Bridging small-gap peripheral nerve defects using biodegradable chitin conduits with cultured schwann and bone marrow stromal cells in rats

Nerve regeneration requires not only an autologous, allogenous, or biodegradable scaffolding, but additional interactions with regeneration-promoting Schwann cells. Considering the pluripotency of bone marrow stromal cells into different lineages, the authors compared biodegradable conduits with the application of cultured Schwann cells and bone marrow stromal cells in a rat sciatic injury model. Simple conduit bridging served as controls. Electrophysiologic evaluation and histologic morphometrical analysis were performed after 6 weeks; both groups with cultured cells showed a statistically significantly higher number of axons, more well-shaped remyelinated axons, and an advance in clinical functional recovery (SFI) than the simple conduit-bridging group. Confocal microscopy found that bone marrow stromal cells adopted the Schwann-cell phenotype, expressing S100 protein. Considering the ease of aspiration and greater resource of bone marrow stromal cells, the implantation of a biodegradable conduit with cultured bone marrow stromal cells was capable of presenting an alternative to conduits with Schwann cells for bridging nerve defects.     

Repair of nerve defect with acellular nerve graft supplemented by bone marrow stromal cells in mice

The acellular nerve graft that can provide internal structure and extracellular matrix components of the nerve is an alternative for repair of peripheral nerve defects. However, results of the acellular nerve grafting for nerve repair still remain inconsistent. This study aimed to investigate if supplementing bone marrow mesenchymal stromal cells (MSCs) could improve the results of nerve repair with the acellular nerve graft in a 10-mm sciatic nerve defect model in mice. Eighteen mice were divided into three groups (n = 6 for each group) for nerve repairs with the nerve autograft, the acellular nerve graft, and the acellular nerve graft by supplemented with MSCs (5 × 10(5)) fibrin glue around the graft. The mouse static sciatic index was evaluated by walking-track testing every 2 weeks. The weight preservation of the triceps surae muscles and histomorphometric assessment of triceps surae muscles and repaired nerves were examined at week 8. The results showed that the nerve repair by the nerve autografting obtained the best functional recovery of limb. The nerve repair with the acellular nerve graft supplemented with MSCs achieved better functional recovery and higher axon number than that with the acellular nerve graft alone at week 8 postoperatively. The results indicated that supplementing MSCs might help to improve nerve regeneration and functional recovery in repair of the nerve defect with the acellular nerve graft.     

纳米支架与犬骨髓基质干细胞体外生物相容性的实验研究

目的研究具有纳米结构二嵌段共聚物左旋聚乳酸-聚己内酯（PLLA-b-PCL）与犬骨髓基质干细胞（BMSCs）的体外生物相容性，探讨其作为软骨组织工程支架的可行性。方法开环聚合制备PLLA-b—PCL，液-液相分离制备PLLA-b-PCL纳米支架，扫描电镜观察材料结构。分离培养犬BMSCs，取第3代BMSCs接种于PLLA-b—PCL膜进行复合二维培养，MTT法检测细胞毒性；通过倒置显微镜、Hoechst33342荧光法观察细胞的形态与黏附情况。另取第3代BMSCs与纳米PLLA—b-PCL支架材料（实验组）、PLLA—b—PCL支架材料（对照组）进行三维培养3周，扫描电镜观察BMSCs的形态、黏附、生长情况，Hoechst33258荧光法检测复合物中细胞DNA含量，BCA法测定蛋白质含量。结果PLLA-b-PCL无细胞毒性，BMSCs在纳米PLLA—b—PCL支架上黏附、增殖良好。随时间延长，BMSCs在支架材料上的DNA和蛋白质含量逐渐增加，DNA和蛋白质含量均明显高于对照组，差异有统计学意义（P〈0．05）。结论PLLA-b—PCL纳米支架能为BMSCs的生长分化提供较好的环境，具有良好的生物相容性，有望成为一种较好的软骨组织工程支架材料。     

Isogenic venous graft supported with bone marrow stromal cells as a natural conduit for bridging a 20 mm nerve gap

