He Wei, Jiang Chao, Zhou Ping, Hu Xujun, Gu XiaoPeng, Zhang SongOu
Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
Department of Clinical Medicine, Health Science Center, Ningbo University, Ningbo, Zhejiang, China.
Front Bioeng Biotechnol. 2024 Aug 8;12:1357696. doi: 10.3389/fbioe.2024.1357696. eCollection 2024.
This review offered a comprehensive analysis of tendon and ligament injuries, emphasizing the crucial role of tendon-derived stem cells (TDSCs) in tissue engineering as a potential solution for these challenging medical conditions. Tendon and ligament injuries, prevalent among athletes, the elderly, and laborers, often result in long-term disability and reduced quality of life due to the poor intrinsic healing capacity of these avascular structures. The formation of biomechanically inferior scar tissue and a high rate of reinjury underscore the need for innovative approaches to enhance and guide the regenerative process. This review delved into the complexities of tendon and ligament structure and function, types of injuries and their impacts, and the limitations of the natural repair process. It particularly focused on the role of TDSCs within the context of tissue engineering. TDSCs, with their ability to differentiate into tenocytes, are explored in various applications, including biocompatible scaffolds for cell tracking, co-culture systems to optimize tendon-bone healing, and graft healing techniques. The review also addressed the challenges of immunoreactivity post-transplantation, the importance of pre-treating TDSCs, and the potential of hydrogels and decellularized matrices in supporting tendon regeneration. It concluded by highlighting the essential roles of mechanical and molecular stimuli in TDSC differentiation and the current challenges in the field, paving the way for future research directions.
本综述对肌腱和韧带损伤进行了全面分析，强调了肌腱衍生干细胞（TDSCs）在组织工程中的关键作用，认为其是解决这些具有挑战性的医学病症的一种潜在方法。肌腱和韧带损伤在运动员、老年人和劳动者中很常见，由于这些无血管结构的内在愈合能力较差，往往会导致长期残疾和生活质量下降。生物力学性能较差的瘢痕组织的形成以及高再损伤率凸显了需要创新方法来增强和引导再生过程。本综述深入探讨了肌腱和韧带的结构与功能复杂性、损伤类型及其影响，以及自然修复过程的局限性。它特别关注了组织工程背景下TDSCs的作用。具有分化为肌腱细胞能力的TDSCs在各种应用中得到了探索，包括用于细胞追踪的生物相容性支架、优化肌腱-骨愈合的共培养系统以及移植愈合技术。该综述还讨论了移植后免疫反应性的挑战、预处理TDSCs的重要性，以及水凝胶和脱细胞基质在支持肌腱再生方面的潜力。综述最后强调了机械和分子刺激在TDSC分化中的重要作用以及该领域当前面临的挑战，为未来的研究方向铺平了道路。
