Facial Reconstruction by Biosurgery: Cell Transplantation Versus Cell Homing
Facial Reconstruction by Biosurgery: Cell Transplantation Versus Cell Homing
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DOI：
10.1089/ten.teb.2009.0496
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发表时间：
2010-04-01
影响因子：
6.4
通讯作者：
Ahn, Jeffrey
中科院分区：
文献类型：
--
作者：
Mao, Jeremy J.;Stosich, Michael S.;Ahn, Jeffrey
面部是区分不同人的特征。当面部因创伤、肿瘤切除、先天性异常或慢性疾病而毁容时，患者对功能和美学修复有着强烈的渴望。目前使用自体移植物、合成填充剂和假体进行面部重建的实践往往达不到外科医生和患者的期望。面部重建尚未利用干细胞生物学、化学工程、生物材料和组织工程等看似不相关领域的最新进展。我们提出的“生物手术”这一新概念，将融合生物活性因子、生物聚合物和/或细胞的新原理和策略来修复面部缺陷。较小的面部缺陷可能通过细胞归巢而非细胞移植来重建。细胞归巢的一个关键优势在于，灵活招募的内源性细胞有可能利用宿主的先天再生能力，从而加快产品开发的监管和商业化进程。然而，据我们目前的了解，较大的面部缺陷可能无法在不进行细胞移植的情况下修复。生物手术的新突破可能源于细胞生物学、细胞因子生物学、化学工程、生物材料和组织工程的综合策略。无论是细胞归巢还是细胞移植方法，生物手术不仅将使手术创伤和重复操作最小化，还能产生持久的效果。同时，必须谨慎对待缺乏科学依据或对细胞、生物材料和生物分子进行教条式组合的产品开发。总之，科学推导的生物手术无疑将发展成为提供越来越自然的面部重建和/或面部填充的新技术。
The face distinguishes one human being from another. When the face is disfigured because of trauma, tumor removal, congenital anomalies, or chronic diseases, the patient has a strong desire for functional and esthetic restoration. Current practice of facial reconstruction using autologous grafts, synthetic fillers, and prostheses is frequently below the surgeon's and patient's expectations. Facial reconstruction is yet to take advantage of recent advances in seemingly unrelated fields of stem cell biology, chemical engineering, biomaterials, and tissue engineering. "Biosurgery,'' a new concept that we propose, will incorporate novel principles and strategies of bioactive cues, biopolymers, and/or cells to restore facial defects. Small facial defects can likely be reconstructed by cell homing and without cell transplantation. A critical advantage of cell homing is that agilely recruited endogenous cells have the potential to harness the host's innate capacity for regeneration, thus accelerating the rate of regulatory and commercialization processes for product development. Large facial defects, however, may not be restorable without cell delivery per our understanding at this time. New breakthrough in biosurgery will likely originate from integrated strategies of cell biology, cytokine biology, chemical engineering, biomaterials, and tissue engineering. Regardless of cell homing or cell delivery approaches, biosurgery not only will minimize surgical trauma and repetitive procedures, but also produce long-lasting results. At the same time, caution must be exercised against the development of products that lack scientific basis or dogmatic combination of cells, biomaterials, and biomolecules. Together, scientifically derived biosurgery will undoubtedly develop into new technologies that offer increasingly natural reconstruction and/or augmentation of the face.