found that auricular chondrocytes were the most suitable seed cells to fabricate elastic cartilage;progenitor cells from auricular cartilage could differentiate into elastic chondrocytes,and other types of chondrocytes had its limitation because of the final ossification.Many types of growth factors had the differing potential ability for accelerating chondrocytes growth,differentiation,or maintaining chondrocytes phenotype.Recent advances in tissue engineering auricular cartilage,including several clinic applications,implied that tissue engineering auricules would become a hopefully potential soulution for the future of auricular reconstruction.