Steinert Andre F, Ghivizzani Steven C, Rethwilm Axel, Tuan Rocky S, Evans Christopher H, Nöth Ulrich
Orthopaedic Center for Musculoskeletal Research, König-Ludwig-Haus, Julius-Maximilians-University, Würzburg, Germany.
Arthritis Res Ther. 2007;9(3):213. doi: 10.1186/ar2195.
Hyaline articular cartilage, the load-bearing tissue of the joint, has very limited repair and regeneration capacities. The lack of efficient treatment modalities for large chondral defects has motivated attempts to engineer cartilage constructs in vitro by combining cells, scaffold materials and environmental factors, including growth factors, signaling molecules, and physical influences. Despite promising experimental approaches, however, none of the current cartilage repair strategies has generated long lasting hyaline cartilage replacement tissue that meets the functional demands placed upon this tissue in vivo. The reasons for this are diverse and can ultimately result in matrix degradation, differentiation or integration insufficiencies, or loss of the transplanted cells and tissues. This article aims to systematically review the different causes that lead to these impairments, including the lack of appropriate differentiation factors, hypertrophy, senescence, apoptosis, necrosis, inflammation, and mechanical stress. The current conceptual basis of the major biological obstacles for persistent cell-based regeneration of articular cartilage is discussed, as well as future trends to overcome these limitations.
透明关节软骨作为关节的承重组织，其修复和再生能力非常有限。由于缺乏针对大面积软骨缺损的有效治疗方法，人们尝试通过将细胞、支架材料和环境因素（包括生长因子、信号分子和物理影响）相结合，在体外构建软骨组织。然而，尽管实验方法前景乐观，但目前的软骨修复策略均未产生能够满足该组织在体内功能需求的持久透明软骨替代组织。造成这种情况的原因多种多样，最终可能导致基质降解、分化或整合不足，或移植细胞和组织的丧失。本文旨在系统回顾导致这些损伤的不同原因，包括缺乏适当的分化因子、肥大、衰老、凋亡、坏死、炎症和机械应力。文中还讨论了基于细胞的关节软骨持续再生面临的主要生物学障碍的当前概念基础，以及克服这些限制的未来趋势。
