Lindahl Anders
Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, and Institute of Biomedicine, Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska University Hospital, SE413 45 Gothenburg, Sweden
Philos Trans R Soc Lond B Biol Sci. 2015 Oct 19;370(1680):20140369. doi: 10.1098/rstb.2014.0369.
This review addresses the progress in cartilage repair technology over the decades with an emphasis on cartilage regeneration with cell therapy. The most abundant cartilage is the hyaline cartilage that covers the surface of our joints and, due to avascularity, this tissue is unable to repair itself. The cartilage degeneration seen in osteoarthritis causes patient suffering and is a huge burden to society. The surgical approach to cartilage repair was non-existing until the 1950s when new surgical techniques emerged. The use of cultured cells for cell therapy started as experimental studies in the 1970s that developed over the years to a clinical application in 1994 with the introduction of the autologous chondrocyte transplantation technique (ACT). The technology is now spread worldwide and has been further refined by combining arthroscopic techniques with cells cultured on matrix (MACI technology). The non-regenerating hypothesis of cartilage has been revisited and we are now able to demonstrate cell divisions and presence of stem-cell niches in the joint. Furthermore, cartilage derived from human embryonic stem cells and induced pluripotent stem cells could be the base for new broader cell treatments for cartilage injuries and the future technology base for prevention and cure of osteoarthritis.
本综述阐述了数十年来软骨修复技术的进展，重点是细胞疗法促进软骨再生。最丰富的软骨是覆盖我们关节表面的透明软骨，由于其无血管性，该组织无法自我修复。骨关节炎中出现的软骨退变给患者带来痛苦，也是社会的巨大负担。直到20世纪50年代新的手术技术出现，软骨修复的手术方法才得以问世。20世纪70年代开始将培养细胞用于细胞疗法的实验研究，经过多年发展，1994年随着自体软骨细胞移植技术（ACT）的引入而应用于临床。该技术现已在全球推广，并通过将关节镜技术与在基质上培养的细胞相结合（MACI技术）得到进一步完善。软骨的非再生假说已被重新审视，我们现在能够证明关节中存在细胞分裂和干细胞龛。此外，源自人类胚胎干细胞和诱导多能干细胞的软骨可能成为治疗软骨损伤的新型更广泛细胞疗法的基础，以及预防和治疗骨关节炎的未来技术基础。
