Uphando ngeendlela eziphambili zeCartilage Regeneration
Ukuhlaziywa kwe-cartilage kuzama ukubuyisela i-articular (joint joint). Izindlela eziliqela sele zisetyenziselwa ukuhlaziywa kwe- cartilage . Nangona ezinye zezi zinto zisetyenziswa namhlanje, abaphandi baqhubeka bejonga iindlela ezintsha zokubuyisela i-cartilage ngenzame yokunika abantu ithuba lokuphucula intlungu ye-osteoarthritis.
Iyiphi i-Carticlage?
I-matrix ye-cartilage iquka i-collagens, i-proteoglycans, kunye namaprotheni angewona asebenzayo.
Nangona i-cartilage yindawo ehlelwe kakuhle, malunga ne-85 ekhulwini ye-cartilage ngamanzi. Oku kunciphisa ukuya kuma-70 ekhulwini kubantu abadala. I-Chondrocytes yizona kuphela iiseli ezitholakala kwi-cartilage kwaye oku kuvelisa kwaye kugcinwe i-cartilage matrix.
I-carticlage ye-Articular isebenza njengendawo yokutya kunye nokuxhalabisa ngaphakathi kwendibano. Iyenjenjalo kuba igalela iiphelo zamathambo amabini ezenza idibeneyo. Umonakalo we-cartilage ungabangelwa yimimiselo embalwa kuquka:
- Ukulimala okuhlangeneyo
- Avascular necrosis
- I-Osteochondritis ntshutshiso
- Osteoarthritis
- Irheumatoid arthritis
Amalungu axhatshazwayo ngumonakalo we-cartilage abe yintlungu, eqinile, kwaye inomlinganiselo omncinci wokunyakaza .
Ingxaki kukuba i-cartilage ayikwazi ukuziphilisa. Ngenxa yoko, i-carticlage ye-articular iye yajoliswa ngabaphandi abaninzi kunye neenjini zezilwanyana ezizama ukukwazi ukukhulisa i-cartilage entsha kunye nokuyifakela endaweni ye-cartilage eyonakalisiweyo.
Inkqubela phambili ngeCarlage
Amacandelo amaninzi aphuhlisiwe abonisa inkqubela phambili yokuhlaziywa kwamathambo.
- Ukutshatyalaliswa okanye ukuchithwa - I- arthroscopically isusa i-cartilage evulekileyo eyenza ukuphaphaza emathambo kunye nokukhula kwe-fibrocartilage (i-cartilage enobumba okanye i- tissue ). Kwezinye iimeko, i-fibrocartilage ingabi namandla ngokwaneleyo ukukhusela ngokufanelekileyo umdibaniselwano.
- I-Microfracture - Ugqirha we-arthroscopically uyayicoca indawo echaphazelekayo kwaye yenza ukuthotywa kwamathambo amaninzi. Le nto yenzelwe ukukhuthaza ukuphuma kwegazi kunye nokukhula kwe-fibrocartilage ngokunjalo.
- I-Mosaicplasty okanye i-Osteochondral Autograft Ukutshatyalaliswa kwe-Transplantation - Ugqirha uyasusa iplagi lesithambo kunye nesigqubuthelo se-cartilage esivela kwindawo enempilo yomdibaniso kwaye siyifake kwindawo eyonakalisiweyo.
- I-Periosteal Flap - Ugqirha uyasusa isahluko se-periosteum (isisombululo esinobungqungquthela esimbola onke amathambo) ukusuka kwi-shin kwaye siyifaka kwindawo yomonakalo we-cartilage .
- Ukufakelwa kwe-Autologous Chondrocyte (ACI) - Ugqirha we-arthroscopically ususa inxalenye encinci ye-cartilage ukusuka emadolweni. Izicubu zithunyelwa kwibhabyri ukuba zikhuliswe. Ukuhlinzwa okwesibini kuyadingeka ukwenzela ukuba iiseli ezikhulile zibekwe kwisiza se-cartilage ewonakele.
- I-Osteochondral Allografts - Ithambo lomnikeli lisetyenziselwa ukulungisa i-cartilage eyonakalisiweyo.
