Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Cell Biology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Clin Anat. 2022 Sep;35(6):808-819. doi: 10.1002/ca.23917. Epub 2022 Jun 8.
Population aging is a global phenomenon and with it, the number of bone fractures increases due to higher incidences of osteoporosis. Bone fractures in the elderly increase the risk of bedridden status and mortality. Therefore, the control of osteoporosis and bone fracture is important for healthy life expectancy, and the fundamental understanding of its pathogenesis and its application in treatment is of great social significance. To solve these clinical problems, it is necessary to integrate clinical medicine and basic research. Bone regeneration after a fracture is an essential function of the living body. The prevailing view is that a small number of resident skeletal stem cells are solely responsible for regenerative capacity. Although these cells have long been considered to be in the bone marrow, it has been shown that they are also present in the growth plate and periosteum. More recently, distinct types of cells in the bone marrow, including bone marrow stromal cells, osteoblast progenitor cells, and osteoblasts, have been shown to participate in bone regeneration. Interestingly, the cellular plasticity of differentiated cells, rather than active recruitment of resident stem cell populations, may largely account for regeneration of bone tissues; terminally differentiated cells de-differentiate into a stem cell-like state, and then re-differentiate into regenerating bone. In this review, we discuss the clinical risk and preventive therapy of bone fractures and the current concept of bone regeneration in basic mechanical insights, which may prove useful to both clinicians and researchers.
人口老龄化是一个全球性现象，随之而来的是骨质疏松症发病率的上升，导致骨折数量增加。老年人骨折会增加卧床不起和死亡的风险。因此，控制骨质疏松症和骨折对于健康预期寿命非常重要，对其发病机制的基本理解及其在治疗中的应用具有重要的社会意义。为了解决这些临床问题，有必要将临床医学和基础研究结合起来。骨折后的骨再生是生物体的基本功能。目前普遍认为，少量的固有骨骼干细胞是再生能力的唯一来源。尽管这些细胞长期以来一直被认为存在于骨髓中，但现已证明它们也存在于生长板和骨膜中。最近，骨髓中的不同类型的细胞，包括骨髓基质细胞、成骨前体细胞和成骨细胞，已被证明参与了骨再生。有趣的是，分化细胞的细胞可塑性，而不是固有干细胞群的主动募集，可能在很大程度上解释了骨组织的再生；终末分化细胞去分化为类似于干细胞的状态，然后再分化为再生的骨。在这篇综述中，我们讨论了骨折的临床风险和预防治疗以及基本机械见解中的骨再生的当前概念，这可能对临床医生和研究人员都有用。
