Stromal cells and stem cells in clinical bone regeneration.
Stromal cells and stem cells in clinical bone regeneration.
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DOI：
10.1038/nrendo.2014.234
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发表时间：
2015-03
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影响因子：
--
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中科院分区：
文献类型：
--
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干细胞介导的骨修复已被用于临床试验，用于再生大型颅颌面缺损，减缓股骨头坏死患者的骨变性进程，并用于预防治疗胫骨远端骨折。这些研究的成功再生结果为基质细胞在骨骼修复治疗中的更广泛使用提供了坚实的基础。然而，利用基质细胞促进或增强骨修复还远未应用于临床实践。科学、技术、实践和管理方面的障碍阻碍了基质细胞在治疗方面的广泛应用。具有讽刺意味的是，其中一个主要挑战在于对移植细胞介导再生的机制了解有限。动物模型被用来提供洞察力，但这些模型在很大程度上无法再现人类疾病和骨缺陷的细微差别。因此，开发有针对性的方法来优化细胞介导的结果是困难的。在这篇综述中，我们重点介绍了几个临床试验中报道的成功和挑战，这些试验涉及使用骨髓来源的间充质细胞或脂肪组织来源的基质细胞。我们发现了几个阻碍使用基质细胞来加强骨骼修复的主流障碍，并强调了在继续推进骨骼再生医学领域中，新技术可能特别有效的技术创新或领域。
Stem-cell-mediated bone repair has been used in clinical trials for the regeneration of large craniomaxillofacial defects, to slow the process of bone degeneration in patients with osteonecrosis of the femoral head and for prophylactic treatment of distal tibial fractures. Successful regenerative outcomes in these investigations have provided a solid foundation for wider use of stromal cells in skeletal repair therapy. However, employing stromal cells to facilitate or enhance bone repair is far from being adopted into clinical practice. Scientific, technical, practical and regulatory obstacles prevent the widespread therapeutic use of stromal cells. Ironically, one of the major challenges lies in the limited understanding of the mechanisms via which transplanted cells mediate regeneration. Animal models have been used to provide insight, but these models largely fail to reproduce the nuances of human diseases and bone defects. Consequently, the development of targeted approaches to optimize cell-mediated outcomes is difficult. In this Review, we highlight the successes and challenges reported in several clinical trials that involved the use of bone-marrow-derived mesenchymal or adipose-tissue-derived stromal cells. We identify several obstacles blocking the mainstream use of stromal cells to enhance skeletal repair and highlight technological innovations or areas in which novel techniques might be particularly fruitful in continuing to advance the field of skeletal regenerative medicine.
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影响因子：
3.3
作者：
Correia C;Grayson W;Eton R;Gimble JM;Sousa RA;Reis RL;Vunjak-Novakovic G
通讯作者：
Vunjak-Novakovic G
影响因子：
6
作者：
Bhumiratana S;Vunjak-Novakovic G
通讯作者：
Vunjak-Novakovic G
影响因子：
6.5
作者：
Erices, A;Conget, P;Minguell, JJ
通讯作者：
Minguell, JJ
影响因子：
9.3
作者：
Belmar-Lopez C;Mendoza G;Oberg D;Burnet J;Simon C;Cervello I;Iglesias M;Ramirez JC;Lopez-Larrubia P;Quintanilla M;Martin-Duque P
通讯作者：
Martin-Duque P
影响因子：
4.3
作者：
Carlier A;Geris L;Bentley K;Carmeliet G;Carmeliet P;Van Oosterwyck H
通讯作者：
Van Oosterwyck H