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骨科再生疗法的进展:富血小板血浆、间充质干细胞、肽疗法及仿生应用的全面综述

Advancements in Regenerative Therapies for Orthopedics: A Comprehensive Review of Platelet-Rich Plasma, Mesenchymal Stem Cells, Peptide Therapies, and Biomimetic Applications.

作者信息

Goulian Andrew J, Goldstein Brielle, Saad Maarouf A

机构信息

College of Medicine, California Northstate University, Elk Grove, CA 95757, USA.

Department of Orthopaedic Surgery, University of California, Sacramento, CA 95817, USA.

出版信息

J Clin Med. 2025 Mar 18;14(6):2061. doi: 10.3390/jcm14062061.


DOI:10.3390/jcm14062061
PMID:40142869
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11943164/
Abstract

: Regenerative therapies have gained interest in orthopedic applications for their potential to enhance tissue regeneration, functional recovery, and pain modification. This review evaluates the clinical efficacy of platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), peptide-based treatments, and biomimetic materials in orthopedic care, with a focus on pain reduction and functional outcomes. : A structured literature search in PubMed (January 2009-January 2025) identified 160 studies. After applying inclusion criteria prioritizing randomized controlled trials (RCTs) and clinical trials, 59 studies were included: 20 on PRP, 20 on MSCs, 10 on peptide therapies, and 7 on biomimetics. Data extraction focused on pain reduction and functional recovery, with risk of bias assessed using the Cochrane Risk of Bias (RoB) tool and ROBINS-I tool. A random-effects meta-regression analysis was conducted to evaluate the impact of therapy type, sample size, and risk of bias on reported pain reduction outcomes. : Meta-regression analysis identified MSC therapy as the most effective intervention for pain reduction (β = 8.45, < 0.05), with PRP and peptide-based therapies showing moderate improvements, and biomimetic therapies demonstrating the lowest effect. PRP provided short-term pain relief, particularly in acute injuries and tendon repair, though inconsistencies in preparation methods limited success in chronic conditions. MSC therapies demonstrated cartilage regeneration and early osteoarthritis improvement, but high costs and ethical concerns remain barriers to widespread adoption. Peptide-based therapies and biomimetic materials, including engineered scaffolds and autologous protein solutions, showed promise for infection control and wound healing, though further research is needed to optimize dosing, delivery methods, and long-term safety. : Regenerative therapies offer significant potential in orthopedic care, with MSC therapies demonstrating the most reliable regenerative effects, PRP providing short-term symptomatic relief, and peptide-based and biomimetic treatments emerging as promising adjuncts. However, standardized protocols and large-scale clinical trials are needed to establish long-term efficacy and improve clinical translation for broader adoption.

摘要

再生疗法因其在促进组织再生、功能恢复和疼痛改善方面的潜力而在骨科应用中受到关注。本综述评估了富血小板血浆(PRP)、间充质干细胞(MSCs)、基于肽的治疗方法和仿生材料在骨科治疗中的临床疗效,重点关注疼痛减轻和功能结果。:在PubMed(2009年1月至2025年1月)中进行的结构化文献检索确定了160项研究。在应用优先考虑随机对照试验(RCT)和临床试验的纳入标准后,纳入了59项研究:20项关于PRP,20项关于MSCs,10项关于肽疗法,7项关于仿生材料。数据提取集中在疼痛减轻和功能恢复方面,使用Cochrane偏倚风险(RoB)工具和ROBINS-I工具评估偏倚风险。进行了随机效应元回归分析,以评估治疗类型、样本量和偏倚风险对报告的疼痛减轻结果的影响。:元回归分析确定MSCs疗法是减轻疼痛最有效的干预措施(β = 8.45,<0.05),PRP和基于肽的疗法显示出适度改善,而仿生疗法效果最低。PRP提供短期疼痛缓解,特别是在急性损伤和肌腱修复中,尽管制备方法的不一致限制了其在慢性疾病中的成功率。MSCs疗法显示出软骨再生和早期骨关节炎改善,但高成本和伦理问题仍然是广泛应用的障碍。基于肽的疗法和仿生材料,包括工程支架和自体蛋白溶液,在感染控制和伤口愈合方面显示出前景,尽管需要进一步研究来优化剂量、给药方法和长期安全性。:再生疗法在骨科治疗中具有巨大潜力,MSCs疗法显示出最可靠的再生效果,PRP提供短期症状缓解,基于肽的和仿生治疗方法成为有前景的辅助手段。然而,需要标准化方案和大规模临床试验来确定长期疗效,并改善临床转化以实现更广泛的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b37d/11943164/0d1339bf313c/jcm-14-02061-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b37d/11943164/12b4b42e4ed2/jcm-14-02061-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b37d/11943164/15be02249c80/jcm-14-02061-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b37d/11943164/0d1339bf313c/jcm-14-02061-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b37d/11943164/12b4b42e4ed2/jcm-14-02061-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b37d/11943164/15be02249c80/jcm-14-02061-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b37d/11943164/0d1339bf313c/jcm-14-02061-g003.jpg

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引用本文的文献

[1]
Recent Evidence for Orthobiologics Combined with Hydrogels for Joint Tissue Regeneration: Focus on Osteoarthritis.

Gels. 2025-7-17

本文引用的文献

[1]
The role of platelet-rich plasma in biomedicine: A comprehensive overview.

iScience. 2025-1-3

[2]
Platelet rich plasma and anterior cruciate ligament repair: A new frontier, or a short term adjunct.

World J Orthop. 2025-1-18

[3]
Mesenchymal Stromal Cells for Aging Cartilage Regeneration: A Review.

Int J Mol Sci. 2024-11-30

[4]
Nanotechnology in Drug Delivery: Anatomy and Molecular Insight into the Self-Assembly of Peptide-Based Hydrogels.

Molecules. 2024-11-29

[5]
Bioinspired synthetic peptide-based biomaterials regenerate bone through biomimicking of extracellular matrix.

J Tissue Eng. 2024-12-12

[6]
Safety and efficacy of autologous adipose-derived stem cells for knee osteoarthritis in the elderly population: A systematic review.

J Clin Orthop Trauma. 2024-11-7

[7]
Advancements in Therapeutic Approaches for Degenerative Tendinopathy: Evaluating Efficacy and Challenges.

Int J Mol Sci. 2024-11-4

[8]
The Potential of Intra-Articular Therapies in Managing Knee Osteoarthritis: A Systematic Review.

Clin Pract. 2024-9-25

[9]
Allogenic bone marrow-derived mesenchymal stromal cell-based therapy for patients with chronic low back pain: a prospective, multicentre, randomised placebo controlled trial (RESPINE study).

Ann Rheum Dis. 2024-10-21

[10]
Functional outcome and histologic analysis of late onset total type brachial plexus injury treated with intercostal nerve transfer to median nerve with local umbilical cord-derived mesenchymal stem cells or secretome injection: a double-blinded, randomized control study.

Eur J Orthop Surg Traumatol. 2024-12

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