Cartilage repair: past and future--lessons for regenerative medicine.
Cartilage repair: past and future--lessons for regenerative medicine.
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DOI：
10.1111/j.1582-4934.2009.00789.x
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发表时间：
2009-05
影响因子：
5.3
通讯作者：
Luyten FP
中科院分区：
文献类型：
--
作者：
van Osch GJ;Brittberg M;Dennis JE;Bastiaansen-Jenniskens YM;Erben RG;Konttinen YT;Luyten FP
自1994年首次细胞疗法研究修复膝关节关节软骨缺损以来，已有几项临床研究报道。对临床研究结果的概述并没有结论性地显示出优于传统方法的改进，主要是因为很少有研究达到中期或长期效果的I级证据。然而，这些探索性试验为研究设计、修复机制和临床结果提供了有价值的信息，并揭示了许多未知的地方，需要进一步改进。此外，利用细胞跟踪、基因阵列和蛋白质组学等新技术的细胞和分子研究为关节表面再生的细胞生物学和机制提供了更多的见解。除了关节软骨外，其他解剖部位的软骨以及祖细胞现在被认为是替代的细胞来源。生长因子研究揭示了支持软骨修复的最佳条件的一些信息。因此，有改善的希望。为了获得更可靠和可重复的结果，需要在许多方面获得更详细的信息，包括细胞的命运，细胞类型的选择和培养参数。至于临床方面，很明显，仔细选择患者群体是一个重要的输入参数，应该针对每个应用程序进行优化。此外，研究结果参数也有待改进。虽然从患者的角度来看，减轻疼痛和改善功能是最重要的结果，但还需要更多与结构/组织相关的结果测量。理想情况下，识别患者风险和治疗反应的标准和/或标记物是这些更复杂的再生方法的最终目标，特别是关节表面修复，以及一般的再生医学。
Since the first cell therapeutic study to repair articular cartilage defects in the knee in 1994, several clinical studies have been reported. An overview of the results of clinical studies did not conclusively show improvement over conventional methods, mainly because few studies reach level I of evidence for effects on middle or long term. However, these explorative trials have provided valuable information about study design, mechanisms of repair and clinical outcome and have revealed that much is still unknown and further improvements are required. Furthermore, cellular and molecular studies using new technologies such as cell tracking, gene arrays and proteomics have provided more insight in the cell biology and mechanisms of joint surface regeneration. Besides articular cartilage, cartilage of other anatomical locations as well as progenitor cells are now considered as alternative cell sources. Growth Factor research has revealed some information on optimal conditions to support cartilage repair. Thus, there is hope for improvement. In order to obtain more robust and reproducible results, more detailed information is needed on many aspects including the fate of the cells, choice of cell type and culture parameters. As for the clinical aspects, it becomes clear that careful selection of patient groups is an important input parameter that should be optimized for each application. In addition, the study outcome parameters should be improved. Although reduced pain and improved function are, from the patient's perspective, the most important outcomes, there is a need for more structure/tissue-related outcome measures. Ideally, criteria and/or markers to identify patients at risk and responders to treatment are the ultimate goal for these more sophisticated regenerative approaches in joint surface repair in particular, and regenerative medicine in general.
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DOI：
10.1302/0301-620x.85b2.13543
发表时间：
2003-03-01
影响因子：
--
作者：
Bentley, G;Biant, LC;Pringle, J
通讯作者：
Pringle, J
影响因子：
1.9
作者：
Behrens, Peter;Bitter, Thomas;Russlies, Martin
通讯作者：
Russlies, Martin
影响因子：
--
作者：
Barbero, A;Ploegert, S;Martin, I
通讯作者：
Martin, I
影响因子：
4.1
作者：
Bastiaansen-Jenniskens, Yvonne Maria;Koevoet, Wendy;Van Osch, Gerjo J. V. M.
通讯作者：
Van Osch, Gerjo J. V. M.
影响因子：
5.2
作者：
Brazelton, TR;Blau, HM
通讯作者：
Blau, HM