De Bari Cosimo, Dell'accio Francesco
Department of Rheumatology, King's College London, London, UK.
Clin Sci (Lond). 2007 Oct;113(8):339-48. doi: 10.1042/CS20070126.
The advent of biologics in rheumatology has considerably changed the evolution and prognosis of chronic inflammatory arthritis. The success of these new treatments has contributed to steering more attention to research focussed on repair and remodelling of joint tissues. Indeed, when the tissue damage is established, treatment options are very limited and the risk of progression towards joint destruction and failure remains high. Increasing evidence indicates that mesenchymal stem cells persist postnatally within joint tissues. It is postulated that they would function to safeguard joint homoeostasis and guarantee tissue remodelling and repair throughout life. Alterations in mesenchymal stem cell biology in arthritis have indeed been reported but a causal relationship has not been demonstrated, mainly because our current knowledge of mesenchymal stem cell niches and functions within the joint in health and disease is very limited. Nonetheless, mesenchymal stem cell technologies have attracted the attention of the biomedical research community as very promising tools to achieve the repair of joint tissues such as articular cartilage, subchondral bone, menisci and tendons. This review will outline stem-cell-mediated strategies for the repair of joint tissues, spanning from the use of expanded mesenchymal stem cell populations to therapeutic targeting of endogenous stem cells, resident in their native tissues, and related reparative signals in traumatic, degenerative and inflammatory joint disorders.
生物制剂在风湿病学领域的出现极大地改变了慢性炎症性关节炎的发展进程和预后。这些新疗法的成功促使人们更加关注聚焦于关节组织修复和重塑的研究。确实，当组织损伤形成后，治疗选择非常有限，且关节破坏和功能丧失的进展风险仍然很高。越来越多的证据表明，间充质干细胞在出生后持续存在于关节组织中。据推测，它们的作用是维持关节内环境稳定，并确保一生的组织重塑和修复。关节炎中间充质干细胞生物学特性的改变确实已有报道，但尚未证实存在因果关系，主要是因为我们目前对健康和疾病状态下关节中间充质干细胞龛及其功能的了解非常有限。尽管如此，间充质干细胞技术作为实现关节组织如关节软骨、软骨下骨、半月板和肌腱修复的极具前景的工具，已引起了生物医学研究界的关注。本综述将概述干细胞介导的关节组织修复策略，范围从使用扩增的间充质干细胞群体到对驻留在其天然组织中的内源性干细胞以及创伤性、退行性和炎症性关节疾病中的相关修复信号进行治疗靶向。
