椎间盘退行性疾病是引起下腰痛的主要病因,严重影响患者的生活质量。纤维环损伤能导致椎间盘严重退变。然而,由于纤维环组织本身在细胞、生物化学和生物力学方面的异质性,纤维环的修复和再生治疗仍面临挑战。近年来,随着组织工程学的发展,利用组织工程化的纤维环为治疗退变椎间盘提供了新的途径。本文从组织工程的主要要素,即细胞、支架、生长因子和力学刺激等方面简要介绍纤维环组织工程业已取得的成果和面临的挑战。进一步研究需结合多学科手段,选取高效的细胞来源、制备多重仿生的支架、利用合适的生长因子和力学刺激等,充分模拟实际纤维环组织及其微环境,从而有效地促进纤维环组织再生,最终实现纤维环组织工程应用于椎间盘退行性疾病的临床治疗。
Degenerative disc disease (DDD) is a leading cause of low back pain, which severely affects the quality of life and incurs significant medical cost. Annulus fibrosus (AF) injuries can lead to substantial deterioration of intervertebral disc degeneration. However, the AF repair/regeneration remains a challenge due to the intrinsic cellular, biochemical and biomechanical heterogeneity of AF tissue. Tissue engineering would be a promising approach for AF regeneration. This article aims to provide a brief overview of the fundamental aspects of AF, the current achievements and future challenges of AF tissue engineering. future studies to fully mimic the native AF A multidisciplinary approach is proposed for tissue and its microenvironment, including choosing adequate cell source, preparing scaffolds with hierarchical microstructures, supplementing appropriate growth factors, and enforcing suitable mechanical stimulation. Hopefully, the engineered AF tissues would be effectively used to facilitate the treatment of DDD in the future.