肌腱周围粘连:治疗靶点与药物治疗进展
Peritendinous adhesion: Therapeutic targets and progress of drug therapy.
作者信息
Wang Shuo, Sha Pan, Zhao Xuewen, Tao Zaijin, Liu Shen
机构信息
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Hanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
出版信息
Comput Struct Biotechnol J. 2023 Nov 30;23:251-263. doi: 10.1016/j.csbj.2023.11.059. eCollection 2024 Dec.
Peritendinous adhesion (PA) is one of the most common complications following hand surgery and characterized with abnormal hyperplasia of connective tissue and excessive deposition of extracellular matrix. Subsequently, various clinical symptoms such as chronic pain, limb dyskinesia and even joint stiffness occur and patients are always involved in the vicious cycle of "adhesion - release - re-adhesion", which seriously compromise the quality of life. Until present, the underlying mechanism remains controversial and lack of specific treatment, with symptomatic treatment being the only option to relieve symptoms, but not contributing no more to the fundamentally rehabilitation of basic structure and function. Recently, novel strategies have been proposed to inhibit the formation of adhesion tissues including implantation of anti-adhesion barriers, anti-inflammation, restraint of myofibroblast transformation and regulation of collagen overproduction. Furthermore, gene therapy has also been considered as a promising anti-adhesion treatment. In this review, we provide an overview of anti-adhesion targets and relevant drugs to summarize the potential pharmacological roles and present subsequent challenges and prospects of anti-adhesion drugs.
肌腱周围粘连(PA)是手部手术后最常见的并发症之一,其特征为结缔组织异常增生和细胞外基质过度沉积。随后,会出现各种临床症状,如慢性疼痛、肢体运动障碍甚至关节僵硬,患者总是陷入“粘连-松解-再粘连”的恶性循环,这严重影响了生活质量。迄今为止,其潜在机制仍存在争议,且缺乏特异性治疗方法,对症治疗是缓解症状的唯一选择,但对基本结构和功能的根本康复并无更多帮助。最近,已提出了抑制粘连组织形成的新策略,包括植入抗粘连屏障、抗炎、抑制肌成纤维细胞转化和调节胶原蛋白过度产生。此外,基因治疗也被认为是一种有前景的抗粘连治疗方法。在本综述中,我们概述了抗粘连靶点和相关药物,以总结潜在的药理作用,并呈现抗粘连药物后续面临的挑战和前景。