自体骨髓间充质干细胞载体复合物修复骨缺损的组织学观察

背景：在骨缺损修复过程中，从修复质量、免疫排斥和疾病传播等多方面来衡量，自体骨都是最佳的选择，但来源有限且取骨区可能产生并发症，给骨缺损的修补及自体骨移植临床应用带来了很大局限。目的：以含自体骨髓间充质干细胞脱钙骨载体复合支架材料植入骨缺损的同时，向植入处微环境内添加碱性成纤维细胞生长因子等因素，从而达到增强骨修复能力，改进修复效果的目的。方法：选择3月龄新西兰大耳白兔45只，建立双侧前臂桡骨中下段骨-骨膜缺损模型，然后将实验兔等分为3组：实验组、对照组和空白组，均于左侧髂骨和股骨转子处抽取骨髓，分离培养扩增骨髓间充质干细胞后，与不同材料体外复合，植入兔桡骨干10 mm缺损处。实验组兔缺损处植入骨髓间充质干细胞、脱钙骨、藻酸钙、碱性成纤维细胞生长因子、维生素C；对照组兔缺损处植入骨髓间充质干细胞、脱钙骨、藻酸钙；空白组兔双侧缺损处均不植入任何材料，自然愈合。结果与结论：植入后30，60，90 d各组之间组织学检查新骨生成速度、生成量差异均有显著性意义。实验组兔缺损修复部位骨痂和移植物化骨及材料降解明显快于对照组和空白组；但对照组和空白组兔缺损修复部位残存物明显多于实验组。实验组兔骨缺损以多点方式直接成骨，对照组和空白组则从两端以“爬行替代”方式成骨。空白组兔自然愈合后90 d骨缺损均无愈合。说明植入体外培养移植物的同时向该植入微环境添加碱性成纤维细胞生长因子和维生素C等有利骨修复，提高骨损伤的愈合。中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程全文链接：

Autogenous bone marrow mesenchymal stem cells carrier complex for bone defect repair: a histological observation

BACKGROUND: Autogenous bone is the best choice for the repair of bone defects from the aspects of repair quality, immune rejection and disease transmission, but the limited sources and complications after bone collection bring a big limitation for bone defect repair and clinical application of autogenous bone graft.OBJECTIVE: To repair the bone defects with demineralized bone carrying autologous bone marrow mesenchymal stem cells and meanwhile to inject basic fibroblast growth factor and other factors into the micro-environment at the implant site, in order to enhance bone repair capacity and improve the repair effect.METHODS: Forty-five New Zealand white rabbits at an age of 3 months were selected to establish bone defect models (the lower segment of bilateral forearm bone-periosteum), and then, the animals were divided into three groups: experimental, control and blank groups. Bone marrow samples were extracted from the left iliac bone and femoral trochanter. Bone marrow mesenchymal stem cells were isolated, cultured and amplified followed by co-cultured with different materials in vitro, and then, the composite scaffolds were implanted to the bone defects of the radial shaft. In the experimental group, bone marrow mesenchymal stem cells, demineralized bone, calcium alginate, basic fibroblast growth factor, vitamin C were implanted; in the control group, bone marrow  mesenchymal stem cells, demineralized bone, calcium alginate were implanted; in the blank group, nothing was implanted. RESULTS AND CONCLUSION: At 30, 60, 90 days after implantation, there were significant differences in the new bone formation rate and new bone amount between different groups. The bone formation speed and material degradation speed were significantly faster in the experimental group than the control and blank groups, while the amount of remnants at the defect region was larger in the latter two groups. Multi-point bone formation was visible in the experimental group, while “creeping substitution” was found in the control and blank group. At 90 days after implantation, bone defects were not healed in the blank group undergoing natural healing. These findings indicate that co-transplantation of bone graft and basic fibroblast growth factor and vitamin C is beneficial to bone repair and improves bone defect healing.