骨髓间充质干细胞定向分化治疗股骨头坏死:应用效果与评价
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摘要
背景:现阶段股骨头坏死逐渐趋向于年轻化,骨髓间充质干细胞为早期股骨头坏死的保髋治疗提供了新的治疗方法。目的:对骨髓间充质干细胞定向分化治疗股骨头坏死的研究进展做一综述。方法:以"BMSCs、ONFH、directional differentiation"为关键词检索PubMed等外文数据库,以"骨髓间充质干细胞、股骨头坏死、定向分化"为关键词检索CNKI、万方等中文数据库,检索时限为2008年1月至2018年10月,排除与文章研究目的无关及重复性文章,纳入符合标准的63篇文献进行综述。结果与结论:①骨髓间充质干细胞可定向分化为成骨细胞、成软骨细胞、脂肪细胞、神经细胞、内皮细胞等细胞;②促进骨髓间充质干细胞成骨分化及抑制成脂分化是现阶段保髋治疗的研究重点;③虽然骨髓间充质干细胞定向分化治疗早期股骨头坏死取得初步成效,但其在体内的作用机制仍需进一步研究。
BACKGROUND: Femoral head necrosis gradually tends to occur at young ages, and bone marrow mesenchymal stem cells provide a new choice for hip-preserving treatment of early femoral head necrosis.OBJECTIVE: To review the research progress on the directed differentiation of bone marrow mesenchymal stem cells for the treatment of femoral head necrosis.METHODS: Foreign databases such as Pub Med were searched with the keywords of "BMSCs, ONFH, directional differentiation", and CNKI, WanFang and other Chinese databases were retrieved using the keywords of "bone marrow mesenchymal stem cells, femoral head necrosis, directional differentiation". The search time was from January 2008 to January 2018. Articles unrelated to the purpose of the research and repetitive articles were excluded, and finally 63 articles met the criteria for review.RESULTS AND CONCLUSION:(1) Bone marrow mesenchymal stem cells can be differentiated into osteoblasts, chondroblasts, adipocytes,nerve cells, endothelial cells.(2) Promoting osteogenic differentiation of bone marrow mesenchymal stem cells and inhibiting adipogenic differentiation are the focus of research on hip-preserving treatment.(3) Although the initial outcomes in the treatment of early femoral head necrosis have been achieved, the mechanism underlying directed differentiation for femoral head necrosis still needs further studies.
BACKGROUND: Femoral head necrosis gradually tends to occur at young ages, and bone marrow mesenchymal stem cells provide a new choice for hip-preserving treatment of early femoral head necrosis.OBJECTIVE: To review the research progress on the directed differentiation of bone marrow mesenchymal stem cells for the treatment of femoral head necrosis.METHODS: Foreign databases such as Pub Med were searched with the keywords of "BMSCs, ONFH, directional differentiation", and CNKI, WanFang and other Chinese databases were retrieved using the keywords of "bone marrow mesenchymal stem cells, femoral head necrosis, directional differentiation". The search time was from January 2008 to January 2018. Articles unrelated to the purpose of the research and repetitive articles were excluded, and finally 63 articles met the criteria for review.RESULTS AND CONCLUSION:(1) Bone marrow mesenchymal stem cells can be differentiated into osteoblasts, chondroblasts, adipocytes,nerve cells, endothelial cells.(2) Promoting osteogenic differentiation of bone marrow mesenchymal stem cells and inhibiting adipogenic differentiation are the focus of research on hip-preserving treatment.(3) Although the initial outcomes in the treatment of early femoral head necrosis have been achieved, the mechanism underlying directed differentiation for femoral head necrosis still needs further studies.
引文
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[2]Piuzzi NS,Chahla J,Schrock JB,et al.Evidence for the Use of Cell-Based Therapy for the Treatment of Osteonecrosis of the Femoral Head:A Systematic Review of the Literature.J Arthroplasty.2017;32(5):1698-1708.
[3]Rackwitz L,Reichert JC,Haversath M,et al.Cell-based and future therapeutic strategies for femoral head necrosis.Orthopade.2018;47(9):770-776.
[4]Bianco P,Robey PG,Simmons PJ.Mesenchymal stem cells:revisiting history,concepts,and assays.Cell Stem Cell.2008;2(4):313-319.
