Primorac Dragan, Molnar Vilim, Tsoukas Dimitrios, Uzieliene Ilona, Tremolada Carlo, Brlek Petar, Klarić Emil, Vidović Dinko, Zekušić Marija, Pachaleva Jolita, Bernotiene Eiva, Wilson Adrian, Mobasheri Ali
Dragan Primorac, Poliklinika Sv. Katarina, Branimirova 71E, 10000 Zagreb, Croatia,
Croat Med J. 2024 Jun 13;65(3):268-287. doi: 10.3325/cmj.2024.65.268.
This review evaluates the current landscape and future directions of regenerative medicine for knee cartilage repair, with a particular focus on tissue engineering strategies. In this context, scaffold-based approaches have emerged as promising solutions for cartilage regeneration. Synthetic scaffolds, while offering superior mechanical properties, often lack the biological cues necessary for effective tissue integration. Natural scaffolds, though biocompatible and biodegradable, frequently suffer from inadequate mechanical strength. Hybrid scaffolds, combining elements of both synthetic and natural materials, present a balanced approach, enhancing both mechanical support and biological functionality. Advances in decellularized extracellular matrix scaffolds have shown potential in promoting cell infiltration and integration with native tissues. Additionally, bioprinting technologies have enabled the creation of complex, bioactive scaffolds that closely mimic the zonal organization of native cartilage, providing an optimal environment for cell growth and differentiation. The review also explores the potential of gene therapy and gene editing techniques, including CRISPR-Cas9, to enhance cartilage repair by targeting specific genetic pathways involved in tissue regeneration. The integration of these advanced therapies with tissue engineering approaches holds promise for developing personalized and durable treatments for knee cartilage injuries and osteoarthritis. In conclusion, this review underscores the importance of continued multidisciplinary collaboration to advance these innovative therapies from bench to bedside and improve outcomes for patients with knee cartilage damage.
本综述评估了用于膝关节软骨修复的再生医学的当前状况和未来方向，特别关注组织工程策略。在此背景下，基于支架的方法已成为软骨再生的有前景的解决方案。合成支架虽然具有优异的机械性能，但往往缺乏有效组织整合所需的生物信号。天然支架虽然具有生物相容性和可生物降解性，但经常存在机械强度不足的问题。结合合成材料和天然材料元素的混合支架提供了一种平衡的方法，增强了机械支撑和生物功能。脱细胞细胞外基质支架的进展已显示出在促进细胞浸润和与天然组织整合方面的潜力。此外，生物打印技术能够创建复杂的生物活性支架，紧密模拟天然软骨的分层结构，为细胞生长和分化提供最佳环境。该综述还探讨了基因治疗和基因编辑技术（包括CRISPR-Cas9）通过靶向参与组织再生的特定基因途径来增强软骨修复的潜力。将这些先进疗法与组织工程方法相结合，有望为膝关节软骨损伤和骨关节炎开发个性化和持久的治疗方法。总之，本综述强调了持续多学科合作的重要性，以将这些创新疗法从实验室推进到临床应用，并改善膝关节软骨损伤患者的治疗效果。