In this study, we introduce a technique for bridging large neural gaps, using an isogenic vein graft supported with isogenic bone marrow stromal cells (BMSC). In three groups a nerve defect of 20 mm was bridged with a vein graft. Our first experimental group comprized an empty venous graft, in group II the venous nerve graft was filled with saline where as in group III the venous nerve graft was filled with BMSC. The animals were tested for functional recovery up to 3 months post repair. Our results show that the BMSC filled venous graft resulted in significantly better regeneration of the nerve defect compared to controls, as confirmed by the functional recovery measured by somatosensory evoked potentials, toe spread, pin prick, and gastrocnemius muscle index. Conclusively, the results confirm that the vein graft supported with BMSC is associated with better functional nerve regeneration. © 2010 Wiley‐Liss, Inc. Microsurgery, 2010.     

Bovine bone implant with bovine bone morphogenetic protein in healing a canine ulnar defect

Xenograft is considered an alternative material for bone transplantation, but its bone healing capacity is inferior compared to that of autografts and allografts. Here, we tested whether bone morphogenetic protein (BMP) addition enhances the suitability of demineralized xenogeneic bovine bone for bone grafting in dogs, and whether xenogeneic bone is a suitable carrier material for BMPs. The capacity of demineralized bovine bone implants, with and without native partially purified bovine BMP, to heal a 2-cm ulnar defect was determined in six dogs over a follow-up time of 20 weeks. No instances of bone union were seen, but there was slightly more bone formation in the xenografts with BMP, though the difference was not statistically significant. The ulnas treated with an implant with BMP were also mechanically stronger, but the difference was not significant. Computed tomography scans showed no differences in the implant area in bone density, bone mineral content, or bone cross-sectional area. It is concluded that native, partially purified BMP does not sufficiently improve the suitability of bovine demineralized xenografts as a bone substitute material for dog. Demineralized xenogeneic bone does not seem to be a feasible carrier material for BMP.     

经诱导的骨髓基质干细胞应用于组织工程化人工神经的实验研究

目的 探讨骨髓基质干细胞应用于组织工程化人工神经修复大鼠10mm长坐骨神经缺损的效果。方法 28只体重在160～200g的雌性F344大鼠随机分成4组，每组7只。A组：种植经诱导5d后的同源骨髓基质干细胞并具有内部支架结构的中空管；B组：种植同源许旺细胞并具有内部支架结构的中空管；C组：无细胞只具有内部支架结构的中空管；D组：自体神经移植组。术后3个月，进行系列神经电生理监测、坐骨神经功能指数测定、神经组织学观察、S—100及神经微丝蛋白兔疫组化染色和轴突计数等检查。结果 术后12周内，实验组(A组)的各项检测指标均优于C组(P＜0．05或0．01)，与B和D组间差异无显著性(P＞0．05)。结论 初步结果显示经诱导的骨髓基质干细胞可作为外周神经组织工程中的种子细胞，并应用于人工神经修复外周神经缺损。     

Collagen‐containing scaffolds enhance attachment and proliferation of non‐cultured bone marrow multipotential stromal cells

Large bone defects are ideally treated with autografts, which have many limitations. Therefore, osteoconductive scaffolds loaded with autologous bone marrow (BM) aspirate are increasingly used as alternatives. The purpose of this study was to compare the growth of multipotential stromal cells (MSCs) from unprocessed BM on a collagen‐containing bovine bone scaffold (Orthoss^® Collagen) with a non‐collagen‐containing bovine bone scaffold, Orthoss^®. Another collagen‐containing synthetic scaffold, Vitoss^® was included in the comparison. Colonization of scaffolds by BM MSCs (n = 23 donors) was evaluated using microscopy, colony forming unit‐fibroblast assay and flow‐cytometry. The number of BM MSCs initially attached to Orthoss^® Collagen and Vitoss^® was similar but greater than Orthoss^® (p = 0.001 and p = 0.041, respectively). Furthermore, the number of MSCs released from Orthoss^® Collagen and Vitoss^® after 2‐week culture was also higher compared to Orthoss^® (p = 0.010 and p = 0.023, respectively). Interestingly, collagen‐containing scaffolds accommodated larger numbers of lymphocytic and myelomonocytic cells. Additionally, the proliferation of culture‐expanded MSCs on Orthoss^® collagen and Vitoss^® was greater compared to Orthoss^® (p = 0.047 and p = 0.004, respectively). Collectively, collagen‐containing scaffolds were superior in supporting the attachment and proliferation of MSCs when they were loaded with unprocessed BM aspirates. This highlights the benefit of collagen incorporation into bone scaffolds for use with autologous bone marrow aspirates as autograft substitutes. © 2015 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 34:597–606, 2016.     

