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中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (03) : 368 -375. doi: 10.3877/cma.j.issn.1674-134X.2023.03.011

综述

3D打印脱细胞的细胞外基质修复软骨缺损的研究进展
钱嘉天, 符培亮†()   
  1. 200003　上海市长征医院关节外科
  • 收稿日期:2020-11-05 出版日期:2023-06-01
  • 通信作者: 符培亮

Research progress of 3D printing based on decellularized extracellular matrix in cartilage defect repair

Jiatian Qian, Peiliang Fu†()   

  1. Joint Divison of Orthopedic Department, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
  • Received:2020-11-05 Published:2023-06-01
  • Corresponding author: Peiliang Fu
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钱嘉天, 符培亮. 3D打印脱细胞的细胞外基质修复软骨缺损的研究进展[J/OL]. 中华关节外科杂志(电子版), 2023, 17(03): 368-375.

Jiatian Qian, Peiliang Fu. Research progress of 3D printing based on decellularized extracellular matrix in cartilage defect repair[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(03): 368-375.

局灶性的关节软骨缺损在临床上很常见，会引起长期疼痛、关节功能障碍，甚至进展为骨关节炎。关节软骨组织自我修复能力差，而目前常用的修复方案，如微骨折术、骨软骨镶嵌成形术、自体软骨细胞移植等，均难以生成足量且生物学功能良好的透明软骨，远期效果有限。脱细胞的细胞外基质(dECM)是动态且复杂的三维(3D)微环境，具有优秀的生物力学、生物物理和生物化学特性，可以直接或间接调节细胞行为，包括增殖、黏附、迁移和分化。干细胞来源的dECM更具有低免疫原性、高组织相容性和高分化潜力的优势，且与天然ECM微环境的相似度更高，在组织工程研究中常作为生物支架应用于软骨修复。结合3D生物打印技术，将dECM同其他生物分子甚至细胞组合作为生物墨水，打印生成的生物支架可以重构软骨细胞存活和增殖所需的物理和机械微环境。通过讨论总结dECM的生物学功能、dECM在修复软骨损伤中的作用机制、3D生物打印dECM支架的技术特点，以及现阶段存在的挑战和不足，能够为软骨缺损修复提供新的研究方向。

关键词: 脱细胞细胞外基质, 生物打印, 打印，三维, 软骨, 组织工程

Focal articular cartilage defects are commonly detected in clinical practice, which can cause long-term pain, joint dysfunction, and even aggravate to osteoarthritis. Articular cartilage tissues are featured by a poor self-repair ability. Current repairs of articular cartilage defects, including microfracture, osteochondral mosaicplasty and autologous chondrocyte transplantation are unable to produce sufficient hyaline cartilages with good biological functions, and the long-term outcome is unsatisfactory. The decellularized extracellular matrix (dECM) constitutes a dynamic and complex three-dimensional (3D) microenvironment, which provides excellent biomechanical, biophysical and biochemical properties. Importantly, dECM can directly or indirectly regulate cell behaviors, including proliferation, adhesion, migration and differentiation. Stem cell-derived dECM has numerous advantages, such as low immunogenicity, high histocompatibility, and high differentiation potential. The microenvironment of stem cell-derived dECM is extremely similar to that of the natural ECM. As a result, it is usually used as a biological scaffold for cartilage repair in tissue engineering field. Using 3D bioprinting technology, dECM, alongside other biomolecules and even cells are utilized as bio-inks, and the printed bio-scaffold can reconstruct the physical and mechanical microenvironment required for the survival and proliferation of chondrocytes. Through a comprehensive summarizing of biological functions of dECM, the mechanism of dECM in repairing cartilage defects, technical characteristics of 3D bioprinting of dECM scaffolds, and their potential challenges and shortcomings, it is conductive to guide novel research directions for cartilage defect repair.

Key words: Decellularized extracellular matrix, Bioprinting, Printing, three-dimensional, Cartilage, Tissue engineering
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