自体骨髓间充质干细胞移植治疗早期股骨头坏死  

Autologous bone marrow mesenchymal stem cell transplantation for the treatment of early femoral head necrosis

作　　者：陈翔 王伟卓[2] 薛建利[2] 夏立峰 李涛 邱岭 宋焕瑾[2] Chen Xiang;Wang Wei-zhuo;Xue Jian-li;Xia Li-feng;Li Tao;Qiu Ling;Song Huan-jin(First Clinical Medical College of Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi Province,China;Department of Orthopaedics,Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,Shaanxi Province,China;Department of Orthopedics,Xi’an Honghui Hospital,Xi’an 710054,Shaanxi Province,China;Department of Orthopaedics,Xi’an First Hospital,Xi’an 710002,Shaanxi Province,China)

机构地区：[1]陕西中医药大学第一临床医学院,陕西省咸阳市712046 [2]西安交通大学第二附属医院骨科,陕西省西安市710004 [3]西安市红会医院骨科,陕西省西安市710054 [4]西安市第一医院骨科,陕西省西安市710002

出　　处：《中国组织工程研究》2018年第25期4007-4013,共7页Chinese Journal of Tissue Engineering Research

基　　金：陕西省自然科学基础研究计划项目(2016JM8129)~~

摘　　要：背景:目前国内外研究表明骨髓间充质干细胞可作为理想的种子细胞用于改善早期股骨头坏死区微循环。目的:观察自体骨髓间充质干细胞移植治疗早期股骨头坏死的疗效。方法:(1)体外实验:利用Transwell系统行骨髓间充质干细胞和成骨细胞共培养为实验组,正常成骨细胞培养为空白组,无血清培养基培养成骨细胞为对照组,培养3 d后MTT检测成骨细胞活力,流式细胞仪检测成骨细胞凋亡率,ELISA检测各组培养液中血管内皮生长因子、骨形态发生蛋白2水平;(2)体内实验:新西兰兔30只随机分为3组:空白组(正常股骨头),对照组(髓芯减压术+生理盐水),实验组(髓芯减压术+自体骨髓间充质干细胞)。移植7 d后获取股骨头标本,行苏木精-伊红染色、免疫组化染色。结果与结论:(1)与对照组和空白组比较,实验组成骨细胞增殖活力增强,成骨细胞凋亡减少,培养液中血管内皮生长因子、骨形态发生蛋白2水平增高(P均<0.05);(2)对照组股骨头区骨小梁断裂,脂肪细胞坏死明显,出现大量空骨陷窝;实验组成骨细胞较对照组增多,毛细血管较对照组增多;实验组早期股骨头坏死区血管内皮生长因子、骨形态发生蛋白2表达较对照组明显增加,差异有显著性意义(P<0.05);(3)结果表明,骨髓间充质干细胞移植后可促进股骨头坏死区血管内皮生长因子、骨形态发生蛋白2表达增加,达到改善早期股骨头坏死区微循环的效果。BACKGROUND:Bone marrow mesenchymal stem cells(BMSCs)as ideal seed cells have been worldwide confirmed to improve the microcirculation in the necrotic area of the femoral head.OBJECTIVE:To observe the efficacy of autologous BMSCs transplantation in the treatment of early necrosis of the femoral head.METHODS:(1)In vitro experiment.Osteoblasts were co-cultured with BMSCs using Transwell system as experimental group,osteoblasts cultured normally as blank group,and osteoblasts cultured in serum-free medium as control group.MTT was used to detect cell viability at 3 days of culture,flow cytometry used to detect cell apoptosis,and ELISA used to detect levels of vascular endothelial growth factor and bone morphogenetic protein 2 in the culture medium.(2)In vivo experiment.Thirty New Zealand white rabbits were randomized into three groups:blank group,control group(core decompression plus normal saline injection),and experimental group(core decompression plus autologous BMSCs injection).Femoral head samples from white rabbits were taken for hematoxylin-eosin and immunohistochemical staining at 7 days after cell transplantation.RESULTS AND CONCLUSION:(1)Compared with the control and blank groups,the experimental group showed increased osteoblast proliferation,decreased osteoblast apoptosis,and enhanced levels of vascular endothelial growth factor and bone morphogenetic protein 2 in the culture medium(all P<0.05).(2)In the control group,broken trabecular bone in the femoral head,evident adipocyte necrosis and a large number of empty bone lacunae were detected.In the experimental group,the number of osteoblasts and capillaries was increased as compared with the control group.The expression levels of vascular endothelial growth factor and bone morphogenetic protein 2 in the necrotic area of the femoral head were significantly increased in the experimental group compared with the control group(P<0.05).To conclude,BMSCs transplantation can improve the microcirculation in the necrotic area of the femoral head by increasing the ex

关 键 词：骨髓间充质干细胞 髓芯减压术 血管内皮生长因子 骨形态发生蛋白2 股骨头坏死 干细胞 骨髓 间质干细胞移植 血管内皮生长因子类 骨形态发生蛋白质类 股骨头坏死 组织工程 

分 类 号：R394.2[医药卫生—医学遗传学]