Dhillon Robinder S, Schwarz Edward M
The Center for Musculoskeletal Research, University of Rochester, Rochester (14623), NY, USA.
Materials (Basel). 2011 Jun;4(6):1117-1131. doi: 10.3390/ma4061117. Epub 2011 Jun 15.
Critically sized large bone defects commonly result from trauma, radical tumor resections or infections. Currently, massive allografting remain as the clinical standard to treat these critical defects. Unfortunately, allograft healing is limited by the lack of osteogenesis and bio-integration of the graft to the host bone. Based on its widely studied anabolic effects on the bone, we have proposed that teriparatide [recombinant parathyroid hormone (PTH(1-34))] could be an effective adjuvant for massive allograft healing. In support of this theory, here we review studies that have demonstrated that intermittent PTH(1-34) treatment enhances and accelerates the skeletal repair process via a number of mechanisms including: effects on mesenchymal stem cells (MSC), angiogenesis, chondrogenesis, bone formation and remodeling. We also review the current literature on the effects of PTH(1-34) therapy on bone healing, and discuss this drug's long term potential as an adjuvant for endogenous tissue engineering.
临界大小的大骨缺损通常由创伤、根治性肿瘤切除或感染引起。目前，大块同种异体骨移植仍是治疗这些临界缺损的临床标准方法。不幸的是，同种异体骨愈合受到缺乏成骨作用以及移植物与宿主骨生物整合的限制。基于其对骨骼广泛研究的合成代谢作用，我们提出特立帕肽[重组甲状旁腺激素（PTH(1-34)）]可能是促进大块同种异体骨愈合的有效辅助药物。为支持这一理论，在此我们回顾了一些研究，这些研究表明间歇性PTH(1-34)治疗通过多种机制增强并加速骨骼修复过程，这些机制包括：对间充质干细胞（MSC）的作用、血管生成、软骨形成、骨形成和重塑。我们还回顾了当前关于PTH(1-34)治疗对骨愈合影响的文献，并讨论了这种药物作为内源性组织工程辅助药物的长期潜力。
