同种异体脱钙松质骨基质材料复合自体骨髓间充质干细胞修复全层关节软骨缺损(英文)  

Repairing full-thickness articular cartilage defects with homograft of mesenchymal stem cells seeded onto cancellous demineralized bone matrix

作　　者：李强[1] 唐际存[1] 孙正义[2] 王栓科[2] 刘文忠[2] 

机构地区：[1]桂林医学院附属医院骨科,广西壮族自治区桂林市541001 [2]兰州大学第二医院骨科研究所,甘肃省兰州市730030

出　　处：《中国组织工程研究与临床康复》2008年第45期8943-8947,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：the grants from Guangxi Administration Bureau of Public Health Program, No. Z2007211~~

摘　　要：背景:到目前为止,还没有一种十分有效的方法治疗关节软骨缺损。许多治疗方法都只能缓解临床症状,而不能有效促进软骨的再生,也不能恢复软骨表面的承重功能。目的:观察脱钙骨基质复合骨髓间充质干细胞修复兔膝关节全层软骨缺损的疗效。设计、时间及地点:随机对照动物实验,分别于 2005-01/03 在兰州大学第二医院骨科研究所和 2008-05/08 在桂林医学院中心实验室完成。材料:取新西兰兔四肢骨干骺端及椎体松质骨,脱钙制备脱钙松质骨基质材料;体外分离培养同种新西兰兔骨髓间充质干细胞种植于脱钙骨基质支架上体外培养。36 只新西兰兔随机分成骨髓间充质干细胞复合同种异体脱钙骨填充组(简称复合组)、同种异体脱钙骨填充组及空白对照组,每组 12 只。方法:在髁间窝髌面上用直径 4 mm 的钻头钻孔深约 3 mm 造成膝关节全层软骨缺损模型。复合组双侧股骨髁间窝软骨缺损处植入脱钙骨基质吸附体外分离培养的自体骨髓间充质干细胞复合物;同种异体脱钙骨填充组单纯植入脱钙骨基质;空白对照组不作任何植入。主要观察指标:分别于植入后 4,8,12 周取材进行组织学及免疫组化染色观察,根据关节软骨组织学计分标准进行评分。结果:36 只新西兰兔均进入结果分析。复合组所修复组织为透明软骨样修复;而同种异体脱钙骨填充组和空白对照组为纤维性修复。植入后 12 周复合组大体评分及组织学评分明显低于同种异体脱钙骨填充组和空白对照组(P < 0.05);同种异体脱钙骨填充组低于空白对照组(P < 0.05)。结论:运用软骨组织工程的原理,以脱钙骨基质为支架材料的自体骨髓间充质干细胞移植是一种修复软骨缺损的行之有效的方法。BACKGROUND： Up to now, no universally successful therapy to treat substantial articular cartilage defects has been available. Numerous therapeutic approaches can oniy improve clinical symptoms of joint lesions, but not stimulate the regenerative and reactive capacity of the biological tissue in the defect, and not restore an articular surface capable of functional load beating. OBJECTIVE： To investigate the curative effects of homograft of meseuchymal stem cells （MSCs） seeded onto cancellous demineralized bone matrix （DBM） on articular cartilage defects. DESIGN, TIME AND SETTING： A randomized controlled study which conducted in Orthopaedics Institute, the Second Hospital of Lanzhou University from January to March 2005 and Central Laboratory of Guilin Medical Collage from May to August 2008. MATERIALS： Bone metaphysis and vertebral cancellous bone were derived from rabbits to prepare DBM materials. MSCs were seed on DBM stent and cultured in vitro. All 36 rabbits were randomly divided into combination group （DBM/MSCs）, DBM alone group, and blank control group, with 12 rabbits per group. METHODS： Full-thickness cartilage defect model of knee joint was frilled using a cylinder of 4 mm diameter and 3 mm thickness on intercondylar fossa. The cartilage defects in the intercondylar fossa were filled with MSCs/DBM in combination group A, with only DBM in the DBM group, and nothing was treated in the blank control group. MAIN OUTCOME MEASURES： Four rabbits were killed at three time points, which were 4, 8 and 12 weeks after the operation in each group, and the reparative tissue samples were evaluated grossly, histologically, immunohistochemically and graded according to gross and histological scale. RESULTS： Tirty-six rabbits were included in the final analysis. The defects of MSCs/DBM transplantation were repaired by hyline-like tissue, and the other defects were repaired by fibrous tissue. Gross and histological grading scale was made on 12 weeks postoperatively. Gross and histological scores

关 键 词：骨髓间充质干细胞 脱钙骨基质 移植 软骨缺损 

分 类 号：R318[医药卫生—生物医学工程]