骨折血管生成与骨愈合:对血管内皮生长因子作用的系统评价

Fracture vascularity and bone healing: a systematic review of the role of VEGF.

作者信息

Keramaris N C, Calori G M, Nikolaou V S, Schemitsch E H, Giannoudis P V

机构信息

Academic Dept of Trauma & Orthopaedics, Leeds Teaching Hospitals, University of Leeds, Leeds, UK.

出版信息

Injury. 2008 Sep;39 Suppl 2:S45-57. doi: 10.1016/S0020-1383(08)70015-9.

Abstract

Fracture healing constitutes a complex and delicate physiological process. Local vascularity at the site of the fracture has been identified as one of the most significant parameters influencing the healing procedure. VEGF is the most important component of the regeneration of the vascular system at the fracture site. The aim of this review is to determine the evidence supporting the direct role of VEGF in the enhancement of fracture healing and the possible clinical use of VEGF for non-unions. The literature search was performed via the internet using the Medline. The key words which were searched in the abstracts were the terms "VEGF", "angiogenesis", "fracture", "bone" and "healing". Twenty-five articles were relevant to the topic of interest. A total of 11 articles were excluded from our research due to non conformity of their content to the inclusion criteria. Evidence retrieved suggests that VEGF could be extremely valuable for the treatment of critical size bone defects and that VEGF could have a direct effect on osteoprogenitor cells, mainly by promoting the differentiation of osteoblasts and by increasing the mineralisation of the regenerated bone. The former observation could have very interesting repercussions for the field of non-unions and the latter for the field of osteoporosis.

摘要

骨折愈合是一个复杂而精细的生理过程。骨折部位的局部血管生成已被确认为影响愈合过程的最重要参数之一。血管内皮生长因子(VEGF)是骨折部位血管系统再生的最重要组成部分。本综述的目的是确定支持VEGF在促进骨折愈合中直接作用的证据以及VEGF在治疗骨不连方面可能的临床应用。通过互联网使用Medline进行文献检索。在摘要中搜索的关键词是“VEGF”、“血管生成”、“骨折”、“骨”和“愈合”。25篇文章与感兴趣的主题相关。由于内容不符合纳入标准,共有11篇文章被排除在我们的研究之外。检索到的证据表明,VEGF对于治疗临界尺寸骨缺损可能极具价值,并且VEGF可能对骨祖细胞有直接作用,主要是通过促进成骨细胞的分化以及增加再生骨的矿化。前一个观察结果可能对骨不连领域有非常有趣的影响,而后一个观察结果对骨质疏松领域有影响。

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