外泌体的优化策略及在促进骨修复再生中的应用研究进展  

Enhancing bone regeneration:advances and innovations in exosome engineering

作　　者：陈长军 赵鑫 罗月 康鹏德[1] Chen Changjun;Zhao Xin;Luo Yue;Kang Pengde(Department of Orthopaedics Surgery,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Orthopaedic Surgery,The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Shandong Key Laboratory of Rheumatic Disease and Translational Medicine,Jinan 250012,China;Department of Orthopaedic Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Orthopaedic Surgery,North Sichuan Medical College,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]四川大学华西医院骨外科,成都610041 [2]山东第一医科大学第一附属医院(山东省千佛山医院)骨外科,山东省风湿免疫病转化医学重点实验室,济南250012 [3]山东第一医科大学附属省立医院骨科,济南250021 [4]川北医学院附属医院骨科,南充637000

出　　处：《中华骨科杂志》2023年第24期1688-1694,共7页Chinese Journal of Orthopaedics

基　　金：国家自然科学基金(82172414,82272483,82372392);山东省自然科学基金(ZR2023QH517,ZR2022QH252);济南市临床医学科技创新计划(202328059)。

摘　　要：促进骨组织修复再生是治疗各类骨科疾病(如股骨头坏死、骨折不愈合、骨折延迟愈合、骨质疏松以及各类原因所致的骨缺损等)的重要手段。外泌体是一种细胞分泌的膜性囊泡,含有多种生物活性物质,如蛋白、脂质、核酸等,并在细胞间通讯中扮演重要角色。其中间质干细胞源性外泌体在骨修复再生中展示了良好的应用和临床转化潜力,但是其功能和治疗效率有待进一步优化。经文献检索证实物理刺激、关键分子干预及小分子化合物和(或)生物材料刺激是促进外泌体分泌的重要策略。对外泌体的亲代细胞及外泌体进行工程化改造是实现优化并增强外泌体功能的的可行手段。而将外泌体通过各种方式整合到生物材料内以促进骨修复再生是目前在骨组织工程领域的主要应用方式。综述外泌体的优化策略,包括促进外泌体分泌及外泌体功能优化的方式,以及外泌体功能化的生物材料促进骨修复再生的研究进展,能够为加强外泌体在骨修复再生中的应用并促进外泌体的临床转化提供参考。Effective bone repair and regeneration is crucial for treating skeletal tissue defects,including osteonecrosis,nonunion fractures,osteoporosis,and various other bone deficiencies.Exosomes,as cellular secretory vesicles,are pivotal in mediating intercellular communication through their cargo of proteins,lipids,and nucleic acids.Mesenchymal stem cell-derived exosomes,in particular,have emerged as promising agents in bone repair and regeneration,showing potential for practical application and clinical translation.Nonetheless,their functional capacity and therapeutic efficacy require enhancement.This review delineates exosome optimization strategies aimed at augmenting secretion and functionality,alongside the incorporation of exosome-functionalized biomaterials for bone healing.Evidence indicates that physical stimulation,molecular interventions,and small-molecule or biomaterial stimuli are effective in increasing exosome output.Moreover,engineering exosomes and their parental cells can further potentiate their therapeutic function.The amalgamation of exosomes with biomaterials represents a burgeoning approach in bone tissue engineering,offering novel therapeutic avenues.This comprehensive analysis aims to guide future applications and the clinical adoption of exosomes in bone tissue restoration.

关 键 词：外泌体 骨再生 生物相容性材料 组织工程 

分 类 号：R68[医药卫生—骨科学]