羧甲基壳聚糖生物材料支架在治疗骨缺损中的应用

Application of a Carboxymethyl-Chitosan Biomaterial Scaffold in the Treatment of Bone Defects

摘要: 背景：在治疗骨缺损的过程中，将羧甲基壳聚糖生物材料支架植入缺损部位可有效提高生物相容性、生物可降解性，减少不良反应的产生，为治疗骨缺损提供新的方法。目的：介绍羧甲基壳聚糖骨生物材料支架的最新应用进展，总结其相关功能，描述其在治疗骨缺损中的应用，并探讨目前的研究重点和未来趋势。方法：第一作者以“Carboxymethyl chitosan, chitosan derivatives, bone tissue engineering, bone defects, scaffold, review；羧甲基壳聚糖；壳聚糖衍生物；骨组织工程；骨缺损；支架；综述”为关键词，检索2000年1月~2023年8月期间PubMed、Web of Science、知网和万方数据库中发表的相关文献。初检文章212篇，筛选后对47篇文章进行分析。结果与结论：羧甲基壳聚糖可以作为抗菌剂来治疗耐药性较强的细菌，作为骨传导性物质可以促进细胞黏附和增殖，还可以经过改性和各种生物材料结合来增强其力学性能和功能性，同时还可以作为可注射水凝胶以任何形状填充到骨缺损部位。但是强度方面依然存在不足，很难在保证抗菌活性的同时实现较好的支持作用。目前大多数研究仍侧重于和其他生物材料复合来增强其力学性能。另外，羧甲基壳聚糖生物材料的应用研究大部分仍处于实验阶段，未能真正应用于临床。改进壳聚糖生物材料的制备工艺将有助于研发具有更多功能的骨修复生物材料，在不久的将来，可将壳聚糖同3D打印技术、基因工程以及医学影像学技术相结合在骨组织工程领域中为骨修复开辟新的道路。

Abstract: Background: In the process of treating bone defects, the implantation of the carboxymethyl chi-tosan biomaterial scaffold into the defect site can effectively improve the biocompatibility and bio-degradability, reduce the generation of adverse reactions, and provide a new method for the treat-ment of bone defects. Objective: To introduce the latest application progress of chitosan bone bio-material scaffold, summarize its related functions, describe its application in the treatment of bone defects, and explore the current research focus and future trends. Methods: The first author searched with the keywords “carboxymethyl chitosan; chitosan derivative; bone tissue engineering; bone defect; stent; review” in the PubMed, Web of Science, CNKI and Wanfang databases from Janu-ary 2000 to August 2023. 212 articles were initially examined, and 47 articles were analyzed after screening. Results and Conclusion: Carboxymethyl chitosan can be used as antibacterial agent to treat resistant bacteria, as bone conductive substance can promote cell adhesion and proliferation, can also be modified by a variety of biological materials combined to enhance its mechanical prop-erties and functionality, but also as an injectable hydrogel in any shape to fill the bone defect. How-ever, there are still deficiencies in strength, and it is difficult to achieve good support effect while ensuring antibacterial activity. Most of the current studies still focus on recombining with other biomaterials to enhance their mechanical properties. In addition, most of the application research of carboxymethyl chitosan biomaterials is still in the experimental stage and has not been really applied in clinical practice. Improving the preparation process of chitosan biomaterials will help in the development of bone repair biomaterials with more functions. In the near future, chitosan can be combined with 3D printing technology, genetic engineering and medical imaging technology to open up a new path for bone repair in the field of bone tissue engineering.