中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2025, Vol. 20 ›› Issue (12): 3476-3500.doi: 10.4103/NRR.NRR-D-24-00844

• 综述:脊髓损伤修复保护与再生 • 上一篇    下一篇

脊髓损伤治疗：基于生物材料策略的新时代

  

  • 出版日期:2025-12-15 发布日期:2025-03-13

Biomaterial-based strategies: a new era in spinal cord injury treatment

Shihong Zhu1, #, Sijun Diao1, #, Xiaoyin Liu1, 2, #, Zhujun Zhang1, #, Fujun Liu3 , Wei Chen1 , Xiyue Lu4 , Huiyang Luo4 , Xu Cheng4 , Qiang Liao5 , Zhongyu Li1 , Jing Chen1, *   

  1. 1 Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China;  2 National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu, Sichuan Province, China;  3 Department of Ophthalmology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China;  4 Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China;  5 Department of Pharmacy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China
  • Online:2025-12-15 Published:2025-03-13
  • Contact: Jing Chen, MD, chenjing6811@126.com.
  • Supported by:
    This work was supported by the Sichuan Science and Technology Program, No. 2023YFS0164 (to JC); the National Natural Science Foundation of China, No. 82401629 (to XL); the Natural Science Foundation of Sichuan Province, No. 2024NSFSC1646 (to XL); and the China Postdoctoral Science Foundation, Nos. GZC20231811 (to XL) and 2024T170601 (to XL).

PDF

37

摘要：

近几十年来，促进脊髓损伤后神经功能恢复和改善预后一直是研究的热点。脊髓损伤后的分子和细胞微环境是十分复杂的，研究人员努力阐明其病理生理机制和微环境的变化，并确定有效且高效的治疗策略。但迄今为止，脊髓损伤修复的主要方法为手术、口服或静脉注射药物和神经营养因子，其疗效仍然存在争议，且其存在严重的不良反应。随着组织工程和再生医学的发展，脊髓损伤修复的新兴策略随之产生，例如基于纳米颗粒的纳米递送系统、基于生物材料、生物工程、干细胞和生长因子研究以及三维（3D）生物打印的支架和功能恢复技术。随着支架技术的不断进步，目前其已进入了优化阶段。要设计一种理想的生物材料支架，不仅为神经元迁移、粘附、增殖和分化提供结构支持，而且也要能模拟天然脊髓组织的机械性能。此外，可通过调节的支架表面形态以及物理和生化性能来促进轴突生长和神经发生。此外，可利用三维仿生打印技术实现的互连多孔结构和物理化学性质，使其最大限度地发挥生物材料在治疗脊髓损伤方面的潜力。正确选择和应用支架，同时确保临床转化的成功，是提高脊髓损伤治疗效果和预后的有前景的临床目标。此次综述阐述了脊髓损伤发生和再生的重要机制，包括神经炎症、氧化应激、轴突再生和血管生成。此外还简要讨论了纳米递送系统在脊髓损伤修复和再生中的重要性，并总结了纳米颗粒的作用和影响递送效率的因素。最后重点介绍了组织工程策略和生物材料支架在脊髓损伤治疗中的应用，包括不同类型的生物材料支架及其与干细胞或生长因子的结合，以及生物材料支架设计的优化方法。

https://orcid.org/0000-0003-2534-6190 (Shihong Zhu); https://orcid.org/0000-0002-3297-9183 (Jing Chen)

关键词: 脊髓损伤, 神经再生, 治疗策略, 纳米粒子, 组织工程, 生物材料, 支架, 干细胞, 生长因子

Abstract: Enhancing neurological recovery and improving the prognosis of spinal cord injury have gained research attention recently. Spinal cord injury is associated with a complex molecular and cellular microenvironment. This complexity has prompted researchers to elucidate the underlying pathophysiological mechanisms and changes and to identify effective treatment strategies. Traditional approaches for spinal cord injury repair include surgery, oral or intravenous medications, and administration of neurotrophic factors; however, the efficacy of these approaches remains inconclusive, and serious adverse reactions continue to be a concern. With advancements in tissue engineering and regenerative medicine, emerging strategies for spinal cord injury repair now involve nanoparticle-based nanodelivery systems, scaffolds, and functional recovery techniques that incorporate biomaterials, bioengineering, stem cell, and growth factors as well as three-dimensional bioprinting. Ideal biomaterial scaffolds should not only provide structural support for neuron migration, adhesion, proliferation, and differentiation but also mimic the mechanical properties of natural spinal cord tissue. Additionally, these scaffolds should facilitate axon growth and neurogenesis by offering adjustable topography and a range of physical and biochemical cues. The three-dimensionally interconnected porous structure and appropriate physicochemical properties enabled by three-dimensional biomimetic printing technology can maximize the potential of biomaterials used for treating spinal cord injury. Therefore, correct selection and application of scaffolds, coupled with successful clinical translation, represent promising clinical objectives to enhance the treatment efficacy for and prognosis of spinal cord injury. This review elucidates the key mechanisms underlying the occurrence of spinal cord injury and regeneration post-injury, including neuroinflammation, oxidative stress, axon regeneration, and angiogenesis. This review also briefly discusses the critical role of nanodelivery systems used for repair and regeneration of injured spinal cord, highlighting the influence of nanoparticles and the factors that affect delivery efficiency. Finally, this review highlights tissue engineering strategies and the application of biomaterial scaffolds for the treatment of spinal cord injury. It discusses various types of scaffolds, their integrations with stem cells or growth factors, and approaches for optimization of scaffold design.

Key words: biomaterials, growth factors, nanoparticles, neural regeneration, scaffolds, spinal cord injury, stem cells, therapy strategies, tissue engineering