背景:支架复合细胞或细胞因子是构建组织工程骨快速血管化的主要策略,并为临床大段骨缺损修复提供了良好应用前景。目的:从组织工程三要素的角度阐述目前组织工程骨血管化研究的相关进展,以寻找组织工程骨快速血管化策略的新契机,并为临床各种缺血性疾病的治疗提供启示。方法:由第一作者检索1990至2014年PumMed数据库、维普和万方数据库相关文献。英文检索词有“bone tissue engineering , vascularization , cytokines , coculture , stem cel s , osteogenesis , angiogenisis , prevascularization,patterned scaffolds”等;中文检索词有“骨缺损,血管生成,血管化组织工程骨,支架”等。经筛选后,最终纳入57篇文献进行归纳分析。结果与结论:当下骨组织工程发展瓶颈之一在于组织工程骨早期血管化。随着自然骨组织发生过程中成骨与血管化的细胞分子水平机制的深入研究以及生物支架的发展,支架复合细胞或细胞因子策略构建快速血管化组织工程骨取得了重要成果。讯息因子作为血管生成或骨生成的“配体”的作用存在个体差异性,应注意发挥干细胞等作为“供体”的优势;同时骨生成与血管生成过程密切相关、彼此依赖,只有实现“配体”与“供体”及“成骨”与“成血管”两个层次的协调统一发展,才能真正实现组织工程骨的快速血管化。调控各种细胞或细胞因子符合严格的时间格局和空间格局表达,仿生自然骨组织的生理状态,是创造快速血管化组织工程骨值得探索的目标。
BACKGROUND:The main strategies to build rapid vascularization of bone tissue engineering focuse on cel-scaffold or cytokine-scaffold composite construction which has shed light upon the repair of large segmental bone defects. OBJECTIVE:To clarify the relevant research progress of the vascularization of bone tissue engineering in the view of the three basic elements of tissue engineering, in order to find out new opportunities for rapid vascularization of bone tissue engineering and to provide inspiration in solving clinical y ischemic diseases. METHODS:The first author searched the PubMed, Wanfang and VIP databases for relevant literatures published from 1990 to 2014. The keywords were“bone tissue engineering, vascularization, cytokines, coculture, stem cel s, osteogenesis, angiogenisis, prevascularization, scaffolds”in English and“bone defect, angiogenesis, vascularized bone tissue engineering, scaffold”in Chinese. After screening, 57 articles were included in result analysis. RESULTS AND CONCLUSION:Early vascularization is one of the current bottlenecks of bone tissue engineering development. With the in-depth study of cel ular and molecular mechanism of osteogenesis and angiogenisis during natural bone development and the advanced biological scaffolds, cel-scaffold or cytokine-scaffold strategies for rapid vascularization of bone tissue engineering have achieved important achievements. Signal transduction factors acting as“ligand”of angiogenesis or osteogenesis exists individual differences, so we should pay attention to take advantage of stem cel s which act as a“donor”;while osteogenesis and angiogenesis are like the two wings of a bird, they are born together and support each other and must function hand in hand, only if they develop coordinately can we realize rapid vascularization of bone tissue engineering. Regulating various cel s or cytokines to meet strict spatial patterns and temporal patterns of expression and simulating the physiological state of natural bone are