椎间盘内源性修复策略的研究进展  

Research progress of endogenous repair strategy in intervertebral disc

作　　者：刘洋[1] 刘浩[1] 孟阳[1] 张亮 LIU Yang;LIU Hao;MENG Yang;ZHANG Liang(Department of Orthopedics,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China;Department of Orthopedics,Northern Jiangsu People’s Hospital,Yangzhou Jiangsu,225000,P.R.China)

机构地区：[1]四川大学华西医院骨科,成都610041 [2]苏北人民医院骨科,江苏扬州225000

出　　处：《中国修复重建外科杂志》2021年第5期636-641,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金青年基金资助项目(81702156);国家自然科学基金资助项目(81572141)。

摘　　要：目的综述椎间盘内源性修复策略的研究进展。方法查阅国内外近年有关椎间盘内源性修复策略相关研究文献,总结其特点、现状及应用前景。结果椎间盘内源性修复的关键是提高椎间盘组织中干/祖细胞活力或促进其从干细胞Niche向需修复的组织迁移。这些干/祖细胞可来源于髓核、纤维环及软骨终板,具有MSCs生物学特点,特异性表达干/祖细胞表面标志物及基因,同时拥有多系分化潜能。但是,椎间盘的发育、衰老及退变消耗了这些干/祖细胞,另外退变椎间盘内极端微环境也会进一步损害干/祖细胞的生物学性能,从而导致椎间盘内源性修复失败。因此,目前相关研究主要从提高内源性干/祖细胞的生物学性能、直接补充内源性干/祖细胞、生物材料及小分子化合物刺激椎间盘内源性修复,以提高修复效果。结论目前,椎间盘内源性修复策略用于椎间盘退变治疗的研究已取得一定进展,但仍处于临床前阶段,下一步应着重于体内实验及临床转化研究。Objective To review the research progress of endogenous repair strategy(ERS) in intervertebral disc(IVD). Methods The domestic and foreign literature related to ERS in IVD in recent years was reviewed, and its characteristics, status, and prospect in the future were summarized. Results The key of ERS in IVD is to improve the vitality of stem/progenitor cells in IVD or promote its migration from stem cell Niche to the tissue that need to repair.These stem/progenitor cells in IVD are derived from nucleus pulposus, annulus fibrosus, and cartilaginous endplate,showing similar biological characteristics to mesenchymal stem cells including the expression of the specific stem/progenitor cell surface markers and gene, and also the capacity of multiple differentiations potential. However, the development, senescence, and degeneration of IVD have consumed these stem/progenitor cells, and the harsh internal microenvironment further impair their biological characteristics, which leads to the failure of endogenous repair in IVD.At present, relevant research mainly focuses on improving the biological characteristics of endogenous stem/progenitor cells, directly supplementing endogenous stem/progenitor cells, biomaterials and small molecule compounds to stimulate the endogenous repair in IVD, so as to improve the effect of endogenous repair. Conclusion At present, ERS has gotten some achievements in the treatment of IVD degeneration, but its related studies are still in the pre-clinical stage. So further studies regarding ERS should be carried out in the future, especially in vivo experiments and clinical transformation.

关 键 词：椎间盘退变 内源性修复策略 椎间盘 干/祖细胞 

分 类 号：R681.5[医药卫生—骨科学]