退行性视网膜疾病如年龄相关性黄斑变性(AMD)可致永久性视力丧失。虽然抗血管内皮生长因子(anti-VEGF)和类固醇注射可有效治疗湿性AMD早期病变,但干性AMD及晚期地图样萎缩仍缺乏治疗方法。视网膜色素上皮(RPE)对维护视功能至关重要,其功能障碍与视网膜退行性疾病相关,行RPE移植可替换病变细胞保证RPE的正常功能,维持视网膜稳态。然而,研究显示单纯细胞注射的短期结果难以维持。成功的细胞移植治疗须同时改进功能异常的RPE细胞和细胞外微环境,生物材料支架的研发成为关键突破点。组织工程学为修复视网膜损伤并恢复其功能的提供了前景。功能性RPE单层移植需重塑极化RPE的紧密排列,组织工程化可实现RPE在生物材料支架——人造Bruch膜上的生长。联合支架培养使细胞生长和可移植性表现更佳。本文回顾了支持RPE培养的人造Bruch膜材料学研究现状,列举了典型案例,总结了RPE支架材料具体分类、机械及生物学特性,为开发新型材料、促进人造Bruch膜的RPE移植临床应用奠定基础。
Degenerative retinal diseases such as age-related macular degeneration (AMD) may cause permanent visual loss.Although anti-vascular endothelial growth factor (anti-VEGF) and steroid injection can effectively treat early lesions of wet AMD, there is still a lack of treatment for dry AMD and late geographic atrophy.Retinal pigment epithelium (RPE) is essential to maintain visual function, and its dysfunction is associated with retinal degenerative diseases.RPE transplantation can replace the diseased cells to ensure the normal function of RPE and maintain retinal homeostasis.However, studies have shown that the short-term results of cell injection alone are difficult to maintain.Successful cell transplantation therapy must simultaneously improve the dysfunctional RPE cells and extracellular microenvironment, and the research and development of biomaterial scaffolds has become a key breakthrough.Tissue engineering offers a prospect for repairing retinal damage and restoring its function.Functional RPE monolayer transplantation needs to remodel the tight arrangement of polarized RPE, and tissue engineering can realize the growth of RPE on the biomaterial scaffold artificial Bruch membrane.Combined with scaffold culture, cell growth and transplantability can be better.This paper reviews the research status of artificial Bruch membrane materials supporting RPE culture, lists typical cases, and summarizes the specific classification, mechanical and biological characteristics of RPE scaffold materials to lay the foundation for developing new materials and promoting the clinical application of artificial Bruch membrane in RPE transplantation.
魏莺,马翔. RPE组织工程复合体中人造Bruch膜的生物材料研究进展[J]. 中华实验眼科杂志,2025,43(03):276-282.
DOI:10.3760/cma.j.cn115989-20220510-00204版权归中华医学会所有。
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