糖尿病肌腱干细胞源性外泌体的功能特性及其在肌腱修复中的作用机制
Functional Characteristics of Diabetic Tendon Stem Cell-Derived Exosomes and Their Mechanism of Action in Tendon Repair
DOI: 10.12677/acm.2026.161274, PDF,   
作者: 唐佳龙, 王 靖*:湖南师范大学附属第一医院(湖南省人民医院)骨关节与运动医学科,湖南 长沙
关键词: 糖尿病肌腱病变肌腱干细胞外泌体分子机制治疗策略Diabetic Tendon Disease Tendon Stem/Progenitor Cells Exosomes Molecular Mechanisms Treatment Strategies
摘要: 糖尿病是常见慢性代谢性疾病,易并发肌腱病,导致疼痛与功能障碍,现有治疗难以实现肌腱功能性再生。肌腱干/祖细胞(TSPCs)是肌腱修复核心,高糖微环境会损害其增殖、分化等功能,而TSPCs源性外泌体(TSPCs-EXOs)可通过传递生物活性分子介导细胞通讯,在肌腱修复中具重要潜力,但糖尿病条件下其形态、分子表达存在异常,限制治疗效能。本文综述了糖尿病TSPCs的病理特征、TSPCs-EXOs的分子调控机制(如VEGFA/mTOR、TGF-β/Smad通路),介绍了外泌体靶向递送、联合治疗及基因编辑等策略,探讨了糖尿病分型影响与临床转化挑战,展望了人工智能的应用前景,为相关靶向治疗提供理论参考。
Abstract: Diabetes is a common chronic metabolic disease prone to complicated tendon lesions, causing pain and functional impairment, with current treatments failing to achieve functional tendon regeneration. Tendon stem/progenitor cells (TSPCs) are core for tendon repair, but a high-glucose microenvironment impairs their proliferation and differentiation. TSPCs-derived exosomes (TSPCs-EXOs) can mediate intercellular communication by delivering bioactive molecules, showing great potential in tendon repair, yet their abnormal morphology and molecular expression under diabetic conditions limit therapeutic efficacy. This article reviews the pathological characteristics of diabetic TSPCs and the molecular regulatory mechanisms of TSPCs-EXOs (e.g., VEGFA/mTOR and TGF-β/Smad pathways), introduces strategies like exosome-targeted delivery, combination therapy and gene editing, discusses the impact of diabetes classification and clinical translation challenges, and prospects the application of artificial intelligence, providing theoretical reference for relevant targeted therapies.
文章引用:唐佳龙, 王靖. 糖尿病肌腱干细胞源性外泌体的功能特性及其在肌腱修复中的作用机制[J]. 临床医学进展, 2026, 16(1): 2178-2186. https://doi.org/10.12677/acm.2026.161274

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