Roelofs Anke J, McClure Jessica J, Hay Elizabeth A, De Bari Cosimo
Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK.
Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK.
Nat Rev Rheumatol. 2025 Apr;21(4):211-220. doi: 10.1038/s41584-025-01222-z. Epub 2025 Mar 5.
Damage to articular cartilage, tendons, ligaments and entheses as a result of trauma, degeneration or inflammation in rheumatic diseases is prevalent. Regenerative medicine offers promising strategies for repairing damaged tissues, with the aim of restoring both their structure and function. While these strategies have traditionally relied on tissue engineering approaches using exogenous cells, interventions based on the activation of endogenous repair mechanisms are an attractive alternative. Key to advancing such approaches is a comprehensive understanding of the diversity of the stem and progenitor cells that reside in the adult synovial joint and how they function to repair damaged tissues. Advances in developmental biology have provided a lens through which to understand the origins, identities and functions of these cells, and insights into the roles of stem and progenitor cells in joint tissue repair, as well as their complex relationship with fibroblasts, have emerged. Integration of knowledge obtained through studies using advanced single-cell technologies will be crucial to establishing unified models of cell populations, lineage hierarchies and their molecular regulation. Ultimately, a more complete understanding of how cells repair tissues in adult life will guide the development of innovative pro-regenerative drugs, which are poised to enter clinical practice in musculoskeletal medicine.
创伤、退行性变或风湿性疾病中的炎症导致的关节软骨、肌腱、韧带和附着点损伤很常见。再生医学为修复受损组织提供了有前景的策略，旨在恢复其结构和功能。虽然这些策略传统上依赖于使用外源性细胞的组织工程方法，但基于激活内源性修复机制的干预措施是一种有吸引力的替代方法。推进此类方法的关键是全面了解存在于成人滑膜关节中的干细胞和祖细胞的多样性以及它们如何发挥作用来修复受损组织。发育生物学的进展提供了一个视角，通过它可以了解这些细胞的起源、身份和功能，并且已经出现了对干细胞和祖细胞在关节组织修复中的作用以及它们与成纤维细胞复杂关系的见解。整合通过使用先进的单细胞技术进行的研究所获得的知识对于建立细胞群体、谱系层次及其分子调控的统一模型至关重要。最终，对成年期细胞如何修复组织的更全面理解将指导创新的促再生药物的开发，这些药物有望进入肌肉骨骼医学的临床实践。
