巨噬细胞在髋假体周围感染与骨整合的作用

Role of macrophages in periprosthetic infection and osseointegration of the hip joint

摘要:

假体周围感染以及由感染导致的骨溶解是目前人工髋关节置换术后的最严峻挑战。巨噬细胞作为机体抵御感染的第一道防线，不仅能够通过吞噬、极化等多种途径发挥抗感染作用，还可以分泌多种活性因子，促进骨髓间充质干细胞成骨分化，实现骨整合。因此，人工髋关节置换术后为同步实现预防感染和促进骨整合，假体-骨界面的巨噬细胞免疫调控机制受到广泛关注。文章综述了巨噬细胞在关节假体置入过程中所涉及的表型转换及其抗感染和成骨作用，可为研发涉及巨噬细胞免疫调控的多功能假体提供理论依据。

Abstract:

Periprosthetic infection and osteolysis caused by infection are the most severe clinical challenges after total hip arthroplasty. As the first line of defense against infection, macrophages can not only play an anti-infection role through phagocytosis, polarization and oth- er ways, but also secrete a variety of active factors to promote the osteogenic differentiation of bone marrow mesenchymal stem cells and real- ize bone integration. Therefore, in order to simultaneously prevent infection and promote osseointegration after hip arthroplasty, the immune regulation mechanism of macrophages at the prosthesis-bone interface has received extensive attention. This paper reviews the phenotypic transformation, anti-infection and osteogenesis of macrophages in the process of biomaterial implantation, which can provide a theoretical basis for the development of multifunctional prosthesis involving macrophage immune regulation.