牵张成骨术中颅面骨和长骨的发育。
Craniofacial and Long Bone Development in the Context of Distraction Osteogenesis.
机构信息
From the Department of Surgery, Division of Plastic and Reconstructive Surgery, and the Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine.
出版信息
Plast Reconstr Surg. 2021 Jan 1;147(1):54e-65e. doi: 10.1097/PRS.0000000000007451.
BACKGROUND
Bone retains regenerative potential into adulthood, and surgeons harness this plasticity during distraction osteogenesis. The underlying biology governing bone development, repair, and regeneration is divergent between the craniofacial and appendicular skeleton. Each type of bone formation is characterized by unique molecular signaling and cellular behavior. Recent discoveries have elucidated the cellular and genetic processes underlying skeletal development and regeneration, providing an opportunity to couple biological and clinical knowledge to improve patient care.
METHODS
A comprehensive literature review of basic and clinical literature regarding craniofacial and long bone development, regeneration, and distraction osteogenesis was performed.
RESULTS
The current understanding in craniofacial and long bone development and regeneration is discussed, and clinical considerations for the respective distraction osteogenesis procedures are presented.
CONCLUSIONS
Distraction osteogenesis is a powerful tool to regenerate bone and thus address a number of craniofacial and appendicular skeletal deficiencies. The molecular mechanisms underlying bone regeneration, however, remain elusive. Recent work has determined that embryologic morphogen gradients constitute important signals during regeneration. In addition, striking discoveries have illuminated the cellular processes underlying mandibular regeneration during distraction osteogenesis, showing that skeletal stem cells reactivate embryologic neural crest transcriptomic processes to carry out bone formation during regeneration. Furthermore, innovative adjuvant therapies to complement distraction osteogenesis use biological processes active in embryogenesis and regeneration. Additional research is needed to further characterize the underlying cellular mechanisms responsible for improved bone formation through adjuvant therapies and the role skeletal stem cells play during regeneration.
背景
骨骼在成年后仍具有再生潜力，外科医生在牵引成骨术中利用这种可塑性。支配颅面骨骼和附肢骨骼发育、修复和再生的基础生物学是不同的。每种类型的骨形成都有其独特的分子信号和细胞行为特征。最近的发现阐明了骨骼发育和再生的细胞和遗传过程，为将生物学和临床知识结合起来改善患者护理提供了机会。
方法
对有关颅面和长骨发育、再生和牵引成骨的基础和临床文献进行了全面的文献回顾。
结果
讨论了目前对颅面和长骨发育和再生的理解，并介绍了各自的牵引成骨术的临床考虑因素。
结论
牵引成骨术是一种强大的再生骨骼的工具，可解决许多颅面和附肢骨骼的缺陷。然而，骨骼再生的分子机制仍然难以捉摸。最近的研究确定，胚胎形态发生梯度在再生过程中构成重要信号。此外，引人注目的发现阐明了牵引成骨过程中下颌骨再生的细胞过程，表明骨骼干细胞重新激活胚胎神经嵴转录组过程，在再生过程中进行骨骼形成。此外，补充牵引成骨术的创新辅助疗法利用了胚胎发生和再生过程中的生物过程。需要进一步的研究来进一步描述通过辅助疗法改善骨形成的潜在细胞机制，以及骨骼干细胞在再生过程中所起的作用。
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