[5]李瑞琦,张国平,任立中,等.骨髓间充质干细胞治疗股骨头坏死的评价[J].中国组织工程研究,2013,17(35):6327-6332.
[6]Yoon BH,Jones LC,Chen CH,et al.Etiologic Classification Criteria of ARCO on Femoral Head Osteonecrosis Part 1:Glucocorticoid-Associated Osteonecrosis.J Arthroplasty.2019;34(1):163-168.
[7]Yoon BH,Jones LC,Chen CH,et al.Etiologic Classification Criteria of ARCO on Femoral Head Osteonecrosis Part 2:Alcohol-Associated Osteonecrosis.J Arthroplasty.2019;34(1):169-174.
[8]Wang Q,Yang Q,Chen G,et al.LncRNA expression profiling of BMSCs in osteonecrosis of the femoral head associated with increased adipogenic and decreased osteogenic differentiation.Sci Rep.2018;8(1):9127.
[9]Li J,Wang Y,Li Y,et al.The effect of combined regulation of the expression of peroxisome proliferator-activated receptor-γand calcitonin gene-related peptide on alcohol-induced adipogenic differentiation of bone marrow mesenchymal stem cells.Mol Cell Biochem.2014;392(1-2):39-48.
[10]杨广杰,卜一多,周炳康,等.激素性股骨头坏死模型大鼠骨髓间充质干细胞增殖及定向诱导能力均降低[J].中国组织工程研究,2015,19(41):6579-6583.
[11]Wang C,Meng H,Wang Y,et al.Analysis of early stage osteonecrosis of the human femoral head and the mechanism of femoral head collapse.Int J Biol Sci.2018;14(2):156-164.
[12]Wen Q,Ma L,Chen YP,et al.Treatment of avascular necrosis of the femoral head by hepatocyte growth factor-transgenic bone marrow stromal stem cells.Gene Ther.2008;15(23):1523-1535.
[13]Wen Q,Jin D,Zhou CY,et al.HGF-transgenic MSCs can improve the effects of tissue self-repair in a rabbit model of traumatic osteonecrosis of the femoral head.PLoS One.2012;7(5):e37503.
[14]Chen YX,Tao SC,Xu ZL,et al.Novel Akt activator SC-79 is a potential treatment for alcohol-induced osteonecrosis of the femoral head.Oncotarget.2017;8(19):31065-31078.
[15]Huang L,Wang Y,Jiang Y,et al.High levels of GSK-3βsignalling reduce osteogenic differentiation of stem cells in osteonecrosis of femoral head.J Biochem.2018;163(3):243-251.
[16]Chen H,Kolman K,Lanciloti N,et al.p53 and MDM2 are involved in the regulation of osteocalcin gene expression.Exp Cell Res.2012;318(8):867-876.
[17]Chen JR,Lazarenko OP,Shankar K,et al.A role for ethanol-induced oxidative stress in controlling lineage commitment of mesenchymal stromal cells through inhibition of Wnt/beta-catenin signaling.J Bone Miner Res.2010;25(5):1117-1127.
[18]Chen YX,Zhu DY,Yin JH,et al.The protective effect of PFTαon alcohol-induced osteonecrosis of the femoral head.Oncotarget.2017;8(59):100691-100707.
[19]Chen YX,Zhu DY,Xu ZL,et al.The Protective Effect of Cordycepin On Alcohol-Induced Osteonecrosis of the Femoral Head.Cell Physiol Biochem.2017;42(6):2391-2403.
[20]Zhun W,Donghai L,Zhouyuan Y,et al.Efficiency of Cell Therapy to GC-Induced ONFH:BMSCs with Dkk-1 Interference Is Not Superior to Unmodified BMSCs.Stem Cells Int.2018;2018:1340252.
[21]Mo J,Yang R,Li F,et al.Geraniin promotes osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)via activatingβ-catenin:a comparative study between BMSCs from normal and osteoporotic rats.J Nat Med.2019;73(1):262-272.
[22]Song HB,Jiang Y,Liu JX,et al.Stimulation of osteogenic differentiation in bone marrow stromal cells via Wnt/β-catenin pathway by Qili Jiegu-containing serum.Biomed Pharmacother.2018;103:1664-1668.
