软骨修复和关节保护的新一代方法

Akira Tsujii , Tomoki Ohori , Hiroto Hanai , Norimasa Nakamura
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引用次数: 0

摘要

导言关节软骨在关节的正常生理功能中发挥着重要作用,如吸收冲击和润滑。遗憾的是,虽然软骨有营养供应,但由于缺乏直接血液供应,其自我愈合能力较低;因此,人们采用了各种治疗方法来改善软骨组织的愈合。方法2023年10月,以 "软骨疗法,下一代 "为关键词进行文献检索,并分别对非手术疗法和手术疗法进行叙述性综述。结果已用于临床实践的生物疗法包括富血小板血浆疗法和间充质干细胞疗法。最近有研究报告称,使用细胞培养物外泌体的非手术疗法很有前景。基于生物材料的手术疗法可消除供体部位的发病率,也很有用。结论目前已报道了各种类型的基于矫形生物学或生物材料的治疗策略,包括无细胞方法和基于干细胞的方法;然而,使用外泌体或诱导多能干细胞的新方法尚未应用于临床,预计将来会有发展。经过精心设计的临床试验将揭示其真正的用途,我们希望它将被确立为一种可以真正提供给患者的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Next generation approaches for cartilage repair and joint preservation

Introduction

Articular cartilage plays an important role in the normal biological functions of joints, such as shock absorption and lubrication. Unfortunately, although cartilage is supplied with nutrients, it has a low self-healing capacity owing to the lack of direct blood supply; thus, various treatments have been used to improve the healing of cartilage tissue. Recent treatment strategies in the field of orthobiologics and biomaterials are expected to improve the healing rate of cartilage tissue.

Objective

To provide the latest research and clinical results related to cartilage therapy and to clarify their efficacy and expected future role.

Methods

A literature search was conducted in October 2023 using the keywords “cartilage therapy, next generation” and a narrative review was conducted separately for nonoperative and operative treatments.

Results

Orthobiologics already used in clinical practice include platelet-rich plasma- and mesenchymal stem cell-based therapies. Recent studies using exosomes derived from cell cultures have reported promising nonoperative therapies. Biomaterial-based operative therapy, which eliminates donor-site morbidity, can also be useful. In addition, a therapeutic strategy using induced pluripotent stem cells is also being promoted, and future developments are expected.

Conclusions

Various types of orthobiologic-based or biomaterials-based therapeutic strategies have been reported, including cell-free and stem cell-based methods; however, new methods using exosomes or induced pluripotent stem cells have not yet been applied clinically and are expected to be developed in the future. Well-designed clinical trials would reveal its true usefulness and we hope that it will be established as a treatment that can actually be offered to patients.

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