复合珊瑚羟基磷灰石人工骨的研制及其成骨效应

目的 自行研制复合珊瑚羟基磷灰石人工骨并评估其成骨效应。方法 取南海澄黄滨珊瑚碳酸钙在特定条件下经过“热液交换反应”，制成单纯珊瑚羟基磷灰石(coralline Hydroxyapatite，CHA)人工骨，并将其与基因重组骨形态发生蛋白(rhBMP2)和几丁糖复合制成了三种复合珊瑚羟基磷灰石(composite Coralline Hydroxyapatite，CCHA)人工骨，将此三种不同配型的复合人工骨和单纯CHA人工骨分别植入四组24只SD大白鼠肌肉内。手术后2、4、6、8周取材进行组织学观察，计数高倍单位视野内的成骨细胞数量和炎性细胞数量。采用SPSS8.0统计软件处理系统分析。结果 术后各时期取材结果显示：B组(CHA rhBMP2)和D组(CHA rhBM2P 几丁糖)的单位视野内成骨细胞数量明显多于A组(单纯CHA)和C组(CHA 几丁糖)：而C组和D组的单位视野内炎性细胞数量明显少于A组和B组。即D组人工骨的单位视野内的成骨细胞数量多、炎性细胞少。结论 rhBMP2-几丁糖／CHA复合人工骨不但具有显著的成骨诱导作用，还具有炎症反应轻及持续的诱导成骨作用，是一良好的骨移植替代物。     

重组人骨形成蛋白2骨诱导中神经生长因子及其受体的表达

目的 观察重组人骨形成蛋白2（recombined human bone morphogenetic protein2，rhBMP-2）异位诱导成骨过程中神经生长因子（nerve growth factor，NGF）及其高亲和力受体（tyrosine kinasere ceptor A，TrkA）的表达，探讨NGF在BMP骨诱导中的作用。方法ICR小鼠36只，随机分为实验组和对照组，每组18只，均制备右侧股后部肌袋异位成骨模型。实验组植入含rhBMP-2胶原复合物，对照组仅植入相同体积的胶原海绵。分别于术后7、14和21d取材，行大体、组织学、免疫组织化学观察及RT-PCR检测。结果大体观察实验组术后7d，右股后部可扪及较硬肿块；术后14、21d，肿块硬度增加。对照组各时间点未发现肿块。组织学观察实验组中rhBMP-2胶原复合物具有良好的诱导成骨能力，免疫组织化学结果显示骨诱导材料植入后7d，NGF于成纤维细胞、成软骨细胞、软骨细胞、肥大软骨细胞和成骨细胞中均有阳性表达；14d，NGF阳性表达局限于部分成骨细胞、幼稚骨细胞和成骨样细胞，同时在骨髓中单核巨噬细胞、多核巨噬细胞和破骨细胞中有明显表达；21d，只有少量成骨样细胞和破骨细胞以及骨髓中多核巨噬细胞有NGF表达；TrkA免疫组织化学染色与NGF的表达基本一致。对照组术后各时间点未见成骨现象。实验组NGFmRNA的RT-PCR检测显示，术后7dNGF的mRNA表达最高，14d表达下降，21d只有微量表达。结论rhBMP-2复合物是一种有效的诱导成骨材料。在外源性BMP诱导成骨过程中有明显的NGF及其高亲和力受体TrkA的表达，NGF可以通过直接和间接的方式参与BMP的诱导成骨过程。     

Extracellular calcium and CaSR drive osteoinduction in mesenchymal stromal cells

Bone is the main store of calcium and progenitor cells in the body. During the resorption process, the local calcium concentration reaches 8–40 mM, and the surrounding cells are exposed to these fluctuations in calcium. This stimulus is a signal that is detected through the calcium sensing receptor (CaSR), which modulates chemotactic and proliferative G protein-dependent signaling pathways. The objective of the present work is to evaluate the roles of extracellular calcium ([Ca²⁺]_o) and the CaSR in osteoinduction. Rat bone marrow mesenchymal stromal cells (rBMSCs) were stimulated with 10 mM of Ca²⁺. Several experiments were conducted to demonstrate the effect of [Ca²⁺]_o on chemotaxis, proliferation and differentiation on the osteoblastic lineage. It was found that [Ca²⁺]_o induces rBMSCs to migrate and proliferate in a concentration-dependent manner. Real-time polymerase chain reaction and immunofluorescence also revealed that 10 mM Ca²⁺ stimulates overexpression of osteogenic markers in rBMSCs, including alkaline phosphatase (ALP), bone sialoprotein, collagen Ia1 and osteocalcin. Functional assays determining ALP activity and mineralization tests both corroborate the increased expression of these markers in rBMSCs stimulated with Ca²⁺. Moreover, CaSR blockage inhibited the cellular response to stimulation with high concentrations of [Ca²⁺]_o, revealing that the CaSR is a key modulator of these cellular responses.     

