巨噬细胞极化在骨修复和骨再生中的作用

作者	单位	邮编
杨标^*	1海军军医大学第二附属医院（上海长征医院）骨科脊柱畸形病区,上海,200003	200003
仇铎润^*	2海军军医大学第二附属医院（上海长征医院）麻醉科,上海,200003	200003
孟怡辰	1海军军医大学第二附属医院（上海长征医院）骨科脊柱畸形病区,上海,200003 3海军军医大学心理系心理应激与神经损伤联合实验室,上海,200003	200003
张郑	1海军军医大学第二附属医院（上海长征医院）骨科脊柱畸形病区,上海,200003 3海军军医大学心理系心理应激与神经损伤联合实验室,上海,200003	200003
周许辉^*	1海军军医大学第二附属医院（上海长征医院）骨科脊柱畸形病区,上海,200003 3海军军医大学心理系心理应激与神经损伤联合实验室,上海,200003	200003

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中文摘要:

骨骼的修复与再生是维持其结构完整性和功能恢复的核心过程。巨噬细胞作为先天免疫系统的重要成员，通过极化（M1/M2表型）在骨修复中发挥关键调控作用。巨噬细胞通过M1（促炎）向M2（抗炎）的表型转换，动态调控骨折愈合进程：M1型分泌TNF-α、IL-6以启动炎症反应，而M2型释放IL-10、VEGF等促进成骨与血管新生。这种时序性极化是骨修复的关键免疫调控节点，也为生物材料设计提供了靶点。重塑期M2型进一步协调破骨与成骨平衡，确保骨稳态。近年来，基于巨噬细胞极化的免疫调控策略成为研究热点，如生物材料（可降解镁合金、纳米水凝胶等）通过调节巨噬细胞表型，优化局部微环境以促进骨整合与再生。本文系统性综述了巨噬细胞极化参与骨修复的分子机制及最新进展，为开发调控免疫微环境的骨再生疗法提供理论支持。

英文摘要:

Bone repair and regeneration are essential for maintaining skeletal integrity and functional recovery. Macrophages, as key innate immune cells, regulate bone repair through polarization into M1 (pro-inflammatory) and M2 (anti-inflammatory) phenotypes. The shift from M1 to M2 polarization dynamically coordinates fracture healing: M1 macrophages secrete TNF-α and IL-6 to initiate inflammation, while M2 macrophages release IL-10 and VEGF to support osteogenesis and angiogenesis. This temporal polarization is a critical immunoregulatory mechanism in bone repair and a target for biomaterial design. During remodeling, M2 macrophages further balance osteoclast and osteoblast activity to maintain bone homeostasis. Recent studies highlight immunomodulatory strategies targeting macrophage polarization, such as biodegradable magnesium alloys and nanohydrogels, which can tune macrophage phenotypes to improve the local microenvironment and enhance bone regeneration. This review outlines the molecular mechanisms and advances in macrophage-mediated bone repair, supporting the development of immune-modulated regenerative therapies.

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