血管内皮细胞生长因子/骨形态发生蛋白2联合修饰骨髓间充质干细胞修复股骨头坏死

背景：将血管内皮细胞生长因子及骨形态发生蛋白二者联合修复坏死骨，有可能在保持种子细胞成骨表型的同时，又能持续高效地分泌血管内皮细胞生长因子及骨形态发生蛋白2，从而有效促进血管再生，促进组织工程化骨组织的形成和再血管化。 目的：观察血管内皮细胞生长因子165/骨形态发生蛋白2体外修饰骨髓间充质干细胞移植治疗兔股骨头缺血性坏死效果。 方法：建立兔右侧股骨头缺血性坏死模型，并以抽签法随机分为3 组：单纯髓芯减压组、髓芯减压+骨髓间充质干细胞组、髓芯减压+血管内皮细胞生长因子165/骨形态发生蛋白2转染骨髓间充质干细胞组。关节镜监视下将坏死骨清除，组织学检查成骨及血管生成情况。 结果与结论：通过关节镜观察显示各组坏死骨清除干净，有新鲜血流出。组织形态学检测发现，髓芯减压+血管内皮细胞生长因子165/骨形态发生蛋白2转染骨髓间充质干细胞组移植后不同时间点血管数量及修复区新骨面积比显著高于单纯髓芯减压组、髓芯减压+骨髓间充质干细胞组(P < 0.05)。提示血管内皮细胞生长因子165/骨形态发生蛋白2基因转染加强了骨髓间充质干细胞成骨作用，提高了新生骨的数量与质量，加快了股骨头缺血性坏死的修复。

Vascular endothelial cell growth factor combined with bone morphogenetic protein-2-modified bone marrow mesenchymal stem cells in repair of femoral head necrosis

BACKGROUND: Vascular endothelial cell growth factor (VEGF) combined with bone morphogenetic protein (BMP) was used to repair necrotic bone, which can maintain the osteogenic phenotype of seed cells, and effectively secrete VEGF and BMP-2, and effectively promote blood vessel regeneration and contribute to formation and revascularization of tissue engineered bone tissues. OBJECTIVE: To observe the therapeutic effect on the treatment of avascular necrosis of the femoral head by using bone marrow mesenchymal stem cells (BMSCs) modified by VEGF-165 and BMP-2 in vitro. METHODS: The model of avascular necrosis of rabbit femoral head on right leg. There were single core decompression group, core decompression and BMSCs group, decompression with VEGF-165/BMP-2/BMSCs group. Necrotic bone was cleared out on arthroscope. Osteogenesis and angiogenesis were inspected by histology. RESULTS AND CONCLUSION: Arthroscope observation demonstrated that necrotic bone was cleared out in each group, and fresh blood was flowed out. Histomorphology determination showed that blood vessel number and new bone area in the repair region were significantly greater at various time points following transplantation in the decompression with VEGF-165/BMP-2/BMSCs group compared with single core decompression group and core decompression and BMSCs group (P < 0.05). These suggested that VEGF-165/BMP-2 gene transfection strengthened osteogenic effects of BMSCs, elevated number and quality of new bones and accelerated the repair of avascular necrosis of the femoral head.