Zimmer Biomet, 56 East Bell Drive, Warsaw, IN 46580, USA.
Biomed Res Int. 2018 Jul 10;2018:6510842. doi: 10.1155/2018/6510842. eCollection 2018.
There has been significant debate over the role of white blood cells (WBCs) in autologous therapies, with several groups suggesting that WBCs are purely inflammatory. Misconceptions in the practice of biologic orthopedics result in the simplified principle that platelets deliver growth factors, WBCs cause inflammation, and the singular value of bone marrow is the stem cells. The aim of this review is to address these common misconceptions which will enable better development of future orthopedic medical devices. WBC behavior is adaptive in nature and, depending on their environment, WBCs can hinder or induce healing. Successful tissue repair occurs when platelets arrive at a wound site, degranulate, and release growth factors and cytokines which, in turn, recruit WBCs to the damaged tissue. Therefore, a key role of even pure platelet-rich plasma is to recruit WBCs to a wound. Bone marrow contains a complex mixture of vascular cells, white blood cells present at much greater concentrations than in blood, and a small number of progenitor cells and stem cells. The negative results observed for WBC-containing autologous therapies have not translated to human clinical studies. With an enhanced understanding of the complex WBC biology, the next generation of biologics will be more specific, likely resulting in improved effectiveness.
关于白细胞（WBC）在自体疗法中的作用存在很大争议，有几个研究小组表明 WBC 纯粹是炎症性的。生物矫形学实践中的误解导致了一个简化的原则，即血小板输送生长因子，WBC 引起炎症，骨髓的唯一价值是干细胞。本综述的目的是解决这些常见的误解，这将有助于更好地开发未来的骨科医疗器械。WBC 的行为本质上是适应性的，并且根据其环境，WBC 可以阻碍或诱导愈合。当血小板到达伤口部位、脱颗粒并释放生长因子和细胞因子时，成功的组织修复就会发生，这些生长因子和细胞因子反过来又会将 WBC 招募到受损组织中。因此，即使是纯血小板丰富血浆的一个关键作用也是将 WBC 招募到伤口中。骨髓中含有复杂的血管细胞混合物，其中白细胞的浓度比血液中高得多，还有少量祖细胞和干细胞。含 WBC 的自体疗法的阴性结果并未转化为人体临床研究。随着对复杂 WBC 生物学的深入了解，下一代生物制剂将更加具体，可能会提高有效性。