Combined Effects of Phosphatidylcholine and Demineralized Bone Matrix on Bone Induction

The osteoinductivity of demineralized bone matrix (DBM) becomes significantly reduced if the specimens are further delipidated with chloroform-methanol. The addition of phosphatidylcholine (PC), a major constituent of the lipid fraction present in the calcification front during normal bone formation, can restore the biological activity. Active endochondral bone formation is observed in the DBM/PC implants placed in the anterior abdominal wall musculature or subcutaneously for 28 days. When PC is added to generate a putty containing 60% PC and 40% DBM, biochemical parameters associated with osteoinductivity are significantly enhanced. Biological responses evaluated histologically and by determination of alkaline phosphatase activity are in very good agreement. The DBM/PC putty has good handling properties, can be molded into different shapes, and does not wash away from the application site. An advantage of adding PC is that it not only enhances the handling properties, but also boosts the osteoinductivity of the preparation.     

Influence of polymer molecular weight in osteoinductive composites for bone tissue regeneration

In bone tissue regeneration, certain polymer and calcium-phosphate-based composites have been reported to enhance some biological surface phenomena, facilitating osteoinduction. Although the crucial role of inorganic fillers in heterotopic bone formation by such materials has been shown, no reports have been published on the potential effects the polymer phase may have. The present work starts from the assumption that the polymer molecular weight regulates the fluid uptake, which determines the hydrolysis rate and the occurrence of biological surface processes. Here, two composites were prepared by extruding two different molecular weight l/d,l-lactide copolymers with calcium phosphate apatite. The lower molecular weight copolymer allowed larger fluid uptake in the composite thereof, which was correlated with a higher capacity to adsorb proteins in vitro. Further, the large fluid absorption led to a quicker composite degradation that generated rougher surfaces and enhanced ion release. Following intramuscular implantation in sheep, only the composite with the lower molecular weight polymer could induce heterotopic bone formation. Besides influencing the biological potential of composites, the molecular weight also regulated their viscoelastic behaviour under cyclic stresses. The results lead to the conclusion that designing biomaterials with appropriate physico-chemical characteristics is crucial for bone tissue regeneration in mechanical load-bearing sites.     

BONE-INDUCTIVE EFFICACY OF RECOMBINANT HUMAN BONE MORPHOGENETIC PROTEIN-2 EXPRESSED IN ESCHERICHIA COLI: AN EXPERIMENTAL STUDY IN RAT MANDIBULAR DEFECTS

Because to our knowledge the efficacy of prokaryotically expressed recombinant human bone morphogenetic proteins (rhBMP) to promote orthotopic osteogenesis has not previously been investigated, our aim was to test the efficacy of rhBMP-2 produced in Escherichia coli to promote bone healing in a standardised experimental bone healing model in rat mandibles. Different doses of rhBMP-2 were delivered in an absorbable collagen sponge carrier, and microporous barrier membranes were placed over half the number of defects in each treatment group, thereby making intraosseous cells the only recruitment source for new osteogenic cells. Results were evaluated by computerised image analysis after 12 and 24 days. The relative efficacy of rhBMP-2 preparations of different purity was also compared. E coli-produced rhBMP-2 stimulated bone healing, but its efficacy was estimated to be about one order of magnitude less than that of rhBMP-2 expressed in eukaryotic cells. We conclude that bacterially expressed rhBMP-2 is osteogenic in vivo, although higher doses will be required than of rhBMP-2 expressed in mammalian cell lines.     

