蚕丝相关组织工程支架在肌腱和韧带再生修复中的应用  

Application of silk-based tissue engineering scaffold for tendon/ligament regeneration

作　　者：胡叶君 乐辉辉 金张楚 陈晓[1] 茵梓[1] 沈炜亮[1,2] 欧阳宏伟[1] 

机构地区：[1]浙江大学医学院干细胞与再生医学系浙江大学李达三·叶耀珍干细胞与再生医学研究中心浙江省组织工程与再生医学技术重点实验室,浙江杭州310058 [2]浙江大学医学院附属第二医院骨科浙江大学骨科研究所,浙江杭州310009

出　　处：《浙江大学学报（医学版）》2016年第2期152-160,共9页Journal of Zhejiang University(Medical Sciences)

基　　金：国家自然科学基金(81572157,81201396,81572115);国家自然科学青年基金(81271970);浙江省自然科学基金(LY14H060003)

摘　　要：肌腱和韧带损伤是临床常见运动系统损伤之一。传统治疗手段因供体来源有限、机体免疫排斥等局限，尚无法达到令人满意的临床疗效，尤其是对那些竞技运动员。目前的组织工程学手段能够突破传统治疗的局限，促进肌腱和韧带损伤的修复再生。蚕丝是一种天然的生物材料，具有生物相容性较好、力学强度跨度大和物理结构可调节等特性，可以作为肌腱和韧带的组织工程支架。以蚕丝支架为核心提供力学支持，复合胶原等其他生物成分能增加支架的三维空间，促进更多细胞黏附，并提升材料的生物相容性。体内研究逐步验证了蚕丝支架在发病率较高的肌腱和韧带（前交叉韧带、内侧副韧带、跟腱、肩袖韧带）修复中的临床应用潜能。生物力学良好，宿主自然整合的组织工程肌腱和韧带需要深入基础微观领域研究和延伸，临床操作领域研究，促进产品走出实验室。开辟临床应用新航路，为肌腱和韧带损伤患者带来新的希望。本文就蚕丝相关组织工程支架的历史演变及其用于肌腱和韧带损伤修复的效果进行综述和展望。Tendon/ligament injury is one of the medicine. The traditional treatments of damaged most common impairments in sports tissue repair are unsatisfactory, especially for athletes, due to lack of donor and immune rejection. The strategy of tissue engineering may break through these limitations, and bring new hopes to tendon/ ligament repair, even regeneration. Silk is a kind of natural biomaterials, which has good biocompatibility, wide range of mechanical properties and tunable physical structures; so it could be applied as tendon/ligament tissue engineering scaffolds. The silk-based scaffold has robust mechanical properties; combined with other biological ingredients, it could increase the surface area, promote more cell adhesion and improve the biocompatibility. The potential clinical application of silk-based scaffold has been confirmed by in vivo studies orl tendon/ligament repairing, such as anterior crueiate ligament, medial collateral ligament, achilles tendon and rotator cuff. To develop novel biomechanically stable and host integrated tissue engineered tendon/ligament needs more further micro and macro studies, combined with product development and clinical application, which will give new hope to patients with tendon/ligament injury.

关 键 词：蚕属 腱损伤 韧带 支架 修复外科手术 组织工程 再生 综述 

分 类 号：R318.08[医药卫生—生物医学工程] R873[医药卫生—基础医学]