Growth plate mechanics and mechanobiology. A survey of present understanding.
Growth plate mechanics and mechanobiology. A survey of present understanding.
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DOI：
10.1016/j.jbiomech.2009.05.021
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发表时间：
2009-08-25
影响因子：
2.4
通讯作者：
Stokes, Ian A. F.
中科院分区：
文献类型：
--
作者：
Villemure, Isabelle;Stokes, Ian A. F.
长骨的纵向生长发生在生长板中，其中软骨细胞合成随后骨化的软骨。由异常机械负荷引起的生长改变和随后的畸形通常被称为骨生长的机械调节。这种现象在婴儿和青少年肌肉骨骼畸形的进展中具有关键意义，例如青少年特发性脊柱侧凸、过度脊柱后凸、膝内翻/外翻、胫骨内翻/外翻以及神经肌肉疾病，并且这些畸形的临床管理通常针对改变受影响骨骼的机械环境。然而，有有限的定量和生理学的理解，如何骨生长的调节，以响应机械负荷。这篇评论发表的工作地址的知识状态有关的关键问题的生物力学调制的骨生长的机制。骨的纵向生长显然是通过改变增殖区中生长板软骨细胞的数量、它们的增殖速率、软骨细胞肥大的量以及整个生长板中基质的受控合成和降解来控制的。这些变量可以被调节以在持续或周期性机械负荷的存在下产生生长速率的变化。机械刺激转导中涉及的组织和细胞变形取决于生长板组织材料的性质，这些性质是高度各向异性的、时间依赖性的，并且在生长板的不同区域和发育阶段中不同。关于软骨细胞的体积、含水量、基质渗透压等随时间变化对软骨细胞分化、成熟和代谢活性的影响的信息很少。此外，生长板上的剪切力和扭转的影响是不完全的特点。未来的工作生长板机械生物学应区分不同的过程，如直接刺激细胞核，物理化学刺激，机械降解的基质或细胞成分和可能的局部血液供应的改变，导致骨生长的调节之间的变化。
The longitudinal growth of long bones occurs in growth plates where chondrocytes synthesize cartilage that is subsequently ossified. Altered growth and subsequent deformity resulting from abnormal mechanical loading is often referred to as mechanical modulation of bone growth. This phenomenon has key implications in the progression of infant and juvenile musculoskeletal deformities, such as adolescent idiopathic scoliosis, hyperkyphosis, genus varus/valgus, tibia vara/valga, as well as neuromuscular diseases and clinical management of these deformities is often directed at modifying the mechanical environment of affected bones. However, there is limited quantitative and physiological understanding of how bone growth is regulated in response to mechanical loading. This review of published work addresses the state of knowledge concerning key questions about the mechanisms underlying biomechanical modulation of bone growth. The longitudinal growth of bones is apparently controlled by modifying the numbers of growth plate chondrocytes in the proliferative zone, their rate of proliferation, the amount of chondrocytic hypertrophy and the controlled synthesis and degradation of matrix throughout the growth plate. These variables may be modulated to produce a change in growth rate in the presence of sustained or cyclic mechanical load. Tissue and cellular deformations involved in the transduction of mechanical stimuli depend on the growth plate tissue material properties that are highly anisotropic, time-dependent, and that differ in different zones of the growth plate and with developmental stages. There is little information about the effects of time-varying changes in volume, water content, osmolarity of matrix, etc. on differentiation, maturation and metabolic activity of chondrocytes. Also, the effects of shear forces and torsion on the growth plate are incompletely characterized. Future work on growth plate mechanobiology should distinguish between changes in the regulation of bone growth resulting from different processes such as direct stimulation of the cell nuclei, physico-chemical stimuli, mechanical degradation of matrix or cellular components and possible alterations of local blood supply.
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