骨再生与修复。

Bone regeneration and repair.

机构信息

Department of Surgery, Stanford University School of Medicine, 257 Campus Drive, Stanford, CA 94305-5148, USA.

出版信息

Curr Stem Cell Res Ther. 2010 Jun;5(2):122-8. doi: 10.2174/157488810791268618.

Abstract

In the face of mounting clinical demand, and armed with reconstructive techniques that are technically challenging and frequently result in suboptimal patient outcomes, increasing focus is being placed on tissue engineering and regenerative medicine as a potential source of novel skeletal reconstructive approaches. Specifically, evidence is accumulating that highlights the promise of osteoprogenitor cell-based reconstructive strategies to meet the needs of an expanding patient population. Historically, the study of cell and molecular biology guiding physiologic and pathologic skeletal development, as well as endogenous bone regeneration following injury, has provided a wealth of information that lends insight toward potential parallel processes that may regulate the osteogenic differentiation of progenitor cells. Multiple progenitor cell populations are now known to possess a capacity to undergo robust osteogenic differentiation in the presence of appropriate environmental cues (hESC, BMSC, ASC, etc.) Recent investigations have put forth multiple advantages of ASC relative to BMSC. Of note, ASC exist in relative abundance, lack the need for in vitro expansion prior to utilization, and can be harvested with relative ease and reduced donor morbidity. Collectively, these factors, paired with promising in vitro and in vivo observations that speak toward the substantial osteogenic potential of ASC, have spurred enthusiasm to pursue the application of ASC in the maturation of skeletal tissue engineering applications. Yet, elucidating what structural and functional properties of scaffolds designed for ASC-mediated skeletal tissue engineering applications (porosity, pore size, composition, mechanical stability, degradation kinetics, etc.), as well as evolving our understanding and capacity to deliver spatiotemporally specific pro-osteogenic targeted molecular manipulation to progenitor cells, remain important hurdles to clear. The scope of this review encompasses the current state of ongoing investigations along these fronts, as well as what future direction will be critical to the transition of cell-based skeletal tissue engineering strategies to the bedside.

摘要

面对日益增长的临床需求,以及技术上具有挑战性且经常导致患者结果不理想的重建技术,人们越来越关注组织工程和再生医学作为一种潜在的新型骨骼重建方法。具体来说,越来越多的证据表明,基于成骨前体细胞的重建策略有望满足不断扩大的患者群体的需求。从历史上看,对指导生理和病理骨骼发育以及损伤后内源性骨再生的细胞和分子生物学的研究提供了大量信息,这些信息为可能调节祖细胞成骨分化的潜在平行过程提供了深入了解。目前已知多种祖细胞群体在适当的环境线索存在下(hESC、BMSC、ASC 等)具有很强的成骨分化能力。最近的研究提出了 ASC 相对于 BMSC 的多个优势。值得注意的是,ASC 大量存在,在使用前无需进行体外扩增,并且可以相对容易且减少供体发病率进行收获。总之,这些因素与 ASC 在体外和体内观察到的有希望的大量成骨潜力相结合,激发了人们对探索 ASC 在骨骼组织工程应用中的成熟度的应用的热情。然而,阐明用于 ASC 介导的骨骼组织工程应用的支架的结构和功能特性(多孔性、孔径、组成、机械稳定性、降解动力学等),以及加深我们对时空特异性促成骨靶向分子操纵向祖细胞传递的理解和能力,仍然是需要克服的重要障碍。这篇综述的范围包括沿着这些前沿正在进行的研究的现状,以及未来的方向对于将基于细胞的骨骼组织工程策略转化为临床应用至关重要。

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