异物反应中巨噬细胞调控在骨组织修复中的研究进展  

Research progress in the regulation of macrophages in foreign body reaction in bone tissue repair

作　　者：魏诗敏 汪媛婧 黄雯[1] 陈奕帆 杨仁丽 屈依丽[3] WEI Shimin;WANG Yuanjing;HUANG Wen;CHEN Yifan;YANG Renli;QU Yili(State Key Laboratory of Oral Dis. eases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China;Depart. mento of Prosthodontics, Stomatological Hospital of Southern Medical University, Guangzhou 510280, China;State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川成都610041 [2]南方医科大学口腔医院修复科,广东广州510280 [3]四川大学口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院种植科,四川成都610041

出　　处：《口腔疾病防治》2019年第9期591-597,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(8187801);国家重点研发计划项目(2016YFA0201703/2016YFA0201700);广东省医学科研基金项目(A2016394)

摘　　要：异物反应是指生物材料植入体内后发生的主要由巨噬细胞和异物巨细胞参与的慢性炎症反应和伤口愈合反应。由于异物反应中巨噬细胞在植入材料后被招募至材料表面,随后分泌一系列炎症因子并融合成异物巨细胞,可能导致生物材料降解、环境应力开裂的发生。不仅如此,巨噬细胞极化时间的延长及受相关受体的影响也可能导致纤维包裹等现象的发生,从而导致预后不佳。部分学者致力于从巨噬细胞和异物巨细胞的角度来降低异物反应的相关研究,具体通过调节相关炎症因子的分泌、减少M1型巨噬细胞的亚型并促进其向M2型巨噬细胞极化、调节巨噬细胞的融合及巨噬细胞相关受体表达以调节纤维化。新的免疫学观点认为异物反应中巨噬细胞具有成血管及成骨修复骨组织的潜能。为此,长久以来再生医学里的金标准,即具有不引起异物反应的惰性材料,有望逐渐被具有调节组织活性和功能的新型材料取代。The foreign body reaction refers to a chronic inflammatory reaction and a wound-healing reaction that mainly involve macrophages and foreign body giant cells, which occur after a biological material is implanted into the body. Since macrophages in the foreign body reaction are recruited to the surface of the material after implantation of the material, subsequent secretion of a series of inflammatory factors and fusion into foreign body giant cells may lead to the degradation of the biological materials and environmental stress cracking. Moreover, the prolongation of macrophage polarization and the influence of related receptors may also lead to the phenomenon of fiber encapsulation, resulting in poor prognosis. Some scholars are committed to reducing the response of foreign bodies from the perspective of macrophages and foreign body giant cells, specifically by regulating the secretion of related inflammatory factors, reducing the subtypes of M1 macrophages, promoting their polarization to M2 macrophages, and regulating the fusion of macrophages and selective expression of macrophage-associated receptors to regulate fibrosis. The new immunological view holds that macrophages have the potential to repair bone tissue via angioplasts and osteogenesis in foreign body reactions. Therefore, the gold standard that has long been considered in regenerative medicine, which is that an inert material does not cause a foreign body reaction, is expected to be gradually replaced by tissue engineering that regulates tissue activity and function.

关 键 词：异物反应 巨噬细胞 异物巨细胞 M2型巨噬细胞 炎症因子 骨组织修复 调控 

分 类 号：R78[医药卫生—口腔医学]