【作者】 徐青镭； 吴海山； 周维江； 赵定麟；

【Author】 XU Qinglei WU Haishan ZHOU Weijiang et al. Department of Orthopaedics Changzheng Hospital the Second Military Medical University Shanghai 200003 China

【机构】 上海第二军医大学长征医院骨科；

【摘要】 目的:探讨用组织工程学原理和方法重建半月板结构及功能的可行性。方法:以胶原-糖胺聚糖glycosaminoplycan GAG模板为载体,将经体外扩增及细胞因子刺激后已进入软骨细胞分化谱系的间充质干细胞mesenchymal stem cells MSCs回植入体内,术后3-24周连续对重建的半月板组织进行大体,组织学及电镜观察。结果:术后3、6、12、24周大体,组织学,电镜观察显示胶原-GAG模板逐渐被降解吸收,而MSCs可逐渐合成分泌新生胶原,经不断改建最终形成半月板样纤维软骨组织,而胶原对照组及空白对照组则仅见纤维组织样的修复组织。结论: 利用自体MSCs经体外扩增及细胞因子的刺激,经由胶原-GAG模板为载体按一定的密度回植入关节腔内来重建半月板的方法,避免了自体取材的限制和同种异体取材的排斥反应,是一种较为可行的重建半月板的方法。为进一步提高这一方法的有效性,还需要在生物材料学、生物力学、生物化学等方面进行更为深入的研究。更多还原

【Abstract】 Objective This is a feasibility study of rabbit meniscus regeneration evaluated with the use of autologous bone marrow derived mesenchymal stem cells MSCs and collagen glycosaminoglycan GAG.Methods Autologous MSCs were prepared from the rabbit proximal tibial bone marrow and stimulated in vitro to start fibrocartilage differentiation lineage by bFGF and TGF β 1. Then collagen GAG templates en-riched with these MSCs were implanted in vivo to the menisci excised rabbit knees as the substitute for the excised meniscus. After 36 12 24 weeks postoperatively the implants were evaluated by the gross his-tological and ultrastructural observations. Results The MSCs enriched collagen GAG implants underwent inflammation degradation MSCs division and remodeling stages in vivo and consequently formed a menis-cus like fibrocartilage tissue. Special staining and electronic microscope observation proved that the regener-ated fibrocartilage were chondrocyte like fibrochondrocytes in contrast the results of the control group showed that both collagen GAG implants without MSCs and no substitute had limited regenerating tissue further e-valuations by histological and electronic microscope showed no evidence of fibrochondrocytes and hence these regenerated tissue were fibrous rather than fibrocartilaginous. Conclusion The inducing of rabbit meniscus regeneration by the autologous bone marrow derived MSCs and porous collagen GAG template is proved to be feasible in this study. However further studies to improve the biomaterial design to evaluate the biome-chanical properties of the regenerated tissue and to ensure clinical safety etc are needed prior to its clinical application.更多还原