摘要
骨关节炎是中老年患者最常见的慢性退行性关节疾病,以关节软骨变性破坏、软骨下骨硬化、滑膜增生为主要病理特点。随着我国人口老龄化,发病人群的不断增加,骨关节炎致残率高,所造成的巨大社会经济负担,难以估量。目前现有的治疗手段包括改变生活方式,止痛药物,关节腔注射激素、透明质酸等,均不能阻止早、中期病变进展,而病变晚期,关节置换术虽然能够获得较好的疗效,但术后感染、假体松动等并发症仍不容忽视。随着对间充质干细胞研究的深入,其作为一种具有多向分化潜能的种子细胞,逐步显示出在慢性退行性疾病治疗中的优势。间充质干细胞能够向目的细胞定向分化,同时分泌一系列因子参与组织修复。目前,已有的临床前研究更多的倾向于间充质干细胞通过间接机制发挥治疗作用。间充质干细胞在临床研究中也显示出对骨关节炎的治疗意义。本文对间充质干细胞的特性、作用机制、应用方式和尚未解决的问题进行总结归纳。
Osteoarthritis, as a most common chronic degenerative disease among elder people, is usually accompanied with cartilage degradation, subehondral bone alteration and synovial hyperplasia as the main features. The disease prevalence is increasing in parallel with an aging population in our country. Osteoarthritis is the most common reason for disability among adults and will impose significant socioeconomic burden. Current treatment, involving modifying life style, oral drugs, corticoste- roid or hyaluronic acid injection, focuses on pain relief and inflammatory modulation but does not prevent the progressive degen- eration of joint tissue. The ultimate solution for osteoarthritis is total joint replacement with artificial prosthetics. This procedure is successfully applied to the hip and knee, however, complications still exist, such as infection, loosening. Mesenchymal stem cell is a multipotent endogenous population of progenitors with capability of differentiation to musculoskeletal tissues and secret- ing a large number of trophic factors, including growth factors, cytokines, chemokines, all participating to the paracrine activity of these ceils. With the discovery of mesenehymal stem cells as possible therapeutic agents, their potential for repairing cartilage damage in osteoarthritis is under investigation. By far, most preclinical studies have given credence to the theory of mesen- chymal stem cells governance of regeneration through paraerine stimulation of the local microenvironment. Proof of concept evi- dence from preclinieal studies has led to the genesis of multiple clinical trials. The purpose of this review is to summarize the current state of mesenchymal stem cells based therapeutics for osteoarthritis and to discuss potential barriers that must be over- come for successful implementation of cell based therapy as a routine treatment strategy in orthopedics.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第1期48-51,共4页
Orthopedic Journal of China
关键词
间充质干细胞
骨关节炎
治疗
mesenchymal stem cells, osteoarthritis, treatment
