Integrating soft and hard tissues via interface tissue engineering.
Integrating soft and hard tissues via interface tissue engineering.
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DOI：
10.1002/jor.23810
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Lu HH
中科院分区：
文献类型：
--
作者：
Patel S;Caldwell JM;Doty SB;Levine WN;Rodeo S;Soslowsky LJ;Thomopoulos S;Lu HH
附着点，或骨与软组织（如韧带和肌腱）之间的界面，易于受伤，并且通常不会愈合，即使在手术干预后也是如此。界面组织工程是一种通过功能性连接软组织和硬组织来再生天然附着点的综合策略，从而改善临床结果。本文综述了针对两种最常见的损伤软组织-骨连接的愈合的综合性和细胞指导性支架设计：肌腱-骨界面（例如，旋转套）和韧带-骨界面（例如，前交叉韧带）。软组织和硬组织之间的固有连接有助于肌肉骨骼运动，因此是软组织再生的关键设计标准。为此，用于软组织再生的支架设计已经从单一组织系统发展到对预整合和功能性复合组织单元的新兴关注。具体地，已经追求多方面的生物启发方法，其中支架被定制为使用空间图案化的结构和化学线索、生长因子和/或机械刺激来刺激相关的细胞反应。此外，目前的努力，阐明通过战略仿生的基本支架设计标准的强调，因为这些将降低复合材料组织再生的复杂性和减轻临床翻译的相关负担。这些创新研究强调了工程结缔组织整合的临床相关性，并对复杂组织的形成和总关节再生产生了更广泛的影响。
The enthesis, or interface between bone and soft tissues such as ligament and tendon, is prone to injury and often does not heal, even post-surgical intervention. Interface tissue engineering represents an integrative strategy for regenerating the native enthesis by functionally connecting soft and hard tissues and thereby improving clinical outcome. This review focuses on integrative and cell-instructive scaffold designs that target the healing of the two most commonly injured soft tissue-bone junctions: tendon-bone interface (e.g., rotator cuff) and ligament-bone interface (e.g., anterior cruciate ligament). The inherent connectivity between soft and hard tissues is instrumental for musculoskeletal motion and is therefore a key design criterion for soft tissue regeneration. To this end, scaffold design for soft tissue regeneration have progressed from single tissue systems to the emerging focus on pre-integrated and functional composite tissue units. Specifically, a multifaceted, bioinspired approach has been pursued wherein scaffolds are tailored to stimulate relevant cell responses using spatially patterned structural and chemical cues, growth factors, and/or mechanical stimulation. Moreover, current efforts to elucidate the essential scaffold design criteria via strategic biomimicry are emphasized as these will reduce complexity in composite tissue regeneration and ease the related burden for clinical translation. These innovative studies underscore the clinical relevance of engineering connective tissue integration and have broader impact in the formation of complex tissues and total joint regeneration.
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