Restoration of bone defect and enhancement of bone ingrowth using partially demineralized bone matrix and marrow stromal cells

PURPOSE: This study aimed to investigate the capability of combining marrow stromal cells (MSC) and partially demineralized bone matrix (PDBM) to fill bone defect and enhance bone ingrowth using a canine non-weight-bearing gap model. METHODS: Custom-made implants with 3mm gap between the porous surface and the host bone were used. The implants were inserted into the distal femurs of 25 mongrel dogs and the gaps were randomly assigned to be filled with culture-expanded autologous MSC-loaded PDBM, autograft, fresh-frozen allograft, PDBM alone, or nothing as controls. Histomorphometry using backscattered scanning electron microscopic examination, and mechanical push-out test were performed at 6 months after surgery. RESULTS: Histomorphometry showed that amounts of bone regeneration in the gap and bone ingrowth into the porous-coated surface in the MSC-loaded PDBM-treated group were comparable to those of autograft-treated group and were significantly greater than those of allograft-treated, PDBM-treated, or non-grafted groups. Mechanical test showed the same differences. CONCLUSION: The results of this study showed that combining PDBM and autologous culture-expanded MSC restored bone stock and enhanced bone ingrowth into the porous-coated area in a canine non-weight-bearing gap model. This combination may provide an option for reconstructing bone defect when we perform a cementless revision arthroplasty.     

在体种植后骨髓基质干细胞(BMSCs)的定位及成骨效应研究

目的 探讨骨髓基质干细胞(BMSCs)与支架材料复合，并种植到动物体内后的定位及成骨情况。方法 分离培养绿色荧光蛋白(GFP)小鼠BMSCs，体外扩增后与猪脱细胞骨基质材料复合，植入裸鼠背部作为实验组，并以单纯材料植入作为对照组，8周后进行大体观察、常规组织学检查及荧光检测、结果 实验组移植物周围部成骨明显，GFP阳性细胞较多；中央部材料降解吸收，GFP阳性细胞少见。对照组成骨较少。结论 BMSCs作为种子细胞参与了骨重建，同时GFP示踪是观测BMSCs的一种较好方法。     

Engineering scaffold‐free bone tissue using bone marrow stromal cell sheets

The use of exogenous scaffolds to engineer bone tissue faces several drawbacks including insufficient biological activity, potential immunogenicity, elevated inflammatory reaction, fluctuating degradation rate, and low cell‐attachment efficiency. To circumvent these limitations, we sought to engineer large scaffold‐free bone tissue using cell sheets. We harvested intact cell sheets from bone marrow stromal cells using a continuous culture method and a scraping technique. The cell sheets were then rolled and fabricated into large constructs. Finally, the constructs were implanted into the subcutaneous pockets of nude mice. The cells within the sheet maintained in vitro osteogenic potential after osteoblast differentiation. Computed tomography scans and histological examination confirmed new bone formation in vivo. Additionally, the engineered bone exhibited enhanced compressive strength. Our results indicate that the BMSC sheets can facilitate the formation of functional three‐dimensional bone tissue without the use of exogenous scaffolds. Hence, the study provides an intriguing alternative strategy for bone repair. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:697–702, 2010     

诱导骨髓基质细胞成血管平滑肌细胞的研究

目的 探讨体外诱导犬骨髓基质细胞(SMSC)为血管平滑肌细胞(VSMC)及其成血管的能力.方法 用含血小板源性生长因子(PDGF-BB)10ìg/L的内皮细胞培养液-2(EGM-2)诱导,无PDGF-BB的EGM-2培养液为对照,检测a-平滑肌肌动蛋白(a-SM actin)与肌钙结合蛋白(calponin)的表达并接种于聚羟基乙酸(PGA)培养4周后取材.结果 诱导组(n=5)细胞逐步呈平滑肌样转变,表达a-SM actin与calponin,流式细胞仪阳性率分别为(45.16±0.97)%、(37.54 4±1.15)%,可成血管样结构,对照组(n=5)变化不明显,阳性率(7.92±1.04)%、(6.37±0.83)%,成血管样结构能力差.结论 体外可诱导犬BMSC为VSMC并有成血管样结构的能力.     

