硫酸软骨素及其衍生生物材料在骨关节炎治疗的研究进展

doi:10.3877/cma.j.issn.1674-134X.2025.04.007

骨关节炎（OA）是一种以关节软骨损害为主，并累及整个关节组织的最常见的慢性退行性疾病，近年来该病发病率在中老年人中逐步上升，具体病因及发病机制尚不明确，其发生与患者年龄、激素水平、体重、炎症、创伤及遗传等多种因素有关。硫酸软骨素（CS）是一类硫酸化的糖胺聚糖，广泛存在于动物组织的细胞外基质和软骨中，具有炎症调节、活性氧调节、免疫调节、组织黏附调节等多种机体内环境稳态维持的作用。近年来，对于CS如何抑制OA的研究愈加深入，并且由CS衍生的生物材料也成为近年来研究的热点，如硫酸软骨素基水凝胶、生物支架以及药物递送系统正在广泛的应用，所以本文从CS如何调节软骨、滑膜、软骨下骨的免疫微环境、软骨基质代谢进而抑制OA的发生发展，以及其衍生生物材料在OA中的应用出发，系统回顾了硫酸软骨素及其衍生生物材料在骨关节炎治疗中的最新进展。

关键词: 软骨素硫酸盐类, 骨关节炎, 软骨, 生物相容性材料

Osteoarthritis (OA) is one of the most common chronic degenerative diseases, which mainly damages articular cartilage and involves the entire joint tissue. In recent years, the incidence rate of the disease has gradually increased among middle-aged and elderly people. The specific etiology and pathogenesis are still unclear, and its occurrence is related to the patient’s age, hormone level, weight, inflammation, trauma, heredity and other factors. Chondroitin sulfate (CS) is a type of sulfated glycosaminoglycan that is widely presented in the extracellular matrix and cartilage of animal tissues. It plays a role in maintaining homeostasis in various intracellular environments, such as inflammation regulation, reactive oxygen species regulation, immune regulation, and tissue adhesion regulation. In recent years, the research on how CS inhibits OA has become more and more in-depth, and biomaterials derived from CS have also become the focus of research in recent years, such as chondroitin sulfate based hydrogels, biological scaffolds and drug delivery systems are being widely used. Therefore, this article systematically reviewed the latest progress of chondroitin sulfate and its derived biomaterials in the treatment of osteoarthritis, focusing on OA development inhibition induced by regulation of CS in the immune microenvironment of cartilage, synovium, and subchondral bone, cartilage matrix metabolism, as well as the application of its derived biomaterials in OA.

Key words: Chondroitin sulfate, Osteoarthritis, Cartilage, Biomaterials

表1 CS基水凝胶类型及性能差异

Table 1 Types and performance differences of chitosan-based hydrogels

类型Types	机械强度（Kpa）Mechanical strength	降解时间（周）Degradation time (week）	优势Advantages	局限性Limitations
CS-Tyr自交联水凝胶CS-Tyr self-crosslinking hydrogel	15~25	4~6	可注射、自修复	长期稳定性不足
HAMA-SA/ChSMA微球HAMA-SA/ChSMA microspheres	8~12	8~10	精准载药、靶向递送	制备成本高
CSMA复合水凝胶CSMA composite hydrogel	50~80	12~16	强度高，高软骨匹配性	细胞浸润速率低

表1 CS基水凝胶类型及性能差异

Table 1 Types and performance differences of chitosan-based hydrogels

类型Types	机械强度（Kpa）Mechanical strength	降解时间（周）Degradation time (week）	优势Advantages	局限性Limitations
CS-Tyr自交联水凝胶CS-Tyr self-crosslinking hydrogel	15~25	4~6	可注射、自修复	长期稳定性不足
HAMA-SA/ChSMA微球HAMA-SA/ChSMA microspheres	8~12	8~10	精准载药、靶向递送	制备成本高
CSMA复合水凝胶CSMA composite hydrogel	50~80	12~16	强度高，高软骨匹配性	细胞浸润速率低

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Research progress of chondroitin sulfate and its derived biomaterials in treatment of osteoarthritis

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Research progress of chondroitin sulfate and its derived biomaterials in treatment of osteoarthritis