School of Medicine, Southeast University, 210009 Nanjing, China.
Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, 210096 Nanjing, China.
ACS Biomater Sci Eng. 2024 Aug 12;10(8):4716-4739. doi: 10.1021/acsbiomaterials.4c00603. Epub 2024 Aug 2.
Increasing attention has been paid to the development of effective strategies for articular cartilage (AC) and osteochondral (OC) regeneration due to their limited self-reparative capacities and the shortage of timely and appropriate clinical treatments. Traditional cell-dependent tissue engineering faces various challenges such as restricted cell sources, phenotypic alterations, and immune rejection. In contrast, endogenous tissue engineering represents a promising alternative, leveraging acellular biomaterials to guide endogenous cells to the injury site and stimulate their intrinsic regenerative potential. This review provides a comprehensive overview of recent advancements in endogenous tissue engineering strategies for AC and OC regeneration, with a focus on the tissue engineering triad comprising endogenous stem/progenitor cells (ESPCs), scaffolds, and biomolecules. Multiple types of ESPCs present within the AC and OC microenvironment, including bone marrow-derived mesenchymal stem cells (BMSCs), adipose-derived mesenchymal stem cells (AD-MSCs), synovial membrane-derived mesenchymal stem cells (SM-MSCs), and AC-derived stem/progenitor cells (CSPCs), exhibit the ability to migrate toward injury sites and demonstrate pro-regenerative properties. The fabrication and characteristics of scaffolds in various formats including hydrogels, porous sponges, electrospun fibers, particles, films, multilayer scaffolds, bioceramics, and bioglass, highlighting their suitability for AC and OC repair, are systemically summarized. Furthermore, the review emphasizes the pivotal role of biomolecules in facilitating ESPCs migration, adhesion, chondrogenesis, osteogenesis, as well as regulating inflammation, aging, and hypertrophy-critical processes for endogenous AC and OC regeneration. Insights into the applications of endogenous tissue engineering strategies for in vivo AC and OC regeneration are provided along with a discussion on future perspectives to enhance regenerative outcomes.
由于关节软骨 (AC) 和骨软骨 (OC) 的自我修复能力有限，以及及时和适当的临床治疗的短缺，人们越来越关注开发有效的策略来促进它们的再生。传统的细胞依赖型组织工程面临着各种挑战，例如细胞来源受限、表型改变和免疫排斥。相比之下，内源性组织工程是一种很有前途的替代方法，它利用无细胞生物材料来引导内源性细胞到达损伤部位，并刺激其内在的再生潜力。本综述全面概述了用于 AC 和 OC 再生的内源性组织工程策略的最新进展，重点介绍了包括内源性干细胞/祖细胞 (ESPCs)、支架和生物分子的组织工程三联体。AC 和 OC 微环境中存在多种类型的 ESPCs，包括骨髓间充质干细胞 (BMSCs)、脂肪间充质干细胞 (AD-MSCs)、滑膜膜间充质干细胞 (SM-MSCs) 和 AC 来源的干细胞/祖细胞 (CSPCs)，它们具有向损伤部位迁移的能力，并表现出促再生特性。系统总结了各种形式的支架的制造和特性，包括水凝胶、多孔海绵、静电纺丝纤维、颗粒、薄膜、多层支架、生物陶瓷和生物玻璃，突出了它们在 AC 和 OC 修复中的适用性。此外，本综述强调了生物分子在促进 ESPCs 迁移、黏附、软骨形成、成骨以及调节炎症、衰老和肥大-内源性 AC 和 OC 再生的关键过程中的关键作用。还提供了内源性组织工程策略在体内 AC 和 OC 再生中的应用的见解，并讨论了增强再生效果的未来展望。
