中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (26): 4255-4259.doi: 10.3969/j.issn.2095-4344.1369

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

组织工程技术修复椎间盘纤维环的研究现状及应用前景

王  爽1,俞  磊1,贺云飞2,马  俊3,温剑坤1,叶晓健1   

  1. 1第二军医大学长征医院脊柱微创中心,上海市  200003;2中国人民解放军联勤保障部队第940医院骨科,甘肃省兰州市  730000;3中国人民解放军中部战区总医院骨科,湖北省武汉市  430070
  • 收稿日期:2019-03-25 出版日期:2019-09-18 发布日期:2021-04-29
  • 通讯作者: 叶晓健,博士,教授,主任医师,第二军医大学长征医院脊柱微创中心,上海市 200433
  • 作者简介:王爽,男,1979年生,辽宁省海城市人,汉族,第二军医大学在读博士,主治医师,主要从事脊柱微创外科方向研究。
  • 基金资助:

    国家自然科学基金资助项目(81772445),项目负责人:叶晓健

Research status and prospects of tissue engineering technology for repairing intervertebral disc annulus fibrosus

Wang Shuang1, Yu Lei1, He Yunfei2, Ma Jun3, Wen Jiankun1, Ye Xiaojian1
  


  • Received:2019-03-25 Online:2019-09-18 Published:2021-04-29
  • Contact: Ye Xiaojian, MD, Professor, Chief physician, Center for Minimally Invasive Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • About author:Wang Shuang, Doctoral candidate, Attending physician, Center for Minimally Invasive Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81772445 (to YXJ)

摘要:

文章快速阅读:

 

文题释义:
椎间盘纤维环:椎间盘位于脊柱各椎体间,在脊柱运动时发挥重要作用,可随脊柱的屈伸、旋转等运动发生相应的形变。椎间盘由内部的髓核和外周的纤维环组成,纤维环为密闭结构,质地坚韧,除连接相邻的2个椎体外,还起到限制髓核的作用,因各种原因导致的纤维环缺损或薄弱将使其限制髓核的作用受到削弱,进而出现髓核由该部位突出,如突出髓核压迫神经根或脊髓、硬膜囊等结构,会出现相应症状。因此,在行髓核摘除手术后,如能恰当地修复纤维环,恢复椎间盘的密闭状态,对椎间盘功能的恢复具有重要作用。
组织工程技术修复纤维环的优势:应用组织工程技术修复纤维环是指在体外构建符合力学要求的支架,再在支架上培养骨髓间充质干细胞等细胞或组织,然后将支架-细胞复合体植入纤维环缺损部位。植入的细胞在体内环境中继续生长并分化为相应的细胞,可以在修复纤维环结构的同时恢复促进纤维环、髓核组织的再生,实现“生物学修复”的效果。因此,组织工程技术修复纤维环较以往的直接缝合、凝胶封堵等方法具有明显的优势。
 
 
背景:椎间盘纤维环的修复对脊柱手术的预后具有重要作用,但目前尚无理想的修复方式,近年来迅速发展的组织工程技术有望解决这一问题,通过构建支架-细胞复合体的方法在修复纤维环的同时实现纤维环及其临近椎间盘的再生长,达到生物学修复的目的。

目的:综述纤维环修复技术的研究现状,重点阐述组织工程技术在该领域的应用情况,并展望及发展方向。

方法:在PubMed、Web of Science等数据库中进行检索,关键词为“Annulus fibrosus;Tissue engineering;Annulus fibrosus;Mesenchymal stem cells”。

结果与结论:组织工程技术在纤维环修复领域的应用已取得一定进展,现可获得理想结构的复合材料支架,干细胞在支架上可良好地黏附、增殖和分化,但具体分子机制尚不完全明确,细胞因子在干细胞增殖、分化方面的作用尚待进一步明确。提示组织工程技术在纤维环修复领域有较好的应用前景,进一步研究可能集中于支架拓扑结构、信号通路、非编码RNA等方面,力争进一步阐明干细胞在不同支架上差异分化的机制,为今后构建满足干细胞差异分化需要的组织工程支架奠定基础。

关键词: 纤维环, 组织工程, 骨髓间充质干细胞, 静电纺丝, 支架, 椎间盘, 拓扑结构, 差异分化, 细胞因子

Abstract:

BACKGROUND: The repair of annulus fibrosus of intervertebral disc plays an important role in the prognosis of spine surgery, but there is no ideal repair method at present. The rapid development of tissue engineering technology in recent years is expected to solve this problem. By constructing scaffold-cell complex, the annulus fibrosus and its adjacent intervertebral discs can regenerate and grow at the same time, so as to achieve the purpose of biological repair.
OBJECTIVE: To review the research status of repairing of annulus fibrosus, especially the tissue engineering technology applying in this field, and prospect the development of the repairing technology in the future.
METHODS: We searched the databases of PubMed and Web of Science with the keywords “Annulus fibrosus; Tissue engineering; Annulus fibrosus; Mesenchymal stem cells”.
RESULTS AND CONCLUSION: There are several achievements in the repair of annulus fibrosus using tissue engineering technology. The compound scaffolds with ideal structure can be obtained, in which stem cells can adhere, proliferate and differentiate well. Nevertheless, the determinate molecular mechanisms are not completely clear. The definite functions of cytokines in the proliferation and differentiation of stem cells remain to be further clarified. Tissue engineering has a good application prospect in the field of annulus fibrosus repair. Further research may focus on the scaffold topology, signaling pathways, and non-coding RNA. The research may strive to further elucidate the mechanism of the differentiation of stem cells on different scaffolds and make the scaffolds more suitable for the application of the repair of annulus fibrosus.

Key words: annulus fibrosus, tissue engineering, mesenchymal stem cells, electrostatic spinning, scaffolds, intervertebral disc, topology, differential differentiation, cytokines

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