- Ukufakelwa kwe-Matrix Associated Chondrocyte (MACI) - I-FDA ivume le nkqubo ngo-2017 ekusebenziseni abantu abangaphantsi kwama-55 kunye "neziphene ze-chondral" - izilonda ezingakhokelela kwi-osteoarthritis yamadolo. Ifana ne-ACI kodwa idinga ukuhlinzwa okungekho ngaphantsi kwaye i-chondrocytes ithunyelwa kubugqirha kwi-patch efana ne-scaffold phezu kwendawo eyonakalisiweyo.
Zonke iinkqubo zivelisa iziphumo ezixutywayo. Kukho imibuzo emininzi enokubandezela iinzame zokuhlaziywa kwe-cartilage.
Kufuneka iimvavanyo ezininzi zekliniki ukuze zifumane iimpendulo ezichanekileyo kwaye ziphuhlise iinkqubo ezinciphisa iimpawu zesifo se-arthritis kwaye zenze iindawo ezinokuthi zitshintshele i-cartilage eyonakalisiweyo.
Uphando luqhubeka
Umngeni wokuza nesisombululo esiphezulu sokuvuselelwa kwe-cartilage isengqondweni yabaphandi abaninzi. Kulo lonke ihlabathi, uphando olutsha kunye nobuchule abatsha baqhubeka bejonge kulo mbandela kwaye iziphumo zakuqala zikhangeleka.
Ngokomzekelo, ngo-2008, i-bioengineers kwi-Yunivesithi yase-Rice yafumanisa ukuba uxinzelelo olunzulu (olufana nelo lufunyenwe ngaphezu kweekhilomitha ezili-2 ngaphantsi komhlaba wolwandle) lukhuthaza iiselitile ze-cartilage ukuba zikhule izicubu ezintsha.
Ezi zicubu ezintsha ziphantse zizonke iipropati zendalo.
Abaphandi bakholelwa ukuba olu phuhliso lunesithembiso sokunyangwa kwe-arthritis. Umphandi okhokele phambili wachaza ukuba kuya kuba yiminyaka emininzi ngaphambi kokuba inkqubo ikulungele ukuvavanywa klinikhi kubantu.
Iiseli zesitembu zisetyenziselwa ukukhulisa i-cartilage entsha kwizintlu ze-arthritic kwiinkqubo eziphuhliswa kwi-University of Washington University School of Medicine ngo-2017. Ngokubambisana neCyclex Therapeutics, ithemba laba baphandi kukuba le nto iya kuba yindlela yokutyunjwa .
Le nqubo ibonisa isithembiso esiphezulu kulabo abangaphantsi kwama-50. Isebenzisa "i-3-D, i-biagradable synthetic scaffold" kwaye ivelise ngokubambisana ukuxhamla umlenze ukuze unciphise intlungu. Kwizigulane ze-arthritic, kunokulibaziseka, ukuba kungenakuqeda, imfuneko yentshukumo entsha.
Imithombo
- I-Axtell B. FDA I-OKs kuqala kwisizukulwana esitsha se-Knee Cartilage Repair. Arthritis Foundation. 2017.
- Boyd J. Cartilage ukuhlaziywa '20, 000 iiLagues phantsi koLwandle '. University of Rice. 2008.
- I-Dryden J. Stem Iiseli ezixhasiweyo zoKhula i-Cartilage, Ukulwa nokuvutha. IYunivesithi yaseWashington University School of Medicine. 2016.
- > Isibhedlele soPhengululo olukhethekileyo. Iinkqubo zokuLungisa i-Knee Cartilage ibonisa ukuba uthembisa ukunyanga iziguli ezingaphezu kwama-40. 2016.
- > Rai V, > Dilissio > MF, Dietz NE, Agrawal DK. Amacandelo anokuLungiswa kweKartilage: Ukuphononongwa ngokuHlangeneyo kweScaffold Development and Engineering Tissue. Umbhalo we-Biomedical Research Research Part A. 2017. i-doi: 10.1002 / jbm.a.36087.