Tendon healing: an overview of physiology, biology, and pathology of tendon healing and systematic review of state of the art in tendon bioengineering
Tendon healing: an overview of physiology, biology, and pathology of tendon healing and systematic review of state of the art in tendon bioengineering
复制标题
DOI：
10.1007/s00167-013-2680-z
复制
发表时间：
2015-07-01
影响因子：
3.8
通讯作者：
Majewski, Martin
中科院分区：
文献类型：
--
作者：
Mueller, Sebastian A.;Todorov, Atanas;Majewski, Martin
肌腱损伤的范围从急性断裂到慢性肌腱病。为了对任何一种情况进行最佳治疗，深厚的知识都是必不可少的。因此，本文将对肌腱愈合的生理学、生物学和病理学以及肌腱生物工程的最新技术进行概述。为了更好地进行全面的调查，对肌腱愈合和肌腱生物工程（包括细胞因子调节、自体生长因子来源、生物材料、基因治疗和基于细胞的治疗）中列出的、发表在英文同行评审期刊（2013年3月）上的现有文献进行了系统回顾。临床和临床前体外研究之间没有区别。肌腱愈合发生在某些炎症、形成和重塑阶段。最近描述了靠近愈合部位的“胶原蛋白回收”的附加过程。随着对肌腱愈合生理学和病理学的理解不断加深，使用生长因子、生物材料、基因疗法或基于细胞的疗法进行肌腱生物工程的几种有前途的方法被描述。然而，只有其中一些已经在临床上常规使用。坚固且有抵抗力的肌腱对于健康的肌肉骨骼系统至关重要。肌腱生物工程的新方法有望帮助肌腱的生理愈合，从而在受伤后产生更坚固、更具抵抗力的肌腱。这一领域不断增长的知识需要进一步纳入临床研究，以便特别是那些长期疗程、修正手术或慢性肌腱病的患者和高要求的患者，即职业运动员，能够受益。
Tendon injuries vary from acute rupture to chronic tendinopathy. For an optimal treatment of either condition, a profound knowledge is essential. Therefore, this article shall give an overview of physiology, biology, and pathology of tendon healing and state of the art in tendon bioengineering.For a preferably comprehensive survey, the current literature listed in PubMed and published in English peer-reviewed journals (March 2013) was systematically reviewed for tendon healing and tendon bioengineering including cytokine modulation, autologous sources of growth factors, biomaterials, gene therapy, and cell-based therapy. No differentiation was made between clinical and preclinical in vitro investigations.Tendon healing happens in certain stadiums of inflammation, formation, and remodelling. An additional process of "collagen recycling" close to the healing site has been described recently. With increasing comprehension of physiology and pathology of tendon healing, several promising approaches in tendon bioengineering using growth factors, biomaterials, gene therapy, or cell-based therapy are described. However, only some of these are already used routinely in clinics.Strong and resistant tendons are crucial for a healthy musculoskeletal system. The new approaches in tendon bioengineering are promising to aid physiological tendon healing and thus resulting in a stronger and more resistant tendon after injury. The growing knowledge in this field will need to be further taken into clinical studies so that especially those patients with prolonged courses, revision surgery, or chronic tendinopathy and high-demanding patients, i.e., professional athletes would benefit.II.