EBioMedicine：上海交大曹谊林团队利用3D打印和组织工程技术，成功让5名儿童长出新耳朵

2018-02-04 代丝雨奇点网

xujie.L

医生/

不知道大家还对那只背上长着耳朵的小鼠有印象吗？奇点糕翻了翻资料，才发现这事儿都二十一年了！

不知道大家还对那只背上长着耳朵的小鼠有印象吗？奇点糕翻了翻资料，才发现这事儿都二十一年了！

这只小鼠给了我们对未来科技的无限畅想

1997年，当时还在哈佛大学医学院进行博士后研究的曹谊林，在裸鼠背上成功再生了人耳廓形态软骨，首次向世界展示了组织工程技术“再生”人体组织、修复缺损的可能性。

2018年，已是上海交通大学教授的曹谊林再发论文，成功利用组织工程技术与3D打印技术，为5名患有先天性小耳畸形的孩子“再造”了漂亮的耳朵！耳软骨细胞来自患者自身，形状根据正常侧耳“定制”，经过最长两年半的随访，再造耳生理形态基本与正常的耳朵一样。

曹谊林教授

先天性小耳畸形是一种不算太罕见的疾病，世界范围内发病率为0.8-17.4/10000，西班牙裔和亚裔发病率相对来说高一些。患有这种病的人，中耳和外耳先天性发育不良，虽然内耳一般不会受到影响，但是外耳的形态异常，还是会严重影响他们的听力。更何况外貌上的异常，会给他们带来极大的心理负担。

目前来说只有手术能解决这个问题。植入的“支架”，要么是用患者自己的肋软骨雕刻成的，要么就是树脂等非生物材料制作的。

取块软骨听起来就很痛！而且雕出来啥样全凭医生手艺和骨头的条件。树脂材料呢，又不那么自然，还有引起免疫反应的风险。

“人耳鼠”就是曹教授在解决这个问题上的第一次尝试。说是“人耳鼠”，其实严格来说并不是人耳，只是有人耳形态的一块软骨，实验中使用的是牛的软骨细胞。考虑到软骨细胞的来源、如何保持软骨形态、生物安全性等等问题，这项技术一直都没有投入应用。

先天性小耳畸形患者，外耳发育不全，常见耳道闭锁

经过二十一年的沉积发酵，这项技术终于在临床试验里取得成功啦！

这次呢，曹教授把自己的老本行组织工程技术与新兴的3D打印技术结合了起来。首先，研究者们给患者正常一侧的耳朵做了个CT扫描，建立三维模型，并利用3D打印技术打印一个形状对称的支架出来，在这个支架的基础上，把取自患者畸形耳侧的软骨细胞放进去培养3个月，再用正常的手术植入。由于支架使用了可生物降解的材料，理想条件下，生长一段时间之后的耳朵将会完全和正常的耳朵一样。

试验流程

实际试验也进行得非常顺利。第一个病人是个六岁的小女孩，从她的“小耳”取出的软骨细胞活性良好，在体外培养到第12周的时候，支架上的软骨已经基本长成，与她对侧的耳朵相似度在90%以上。

这只在培养皿中生长的耳朵，在她的身上也正常生长了。植入9个月以后，耳朵出现了明显的轮廓；24个月以后，耳部的灵活性更好、结构更明显了。对软骨取样检测，这只人造耳的组织学也与天然软骨类似，只是弹性蛋白略低一些，支架则降解得差不多了。

另外的四个案例也均表现良好，有两个孩子的耳部形态略有些扭曲，不过这在下一步手术中是可以进行改善的。

其他四个案例，基本成功

目前，对首个案例的随访已经进行了两年半，研究者准备继续随访至第五年，以确定支架完全降解之后，软骨的形态是否还正常。

这是世界首例成功在体外培养人耳状软骨并成功进行移植的临床试验，相信未来直接使用3D打印出一个耳朵移植也不是梦了。

中国学者，加油！

原始出处：Guangdong Zhou, Haiyue Jiang, Zongqi Yin, et al. In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction. EBioMedicine(2018).

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2018-10-16 linagood

#EBI#

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2018-06-28 kalseyzl

#CIN#

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2018-03-02 sunylz

#Bio#

31 0
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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Wed Feb 07 09:12:09 CST 2018, time=2018-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336029, encodeId=53c41336029fe, content=<a href='/topic/show?id=792612047e' target=_blank style='color:#2F92EE;'>#3D#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1204, encryptionId=792612047e, topicName=3D)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/pSGl6CJeZ2PzWxdhCtrvv4U9Q281RV8e0AKmlB5ib93DibbiaRyOzmkCdz5F04cbfX5RGOpG4dOXvuQW1fumibVeBg/132, createdBy=fc342500110, createdName=ms9833124466084992, createdTime=Tue Feb 06 14:45:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), 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createdBy=8a6414444709, createdName=gao_jian4222, createdTime=Tue Feb 06 14:45:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577589, encodeId=61fa15e758983, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Tue Feb 06 14:45:00 CST 2018, time=2018-02-06, status=1, ipAttribution=)]
2018-02-19 大爰

学习了谢谢分享!!

82 0
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2018-07-31 jeanqiuqiu

#DIC#

28 0
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2018-02-07 大爰

学习了谢谢分享!!

71 0
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2018-02-06 ms9833124466084992

#3D#

29 0
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2018-02-06 zhu_jun9838

#组织工程#

31 0
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2018-02-06 gao_jian4222

#上海交大#

42 0
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GetPortalCommentsPageByObjectIdResponse(id=1417169, encodeId=6584141e1696f, content=<a href='/topic/show?id=8b72e769056' target=_blank style='color:#2F92EE;'>#组织工程#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77690, encryptionId=8b72e769056, topicName=组织工程)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c62f3243688, createdName=zhu_jun9838, createdTime=Tue Feb 06 14:45:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1553837, encodeId=4e5a155383e96, content=<a href='/topic/show?id=0ba81988692' target=_blank style='color:#2F92EE;'>#上海交大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19886, encryptionId=0ba81988692, topicName=上海交大)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8a6414444709, createdName=gao_jian4222, createdTime=Tue Feb 06 14:45:00 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577589, encodeId=61fa15e758983, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Tue Feb 06 14:45:00 CST 2018, time=2018-02-06, status=1, ipAttribution=)]
2018-02-06 ms1692212821629096

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