Department of Clinical Sciences, VMC C3-181, Cornell University, Ithaca, NY 14853, USA.
Clin Orthop Relat Res. 2011 Oct;469(10):2706-15. doi: 10.1007/s11999-011-1857-3.
Full-thickness chondral defects and early osteoarthritis continue to present major challenges for the patient and the orthopaedic surgeon as a result of the limited healing potential of articular cartilage. The use of bioactive growth factors is under consideration as a potential therapy to enhance healing of chondral injuries and modify the arthritic disease process.
QUESTIONS/PURPOSES: We reviewed the role of growth factors in articular cartilage repair and identified specific growth factors and combinations of growth factors that have the capacity to improve cartilage regeneration. Additionally, we discuss the potential use of platelet-rich plasma, autologous-conditioned serum, and bone marrow concentrate preparations as methods of combined growth factor delivery.
A PubMed search was performed using key words cartilage or chondrocyte alone and in combination with growth factor. The search was open for original manuscripts and review papers and open for all dates. From these searches we selected manuscripts investigating the effects of growth factors on extracellular matrix synthesis and excluded those investigating molecular mechanisms of action.
By modulating the local microenvironment, the anabolic and anticatabolic effects of a variety of growth factors have demonstrated potential in both in vitro and animal studies of cartilage injury and repair. Members of the transforming growth factor-β superfamily, fibroblast growth factor family, insulin-like growth factor-I, and platelet-derived growth factor have all been investigated as possible treatment augments in the management of chondral injuries and early arthritis.
The application of growth factors in the treatment of local cartilage defects as well as osteoarthritis appears promising; however, further research is needed at both the basic science and clinical levels before routine application.
由于关节软骨的愈合潜力有限，全层软骨缺损和早期骨关节炎仍然是患者和骨科医生面临的主要挑战。生物活性生长因子的应用被认为是一种潜在的治疗方法，可以增强软骨损伤的愈合，并改变关节炎的病程。
问题/目的：我们回顾了生长因子在关节软骨修复中的作用，并确定了具有改善软骨再生能力的特定生长因子及其组合。此外，我们还讨论了富血小板血浆、自体条件血清和骨髓浓缩物制剂作为联合生长因子递送方法的潜在用途。
使用关键词“cartilage 或 chondrocyte”单独或与生长因子组合，在 PubMed 上进行了搜索。搜索范围包括原始手稿和综述论文，并涵盖所有日期。从这些搜索中，我们选择了研究生长因子对细胞外基质合成影响的手稿，并排除了研究作用机制的手稿。
通过调节局部微环境，多种生长因子的合成代谢和抗分解代谢作用已在软骨损伤和修复的体外和动物研究中显示出潜力。转化生长因子-β超家族、成纤维细胞生长因子家族、胰岛素样生长因子-I 和血小板衍生生长因子等成员都被研究作为软骨损伤和早期关节炎治疗的潜在辅助手段。
生长因子在局部软骨缺损和骨关节炎治疗中的应用前景广阔；然而，在常规应用之前，还需要在基础科学和临床水平进行进一步的研究。
