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组织工程关节软骨梯度仿生支架的研究进展
引用本文:付力伟,李品学,高仓健,李浩,杨振,赵天元,陈威,廖志垚,曹福洋,眭翔,刘舒云,郭全义.组织工程关节软骨梯度仿生支架的研究进展[J].中华骨科杂志,2021(6):386-397.
作者姓名:付力伟  李品学  高仓健  李浩  杨振  赵天元  陈威  廖志垚  曹福洋  眭翔  刘舒云  郭全义
作者单位:中国人民解放军总医院第一医学中心骨科研究所;南开大学医学院;郑州大学第一附属医院骨科
基金项目:国家重点研发计划课题(2019YFA0110600);国家自然科学基金(81772319)。
摘    要:由于良好的机械性能和生物相容性,组织工程支架已经成为修复和再生关节软骨缺损的重要方法。随着组织工程技术的不断发展,过去十年已经开发和测试了许多支架的制备和形成方法,但是理想再生支架的制备一直存在争议。关节软骨作为人体关节内的承重组织,其基质结构和细胞组成呈带状,并且从软骨表层至软骨下骨存在着几个平滑的自然梯度,包括细胞表型和数量、特异性的生长因子、基质的组成、纤维的排列、力学性能、营养和氧气的消耗量等均有较为明显的不同。因此,在再生支架的设计中有必要通过重现这些梯度来原位再生关节软骨。最近的文献报道已经有许多新型的梯度仿生支架用于模拟天然关节软骨的自然梯度,这些支架在结构上呈现出不同的机械、物理、化学或者生物梯度,并且取得了不错的修复效果。通过检索关于梯度支架治疗关节软骨缺损的相关文献,首先对天然关节软骨组织的结构、生物化学、生物力学、营养代谢等梯度特性进行研究和总结,然后对目前关节软骨梯度支架的最新设计和构建进行了归类,其次从材料构成(如水凝胶、纳米材料等)以及制备工艺(如静电纺丝、3D打印等)进一步加深对梯度支架的认识,最后讨论了梯度仿生支架在软骨原位组织工程技术中的前景和挑战,为梯度支架成功用于临床转化提供理论基础。

关 键 词:组织工程技术  人体关节  软骨下骨  关节软骨  仿生支架  自然梯度  生物力学  3D打印

Biomimetic grandient scaffolds for articular cartilage tissue engineering
Fu Liwei,Li Pinxue,Gao Cangjian,Li Hao,Yang Zhen,Zhao Tianyuan,Chen Wei,Liao Zhiyao,Cao Fuyang,Sui Xiang,Liu Shuyun,Guo Quanyi.Biomimetic grandient scaffolds for articular cartilage tissue engineering[J].Chinese Journal of Orthopaedics,2021(6):386-397.
Authors:Fu Liwei  Li Pinxue  Gao Cangjian  Li Hao  Yang Zhen  Zhao Tianyuan  Chen Wei  Liao Zhiyao  Cao Fuyang  Sui Xiang  Liu Shuyun  Guo Quanyi
Institution:(Institute of Orthopaedics,the First Medical Centre,Chinese PLA General Hospital,Beijing Key Lab of Regenerative Medicine in Orthopedics,Key Laboratory of Musculoskeletal Trauma&War Injuries PLA,Beijing 100853,China;School of Medicine,Nanhai University,Tianjin 300071,China;Department of Orthopaedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
Abstract:Due to good mechanical properties and biocompatibility, tissue engineering scaffolds have become the vital method for repairing and regenerating articular cartilage defects. With the continuous development of tissue engineering technology, many scaffolds preparation and formation methods have been developed and tested in the past decade, however, the preparation of ideal regenerative scaffolds remain controversial. As load-bearing tissue inside the body joints, the matrix structure and cell composition of articular cartilage are hierarchical, and there are several smooth natural gradients from the cartilage surface to the subchondral bone layer, including cell phenotype and number, specific growth factors, matrix composition, fiber arrangement, mechanical properties, nutrient and oxygen consumption. Therefore, in the design of regenerative scaffolds, it is necessary to achieve these gradients to regenerate articular cartilage in situ. In recent studies, many new biomimetic gradient scaffolds have been used to simulate the natural gradient of articular cartilage. These scaffolds show different mechanical, physicochemical or biological gradients in the structure, and have achieved good repair effects. The related articles on tissue engineering for the treatment of articular cartilage defects were retrieved by searching databases with key wordsarticular cartilage injury, cartilage repair and gradient scaffolds. In this work,the structural, biochemical, biomechanical and nutrient metabolism gradients of natural articular cartilage were studied and summarized firstly. Then, the latest design and construction of articular cartilage gradient scaffolds were classified. Besides that, the material composition (such as hydrogels, nanomaterials, etc.) and the preparation process (such as electrospinning, 3D printing, etc.) of grandient scaffolds were further enhanced. Finally, the prospect and challenge of biomimetic gradient scaffolds in cartilage engineering are discussed, which provides a theoretical basis for the successful application of gradient scaffolds in clinical transformation.
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