关节腔内注射细胞制剂治疗骨关节炎的临床研究进展

关节腔内注射细胞制剂是治疗骨关节炎(OA)的新趋势,且展现了良好的临床效果、安全性及可行性。细胞制剂有多种类型,包括血小板、干细胞和单个核细胞(MNCs)。血小板制剂倾向于基层医疗机构应用和早期OA患者的治疗;MNCs较适用于不具备干细胞培养条件的医疗机构和中期OA患者应用;而干细胞制剂较适合高级别医疗机构和晚期OA患者应用。虽然腔内注射细胞产品治疗OA进行了大量临床研究,但亦有不足;因此制定腔内注射治疗OA不同细胞制剂的质量控制标准、临床应用标准和进行大样本多中心随机对照临床试验势在必行。探索外泌体、外周血MNCs治疗OA的临床研究及其分子机制,是研究的新切入点。

Overview of cellular agents injection into intracavity therapy for osteoarthritis in clinical research

In recent years,intra-articular injection of cellular agents is a new trend in the treatment of osteoarthritis(OA)and clinical studies also showed it has good effectiveness,safety and feasibility.Cell agents including platelets,stem cells and mononuclear cells(MNCs)and they are mainly applied in the injection with their own advantages and disadvantages.Platelet agents are mainly used for primary medical institutions and early OA patients.MNCs are suitable for mid-term OA patients and medical institutions where stem cells cannot be cultured.By contrast,stem cells may be suitable for high-level medical institutions and patients with advanced OA.Although a large number of clinical studies have been carried out on intracavity injection of cellular agents in the treatment of OA,there are still found many problems.It is necessary to establish the quality control standard,clinical application standard and large sample multicenter for randomized controlled clinical trial of cellular agents for the treatment.In the next step,we should further study the therapeutic mechanism and the clinical application of exosomes and peripheral blood MNCs in the treatment of OA.