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Engineering    2017, Vol. 3 Issue (1) : 16-27     https://doi.org/10.1016/J.ENG.2017.01.003
Research |
膝关节骨性关节炎治疗的再生工程:生物材料以及基于细胞的技术
Escobar Ivirico Jorge L.1,2,3,Bhattacharjee Maumita1,2,3,Kuyinu Emmanuel1,2,3,Nair Lakshmi S.1,2,3,4,5,Laurencin Cato T.1,2,3,4,5,6,7,8()
1. Institute for Regenerative Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
2. Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA
3. Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT 06030, USA
4. Department of Biomedical Engineering, School of Engineering, University of Connecticut, Storrs, CT 06269, USA
5. Department of Materials Science and Engineering, School of Engineering, University of Connecticut, Storrs, CT 06269, USA
6. Institute of Materials Science, University of Connecticut, Storrs, CT 06269, USA
7. Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA
8. Department of Chemical and Biomolecular Engineering, School of Engineering, University of Connecticut, Storrs, CT 06269, USA
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摘要 

膝关节骨性关节炎(OA) 是世界上常见的关节炎,其发病率年上升。不断上涨的治疗费用给患者带来了经济负担。膝关节OA 治疗的两个早期干预目标是减轻膝关节的疼痛和关节软骨的损害。目前用于治疗膝关节OA 的方法虽取得了一定疗效,但仍没有种方法可达到全膝关节置换术(TKA) 的治疗效果TKA 主要应用于治疗末期膝关节OA,其缺点是有手术侵入性和手术费用昂贵。因而,应该重视创新性的再生术,以推迟甚至消除患者对TKA 的需求一些基于生物材料和细胞的疗法目前正处于发展阶段,并已在临床前和临床研究方面取得了初步进展单独或联合应用先进的生物材料和干细胞治疗膝关节OA 可减轻疼痛,使损害的关节软骨再生。在此综述中,我们讨论了膝关节OA 疼痛和软骨损害的发病机制,并探讨了该病的新治疗策略及其局限

关键词 膝关节骨性关节炎骨关节炎疼痛间充质干细胞生物材料再生工程    
Abstract

Knee osteoarthritis (OA) is the most common form of arthritis worldwide. The incidence of this disease is rising and its treatment poses an economic burden. Two early targets of knee OA treatment include the predominant symptom of pain, and cartilage damage in the knee joint. Current treatments have been beneficial in treating the disease but none is as effective as total knee arthroplasty (TKA). However, while TKA is an end-stage solution of the disease, it is an invasive and expensive procedure. Therefore, innovative regenerative engineering strategies should be established as these could defer or annul the need for a TKA. Several biomaterial and cell-based therapies are currently in development and have shown early promise in both preclinical and clinical studies. The use of advanced biomaterials and stem cells independently or in conjunction to treat knee OA could potentially reduce pain and regenerate focal articular cartilage damage. In this review, we discuss the pathogenesis of pain and cartilage damage in knee OA and explore novel treatment options currently being studied, along with some of their limitations.

Keywords Knee osteoarthritis      Osteoarthritic pain      Mesenchymal stem cells      Biomaterials      Regenerative engineering     
基金资助: 
通讯作者: Laurencin Cato T.     E-mail: laurencin@uchc.edu
最新录用日期:    在线预览日期:    发布日期: 2017-03-02
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作者相关文章
Jorge L. Escobar Ivirico
Maumita Bhattacharjee
Emmanuel Kuyinu
Lakshmi S. Nair
Cato T. Laurencin
引用本文:   
Jorge L. Escobar Ivirico,Maumita Bhattacharjee,Emmanuel Kuyinu, et al. Regenerative Engineering for Knee Osteoarthritis Treatment: Biomaterials and Cell-Based Technologies[J]. Engineering, 2017, 3(1): 16-27.
网址:  
http://engineering.org.cn/EN/10.1016/J.ENG.2017.01.003     OR     http://engineering.org.cn/EN/Y2017/V3/I1/16
Fig.1  Structural changes between (a) a healthy joint and (b) an OA joint. Expression of matrix proteinase plays an important role in inducing OA. (Adapted with permission from Ref. [2])
Product Dose (mg) Frequency Cross-linked gel
Euflexxa 20 (3 doses) Weekly No
Gel-One 30(1 dose) Once Yes
Hyalgan 20 (5 doses) Weekly No
Monovisc 88 (1 dose) Once Yes
Orthovisc 30 (3–4 doses) Weekly No
Supartz FX 25 (5 doses) Weekly No
Synvisc 16 (3 doses) Weekly Yes
Synvisc-One 48 (1 dose) Once Yes
Tab.1  FDA-approved injectable HA viscosupplementation products [5057].
Fig.2  Cell-biomaterial approaches for cartilage repair.
Fig.3  Chemical modifications of HA.
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