[23]Deng ZL,Sharff KA,Tang N,et al.Regulation of osteogenic differentiation during skeletal development.Front Biosci.2008;13:2001-2021.
[24]Kwon HS,Johnson TV,Tomarev SI.Myocilin stimulates osteogenic differentiation of mesenchymal stem cells through mitogen-activated protein kinase signaling.J Biol Chem.2013;288(23):16882-16894.
[25]任磊,代光明,林枭,等.骨细胞Wnt/β-Catenin通过Notch信号促进BMSCs成骨分化[J].中国骨质疏松杂志,2018,24(5):600-605.
[26]迟博婧,刘光源,邢磊,等.Hedgehog信号通路调控骨形成及BMSCs成骨分化的研究进展[J].中国修复重建外科杂志,2016,30(12):1545-1550.
[27]王大伟,卢培根,贾永龙,等.三七总皂苷干预酒精性股骨头缺血坏死模型兔的超微结构[J].中国组织工程研究,2014,18(27):4277-4281.
[28]Qiang H,Liu H,Ling M,et al.Early Steroid-Induced Osteonecrosis of Rabbit Femoral Head and Panax notoginseng Saponins:Mechanism and Protective Effects.Evid Based Complement Alternat Med.2015;2015:719370.
[29]Wang Y,Huang X,Tang Y,et al.Effects of panax notoginseng saponins on the osteogenic differentiation of rabbit bone mesenchymal stem cells through TGF-β1 signaling pathway.BMC Complement Altern Med.2016;16(1):319.
[30]Hao C,Yang S,Xu W,et al.MiR-708 promotes steroid-induced osteonecrosis of femoral head,suppresses osteogenic differentiation by targeting SMAD3.Sci Rep.2016;6:22599.
[31]李学东,陈斌,郑创义,等.三七总皂甙通过P38MAPK信号通路促进大鼠骨髓基质细胞向成骨细胞的增殖、分化[J].中国伤残医学,2009,17(4):167-168.
[32]Han N,Li Z,Cai Z,et al.P-glycoprotein overexpression in bone marrow-derived multipotent stromal cells decreases the risk of steroid-induced osteonecrosis in the femoral head.J Cell Mol Med.2016;20(11):2173-2182.
[33]Zhou D,Chen YX,Yin JH,et al.Valproic acid prevents glucocorticoid?induced osteonecrosis of the femoral head of rats.Int J Mol Med.2018;41(6):3433-3447.
[34]Samy AM.Management of osteonecrosis of the femoral head:A novel technique.Indian J Orthop.2016;50(4):359-365.
[35]Seamon J,Keller T,Saleh J,et al.The pathogenesis of nontraumatic osteonecrosis.Arthritis.2012;2012:601763.
[36]Yu Z,Fan L,Li J,et al.Lithium chloride attenuates the abnormal osteogenic/adipogenic differentiation of bone marrow-derived mesenchymal stem cells obtained from rats with steroid-related osteonecrosis by activating theβ-catenin pathway.Int J Mol Med.2015;36(5):1264-1272.
[37]Han N,Yan ZQ,Guo CA,et al.Effect of rifampicin on the risk of steroid-induced osteonecrosis of the femoral head.Orthop Surg.2010;2(2):124-133.
[38]Zhang Y,Kong X,Wang R,et al.Genetic association of the P-glycoprotein gene ABCB1 polymorphisms with the risk for steroid-induced osteonecrosis of the femoral head in Chinese population.Mol Biol Rep.2014;41(5):3135-3146.
[39]Sun ZB,Wang JW,Xiao H,et al.Icariin may benefit the mesenchymal stem cells of patients with steroid-associated osteonecrosis by ABCB1-promoter demethylation:a preliminary study.Osteoporos Int.2015;26(1):187-197.
[40]Yuan N,Li J,Li M,et al.BADGE,a synthetic antagonist for PPARγ,prevents steroid-related osteonecrosis in a rabbit model.BMCMusculoskelet Disord.2018;19(1):129.
[41]Jiang Y,Zhang Y,Zhang H,et al.Pravastatin prevents steroid-induced osteonecrosis in rats by suppressing PPARγexpression and activating Wnt signaling pathway.Exp Biol Med(Maywood).2014;239(3):347-355.
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