不同间质干细胞来源外泌体在激素性股骨头坏死进展及治疗中的作用  

The role of exosomes derived from different mesenchymal stem cells in the progression and treatment of steroid induced necrosis of the femoral head

作　　者：贺万雄 王国强 王建忠[2] 张葆鑫 He Wanxiong;Wang Guoqiang;Wang Jianzhong;Zhang Baoxin(Graduate School of Inner Mongolia Medical University,Hohhot 010107,China;Department of Trauma and Orthopaedics,the Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010090,China)

机构地区：[1]内蒙古医科大学研究生院,呼和浩特010107 [2]内蒙古医科大学第二附属医院创伤骨科,呼和浩特010090

出　　处：《中华骨科杂志》2022年第20期1391-1398,共8页Chinese Journal of Orthopaedics

基　　金：内蒙古自治区科技攻关计划(2020GG0195)。

摘　　要：激素性股骨头坏死(steroid-induced osteonecrosis of femoral head,SONFH)是一种进行性和难治性骨科疾病,对患者身心健康有较大的影响,但目前SONFH的致病机制仍不清楚。外泌体是大多数类型的细胞均能够产生的一种直径为30-120 nm的细胞外脂质结构囊泡,囊泡能够反映出来源细胞的生理特性,同时将生物活性物质传递到靶细胞进而影响细胞活动。不同间质干细胞(mesenchymal stem cells,MSCs)来源外泌体在SONFH病程发展等诸多方面发挥较为重要的作用。此外,目前研究还提示外泌体有望成为SONFH诊疗的重要工具,甚至用以指导早期临床对糖皮质激素的使用,但需要更多高质量研究和循证医学的证据。以不同MSCs来源外泌体对SONFH的治疗研究进展为核心,同时阐述了其他不同来源外泌体及外泌体在SONFH诊断中的作用研究进展,以期为SONFH的诊疗提供一种新的思路。Steroid induced osteonecrosis of femoral head(SONFH)is a progressive and refractory orthopedic disease,which has a great impact on the physical and mental health of patients,but the pathogenesis of SONFH is still unclear.Exosomes are extracellular lipid structural vesicles with a diameter of 30-120 nm that can be produced by most types of cells.The vesicles can reflect the physiological characteristics of the source cells,and transfer bioactive substances to target cells to affect cell activities.Exosomes derived from different mesenchymal stem cells(MSCs)play an important role in the development of SONFH and many other aspects.In addition,the current research also suggests that exosomes are expected to become an important tool for diagnosis and treatment of SONFH,and even to guide the early clinical use of glucocorticoids,but more high-quality research and evidence based medicine are needed.Focusing on the research progress in the treatment of SONFH by exosomes from different MSCs,the research progress in the role of exosomes from other different sources and exosomes in the diagnosis of SONFH is expounded,in order to provide a new idea for the diagnosis and treatment of SONFH.

关 键 词：激素性股骨头坏死 外泌体 骨科疾病 循证医学 病程发展 间质干细胞 早期临床 糖皮质激素 

分 类 号：R681.8[医药卫生—骨科学]