摘要
学术背景:由骨性关节炎所造成的关节软骨缺损,如果采用传统治疗方法常难以自行完善修复。近年研究发现骨髓间充质干细胞具有较强的自我更新能力和多向分化潜能,在特定的诱导条件下可分化为软骨细胞。目的:总结骨髓间充质干细胞移植治疗骨性关节炎软骨缺损的研究进展。检索策略:由该论文的研究人员应用计算机检索Pubmed数据库2000-01/2006-12的相关文献,检索词"Mesenchymal stem cells,Osteoarthritis,Cartilage defect,Chondrocyte",并限定文章语言种类为English。共检索到57篇文献,对资料进行初审,纳入标准:①与骨髓间充质干细胞修复骨性关节炎软骨缺损密切相关。②同一领域选择近期发表或在权威杂志上发表的文章。排除标准:重复性研究。文献评价:文献的来源主要是骨髓间充质干细胞修复骨性关节炎软骨缺损方面的随机对照试验。所选用的33篇文献中,5篇为综述,其余均为临床或基础实验研究。资料综合:①骨性关节炎的发病率随着老年人口的增长而呈不断上升趋势,因此需要一种有效的促进软骨修复的治疗方法。②骨髓间充质干细胞具有自我更新、增殖和多向分化潜能,在合适细胞因子调控下可分化为软骨细胞。③研究表明,骨髓间充质干细胞复合适当支架可以修复软骨缺损;其在体外诱导培养以及体内移植均能生成软骨,组织形态和化学成分与关节透明软骨接近。④关于骨髓间充质干细胞在软骨修复方面的研究虽已取得较大进展,但仍存在许多问题,如种子细胞的保存;细胞体外培养中分化增殖的调控机制不十分清楚;产生的软骨组织的生物力学性能不太满意;新生软骨中后期是否发生退化;修复组织内细胞分子生物学特性等。结论:骨髓间充质干细胞作为理想的种子细胞,为修复骨性关节炎软骨缺损提供机会窗口,开启了临床应用干细胞治疗的时代,这将为解决骨性关节炎软骨缺损后难以治愈带来曙光。
BACKGROUND： The defect of articular cartilage caused by osteoarthritis cannot be repaired perfectly by traditional treatment. Recent research has found that mesenchymal stem cells （MSCs） have the potential of self-renewal and multiple differentiations and can be induced into chondrocytes under certain conditions. OBJECTIVE： To sum up the research advancement in MSCs transplantation for cartilage defect of osteoarthdtis. RETRIEVE STRATEGY： The relevant articles published between January 2000 and December 2006 were searched for in Pubmed database with the keywords of ＂mesenchymal stem cells, osteoarthritis, cartilage defect, chondrocyte＂ in English. A total of 57 articles were selected firstly. Inclusive criteria included （1）articles closely related with the application of MSCs in the repair of cartilage defect, and （2）the latest articles and articles in authorized journals in the same field. Exclusive criteria included articles on repetitive studies. LITERATURE EVALUATION： The main sources of literatures are randomized controlled trial （RCT） on repair of cartilage defect of osteoarthdtis by MSCs. Among the selected 33 articles, 5 are reviews, and others are clinical or elementary experimental studies. DATA SYNTHESIS： （1）As the. incidence rate of arthritis increases with the aging population, an effective therapy to induce repair of cartilage is needed. （2）MSCs have the potential of self-renewal, proliferation and multiple differentiation and can differentiate into chondrocyte under certain cytokines. （3）The research indicated that MSCs compounded with appropriate scaffold could be utilized for repairing cartilage defect; MSCs could differentiate into chondrocytes via induced culture in vitro and generate articular cartilage in vivo, which could reach the similar tissue form and biochemical component with articular hyaline cartilage. （4）Great progress has been made in research of cartilage defect by MSCs, however there are still a lot of problems, such as the conservation of seeding cells; The regulation mechanism of differentiation and proliferation of cells cultured in vitro is unclear; the biomechanical nature of generated cartilage tissues is not satisfactory; whether the neogenesis cartilage would degenerate in midanaphase; the cellular molecular biological nature in repair tissues and so on. CONCLUSION： As an ideal seeding cells, MSCs provide opportunity for the repair of cartilage defect of osteoarthritis and start an era of using stem cells for clinical treatment. This will bring first light of morning for solving the cartilage defect of osteoarthritis that is hard to cure.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第42期8561-8564,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
