Shang Fengqing, Yu Yang, Liu Shiyu, Ming Leiguo, Zhang Yongjie, Zhou Zhifei, Zhao Jiayu, Jin Yan
State Key Laboratory of Military Stomatology & National Clinical Research, Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Center for Tissue Engineering, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
Department of Stomatology, The 306th Hospital of PLA, Beijing, 100101, China.
Bioact Mater. 2020 Sep 21;6(3):666-683. doi: 10.1016/j.bioactmat.2020.08.014. eCollection 2021 Mar.
Reconstruction of bone defects, especially the critical-sized defects, with mechanical integrity to the skeleton is important for a patient's rehabilitation, however, it still remains challenge. Utilizing biomaterials of human origin bone tissue for therapeutic purposes has provided a facilitated approach that closely mimics the critical aspects of natural bone tissue with regard to its properties. However, not only efficacious and safe but also cost-effective and convenient are important for regenerative biomaterials to achieve clinical translation and commercial success. Advances in our understanding of regenerative biomaterials and their roles in new bone formation potentially opened a new frontier in the fast-growing field of regenerative medicine. Taking inspiration from the role and multicomponent construction of native extracellular matrix (ECM) for cell accommodation, the ECM-mimicking biomaterials and the naturally decellularized ECM scaffolds were used to create new tissues for bone restoration. On the other hand, with the going deep in understanding of mesenchymal stem cells (MSCs), they have shown great promise to jumpstart and facilitate bone healing even in diseased microenvironments with pharmacology-based endogenous MSCs rescue/mobilization, systemic/local infusion of MSCs for cytotherapy, biomaterials-based approaches, cell-sheets/-aggregates technology and usage of subcellular vesicles of MSCs to achieve scaffolds-free or cell-free delivery system, all of them have been shown can improve MSCs-mediated regeneration in preclinical studies and several clinical trials. Here, following an overview discussed autogenous/allogenic and ECM-based bone biomaterials for reconstructive surgery and applications of MSCs-mediated bone healing and tissue engineering to further offer principles and effective strategies to optimize MSCs-based bone regeneration.
重建骨缺损,尤其是临界尺寸骨缺损,并使其具备与骨骼的机械完整性,对患者康复至关重要,然而这仍然是一项挑战。利用源自人类骨组织的生物材料进行治疗,提供了一种便利的方法,该方法在特性方面能紧密模拟天然骨组织的关键特征。然而,对于再生生物材料而言,要实现临床转化和商业成功,不仅要有效且安全,还要具有成本效益且方便易用。我们对再生生物材料及其在新骨形成中作用的理解取得进展,这有可能在快速发展的再生医学领域开辟一个新的前沿。从天然细胞外基质(ECM)对细胞容纳的作用和多组分结构中获取灵感,人们使用模仿ECM的生物材料和天然去细胞ECM支架来创建用于骨修复的新组织。另一方面,随着对间充质干细胞(MSCs)理解的深入,它们已显示出巨大潜力,即使在患病的微环境中,也能通过基于药理学的内源性MSCs拯救/动员、全身/局部输注MSCs进行细胞治疗、基于生物材料的方法、细胞片/聚集体技术以及使用MSCs的亚细胞囊泡来实现无支架或无细胞递送系统,从而启动并促进骨愈合。在临床前研究和一些临床试验中,所有这些方法均已证明可以改善MSCs介导的再生。在此,在进行概述之后,讨论了用于重建手术的自体/异体和基于ECM的骨生物材料,以及MSCs介导的骨愈合和组织工程的应用,以进一步提供优化基于MSCs的骨再生的原则和有效策略。