中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (16): 2587-2594.doi: 10.12307/2023.169
• 生物材料综述 biomaterial review • 上一篇 下一篇
贾源源1,2,段棉棉1,唐正龙1,2
收稿日期:
2022-04-15
接受日期:
2022-06-13
出版日期:
2023-06-08
发布日期:
2022-11-11
通讯作者:
唐正龙,博士,教授,贵州医科大学口腔医学院,贵州省贵阳市 550000;贵州医科大学基础医学院病理生理教研室,贵州省贵阳市 550025
作者简介:
贾源源,女,1988年生,贵州省贵阳市人,汉族,2022年贵州医科大学毕业,博士,主治医师,主要从事骨组织工程相关研究。
基金资助:
Jia Yuanyuan1, 2, Duan Mianmian1, Tang Zhenglong1, 2
Received:
2022-04-15
Accepted:
2022-06-13
Online:
2023-06-08
Published:
2022-11-11
Contact:
Tang Zhenglong, MD, Professor, School of Stomatology, Guizhou Medical University, Guiyang 550000, Guizhou Province, China; Department of Pathophysiology, School of Basic Medicine, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
About author:
Jia Yuanyuan, MD, Attending physician, School of Stomatology, Guizhou Medical University, Guiyang 550000, Guizhou Province, China; Department of Pathophysiology, School of Basic Medicine, Guizhou Medical University, Guiyang 550025, Guizhou Province, China
Supported by:
摘要:
文题释义:
局部载药体系:给药途径有2种,分别为全身系统性给药和局部给药。传统的全身给药途径是药物通过循环系统递送,会导致如全身毒性、肝肾并发症、药物相互作用、药物达到靶器官的活性及剂量低以及患者依从性低等问题。而局部载药体系将药物递送到作用的靶器官,具有靶器官浓度高、不良反应小以及全身吸收少等优势。文章主要针对骨折愈合的药物递送体系,故而研究重点为术中植入材料负载活性因子的应用。中图分类号:
贾源源, 段棉棉, 唐正龙. 局部载药系统促进骨折愈合的研究与应用[J]. 中国组织工程研究, 2023, 27(16): 2587-2594.
Jia Yuanyuan, Duan Mianmian, Tang Zhenglong. Research and application of local drug delivery system in promoting fracture healing[J]. Chinese Journal of Tissue Engineering Research, 2023, 27(16): 2587-2594.
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1.1 资料来源
1.1.1 检索人及检索时间 第一作者在2022年3月进行检索。
1.1.2 检索文献时限 1990年1月至2022年3月。
1.1.3 检索数据库 PubMed和中国知网(CNKI)数据库。
1.1.4 检索词 英文检索词为“drug delivery, fracture”,中文检索词为“载药系统,骨折”。
1.1.5 检索文献类型 研究性论文、综述性论文、著作。
1.1.6 手工检索情况 无。
1.1.7 检索策略 包括英文及中文检索词、检索词的逻辑组配等。以PubMed数据库为例,检索策略见图2。
1.1.8 检索文献量 共检索到文献278篇,其中包括中文文献22篇,英文文献256篇。
1.2 纳入与排除标准
1.2.1 纳入标准 ①递送药物体系局部应用于骨折的实验性或基础研究、综述研究;②同一领域中论点、论据可靠的文献。
1.2.2 排除标准 ①重复性研究且与研究目的无相关性的文献;②逻辑不严谨可信度差的文献。
1.3 质量评估与数据提取 共检索到文献278篇,其中英文文献256篇,中文文献22篇,排除与研究目的相关性差及内容陈旧、重复的文献148篇,纳入130篇符合标准的文献进行综述,筛选流程见图3。
3.2 作者综述区别与他人他篇的特点 骨骼类疾病及损伤影响了大量的人群。虽然目前已经批准了几种蛋白类药物治疗骨骼类疾病,但这些药物用于治疗局部骨折均可能会导致严重的不良反应。骨折愈合修复是一个复杂的生理过程,包括炎症免疫、血管生成、成骨分化和生物矿化早期调节。目前,尚未设计出针对骨折愈合不同阶段的特点,次序性给予相应刺激因子的临床治疗方案。未来研究可根据骨折愈合的各阶段重点不同,选择特定的治疗方法和药物输送系统。通过评估损伤程度、愈合潜力和每个病例的具体要求,可以将药物递送系统按各种方式组合,形成多途径治疗的协同疗法,以最大限度促进骨折愈合。文章根据生物材料和药物递送领域的最新进展,概述当前骨折区局部载药体系的治疗方法及未来的研究方向,将有效的治疗剂与理想的递送系统相结合,为将来药物递送体系促骨折愈合的临床应用提供一定的参考价值。
3.3 综述的局限性 文章重点在于阐述促成骨因子和载药体系,然而并未对药物或分子释放的时效性进行讨论。
3.4 综述的重要意义与展望 到目前为止,还没有一种能够促进骨折修复并降低骨折相关并发症风险的非侵入性疗法获得批准,包括RNA干扰疗法和小分子化合物在内的新方法也正在开发中,以规避传统生长因子的挑战。研究表明,药物递送系统改变了治疗剂的生物分布,此外,这些局部递药系统增强了骨桥形成,并减少了不良反应。随着生物材料和药物输送技术的不断发展,这些技术在再生医学领域的应用将不断扩大,最终带来促进骨折愈合的新工具。
中国组织工程研究杂志出版内容重点:生物材料;骨生物材料;口腔生物材料;纳米材料;缓释材料;材料相容性;组织工程
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文题释义:
局部载药体系:给药途径有2种,分别为全身系统性给药和局部给药。传统的全身给药途径是药物通过循环系统递送,会导致如全身毒性、肝肾并发症、药物相互作用、药物达到靶器官的活性及剂量低以及患者依从性低等问题。而局部载药体系将药物递送到作用的靶器官,具有靶器官浓度高、不良反应小以及全身吸收少等优势。文章主要针对骨折愈合的药物递送体系,故而研究重点为术中植入材料负载活性因子的应用。近年来,由于组织工程技术的发展以及载药体系的精细化与可控化,使骨折区局部用药研究成为热点。在骨折区域局部应用药物释放体系,解决药物释放障碍,如药物溶解性差、半衰期短和靶向效应。文章就目前采用的载药体系和促成骨因子的选择做出总结综述,旨在为后续研究者提供促进骨折修复的相应研究思路。
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