Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, P.R. China.
National Tissue Engineering Center of China, Shanghai, P.R. China.
Sci Rep. 2017 Jan 13;7:40489. doi: 10.1038/srep40489.
Functional reconstruction of large osteochondral defects is always a major challenge in articular surgery. Some studies have reported the feasibility of repairing articular osteochondral defects using bone marrow stromal cells (BMSCs) and biodegradable scaffolds. However, no significant breakthroughs have been achieved in clinical translation due to the instability of in vivo cartilage regeneration based on direct cell-scaffold construct implantation. To overcome the disadvantages of direct cell-scaffold construct implantation, the current study proposed an in vitro cartilage regeneration strategy, providing relatively mature cartilage-like tissue with superior mechanical properties. Our strategy involved in vitro cartilage engineering, repair of osteochondral defects, and evaluation of in vivo repair efficacy. The results demonstrated that BMSC engineered cartilage in vitro (BEC-vitro) presented a time-depended maturation process. The implantation of BEC-vitro alone could successfully realize tissue-specific repair of osteochondral defects with both cartilage and subchondral bone. Furthermore, the maturity level of BEC-vitro had significant influence on the repaired results. These results indicated that in vitro cartilage regeneration using BMSCs is a promising strategy for functional reconstruction of osteochondral defect, thus promoting the clinical translation of cartilage regeneration techniques incorporating BMSCs.
功能重建大的骨软骨缺损一直是关节手术的一个主要挑战。一些研究已经报道了使用骨髓基质细胞（BMSCs）和可生物降解支架修复关节骨软骨缺损的可行性。然而，由于基于直接细胞-支架构建体植入的体内软骨再生的不稳定性，在临床转化方面尚未取得重大突破。为了克服直接细胞-支架构建体植入的缺点，本研究提出了一种体外软骨再生策略，提供了相对成熟的具有优异机械性能的软骨样组织。我们的策略涉及体外软骨工程、骨软骨缺损修复和体内修复效果评估。结果表明，体外工程化的 BMSC 软骨（BEC-vitro）呈现出时间依赖性成熟过程。单独植入 BEC-vitro 可以成功实现具有软骨和软骨下骨的骨软骨缺损的组织特异性修复。此外，BEC-vitro 的成熟度水平对修复结果有显著影响。这些结果表明，使用 BMSCs 的体外软骨再生是骨软骨缺损功能重建的一种有前途的策略，从而促进了包含 BMSCs 的软骨再生技术的临床转化。
