干细胞疗法:一种用于前交叉韧带重建术后腱骨愈合的有前景的生物学策略。

Stem cell therapy: a promising biological strategy for tendon-bone healing after anterior cruciate ligament reconstruction.

作者信息

Hao Zi-Chen, Wang Shan-Zheng, Zhang Xue-Jun, Lu Jun

机构信息

Department of Orthopaedics, Zhongda Hospital, Medical School of Southeast University, Nanjing, 210009, China.

Surgical Research Center, Medical School of Southeast University, Nanjing, 210009, China.

出版信息

Cell Prolif. 2016 Apr;49(2):154-62. doi: 10.1111/cpr.12242. Epub 2016 Mar 1.

Abstract

Tendon-bone healing after anterior cruciate ligament (ACL) reconstruction is a complex process, impacting significantly on patients' prognosis. Natural tendon-bone healing usually results in fibrous scar tissue, which is of inferior quality compared to native attachment. In addition, the early formed fibrous attachment after surgery is often not reliable to support functional rehabilitation, which may lead to graft failure or unsatisfied function of the knee joint. Thus, strategies to promote tendon-bone healing are crucial for prompt and satisfactory functional recovery. Recently, a variety of biological approaches, including active substances, gene transfer, tissue engineering and stem cells, have been proposed and applied to enhance tendon-bone healing. Among these, stem cell therapy has been shown to have promising prospects and draws increasing attention. From commonly investigated bone marrow-derived mesenchymal stem cells (bMSCs) to emerging ACL-derived CD34+ stem cells, multiple stem cell types have been proven to be effective in accelerating tendon-bone healing. This review describes the current understanding of tendon-bone healing and summarizes the current status of related stem cell therapy. Future limitations and perspectives are also discussed.

摘要

前交叉韧带(ACL)重建术后的腱骨愈合是一个复杂的过程,对患者的预后有重大影响。自然的腱骨愈合通常会形成纤维瘢痕组织,其质量低于天然附着组织。此外,手术后早期形成的纤维附着通常不足以支持功能康复,这可能导致移植物失败或膝关节功能不理想。因此,促进腱骨愈合的策略对于迅速且令人满意的功能恢复至关重要。最近,包括活性物质、基因转移、组织工程和干细胞在内的多种生物学方法已被提出并应用于增强腱骨愈合。其中,干细胞疗法已显示出有前景的前景并受到越来越多的关注。从常用的骨髓间充质干细胞(bMSCs)到新兴的ACL来源的CD34 +干细胞,多种干细胞类型已被证明可有效加速腱骨愈合。本文综述了目前对腱骨愈合的认识,并总结了相关干细胞治疗的现状。还讨论了未来的局限性和前景。

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