Groupe de recherche en écologie buccale, Faculté de médecine dentaire, Université Laval, Pavillon de médecine dentaire, 2420 Rue de la Terrasse, Local 1728, Québec, Canada G1V 0A6.
Med Hypotheses. 2011 Apr;76(4):489-91. doi: 10.1016/j.mehy.2010.11.031. Epub 2010 Dec 22.
Translating advances in the laboratory into sound clinical practice presents a series of formidable conceptual and technical challenges. One of them is our inability to maintain large grafts of living cells upon transfer from in vitro conditions into the host in vivo. This is due mainly to diffusion limitations within the grafting material. We embrace the well-known hypothesis of the "Diamond Concept" in bone tissue regeneration, which includes four key factors. Based on the understanding of basic elements of tissue engineering constructs, prefabrication and conditioning techniques and the nano-vascularisation of the scaffold, we furthermore hypothesize that combinations of cells, solid multipolymeric scaffold as the "core element" working as the extracellular matrix (ECM), growth factors and nano-vascularisation setting may eventually generate a large "ready-to-use"in vitro/in vivo graft. We are confident and think that growth factors will help in the construction of a step-by-step organisation of the bone tissue engineering construct (BTEC). A medical device, named in vitro/in vivo Bone Bioreactor Tissue Engineering Construct (IV2B2TEC), is proposed to fulfil the hypothesis. Soon, we hope to test the above hypothesis on a non-union bone defect in an animal model. This novel strategy will likely open new options for reconstructing extended bone defects and facilitate clinical translation of bone tissue engineering. As compared with conventional reconstructive methods, the strategy has four key advantages and might prove to be a novel armamentarium for clinicians in regenerative medicine.
将实验室的进展转化为合理的临床实践提出了一系列艰巨的概念和技术挑战。其中之一是，我们无法将大量活细胞从体外条件转移到宿主体内时，保持其存活。这主要是由于移植物内的扩散限制所致。我们接受骨组织再生的“钻石概念”这一著名假说，其中包括四个关键因素。基于对组织工程构建体的基本要素、预制和调节技术以及支架的纳米血管化的理解，我们进一步假设细胞、作为细胞外基质（ECM）的“核心元素”的固体多聚物支架、生长因子和纳米血管化的组合可能最终产生一个大型的“即用型”体外/体内移植物。我们有信心并认为，生长因子将有助于构建骨组织工程构建体（BTEC）的逐步组织化。提出了一种名为体外/体内骨生物反应器组织工程构建体（IV2B2TEC）的医疗器械来验证该假说。我们希望很快在动物模型的骨不连缺损上对上述假说进行测试。这种新策略可能为重建扩展的骨缺损提供新的选择，并促进骨组织工程的临床转化。与传统的重建方法相比，该策略有四个关键优势，可能为再生医学的临床医生提供一种新的手段。
