β-磷酸三钙的骨诱导性和组织工程应用研究进展  

Advances in osteoinductivity and tissue engineering applications ofβ-TCP

作　　者：杜锦洲 钱运[1] 范存义[1] Du Jinzhou;Qian Yun;Fan Cunyi(Department of Orthopaedics,Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiaotong University School of Medicine(National Orthopaedics Center),Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院(国家骨科医学中心)骨科,上海200233

出　　处：《中华骨科杂志》2024年第13期906-914,共9页Chinese Journal of Orthopaedics

摘　　要：目前,在临床中仅应用自体骨已不能满足骨缺损治疗的需求。β-磷酸三钙(beta-tricalcium phosphate,β-TCP)类骨移植替代物因具有良好的修复效果和一定的骨诱导能力而受到广泛关注。可降解β-TCP植入人体后可有效调控炎症,促进血管再生,并以膜内成骨的方式形成新骨,实现骨缺损的愈合。对β-TCP诱导间质干细胞分化为成骨细胞机制的探索也从未停止,最初将骨诱导性归功于被释放钙磷离子和被吸附蛋白的功能,最近的研究热点是材料表面结构对细胞的影响(即整合素与细胞骨架被改变),以及调节信号通路的传导,包括丝裂原活化蛋白激酶/细胞外信号调节激酶(mitogen-activated protein kinase,MAPK/extracellular regulated protein kinases,ERK)通路、WNT家族分泌蛋白通路、Hippo-Yes相关蛋白/转录共激活因子(Yes-associated protein,YAP/transcriptional coactivator with PDZ-binding motif,TAZ)通路等。目前,β-TCP产品的基础结构日趋成熟,宏观与微观设计也被不断创新,相关骨移植替代物广泛用于临床,经临床研究证实具有长期的安全性和有效性。The use of autogenous bone in treating bone defects has not met clinical demands,leading to increased attention on beta-tricalcium phosphate(β-TCP)as a bone graft substitute due to its effective repair capabilities and inherent osteoinductive properties.Upon implantation,biodegradableβ-TCP can effectively modulate inflammation,promote vascular regeneration,and facilitate new bone formation through intramembranous ossification,thereby achieving bone defect healing.Continuous research has sought to understand the mechanisms underlyingβ-TCP's ability to induce mesenchymal stem cell differentiation into osteoblasts,initially attributed to the release of calcium and phosphorus ions and the adsorption of proteins.Current research emphasizes the impact of the material's surface structure on cellular interactions,particularly focusing on changes in cell-integrin and cytoskeleton dynamics,which regulate signal transduction pathways such as the mitogen-activated protein kinase/extracellular signal-regulated kinases(MAPK/ERK)pathway,the Wnt pathway,and the Yes-associated protein/transcriptional coactivator with PDZ-binding motif(Yap/Taz)pathway.Presently,the fundamental structure ofβ-TCP products has matured,with continuous innovations in macro and micro design.These bone graft substitutes are widely used in clinical settings,demonstrating long-term safety and efficacy.

关 键 词：磷酸钙类 组织工程 骨缺损 

分 类 号：R68[医药卫生—骨科学]