Injectable hydrogel-based drug delivery system for cartilage regeneration
Injectable hydrogel-based drug delivery system for cartilage regeneration
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DOI：
10.1016/j.msec.2020.110702
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发表时间：
2020-05-01
影响因子：
7.9
通讯作者：
Vazquez-Lasa, Blanca
中科院分区：
文献类型：
--
作者：
Garcia-Fernandez, Luis;Olmeda-Lozano, Marta;Vazquez-Lasa, Blanca
骨关节病（OA）是一种慢性退行性疾病的缓慢进展，影响髋关节，膝关节，远端指骨和椎间关节。其特征在于关节疼痛、敏感性加重、僵硬和活动性改变[1]。该病症首先表现在分子和细胞水平（关节组织的异常代谢），然后是解剖学或生理学改变（软骨的降解和损失、骨重塑、骨赘形成、滑膜炎症、硬化和软骨下骨的损失）。髋关节和膝关节的负担是残疾的常见原因。OA是一个严重的临床和公共卫生问题，近50%的人患有不同程度的OA，但目前可用的临床治疗无法逆转疾病进展[2]，目前最常用的治疗是口服非甾体抗炎药（NSAID）或皮质激素，但这些治疗会引起不同的不良反应，如胃肠道反应或肾功能不全[2]。在严重OA（使人衰弱的疼痛，主要功能限制）的情况下，有必要使用手术。目前，软骨组织的再生正在研究中，没有找到临床满意的解决方案[3]。微骨折技术是治疗软骨损伤最广泛使用的临床程序[4]。该技术包括固定软骨下骨，允许出血并形成富含生长因子和间充质细胞的凝块[4，5]。通过该技术再生的软骨是纤维软骨，其呈现比原始软骨更差的物理性质，并且具有与周围组织整合的问题。
Osteoarthrosis (OA) is a chronic degenerative disease of slow progression that affects the hip, knee, distal phalangeal and intervertebral joints. It is characterized by joint pain, accentuated sensitivity, rigidity and alteration in mobility [1]. The disorder first manifests at the molecular and cellular level (abnormal metabolism of the tissues of the joint) followed by anatomical or physiological alterations (degradation and loss of cartilage, bone remodeling, osteophyte formation, synovial inflammation, sclerosis and loss of subchondral bone). The commitment of the hip and knees are a common cause of disability. OA is a severe clinical and public health problem, close to 50% of the people suffered OA at different levels, but the current clinical treatments available are incapable to reverse disease progression [2].The most used current treatment is oral medications with nonsteroidal anti-inflammatory drugs (NSAID) or corticoids, but these treatments cause different adverse effects, such as gastrointestinal reactions or renal dysfunction [2]. In the case of severe OA (debilitating pain, major functional limitation) is necessary the use of surgery. Currently, the regeneration of cartilage tissue is under research without found clinical satisfactory solutions [3]. The technique of microfracture is the clinical procedure most widely used to treat cartilage injury [4]. This technique consists in perforate the subchondral bone, allowing the bleeding and the formation of a clot rich in growth factor and mesenchymal cells [4, 5]. The cartilage regenerated by this technique is a fibrocartilage, which presents worst physical properties than the original one and has problems of integration with the surrounding tissue.