中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (30): 4889-4896.doi: 10.3969/j.issn.2095-4344.1424

• 生物材料综述 biomaterial review • 上一篇    下一篇

椎间盘退变分子生物学机制及再生治疗的优势与未来

余城墙1，2，张  宇1，2，谢程欣1，欧裕福2，韦建勋2
  

  1. 1广西中医药大学研究生院，广西壮族自治区南宁市  530001；2广西壮族自治区人民医院脊柱外科，广西壮族自治区南宁市  530021
  • 收稿日期:2019-05-25 出版日期:2019-10-28 发布日期:2019-10-28
  • 通讯作者: 韦建勋，硕士，主任医师，硕士生导师，广西壮族自治区人民医院脊柱外科，广西壮族自治区南宁市 530021
  • 作者简介:余城墙，男，1993年生，湖南省怀化市人，汉族，广西中医药大学脊柱外科在读硕士。
  • 基金资助:

    广西自然科学基金项目(2016GXNSFAA380058)，项目负责人：韦建勋

Molecular biological mechanism of intervertebral disc degeneration and the advantages and prospects of regenerative therapy

Yu Chengqiang1, 2, Zhang Yu1, 2, Xie Chengxin1, Ou Yufu2, Wei Jianxun2
  

  1. 1Graduate School of Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 2Department of Spinal Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Received:2019-05-25 Online:2019-10-28 Published:2019-10-28
  • Contact: Jianxun, Master, Chief physician, Master’s supervisor, Department of Spinal Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • About author:Yu Chengqiang, Master candidate, Graduate School of Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; Department of Spinal Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    the Natural Science Foundation of Guangxi Zhuang Autonomous Region, No. 2016GXNSFAA380058 (to WJX)

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摘要：

文章快速阅读：

 

文题释义：
椎间盘退变：椎间盘退变是指在青春期过后，随着年龄的增长椎间盘中的髓核组织含水量逐渐减少，使椎间盘失去了正常的弹性和张力，在受到来自外界的因素的影响下，如损伤，劳累等，致使椎间盘的纤维环结构发生退行性变化，出现同心圆、辐射状或水平裂缝等改变。
椎间盘再生疗法：椎间盘再生疗法是指在通过深入研究椎间盘的结构和功能以及椎间盘退变的发生机制后，使用有效的生物治疗方法刺激椎间盘的自我修复与再生，来恢复或者逆转椎间盘的结构或功能，从而能在功能上治愈这种以前无法自我修复的疾病。
 
 
背景：多因素引起的椎间盘退行性病变所导致的严重的腰背痛是致残率最高的脊柱疾病，随着医学分子生物学的发展及椎间盘退变机制研究的深入，椎间盘退变的再生疗法为恢复这种难治性疾病提够了可能。
目的：文章对近年来国内外各研究者关于椎间盘退变的相关分子和各种再生疗法在椎间盘退变中应用的研究进行归纳总结。
方法：使用计算机检索PubMed、Embase、Web of science数据库和中国知网、万方、维普数据库在1995年1月至2019年3月发表的关于椎间盘退变再生治疗的相关文献，其中中文的检索关键词包括“椎间盘退变、腰背痛、再生治疗、生长因子、细胞治疗、基因治疗、病毒载体、非病毒载体”，英文的关键词为“Intervertebral disc degeneration，low back pain，regenerative therapy，growth factor，cell therapy；gene therapy，viral vector，non-viral vector”，筛选出相关文献后再进一步归纳总结。
结果与结论：研究显示，近20多种基因影响着髓核细胞的变性，其中就包括各种非编码RNA(如microRNA、lincRNA和lncRNA)。目前，生长因子疗法、细胞疗法和基因疗法等再生研究已经取得了预期效果。非病毒载体转导的基因治疗能避免感染的风险和靶细胞突变的可能，将成为恢复或缓解椎间盘退变的强大工具，具用广阔的应用前景。然而，这些再生疗法也有一定的局限性，在其应用于临床之前，需进行大量的基础研究和临床实验，以便评估其疗效和对逆转退变的影响。

关键词: 椎间盘退变, 腰背痛, 再生治疗, 生长因子, 细胞治疗, 基因治疗, 病毒载体, 非病毒载体, 组织工程

Abstract:

BACKGROUND: Severe low back pain caused by multi-factor disc degeneration is the most disabling spinal disease. However, existing treatments cannot cure this painful disease. Fortunately, with the development of medical molecular biology and the in-depth study of the mechanism of intervertebral disc degeneration, the regenerative therapy of intervertebral disc degeneration is possible to cure this refractory disease.
OBJECTIVE: To summarize the researches on the related molecules of intervertebral disc degeneration and the application of various regenerative therapies in intervertebral disc degeneration in recent years.
METHODS: A computer based online search of PubMed, Embase, Web of science, CNKI, Wanfang, VIP databases for related literature on the treatment of intervertebral disc degeneration and regeneration published during January 1995 to March 2019 using the search terms “intervertebral disc degeneration, low back pain, regenerative therapy, growth factor, cell therapy, gene therapy, viral vector, non-viral vector” in Chinese and English. The related literatures were included in the final analysis.
RESULTS AND CONCLUSION: Studies have shown that nearly 20 genes affect the degeneration of nucleus pulposus cells, including various non-coding RNAs (such as microRNA, lincRNA and lncRNA). Currently, regeneration studies such as growth factor therapy, cell therapy, and gene therapy have achieved the desired results. Non-viral vector-transduced gene therapy can avoid the risk of infection and the possibility of target cell mutation, and will become a powerful tool for restoring or relieving disc degeneration, and has broad application prospects. However, these regenerative therapies also have certain limitations. Before they are applied to the clinic, a large number of basic and clinical experiments are needed to evaluate their efficacy and the effects on reversing degeneration.

Key words: intervertebral disc degeneration, low back pain, regenerative therapy, growth factor, cell therapy, gene therapy, viral vector, non-viral , tissue engineering

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