Arthroplasty of the lunate using bone marrow mesenchymal stromal cells

Mesenchymal stromal cells have the potential to differentiate into a variety of mesenchymal tissues such as bone, cartilage and ligaments. The potential for the regeneration of bone with cartilage coverage has still not been achieved. We evaluated the ability of bone marrow mesenchymal stromal cells to regenerate osteochondral defects in the cavity of the lunate in an animal model. Autologous mesenchymal stromal cells were harvested from the iliac crest of New Zealand white rabbits and expanded in vitro. Total lunate excision was performed in 24 animals and the isolated cells were loaded onto scaffolds. Cell-free scaffolds were implanted in the lunate space of the right wrists of all animals, and the left lunate spaces were filled with predifferentiated, cell-loaded scaffolds. Radiographic and histological analyses were performed after two, six and 12 weeks. In addition, the animals were injected with a fluorescent agent every five days, starting at day 30. After two and six weeks there was no radiographic evidence of ossification, whereas after 12 weeks all animals showed radiographic evidence of ossification. Histological sections showed increasing evidence of cartilage-like cell formation at the edges and new bone tissue in the centre of the newly formed tissue in all groups. The histological examinations showed that bone tissue was located around the newly incorporated vascularisation. This study demonstrated that newly formed vascularisation is necessary for the regeneration of bone tissue with cell-loaded scaffolds.     

聚乳酸-聚羟基乙酸神经导管和骨髓间充质干细胞构建组织工程神经

[目的]用聚乳酸-聚羟基乙酸共聚物(poly lactide-co-glycolide acid,PLGA)为原料制备新型神经导管,同时对兔骨髓间充质干细胞与PLGA构建组织工程神经的可行性进行观察.[方法]以聚乳酸-聚羟基乙酸共聚物和壳寡糖为原料,采用静电纺丝工艺制备中空的PLGA神经导管.通过扫描电镜观察材料的微观结构,排水法测定材料的孔隙率.将兔的骨髓间充质干细胞(BMSCs)分离培养后与导管共培养,扫描电镜观察细胞在材料上的生长粘附情况,MTT方法检测细胞在材料上的增殖活性.[结果]PLGA神经导管管壁具有疏松多孔结构,管壁纤维直径为18 μm左右,孔隙率为85.4%±1.6%,MTT结果显示导管无细胞毒性.兔骨髓间充质干细胞在导管表面生长良好.[结论]PLGA神经导管具有良好的孔隙率,生物相容性好,是构建组织工程神经的良好材料.     

Bone formation following OP-1 implantation is improved by addition of autogenous bone marrow cells in a canine femur defect model.

Osteogenic Protein-1 (OP-1, BMP-7) acts locally on connective tissue progenitors (CTPs) to induce bone formation. The response to OP-1 and similar agents is potentially limited by the number of local CTPs. This study tested the hypothesis that supplementing local CTPs using autogenous bone marrow will enhance bone formation at an OP-1 implant. Four 1.0-cm diameter unicortical cylindrical defects in the left proximal femur were grafted in each of seven dogs. Radial ingrowth of new bone formation was assessed at 4 weeks using micro CT. The OP-1 (3.5 mg rhOP-1 in 1 g bovine collagen I matrix) was implanted in each site combined with either clotted blood or aspirated bone marrow (BM). Bone formation was increased in the group augmented with transplanted marrow. These data suggest that increasing the local population of cells and CTPs using aspirated bone marrow can enhance the performance of OP-1, but may not eliminate the effects of site variation on the response to OP-1 and similar agents. The canine multiple femoral defect model defined in this study is well suited to quantitatively evaluate strategies for augmenting bone repair using local cell targeting and cell transplantation strategies.     

