中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (18): 2939-2945.doi: 10.3969/j.issn.2095-4344.0874

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

骨质疏松性骨缺损的治疗进展:支架植入与局部药物递送

李祖浩,王辰宇,王中汉,高超华,史晨玉,杨 帆,刘 贺,王金成   

  1. 吉林大学第二医院骨科,吉林省长春市 130041
  • 收稿日期:2018-03-22 出版日期:2018-06-28 发布日期:2018-06-28
  • 通讯作者: 王金成,主任医师,教授,博士生导师,吉林大学第二医院骨科,吉林省长春市 130041
  • 作者简介:李祖浩,男,1992 年生,汉族,吉林大学第二医院骨科在读硕士,主要从事骨质疏松性骨缺损骨再生的研究。
  • 基金资助:

    国家自然科学基金(81671804,81772456,81771681);吉林省自然科学基金(20160101109JC,20150414006GH,20150312028ZG,20130206060GX);吉林大学白求恩医学部博士研究生优秀拔尖人才培育计划(YB201501);吉林大学研究生创新研究计划(2017032)

Progress in the repair of osteoporotic bone defects: scaffold implantation and local drug delivery

Li Zu-hao, Wang Chen-yu, Wang Zhong-han, Gao Chao-hua, Shi Chen-yu, Yang Fan, Liu He, Wang Jin-cheng   

  1. Department of Orthopedics, Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
  • Received:2018-03-22 Online:2018-06-28 Published:2018-06-28
  • Contact: Wang Jin-cheng, Chief physician, Professor, Doctoral supervisor, Department of Orthopedics, Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
  • About author:Li Zu-hao, Master candidate, Department of Orthopedics, Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81671804, 81772456, 81771681; the Natural Science Foundation of Jilin Province, No. 20160101109JC, 20150414006GH, 20150312028ZG, 20130206060GX; Ph.D. Outstanding Talent Cultivation Program of Norman Bethune Health Science Center of Jilin University, No. YB201501; the Innovation Research Program for Postgraduates in Jilin University, No. 2017032

摘要:

文章快速阅读:

 

文题释义:
支架:具有三维结构的骨组织工程支架,既可填充骨缺损,提供必要的机械强度,具有良好的生物相容性和多孔结构可为骨细胞提供附着,又可搭载抗骨质疏松药物,对修复骨缺损起积极作用。
骨质疏松性骨缺损:骨质疏松是一种以骨量减少,骨微观结构改变,易引起脆性骨折为特征的渐进性、全身性疾病。骨缺损是骨科常见的情况,最常见于桡骨远端或股骨近端骨折、转移性骨肿瘤切除术和关节翻修术。绝经后妇女和老年人由于更容易患骨质疏松症,经常出现骨缺损。
 
 
背景:随着化学合成技术的发展,将抗骨质疏松药物纳入组织工程支架,用于促进骨质疏松性骨缺损骨再生已成为当今研究的热点。
目的:介绍骨组织工程支架,讨论并总结其搭载抗骨质疏松药物在骨质疏松性骨缺损愈合方面的应用。
方法:作者以“Osteoporosis,Bone defect,Scaffold,骨质疏松,骨缺损,支架”为关键词,检索2005至2017年期间PubMed、Web of Science、Springerlink、Medline、万方、CNKI数据库中相关文献。初检文章201篇,筛选后对64篇文章进行分析。

结果与结论:各种类型的骨组织工程支架被用于治疗骨质疏松性骨缺损,如经过改性的磷酸钙骨水泥、β-磷酸三钙、羟基磷灰石等支架均起到一定促进骨再生的作用。但骨质疏松状态下的骨再生受损严重,常规支架促进骨再生能力有限,需要加以抗骨质疏松治疗。考虑到全身抗骨质疏松药物治疗不良反应大、骨缺损局部作用小的特点,近年来研究者对支架植入与局部药物递送相结合促进骨质疏松性骨缺损愈合进行了研究,如何将骨再生诱导因子纳入支架中,并稳定地从支架中释放而不影响其生物活性是关键。其中,双膦酸盐、金属锶、骨形态发生蛋白2、甲状旁腺激素、中药成分、间充质干细胞作为常用药物,将其纳入凝胶中或通过涂层的方法与骨组织工程支架结合可达到缓释效果;随着分子生物技术的发展,经成骨相关基因修饰的干细胞复合支架也逐渐成为一个研究热点。

ORCID: 0000-0002-1217-5962(王金成) 

 

关键词: 骨质疏松, 骨缺损, 支架, 药物缓释, 骨再生, 综述, 生物材料

Abstract:

BACKGROUND: With the development of chemical synthesis technology, the application of anti-osteoporosis drugs incorporated into scaffolds to promote bone regeneration in osteoporotic bone defects has become a hot issue nowadays.

OBJECTIVE: To introduce bone tissue engineering scaffolds, and to discuss and summarize the application of the scaffolds carrying anti-osteoporosis drugs for osteogenesis in osteoporotic bone defects.
METHODS: PubMed, Web of Science, Springerlink, Medline, WanFang and CNKI databases were retrieved with “osteoporosis, bone defect, scaffold” as key words for relevant articles published from 2005 to 2017. Initially, 201 articles were retrieved, and finally 64 articles were selected for further analysis.

RESULTS AND CONCLUSION: With the development of biochemical synthesis technology, various types of tissue-engineered bone scaffolds have been used for the treatment of osteoporotic bone defects. For example, the modified calcium phosphate cement, β-tricalcium phosphate, and hydroxyapatite all can promote bone regeneration. However, the ability of conventional scaffolds to promote bone regeneration is severely damaged under the state of osteoporosis. In this case, an anti-osteoporosis therapy becomes necessary. Considering severe adverse effects of systemic anti-osteoporosis drugs and limited local bone regeneration, the combination of scaffold implantation and local drug delivery can promote osteoporotic bone defect healing. Importantly, to incorporate bone regeneration inducers into scaffolds and steadily release with their biological activity is the key to success. Bisphosphonate, strontium, bone morphogenetic protein 2 and parathyroid hormone, traditional Chinese medicine and mesenchymal stem cells are the drugs commonly combined with tissue-engineered bone scaffolds. With the development of biotechnology, genetically modified stem cell-scaffold composites have gradually appealed to researchers.

 

Key words: Osteoporosis, Bone Regeneration, Delayed-Action Preparations, Tissue Engineering

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