透明质酸钠溶液复合可注射型骨髓间充质干细胞修复退变椎间盘

背景：透明质酸作为椎间盘组织工程支架的基质材料,可提供蛋白多糖附着点,增加蛋白多糖的沉积,以足够大的孔率允许种子细胞长入。目的：观察透明质酸钠混合溶液复合骨髓间充质干细胞修复兔退变椎间盘的效果。方法：以后外侧穿刺抽吸L1/2和L3/4髓核构建日本大耳白兔椎间盘退变模型,造模后2周应用微量注射器向L3/4椎间盘内注射同种异体骨髓间充质干细胞与透明质酸钠混合溶液作为实验组,L1/2椎间盘注射透明质酸钠作为对照组。注射后2,4,8,12周时行兔椎间盘影像学及病理学检查。结果与结论：对照组椎间盘高度呈降低趋势,实验组注射后2周椎间盘高度缓慢下降,之后缓慢升高,两组在4个时间点椎间盘高度指数改变差异有显著性意义（P〈0.05）。病理结果显示实验组髓核纤维环形态得到保留,髓核纤维环边界清晰,植入的骨髓间充质干细胞产生增殖分裂,并向周围迁徙规律排列,其病理学评分明显高于对照组。12周内实验组Ⅱ型胶原含量高于对照组（P〈0.05）。说明移植于退变椎间盘内的骨髓间充质干细胞能够存活,且有增殖能力,其与透明质酸钠混合溶液联合移植可以延缓退变椎间盘进一步退变,并促进退变椎间盘修复。

Effect of injectable bone mesenchymal stem cells compounded with sodium hyaluronate in repairing disc degeneration

BACKGROUND： Sodium hyaluronate, as the matrix material of intervertebral disc tissue engineering scaffolds, can provide proteoglycan attachment points and increase deposition of proteoglycan, to make enough large porosity allowing the seed cell ingrowth. OBJECTIVE： To observe the effect of bone mesenchymal stem cells （BMSCs） mixed with sodium hyaluronate solution in repair of disc degeneration in rabbits. METHODS： The animal mode of degenerative intervertebral disc was built in rabbits by aspirating the nucleus pulposus （L1-2 and L3-4） through an posterolateral approach. Two weeks later, the mixture of BMSCs and sodium hyaluronate were injected into L3-4 discs using micro-injection syringe as study group, while sodium hyaluronate alone was injected into L1-2 as control group. At 2, 4, 8, 12 weeks after injection, the rabbit intervertebral disc was determined by plain radiography and histology. RESULTS AND CONCLUSION： The intervertebral disc height was reduced in control group, and gradually reduced in experiment group at 2 weeks after injection and then raised. There were significant differences in disc height index between two groups （P 0.05）. Pathological examination showed the structure of the inner annulus fibrosus was significantly preserved in the experiment group, and the boundary between the nucleus and annulus could be clearly visualized. The implanted BMSCs proliferated and the pathological grading scores were significantly higher than control group. Expression of type Ⅱ collagen was significantly greater in the experiment group than in control group （P 0.05）. BMSCs transplanted into intervertebral discs are shown to well survive and proliferate. The mixture of BMSCs and sodium hyaluronate could decelerate disc degeneration and repair the degenerated intervertebral discs.