优化组织工程,提高肩袖修复的临床实用性。

IF 5.1 2区 医学 Q2 CELL & TISSUE ENGINEERING
Tissue Engineering. Part B, Reviews Pub Date : 2024-10-01 Epub Date: 2024-04-29 DOI:10.1089/ten.TEB.2023.0320
Maxwell S Durtschi, Sungwoo Kim, Jiannan Li, Carolyn Kim, Constance Chu, Emilie Cheung, Marc Safran, Geoff Abrams, Yunzhi Peter Yang
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引用次数: 0

摘要

肩袖撕裂(RCT)是导致上肢残疾的最常见原因。1 在美国,每年有450万人次因肩袖撕裂而就诊,这也是骨科医生评估肩部疾病的最常见病因。文献表明,再撕裂率从 29.5% 到高达 94% 不等6,7。8 虽然市场上已有 RC 修复移植物用于增强 RC 肌腱修复,但其临床疗效参差不齐9,10。这些移植物缺乏适当的生物线索,如骨腱界面的干细胞和信号分子。9,10这些移植物缺乏适当的生物线索,如骨-肌腱界面上的干细胞和信号分子。此外,它们几乎无法防止纤维血管瘢痕组织的形成,从而导致 RC 易于再次撕裂。组织工程学的研究进展表明,间充质干细胞(MSCs)和生长因子(GFs)可增强动物模型中 RC 内膜的再生。这些模型显示,将间充质干细胞和生长因子输送到 RC 撕裂部位可增强原生假体的修复,并带来更大的机械强度。此外,这些模型还证明了间充质干细胞和凝血因子可通过多种方法输送,包括直接注射、修复材料饱和和负载微球。含有间充质干细胞和谷胱甘肽的移植物可在 RC 修复过程中增强抗炎、骨生成、血管生成和软骨生成。将在动物模型中取得成功的技术应用于临床至关重要。目前,在动物模型中研究出的有前景的生物因素与可用于临床的 RC 修复移植物之间还存在差距。未来的 RC 修复移植物必须能稳定植入和固定,与当前的关节镜技术兼容,并能输送间充质干细胞和/或 GF。参考文献(手稿中包含完整引文) 1.Kovacevic (2020) 2.Moran (2023) 3.Piper (2018) 4.IData (2018) 5.Yamaura (2023) 6.Park (2021) 7.戴维(2023 年) 8.斯米塔纳(2017) 9.沃尔顿(2007 年) 10.索勒(2007 年)
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimizing Tissue Engineering for Clinical Relevance in Rotator Cuff Repair.

Rotator cuff tear (RCT) is the most common cause of disability in the upper extremity. It results in 4.5 million physician visits in the United States every year and is the most common etiology of shoulder conditions evaluated by orthopedic surgeons. Over 460,000 RCT repair surgeries are performed in the United States annually. Rotator cuff (RC) retear and failure to heal remain significant postoperative complications. Literature suggests that the retear rates can range from 29.5% to as high as 94%. Weakened and irregular enthesis regeneration is a crucial factor in postsurgical failure. Although commercially available RC repair grafts have been introduced to augment RC enthesis repair, they have been associated with mixed clinical outcomes. These grafts lack appropriate biological cues such as stem cells and signaling molecules at the bone-tendon interface. In addition, they do little to prevent fibrovascular scar tissue formation, which causes the RC to be susceptible to retear. Advances in tissue engineering have demonstrated that mesenchymal stem cells (MSCs) and growth factors (GFs) enhance RC enthesis regeneration in animal models. These models show that delivering MSCs and GFs to the site of RCT enhances native enthesis repair and leads to greater mechanical strength. In addition, these models demonstrate that MSCs and GFs may be delivered through a variety of methods including direct injection, saturation of repair materials, and loaded microspheres. Grafts that incorporate MSCs and GFs enhance anti-inflammation, osteogenesis, angiogenesis, and chondrogenesis in the RC repair process. It is crucial that the techniques that have shown success in animal models are incorporated into the clinical setting. A gap currently exists between the promising biological factors that have been investigated in animal models and the RC repair grafts that can be used in the clinical setting. Future RC repair grafts must allow for stable implantation and fixation, be compatible with current arthroscopic techniques, and have the capability to deliver MSCs and/or GFs.

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来源期刊
Tissue Engineering. Part B, Reviews
Tissue Engineering. Part B, Reviews Biochemistry, Genetics and Molecular Biology-Biochemistry
CiteScore
12.80
自引率
1.60%
发文量
150
期刊介绍: Tissue Engineering Reviews (Part B) meets the urgent need for high-quality review articles by presenting critical literature overviews and systematic summaries of research within the field to assess the current standing and future directions within relevant areas and technologies. Part B publishes bi-monthly.
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