中国组织工程研究

中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (34): 5565-5570.doi: 10.3969/j.issn.2095-4344.2017.34.025

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

同种异体幼年软骨微粒移植修复关节软骨缺损：问题及前景

尤  奇1，刘  毅1，段小军2，杨  柳2，李豫皖1，朱喜忠1
  

  1. 1遵义医学院附属医院关节科，贵州省遵义市  563000；2解放军第三军医大学西南医院关节外科，重庆市  400038
  • 收稿日期:2017-09-01 出版日期:2017-12-08 发布日期:2018-01-04
  • 通讯作者: 刘毅，教授，硕士生导师，遵义医学院附属医院关节外科，贵州省遵义市 563000
  • 作者简介:尤奇，男，1989年生，安徽省阜阳市人，汉族，遵义医学院在读硕士，主要从事软骨组织工程研究。
  • 基金资助:

    国家自然科学基金(81071484)；贵州省科学技术基金资助项目(黔科合LH字[2016]7477号)

Articular cartilage defect repair with particulated juvenile cartilage allograft: existing problems and prospects

You Qi1, Liu Yi1, Duan Xiao-jun2, Yang Liu2, Li Yu-wan1, Zhu Xi-zhong1
  

  1. 1Department of Joint Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China; 2Department of Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
  • Received:2017-09-01 Online:2017-12-08 Published:2018-01-04
  • Contact: Liu Yi, Professor, Master’s supervisor, Department of Joint Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
  • About author:You Qi, Studying for master’s degree, Department of Joint Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
  • Supported by:
    the National Natural Science Foundation of China, No. 81071484; the Science & Technology Program of Guizhou Province, No. LH[2016]7477

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摘要：

文章快速阅读：

 

文题释义：
同种异体移植：同一物种内不同基因型的个体间器官、组织、细胞的移植，是临床最常见的移植类型，也是移植免疫学研究的重点。
幼年软骨微粒：是将取得的幼年关节软骨组织(一般年龄<13岁)，切成大小为1 mm×1 mm×1 mm的微粒。
 
背景：同种异体幼年软骨微粒制备简单、容易获取，体外培养证实软骨细胞能够迁移、增殖。在美国，同种异体幼年软骨微粒移植技术已经应用于髋、膝、肘、踝关节软骨缺损的修复。
目的：对目前应用同种异体幼年软骨微粒移植修复关节软骨缺损的研究现状、应用以及价值进行综述。
方法：计算机检索CNKI数据库、PubMed数据库以及Elsevier数据库的相关文献，检索词为“Allogeneic juvenile cartilage particles；cartilage tissue engineering；articular cartilage defects；repair”。查阅1983年10月至2017年6月期间收录的同种异体幼年软骨微粒修复关节软骨缺损的相关文章，包括综述、基础研究以及临床研究。通过阅读文题和摘要进行初步筛选，排除与文章主题不相关的文献，根据纳入标准和排除标准，最终纳入48篇文献进行结果分析。
结果与结论：①临床上治疗软骨缺损的方法很多，在短期的随访中有较好的临床效果，能够改善患者的运动功能和缓解疼痛，但最终会导致关节软骨的进行性退变和骨性关节炎的发生；②同种异体幼年软骨微粒不同于传统的异体骨软骨移植术，其具有较强的软骨细胞增殖能力和体外形成组织工程软骨的能力，且抗原性弱，体内移植不会引起强烈的排斥反应。此外，同种异体幼年软骨微粒修复在关节镜下发现软骨缺损后即可行一期手术治疗；③同种异体幼年软骨微粒移植得良好修复效果不仅在基础研究中获得证实，同时在美国临床已经取得重要进展，其潜在的优越性能已逐渐被医生及患者接受；④然而同种异体幼年软骨微粒也存在移植物加工过程污染、疾病传播的风险。虽然该技术在美国临床已经较为广泛应用，但术后追踪随访的资料却很少，尚不能对其长期有效性进行客观评估，未来还需进行长期随访，以期可在临床广泛推广。

关键词: 生物材料, 软骨生物材料, 同种异体幼年软骨微粒, 关节软骨缺损, 组织构建, 细胞移植, 修复, 临床研究, 基础研究, 综述, 国家自然科学基金

Abstract:

BACKGROUND: Particulated juvenile cartilage allograft is simple and easy to obtain, and chondrocytes can migrate and proliferate as confirmed by in vitro culture. In the Unite States, this technique has been used in the repair of cartilage defects in the hip, knee, ankle, and elbow joints.
OBJECTIVE: To review the present situation, application, and value of particulated juvenile cartilage allograft transplantation for articular cartilage repair.
METHODS: A computer-based search of CNKI, PubMed, and Elsevier was performed for retrieving articles concerning particulated juvenile cartilage allograft transplantation for articular cartilage repair published from October 1983 to June 2017. The keywords were “allogeneic juvenile cartilage particles; cartilage tissue engineering; articular cartilage defects; repair” in Chinese and English, respectively. After initial screening of titles and abstracts and exclusion of irrelevant articles, 48 eligible articles were included in final analysis.
RESULTS AND CONCLUSION: (1) Although a variety of treatments for cartilage repair have achieved good clinical outcomes in short-term follow-up, improving the motor function of patients and relieving pain, patients eventually develop progressive degeneration of the articular cartilage and suffer from osteoarthritis. (2) Chondrocytes from allogeneic juvenile cartilage particles have stronger ability of proliferating and repairing cartilage defects in vitro than mature chondrocytes, and have low antigenicity, which cannot cause a strong rejection after in vivo transplantation. What’s more, particulated juvenile cartilage allograft transplantation can be performed as one-stage surgery if cartilage defects are confirmed under arthroscopy. (3) Particulated juvenile cartilage allograft transplantation has achieved good outcomes in basic and clinical studies in the United States. Its potential superiority has gradually been accepted by doctors and patients. (4) There are also risks for being contaminated and spreading diseases during the preparation of particulated juvenile cartilage allograft. This technology has been widely used in the United States, but there are rare data concerning its follow-up studies. Therefore, an investigation on its long-term follow-up is indispensable for the objective assessment of its long-term efficacy, with a view to the extensive promotion of this technology in the clinical practice.

Key words: Cartilage, Articular, Transplantation, Homologous, Tissue Engineering

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