关节腔内注射IGF-1修复关节软骨缺损及预防骨关节炎的实验研究

THE EXPERIMENTAL STUDY ON THE REPAIR OF ARTICULAR CARTILAGE DEFECTS AND THE PREVENTION OF OSTEOARTHRITIS BY INTRA-ARTICULAR INJECTION OF IGF-Ⅰ

目的探讨关节腔内注射胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)对修复关节软骨缺损及预防骨关节炎的作用。方法20只雄性成年新西兰大白兔随机分成A、B、C、D4组,每组5只,A、B、C三组分别在膝关节滑车处钻孔造成关节软骨全层缺损,以右膝为实验侧,术后向关节腔内注射1mg/ml的IGF-10.1ml,每周1次;左膝为对照侧,与实验组同一时间注射等量生理盐水;D组为正常对照组,不作任何处理。于术后1、4、8周分别取材进行大体观察,HE和Safranin O染色评分,同时运用免疫组织化学方法观察IGF-1及IGF-1R的表达情况。结果各组实验侧软骨缺损处组织的修复情况均优于对照侧,并且实验侧在各组软骨缺损周围的正常软骨未发生明显退变,而对照侧周围软骨在4、8周时发生了不同程度的退变,周围软骨中IGF-1的表达实验侧与正常组比较无统计学意义(p>0·05),而对照侧4、8周与正常组比较差异有显著性(p<0·01);IGF-1R的表达在各组实验侧和对照侧与正常组比较均无统计学意义(p>0·05)。结论IGF-1在关节软骨缺损早期即行关节腔内注射可有效的促进关节软骨缺损的修复,并延缓周围软骨的退变,从而预防骨关节炎(osteoarthritis,OA)的发生。

Objective To investigate the effect of insulin - like growth factor - 1 on the repair of articular cartilage defects and the prevention of osteoarthritis by intra - articular injection. Methods A total of 20 healthy matured New Zealand rabbits were divided into 4 groups randomly. The cartilage damage model was established by drilling on the knee joint trochlea zone with group A, B and C. On the right knee, 0.1 ml IGF - 1 was injected into the knee cavity every week, while on the left knee the defect was left as a control and 0.1 ml normal saline was injected in the same time. Nothing was done with the group D. The animals were killed respectively after 1,4,8 weeks, and then the macroscopic examination, hematoxylin and eosin stain, safranin o stain, IGF - 1 and IGF - 1R immunohistochemical examination were performed. Results The regeneration tissue of the experiment side was better than the control side in each group. Besides, the cataplasia didn＇t find in the normal cartilage around the defect on the experiment side, but different degrees cataplasia were found on the control side in group B and C. There wasn＇ t statistical difference （p 〉0.05） between the experiment side and the normal group with the expression of IGF- 1 in the normal cartilage around the defect, but there was a significant statistical.