藻酸钙凝胶复合骨形态发生蛋白、红骨髓异位诱导成骨的实验研究

目的探讨骨形态发生蛋白、自体红骨髓及藻酸钙凝胶复合物的制备方法及其诱导成骨活性。方法在大白鼠股后肌群分别注入CaAG-BMP-RBM、CaAG-BMP、CaAG,按1、2、4周三个时间点进行大体标本、组织病理学观察及AKP检测,比较各组间诱导成骨活性。结果CaAG-BMP-RBM组凝胶复合物有较多的新生软骨和骨形成,AKP活性各组比较显示CaAG-BMP-RBM组最强,且于第2周最高。结论CaAG-BMP-RBM复合物具有良好的诱导成骨能力。     

Osseous tissue engineering with gene therapy for facial bone reconstruction

OBJECTIVE: Facial osseous defects remain a major functional and esthetic challenge for the head and neck surgeon. Tissue engineering may provide advantageous alternatives to conventional therapies. The objective of the study was to evaluate the efficacy of gene therapy in the repair of osseous facial defects. STUDY DESIGN: Blinded, controlled, prospective animal experiment. METHODS: Thirty adult athymic nude rats were divided into five groups of six animals. Three groups were used as control subjects. Two groups were treated with 3.75 x 10(8) viral particles containing recombinant type 5 adenoviral vectors. One group received viruses that coded for beta-galactosidase production, another received viruses that coded for bone morphogenetic protein (BMP-2) production. After 120 days rats were examined at necropsy with precise planimetry, histological analysis of new bone growth, and radio-densitometric analysis of bone thickness. RESULTS: Radio-densitometric measurements showed that BMP-2-treated nude athymic rats had significantly enhanced osseous repair compared with control subjects when evaluated by both radio-densitometry and histological examination. CONCLUSION: Gene therapy-treated, immunosuppressed rodents had an enhanced osteoinductive repair of a dorsal osseous nasal defect.     

The effect of deficiencies of manganese and copper on osteoinduction and on resorption of bone particles in rats

Summary Subcutaneous implantation of devitalized demineralized bone powders (DBP) and mineral-containing bone particles (BP) into rats raised on either a control (C), low manganese and low copper (L), or manganese-deplete (D) diet, allowed the separate evaluation of bone formation and of bone resorption, respectively. DBP failed to induce chondrogenesis or osteogenesis in D rats. Cartilage formation was delayed in the L rats compared to C rats. There was significantly less resorption of BP by L and D rats than C rats. These results show multiple cellular effects of long-term manganese (Mn) and copper (Cu) deficiencies on bone metabolism including decreased osteogenesis and a decrease in osteoclast activity.     

bBMP异位诱导成骨的Micro—CT评价

借助Micro—CT评价单纯牛骨形态发生蛋白（bovine bone morphogenetic protein,bBMP）异位诱导成骨的长期三维影像学及骨质变化。（20±2）g昆明小鼠21只,麻醉后于双侧股部肌肉中植入bBMP各2mg,分别于1、2、4、6、8、10、12周各处死3只,切取诱导分化组织,5％戊二醛固定,行Micro—CT扫描和三维重建,运用ABA专用骨骼分析软件测定组织矿含量（tissue mineral content,TMC）,组织骨密度（tissue mineral density,TUB）,骨体积分数（bone volume fraction,BVF）,结构模型指数（structure model index,SMI）,骨小梁厚度（trabecular thickness,Tb．Th）,骨小梁数量（trabecular number,Tb．N）及皮质骨骨密度（bone mineral density,BMD）等参数,运用SPSS10．0统计软件进行统计学分析。bBMP从植入2周开始逐渐形成一椭圆形骨组织块,2～4周,异位生成骨呈疏松的新生骨,4周时组织矿含量达第一个峰值,骨小梁数量最多;随着观察时间的延长（6-12周）,异位诱导生成的椭圆形骨组织内部骨小梁逐渐吸收,数量减少,12周时骨小梁数量最少;而外层骨组织逐渐塑形成为皮质骨,12周时骨矿含量值、骨小梁厚度、组织骨密度和皮质骨骨密度均达最大值。说明bBMP具有强大的异位骨诱导能力,血供不足时,骨质降解吸收;血供充足时,骨质逐渐成熟改建。