Growth factors in bone repair.
Growth factors in bone repair.
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DOI：
10.1007/s12306-008-0064-1
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发表时间：
2008-12-01
期刊：
影响因子：
--
通讯作者：
Cenni, Elisabetta
中科院分区：
文献类型：
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作者：
Devescovi, Valentina;Leonardi, Elisa;Cenni, Elisabetta
生长因子（GF）在骨修复中的作用得到广泛认可，特别是骨形态发生蛋白（BMP）、成纤维细胞生长因子（FGF）、胰岛素样生长因子（IGF）、血小板衍生生长因子（PDGF）、转化生长因子-β（TGF-β）和血管内皮生长因子（VEGF）。GF通常储存在细胞外基质（ECM）中，但在损伤后由ECM、细胞和血小板主动释放。本文就不同重组生长因子在骨修复刺激中的实验研究和临床应用作一综述。需要药物递送系统，包括载体、细胞或基因治疗，以确保因子的持续局部释放，但在临床应用之前，需要对此类系统的功效和潜在副作用进行额外的研究。目前用于将GF混合物递送到骨修复部位的来源是血小板凝胶和脱矿骨基质。然而，这些制剂中的GF水平受到供体之间的变异性和制剂差异的影响。在骨修复过程中由患者自身产生的自体GF可能会干扰假体器械，甚至由于假体周围组织反应而导致植入物松动。总之，GF是功能性骨再生的关键成分：基础研究成果的筛选和对照临床试验正在加速GF在骨科手术中的发展。
The role of growth factors (GF) in bone repair is widely recognised, particularly for bone morphogenetic proteins (BMPs), fibroblast growth factor (FGF), insulin-like growth factors (IGFs), platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-beta) and vascular endothelial growth factor (VEGF). GF are usually stored in the extracellular matrix (ECM), but after injury are actively released by ECM, cells and platelets. In this paper, the use of different recombinant GF for bone repair stimulation is summarised in experimental research and clinical applications. Drug delivery systems, including carriers, cell or gene therapy, are needed to ensure a sustained local release of the factors, but efficacy and potential side effects of such systems require additional research prior to clinical applications. Current sources for delivery of a GF mixture into the site of bone repair are platelet gel and demineralised bone matrix. Nevertheless, the levels of GF in such preparations are affected by variability among donors and differences in preparation. Autogenous GF, produced by the patient himself during the bone repair process, potentially interfere with prosthetic devices or even have a role in implant loosening due to the periprosthetic tissue reaction. In conclusion, GF are key components of functional bone regeneration: screening of basic research results and controlled clinical trials are accelerating the development of GF in orthopaedic surgery.