Revell Christopher M, Athanasiou Kyriacos A
Department of Bioengineering, Rice University, Houston, Texas 77005, USA.
Tissue Eng Part B Rev. 2009 Mar;15(1):1-15. doi: 10.1089/ten.teb.2008.0189.
This review examines current approaches available for articular cartilage repair, not only in terms of their regeneration potential, but also as a function of immunologic response. Autogenic repair techniques, including osteochondral plug transplantation, chondrocyte implantation, and microfracture, are the most widely accepted clinical treatment options due to the lack of immunogenic reactions, but only moderate graft success rates have been reported. Although suspended allogenic chondrocytes are shown to evoke an immune response upon implantation, allogenic osteochondral plugs and tissue-engineered grafts using allogenic chondrocytes exhibit a tolerable immunogenic response. Additionally, these repair techniques produce neotissue with success rates approaching those of currently available autogenic repair techniques, while simultaneously obviating their major hindrance of donor tissue scarcity. To date, limited research has been performed with xenogenic tissue, although several studies demonstrate the potential for its long-term success. This article focuses on the various treatment options for cartilage repair and their associated success rates and immunologic responses.
本综述探讨了目前可用于关节软骨修复的方法,不仅涉及其再生潜力,还涉及其免疫反应功能。自体修复技术,包括骨软骨栓移植、软骨细胞植入和微骨折,由于缺乏免疫原性反应,是目前临床上最广泛接受的治疗选择,但据报道移植成功率仅为中等。尽管悬浮异体软骨细胞在植入后会引发免疫反应,但异体骨软骨栓和使用异体软骨细胞的组织工程移植物表现出可耐受的免疫原性反应。此外,这些修复技术产生新组织的成功率接近目前可用的自体修复技术,同时消除了供体组织稀缺这一主要障碍。迄今为止,关于异种组织的研究有限,尽管有几项研究证明了其长期成功的潜力。本文重点介绍了软骨修复的各种治疗选择及其相关的成功率和免疫反应。