Division of Bioengineering, National University of Singapore, Singapore.
Biomaterials. 2011 Jan;32(2):395-409. doi: 10.1016/j.biomaterials.2010.08.101. Epub 2010 Oct 8.
The regenerative potential of injured adult tissue suggests the physiological existence of cells capable of participating in the reparative process. Recent studies indicate that stem-like cells residing in tissues contribute to tissue repair and are replenished by precursor bone marrow-derived cells. Mesenchymal stromal cells (MSC) are among the candidates for reparative cells. These cells can potentially be mobilized into the circulation in response to injury signals and exert their reparative effects at the site of injury. Current therapies for musculoskeletal injuries pose unavoidable risks which can impede full recovery. Trafficking of MSC to the injury site and their subsequent participation in the regenerative process is thought to be a natural healing response that can be imitated or augmented by enhancing the endogenous MSC pool with exogenously administered MSC. Therefore, a promising alternative to the existing strategies employed in the treatment of musculoskeletal injuries is to reinforce the inherent reparative capacity of the body by delivering MSC harvested from the patient's own tissues to the site of injury. The aim of this review is to inform the reader of studies that have evaluated the intrinsic homing and regenerative abilities of MSC, with particular emphasis on the repair of musculoskeletal injuries. Research that supports the direct use of MSC (without in vitro differentiation into tissue-specific cells) will also be reported. Based on accruing evidence that the natural healing mechanism involves the recruitment of MSC and their subsequent reparative actions at the site of injury, as well as documented therapeutic response after the exogenous administration of MSC, the feasibility of the emerging strategy of instant stem-cell therapy will be proposed.
受伤成人组织的再生潜能表明存在能够参与修复过程的细胞的生理存在。最近的研究表明，驻留在组织中的干细胞样细胞有助于组织修复，并通过前体细胞骨髓来源的细胞得到补充。间充质基质细胞（MSC）是修复细胞的候选者之一。这些细胞可能会响应损伤信号而被动员到循环中，并在损伤部位发挥其修复作用。目前治疗肌肉骨骼损伤的方法存在不可避免的风险，这可能会阻碍完全康复。MSC 向损伤部位的迁移及其随后参与再生过程被认为是一种自然的愈合反应，可以通过增强内源性 MSC 池来模仿或增强，用外源性给予的 MSC 进行增强。因此，替代目前用于治疗肌肉骨骼损伤的策略的有前途的方法是通过将从患者自身组织中采集的 MSC 递送到损伤部位，来增强身体的固有修复能力。本文的目的是让读者了解评估 MSC 固有归巢和再生能力的研究，特别是侧重于肌肉骨骼损伤的修复。还将报告支持直接使用 MSC（无需体外分化为组织特异性细胞）的研究。基于越来越多的证据表明，自然愈合机制涉及 MSC 的募集及其随后在损伤部位的修复作用，以及外源性给予 MSC 后的治疗反应记录，新兴的即时干细胞治疗策略的可行性将被提出。
