环境、材料、安全、可控：组织工程技术修复关节软骨的症结*

背景：传统的软骨缺损的修复方法都有其局限性,组织工程技术的出现从根本上改变了“以创伤修复创伤”的传统治疗模式。 目的：总结分析目前组织工程技术修复关节软骨的研究进展。 方法：由第一作者检索1990年至2011年 PubMed数据及中国知网数据库有关应用组织工程技术修复关节软骨方面的文献。共检索中文187 篇,英文211 篇,最终保留49篇进入结果分析。 结果与结论：软骨组织工程的主要方法就是应用工程学和生命科学原理,在体外分离、培养、扩增所需要的种子细胞,然后将之种植于合适的生物支架材料上,将细胞支架复合体植入体内组织缺损部位,并加入一定的诱导条件,逐渐形成新的有功能的软骨组织。文章在种子细胞的选择方面重点叙述了自体软骨细胞、异体软骨细胞、胚胎干细胞、骨髓间充质干细胞的研究进展;在细胞诱导及条件培养方面重点叙述了细胞因子、细胞条件培养、转基因技术的研究进展;并对生物支架材料的选择和研究进行了相关叙述。找到最理想的种子细胞,合理联合应用细胞因子,更加真实的模拟细胞生存的微环境,基因工程安全、高效、可控转染,构建理想的支架材料,将是今后组织工程研究的重点和热点。

Tissue engineering technique to repair articular cartilage injury: Environment,material, safety and controllability

BACKGROUND: The traditional methods for cartilage defect repair have their limitations. The application of tissue engineering methods to repair articular cartilage defects has shown promising prospects. OBJECTIVE: To review the progress of tissue engineering technique to repair articular cartilage at home and abroad in recent years. METHODS:PubMed and CNKI databases were searched online by the first author for papers concerning applying tissue engineering technique to repair articular cartilage defects in 1990-2011. Totally 187 Chinese papers and 211 English papers were retrieved, and finally 49 papers were included in result analysis. RESULTS AND CONCLUSION: The main method of cartilage tissue engineering is to apply the principle of engineering and life sciences to isolate, culture and proliferate needed seed cells. Then, the cells were implanted onto the appropriate biological scaffold, and the cytoskeleton was implanted into the defect site. Gradually, new cartilage tissues form under some inducing conditions. In recent years, the cartilage tissue engineering research focuses on the following aspects: (1) Selection of seed cells, including autologous chondrocytes, allogenic chondrocytes, embryonic stem cells and bone marrow mesenchymal stem cells; (2) Cell induction and conditional culture, including cytokines, cell culture conditions, transgenic technology; (3) Selection and research of biological scaffold materials. The following aspects have become hotspots in the tissue engineering research: finding ideal seed cells, combination with cytokines, literally imitating microenvironment for cell survival, safety, high efficiency, and controlled transfection of gene engineering, and constructing ideal scaffold materials.