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关节腔注射脐带血单个核细胞治疗膝骨关节炎的相关研究
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Abstract:
膝骨关节炎(KOA)是一种严重危害中老年人健康的慢性膝关节退行性疾病，关节软骨的退变损伤、骨赘异常增生、软骨下骨硬化是其主要的病理改变，常引起关节疼痛、肿胀、活动受限、僵硬及畸形，甚至致残，严重影响患者的生活质量。目前临床上KOA的治疗主要包括保守治疗和手术治疗，然而其效果均不能令人满意。脐带血单个核细胞(UCB-MNCs)是脐带血中具有单个细胞核的细胞总称，包含多种异质性细胞群，如造血干细胞、间充质干细胞、内皮祖细胞、淋巴细胞、单核细胞等。在KOA患者膝关节腔内注射UCB-MNCs，利用不同细胞间的协同作用，通过抗炎、调节免疫、修复组织损伤、促进软骨再生等机制，发挥消除或减轻临床症状、改善关节功能、减少关节退行性变、阻止或延缓病程进展等作用，且安全性良好。但是，该方法存在注射剂量、次数、观察指标不统一，以及缺乏严格的单个核细胞质量控制等问题。本文主要对关节腔注射UCB-MNCs治疗KOA的相关研究作一综述。
Knee osteoarthritis (KOA) is a chronic degenerative disease of the knee joint that seriously endangers the health of middle-aged and elderly people. The main pathological changes of KOA include degeneration and damage of joint cartilage, abnormal proliferation of osteophytes, and subchondral bone sclerosis, which often cause joint pain, swelling, limited mobility, stiffness, deformity, and even disability, seriously affecting the quality of life of patients. At present, the treatment of KOA in clinical practice mainly includes conservative treatment and surgical treatment, but their effects are not satisfactory. Umbilical cord blood mononuclear mells (UCB-MNCs) are a collective term for cells in cord blood that have a single nucleus and contain various heterogeneous cell populations, such as hematopoietic stem cells, mesenchymal stem cells, endothelial progenitor cells, lymphocytes, monocytes, etc. Injecting UCB-MNCs into the knee joint cavity of KOA patients utilizes the synergistic effect between different cells to eliminate or alleviate clinical symptoms, improve joint function, reduce joint degeneration, prevent or delay disease progression through mechanisms such as anti-inflammatory, immune regulation, repair of tissue damage, and promotion of cartilage regeneration, with good safety. However, this method has some problems, such as inconsistent injection dose, times, observation indicators, and lack of strict quality control of mononuclear cells. This article mainly reviews the relevant research on the treatment of knee osteoarthritis with joint cavity injection of UCB-MNCs.
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