Mesenchymal stem cells in the aseptic loosening of total joint replacements.
Mesenchymal stem cells in the aseptic loosening of total joint replacements.
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DOI：
10.1002/jbm.a.35978
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发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Goodman SB
中科院分区：
文献类型：
--
作者：
Pajarinen J;Lin TH;Nabeshima A;Jämsen E;Lu L;Nathan K;Yao Z;Goodman SB
假体周围骨溶解仍然是全关节置换术的主要长期并发症。四十多年的研究已经确定植入物磨损是植入物周围组织慢性炎症的罪魁祸首，巨噬细胞是介导宿主对植入物衍生磨损颗粒反应的关键细胞。磨损碎屑激活的巨噬细胞分泌刺激骨再吸收破骨细胞的炎症介质;因此种植体周围组织中的骨丢失增加。然而，骨转换的平衡不仅由破骨细胞介导的骨吸收决定，而且还由成骨细胞形成新骨决定;在生理条件下，这两个过程紧密耦合。越来越多的兴趣已经放在磨损碎屑对骨形成谱系细胞的影响。这些细胞主要来源于存在于骨髓和微血管壁中的多能间充质干细胞（MSC）。越来越多的证据表明，磨损碎屑显着损害MSC成骨细胞分化和随后的骨形成。在这篇综述中，我们总结了目前的理解生物材料植入磨损碎片对骨髓间充质干细胞的影响。还讨论了通过利用或靶向间充质干细胞来改善初始植入物整合和治疗正在发展的溶骨性病变的新兴治疗方案。
Peri-prosthetic osteolysis remains as the main long-term complication of total joint replacement surgery. Research over four decades has established implant wear as the main culprit for chronic inflammation in the peri-implant tissues and macrophages as the key cells mediating the host reaction to implant-derived wear particles. Wear debris activated macrophages secrete inflammatory mediators that stimulate bone resorbing osteoclasts; thus bone loss in the peri-implant tissues is increased. However, the balance of bone turnover is not only dictated by osteoclast-mediated bone resorption but also by the formation of new bone by osteoblasts; under physiological conditions these two processes are tightly coupled. Increasing interest has been placed on the effects of wear debris on the cells of the bone-forming lineage. These cells are derived primarily from multipotent mesenchymal stem cells (MSCs) residing in bone marrow and the walls of the microvasculature. Accumulating evidence indicates that wear debris significantly impairs MSC-to-osteoblast differentiation and subsequent bone formation. In this review, we summarize the current understanding of the effects of biomaterial implant wear debris on MSCs. Emerging treatment options to improve initial implant integration and treat developing osteolytic lesions by utilizing or targeting MSCs are also discussed.
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