Amini Ami R, Laurencin Cato T, Nukavarapu Syam P
Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, CT, USA.
Crit Rev Biomed Eng. 2012;40(5):363-408. doi: 10.1615/critrevbiomedeng.v40.i5.10.
The worldwide incidence of bone disorders and conditions has trended steeply upward and is expected to double by 2020, especially in populations where aging is coupled with increased obesity and poor physical activity. Engineered bone tissue has been viewed as a potential alternative to the conventional use of bone grafts, due to their limitless supply and no disease transmission. However, bone tissue engineering practices have not proceeded to clinical practice due to several limitations or challenges. Bone tissue engineering aims to induce new functional bone regeneration via the synergistic combination of biomaterials, cells, and factor therapy. In this review, we discuss the fundamentals of bone tissue engineering, highlighting the current state of this field. Further, we review the recent advances of biomaterial and cell-based research, as well as approaches used to enhance bone regeneration. Specifically, we discuss widely investigated biomaterial scaffolds, micro- and nano-structural properties of these scaffolds, and the incorporation of biomimetic properties and/or growth factors. In addition, we examine various cellular approaches, including the use of mesenchymal stem cells (MSCs), embryonic stem cells (ESCs), adult stem cells, induced pluripotent stem cells (iPSCs), and platelet-rich plasma (PRP), and their clinical application strengths and limitations. We conclude by overviewing the challenges that face the bone tissue engineering field, such as the lack of sufficient vascularization at the defect site, and the research aimed at functional bone tissue engineering. These challenges will drive future research in the field.
全球范围内骨疾病和病症的发病率急剧上升，预计到2020年将翻倍，尤其是在老龄化与肥胖增加及身体活动不足并存的人群中。由于工程化骨组织供应无限且无疾病传播，它被视为传统骨移植的潜在替代物。然而，由于一些限制或挑战，骨组织工程实践尚未进入临床应用。骨组织工程旨在通过生物材料、细胞和因子治疗的协同组合诱导新的功能性骨再生。在本综述中，我们讨论骨组织工程的基本原理，突出该领域的现状。此外，我们回顾生物材料和基于细胞研究的最新进展，以及用于增强骨再生的方法。具体而言，我们讨论广泛研究的生物材料支架、这些支架的微观和纳米结构特性，以及仿生特性和/或生长因子的掺入。此外，我们研究各种细胞方法，包括间充质干细胞（MSC）、胚胎干细胞（ESC）、成体干细胞、诱导多能干细胞（iPSC）和富血小板血浆（PRP）的使用，以及它们的临床应用优势和局限性。我们通过概述骨组织工程领域面临的挑战来得出结论，例如缺损部位血管化不足，以及针对功能性骨组织工程的研究。这些挑战将推动该领域未来的研究。
