Immunomodulatory Strategies for Cartilage Regeneration in Osteoarthritis
Immunomodulatory Strategies for Cartilage Regeneration in Osteoarthritis
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DOI：
10.1089/ten.tea.2023.0255
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发表时间：
2024-01-24
影响因子：
4.1
通讯作者：
Gonzalez-Fernandez，Tomas
中科院分区：
文献类型：
--
作者：
Kennedy，Orlaith;Kitson，Andrew;Gonzalez-Fernandez，Tomas
骨关节炎是最常见的肌肉骨骼疾病，也是全球致残的主要原因。尽管已经做出了许多努力来治疗这种疾病，但目前的组织工程(TE)和再生医学策略未能解决导致疾病快速发展的炎症组织环境，并阻止软骨组织的形成。首先，这篇综述详细介绍了目前治疗骨性关节炎的抗炎治疗方法，特别是药物治疗、基因治疗和间充质基质细胞(MSC)关节内注射，并讨论了这些方法在促进软骨再生方面临床成功有限的原因。然后，我们分析了最新的TE策略，以及如何通过整合免疫调节功能来改进它们，例如优化生物材料组成、孔隙率和几何形状，以及在工程结构中加载抗炎分子。最后，综述讨论了新一代骨关节炎TE治疗策略的未来方向，特别是抗炎剂呈现的时空调节，以实现针对患者的量身定制的治疗。影响声明骨关节炎(OA)是一种流行的和衰弱的肌肉骨骼疾病，影响全球数百万人。尽管再生医学和组织工程学(TE)取得了重大进展，但在缓解炎症的同时促进软骨组织再生在OA中仍然是遥不可及的。在这篇综述文章中，我们讨论了目前的抗炎治疗，并探索了它们与尖端软骨TE策略的潜在协同作用，特别关注新的时空和患者特有的抗炎策略。
Osteoarthritis (OA) is the most prevalent musculoskeletal disorder and a leading cause of disability globally. Although many efforts have been made to treat this condition, current tissue engineering (TE) and regenerative medicine strategies fail to address the inflammatory tissue environment that leads to the rapid progression of the disease and prevents cartilage tissue formation. First, this review addresses in detail the current anti-inflammatory therapies for OA with a special emphasis on pharmacological approaches, gene therapy, and mesenchymal stromal cell (MSC) intra-articular administration, and discusses the reasons behind the limited clinical success of these approaches at enabling cartilage regeneration. Then, we analyze the state-of-the-art TE strategies and how they can be improved by incorporating immunomodulatory capabilities such as the optimization of biomaterial composition, porosity and geometry, and the loading of anti-inflammatory molecules within an engineered structure. Finally, the review discusses the future directions for the new generation of TE strategies for OA treatment, specifically focusing on the spatiotemporal modulation of anti-inflammatory agent presentation to allow for tailored patient-specific therapies.Impact statementOsteoarthritis (OA) is a prevalent and debilitating musculoskeletal disorder affecting millions worldwide. Despite significant advancements in regenerative medicine and tissue engineering (TE), mitigating inflammation while simultaneously promoting cartilage tissue regeneration in OA remains elusive. In this review article, we discuss current anti-inflammatory therapies and explore their potential synergy with cutting-edge cartilage TE strategies, with a special focus on novel spatiotemporal and patient-specific anti-inflammatory strategies.