内源性修复细胞募集支架与组织工程自体软骨移植修复兔膝关节软骨缺损的长期疗效对比研究  

A comparative study on the long-term efficacy of endogenous repair cell recruitment scaffold and tissue engineering autologous cartilage transplantation for repairing cartilage defects of rabbit knee joint

作　　者：梁菁 勾禹 夏荣林 邢飞 刘畅[2] 蔡成阔 李姗[1] 孙逊 Liang Jing;Gou Yu;Xia Ronglin;Xing Fei;Liu Chang;Cai Chengkuo;Li Shan;Sun Xun(Department of Pediatrics,Tianjin Hospital,Tianjin University,Hexi District,Tianjin 300211,China;Department of Orthopedics,Tianjin Hospital,Tianjin University,Hexi District,Tianjin 300211,China)

机构地区：[1]天津大学天津医院儿科,天津300211 [2]天津大学天津医院骨科,天津300211

出　　处：《中华生物医学工程杂志》2023年第2期121-128,共8页Chinese Journal of Biomedical Engineering

基　　金：国家自然科学基金面上项目(82072435);天津市应用基础研究项目(22JCQNJC00230,22JCQNJC00360);天津市应用基础研究多元投入基金项目(21JCQNJC01340);天津市卫生健康委员会科技人才培育项目(KJ20052,KJ20132)。

摘　　要：目的对比研究内源性修复细胞募集支架与组织工程自体软骨移植修复关节软骨缺损的长期疗效,为内源性修复细胞募集支架的临床应用及转化提供参考。方法利用兔股骨滑车全层软骨缺损模型,分别予以旷置(对照组)、组织工程自体软骨填充(TE-MACI组)及内源性修复细胞募集支架填充(DCM-RAD/SKP组)进行干预,分别于术后12个月行核磁共振(MRI)检查,术后18个月行大体观评价、微型计算机断层成像(micro-CT)检查、组织学评价及蛋白表达水平分析。结果修复术后12个月MRI检查结果显示TE-MACI组和DCM-RAD/SKP组的缺损修复区则几乎完全被正常软骨密度影填充,二者的T2 mapping序列T2值接近周边正常关节软骨组织,显著低于对照组。修复术后18个月的大体观及组织学评价表明TE-MACI组和DCM-RAD/SKP组缺损修复区成透明软骨样修复,与临近正常关节软骨融合良好,其内部存在一定含量的GAG成分及典型的软骨陷窝结构,修复效果显著优于对照组。micro-CT结果可见对照组的骨密度[BMD(360.87±5.96)mg/cm^(3)]和骨体积分数[BV/TV(56.47±1.62)%]均显著高于TE-MACI组和DCM-RAD/SKP组,且后二者间差异无统计学意义。蛋白表达分析结果显示TE-MACI组和DCM-RAD/SKP组的与关节软骨修复相关蛋白Ⅱ型胶原、Ⅹ型胶原以及软骨蛋白聚糖(aggrecan)的表达水平明显高于对照组,而前两组间差异无统计学意义。结论内源性修复细胞募集支架能有效修复关节软骨缺损,与组织工程自体软骨移植的长期疗效相当,未见严重远期退变,这种利用宿主自身巨大再生潜力的治疗策略有望成为一种仅需单次手术即可完成的关节软骨组织再生治疗方案应用于临床。Objective This study aimed to compare the long-term efficacy of endogenous repair cell recruitment scaffold and tissue engineering autologous cartilage transplantation for the repair of articular cartilage defects and to provide a reference for the clinical application and transformation of endogenous repair cell recruitment scaffold.Methods Rabbits with full-thickness cartilage defects in the femoral trochlea were treated with open placement(Control group),tissue engineered autologous cartilage filling(TE-MACI group),or endogenous repair cell recruitment scaffold filling(DCM-RAD/SKP group).Magnetic resonance imaging(MRI)was performed 12 months after surgery,and macroscopic evaluation,micro-computed tomography(micro-CT),histological evaluation and protein expression level analysis were performed 18 months after surgery.Results MRI at 12 months after surgery revealed that the defect repair area in the TE-MACI and the DCM-RAD/SKP groups was almost filled by normal cartilage,as shown by the density shadow.The T2 values of the T2 mapping sequence of the two groups were close to that of the surrounding normal articular cartilage and significantly lower than that of the Control group.The macroscopic evaluation and histological evaluation at 18 months after surgery showed that the defect repair area in the TE-MACI and DCM-RAD/SKP groups contained hyaline cartilage,which was well fused to the adjacent normal articular cartilage.Some of the cartilage comprised a glycosaminoglycan component and exhibited a typical cartilage lacuna structure in the defect repair area.Moreover,the repair effect was significantly better than that in the Control group.Micro-CT revealed that bone mineral density[BMD(360.87±5.96)mg/cm^(3)]and bone volume-to-tissue volume ratio[BV/TV(56.47±1.62)%]in the Control group were significantly higher than those in the TE-MACI and DCM-RAD/SKP groups,but no statistical significance between the latter two groups.Protein expression analysis showed that the expression levels of collagenⅡ(Col 2),collagen�

关 键 词：组织工程 自体软骨细胞移植 软骨再生 内源性修复 

分 类 号：R684[医药卫生—骨科学]