Repair of large segmental bone defects using bone marrow stromal cells with demineralized bone matrix

Objective: The aim of the present study was to evaluate the effect of tissue‐engineered constructs on repair of large segmental bone defects in goats. Methods: Allogenic demineralized bone matrix (aDBM) was seeded with autologous marrow stromal cells (aMSC) for seven days to construct DBM–MSC grafts prior to implantation. 24 goats were randomly divided into three groups (eight in each). In each group, 3 cm diaphyseal femoral defects were created unilaterally, and subsequently filled with the DBM‐MSC grafts, DBM alone and an untreated control, respectively. Radiological analysis and biomechanical evaluation were performed at 12 and 24 weeks after operation. Results: Obvious increases in radiological scoring and biomechanical strength were found in the DBM‐MSC group when compared to the DBM group. X‐ray examination showed excellent bone healing in the DBM‐MSC group, whereas only partial bone repair was seen in the DBM group, and no healing in untreated controls. Histologically, a tendency to bone regeneration and remodeling was far more obvious for the DBM‐MSC group than the DBM only and untreated controls. Conclusion: Our results strongly suggest that transplantation of bone MSC within a DBM could have advantages for the bone repair of large segmental defects.     

自体骨髓基质干细胞复合珊瑚修复犬下颌骨节段缺损的初步研究

目的应用自体骨髓基质干细胞(bonemarrowstromalcells,BMSCs)复合珊瑚构建组织工程化骨,修复犬下颌骨节段性缺损。方法体外扩增培养、成骨诱导犬BMSCs。将第二代细胞复合珊瑚后修复犬自体右侧3cm的下颌骨节段缺损(n=6);以单纯珊瑚植入缺损处为对照(n=6),术后12、32周分别通过影像学,大体形态观察,组织学和生物力学的方法检测骨缺损的修复效果。结果成骨诱导的BMSCs在珊瑚支架上生长良好。X线片显示12周时实验组骨痂较多,对照组材料明显吸收;32周时CT、X线片和大体观察显示术后实验组骨愈合良好,对照组为骨不连;骨密度检测示实验组显著高于对照组(P<0.05);组织学示实验组有较多成熟骨呈骨性愈合,对照组为纤维性愈合;生物力学测试实验组与正常下颌骨力学强度差异无统计学意义(P>0.05)。结论自体成骨诱导BMSCs复合珊瑚形成的组织工程化骨可修复犬下颌骨节段缺损。     

Transcoronary implantation of bone marrow stromal cells ameliorates cardiac function after myocardial infarction

OBJECTIVES: Bone marrow stromal cells are capable of differentiating into cardiomyogenic cells. We tested the hypothesis that transcoronary implantation of bone marrow stromal cells may regenerate infarcted myocardium and reduce cardiac dysfunction. METHODS: Isolated bone marrow stromal cells from the isogenic donor rats were transfected with LacZ reporter gene for cell labeling. To induce cardiomyogenic differentiation, the bone marrow stromal cells were treated with 5-azacytidine before implantation. Two weeks after left coronary ligation, these cells (1 x 10(6) in 150 microL) were infused into the briefly distally occluded ascending aorta of the recipient rats (n = 15) to simulate direct coronary infusion clinically. Control animals were infused with cell-free medium (n = 14). Cardiac function was evaluated by echocardiography at preimplantation and 4 and 8 weeks postimplantation. The hearts were then immunohistochemically studied to identify phenotypic changes of implanted bone marrow stromal cells. RESULTS: Immediately after cell infusion, the bone marrow stromal cells were trapped within coronary vessels in both infarcted and noninfarcted areas. However, after 8 weeks, most of the cells were identified in the scar and periscar tissue, expressing sarcomeric myosin heavy chain and cardiomyocyte-specific protein troponin I-C. Some bone marrow stromal cells were found to be connected to the adjacent host cardiomyocytes with gap junction. Two-way repeated-measures analysis of variance revealed significant improvement in fractional shortening and end-diastolic and end-systolic diameter of the left ventricle (P =.0465,.002,.0004, respectively) in the bone marrow stromal cell group. CONCLUSIONS: Although bone marrow stromal cells had been reported to improve cardiac function when injected directly into the myocardial scar, this study demonstrated for the first time that bone marrow stromal cells can be delivered via the coronary artery, as they are capable of targeted migration and differentiation into cardiomyocytes in the scar tissue to improve cardiac function.