摘要
椎间盘退变引起的颈肩腰腿痛已成为严重影响人民群众身体健康的全球性难题。随着人类寿命的延长及老龄化社会的到来，患病人数将快速增长。目前，无论是保守治疗还是外科手术仅是缓解症状，而不是针对退变过程的根本治疗。因此，致力于退变椎间盘再生修复的细胞治疗方法是一种创新性的治疗思路。然而，退变椎间盘内高应力、高酸度、高渗透压及低营养的＂恶劣＂微环境使移植的外源性干细胞难于存活，成为该领域的一大瓶颈。近年来，组织的内源性修复被证明几乎存在于所有人体组织中，且在这一过程中内源性干细胞发挥关键作用。同样，椎间盘髓核中也被证实存在这样一类组织特异性干细胞--髓核来源干细胞（nucleus pulposus derived stem cells, NPSCs），这一重大发现给退变椎间盘的细胞治疗开启了新的应用前景。作为髓核组织内源性干细胞，NPSCs即具有干细胞增殖分化的潜能又有较多自身独特的优势，如较好的椎间盘微环境适应性、较强的成软骨分化能力等。然而，多种多样的NPSCs分离提纯方式、表型鉴定标准的不统一以及不同组织来源NPSCs的生物学差异使这一领域迫切需要形成广为接受的共识。此外，其能否在椎间盘组织工程领域中发挥应有作用仍不明确。最后，在目前椎间盘退变的机制仍未完全阐明的情况下，对NPSCs损伤退变的深入研究可能是重新认识椎间盘退变机制的重要契机。
Intervertebral disc degeneration （IVDD） takes great affection on people health all over the world. With the ex- tension of human life and aging, the number of sick people will grow rapidly. At present, both conservative and surgical treatment can only alleviate the symptoms, rather than the fundamental treatment for the process of degeneration. Therefore, the application of cell therapy in the treatment of degenerative disc regeneration is an innovative treatment. However, it＇s a great bottleneck for ex- ogenous transplanted stem cells to survive in degenerated intervertebral disc with harsh environment containing strong force, acid- ic pH, hypoxia, hyperosmolarity and limited nutrition. In recent years, tissue endogenous repair has been demonstrated to be pres- ent in almost all human tissues, and endogenous stem cell play an important role in the process. Similarly, nucleus pulposus was al- so confirmed the existence of such a kind of tissue specific stem cells-nucleus pulposus derived stem cells （NPSCs）-a new promis- ing candidate for the treatment of IVDD. NPSCs, as a new kind of stem cells, hold either the characteristic of stem cell and the spe- cial potential of themselves, such as the nice adaption of the environment in intervertebral disc and the superior potential of carti- lage differentiation. Nonetheless, the isolations of NPSCs were different; cell phenotypes were lack of wildly acceptable standard and the biological characteristics were various among different NP sources. In addition, whether the application of NPSCs could be used in nucleus pulposus tissue engineering still calls for further research. Due to the unclear in degeneration mechanism of IVDD, the study on degeneration mechanism of NPSCs may play a great important role in clarifying this issue.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2017年第6期377-384,共8页
Chinese Journal of Orthopaedics
基金
国家自然科学基金（81470102
81171740
81301579）
