Levi Benjamin, Glotzbach Jason P, Wong Victor W, Nelson Emily R, Hyun Jeong, Wan Derrick C, Gurtner Geoffrey C, Longaker Michael T
Hagey Laboratory for Pediatric Regenerative Medicine Research Laboratory and Plastic and Reconstructive Surgery Division, Department of Surgery, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California 94305, USA.
J Craniofac Surg. 2012 Jan;23(1):319-22. doi: 10.1097/SCS.0b013e318241dbaf.
With the rapidly expanding field of tissue engineering, surgeons have been eager to apply these principles to craniofacial surgery. Tissue engineering strategies combine the use of a cell type placed on a scaffold and subsequently implanted to address a tissue defect or tissue dysfunction. In this review we will discuss the current clinical need for skeletal and soft tissue engineering faced by craniofacial surgeons and subsequently we will explore cell types and scaffold designs being employed for tissue engineering treatment options. We will conclude by discussing ways to enhance the vascularity of tissue engineered constructs as this will ultimately allow for a definitive repair. Current “stem cell” options include pluripotent stem cells as well as multipotent mesenchymal cells. Biomimetic scaffolds can function to protect and enhance differentiation of stem cells by providing inductive cues. Larger scale studies including prospective, randomized control trials must be performed to determine the optimum cell delivery method and cytokine stimuli for tissue engineering driven strategies to address the clinical needs in skeletal and soft tissue reconstruction.
随着组织工程领域的迅速发展，外科医生一直渴望将这些原理应用于颅面外科手术。组织工程策略将置于支架上的细胞类型的使用与随后的植入相结合，以解决组织缺损或组织功能障碍。在本综述中，我们将讨论颅面外科医生目前在骨骼和软组织工程方面面临的临床需求，随后我们将探讨用于组织工程治疗方案的细胞类型和支架设计。我们将通过讨论增强组织工程构建体血管化的方法来得出结论，因为这最终将实现确定性修复。当前的“干细胞”选择包括多能干细胞以及多能间充质细胞。仿生支架可通过提供诱导信号来保护和增强干细胞的分化。必须进行包括前瞻性、随机对照试验在内的更大规模研究，以确定用于组织工程驱动策略的最佳细胞递送方法和细胞因子刺激，以满足骨骼和软组织重建的临床需求。
