机构地区:[1]西南医科大学体育学院,四川省泸州市646000 [2]西南医科大学附属中医医院,四川省泸州市646000
出 处:《中国组织工程研究》2024年第13期2098-2104,共7页Chinese Journal of Tissue Engineering Research
基 金:四川省科技计划(2022YFS0609),项目负责人:石厚银;泸州市政府-西南医科大学科技战略合作项目(2021LZXNYD-J10),项目负责人:李森;西南医科大学应用基础研究项目(2021ZKMS050),项目负责人:李森~~。
摘 要:背景:肌腱病是一种肌肉骨骼疾病,以疼痛和活动能力下降为特征,伴有胶原蛋白紊乱和血管增生的病理变化。肌腱病常易发生在运动员、体力劳动者和老年人身上。肌腱病的机制之一是“失败的愈合反应”,而导致失败愈合反应的部分原因是肌腱干细胞的错误分化。目的:通过阅读相关文献,介绍肌腱干细胞的特性,总结影响肌腱干细胞向肌腱细胞分化的因素以及导致肌腱干细胞错误分化(分化为脂肪细胞、骨细胞和软骨细胞)的因素,同时阐述肌腱干细胞在临床中的应用局限。方法:检索PubMed及Web of Science数据库中相关文献,检索词为“Tendon Stem/Progenitor Cells,Tendinopathy,Tendon injury,differentiation”,通过阅读筛选出相关文献,最终纳入109篇文献进行结果分析。结果与结论:①肌腱干细胞是可以自发分化为肌腱的一种干细胞,它具有自我更新、克隆和多向分化的能力,不同的外部条件作用于肌腱干细胞可以导致其向不同方向分化。调节肌腱干细胞命运的具体因素并不确定。当肌腱中的干细胞更新和分化出现异常时,会导致肌腱愈合失败,进而导致肌腱病。②衰老、细胞外基质成分的变化、过度的机械刺激、前列腺素E2和白细胞介素6以及白细胞介素10和一些系统性疾病可能对调控肌腱干细胞的错误分化有重要意义。③促进肌腱干细胞向腱细胞分化的可能有利因素有:一些生长因子和细胞因子、适度的机械刺激和细胞外基质的地形、低氧张力、药物以及某些转录基因和蛋白。④目前最为理想的治疗手段则是对内源性肌腱干细胞进行调节,或者外源性肌腱干细胞刺激内源性肌腱干细胞的增殖分化。⑤未来研究进一步了解调节肌腱干细胞错误分化的因素,可深入了解肌腱病的发病机制并找到治疗靶点,阐述诱导肌腱干细胞向肌腱分化则可促进其在组织工程中的应用。BACKGROUND:Tendinopathy is a musculoskeletal disorder characterized by pain and decreased mobility,with pathological changes of disturbed collagen and hyperplasia of the vasculature.Tendinopathy tends to occur in athletes,physical workers,and the elderly.One of the mechanisms of tendinopathy is the“failed healing response”,and part of what causes the failed healing response is the erroneous differentiation of tendon stem/progenitor cells.OBJECTIVE:By reviewing the relevant literature,we introduce the characteristics of tendon stem/progenitor cells,summarize the factors that affect the differentiation of tendon stem/progenitor cells to tendon cells and those that lead to mis-differentiation of tendon stem/progenitor cells(differentiation to adipocytes,osteocytes and chondrocytes),and also describe the limitations of tendon stem/progenitor cells in clinical applications.METHODS:PubMed and Web of Science databases were searched for the terms“tendon stem/progenitor cells,tendinopathy,tendon injury,differentiation”.The relevant literature was screened by reading and 109 articles were included for the analysis of the results.RESULTS AND CONCLUSION:(1)Tendon stem/progenitor cells are a type of stem cells that can spontaneously differentiate into tendons and have the ability to self-renew,clone,and multi-differentiate.Various external conditions acting on tendon stem/progenitor cells can lead them to differentiate in diverse directions.The specific factors that regulate the fate of tendon stem/progenitor cells are not known with certainty.When stem cell renewal and differentiation in tendons becomes abnormal,it can lead to failure of tendon healing and consequently to tendinopathy.(2)Aging,changes in extracellular matrix composition,excessive mechanical stimulation,prostaglandin E2 and interleukin-6 as well as interleukin-10 and some systemic diseases may be important in regulating the mis-differentiation of tendon stem/progenitor cells.(3)Possible favorable factors that promote the differentiation of tendon stem
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