自体间充质干细胞构建组织工程骨修复人长骨缺损的临床观察

Autogenous mesenchymal stem cells repair long bone defects:clinical report of 30 cases

目的观察个体化组织工程骨用以修复患者长骨缺损的疗效与安全性。方法利用组织工程技术,通过抽取临床上骨源缺乏的患者少量骨髓分离出其中的人骨髓间充质干细胞(human mesenchymal stem cell,hMSCs),并在体外对其进行扩增培养并诱导分化后,与自制的同种异体脱钙骨基质相复合,构建个体化的组织工程骨并应用于临床,通过临床随访其放射学及血液学结果评价其疗效与安全性。结果30例个体化组织工程骨临床应用患者均达到随访半年以上,随访资料显示成骨速度及效果均与自体骨类似,且术后肝肾功、血沉等指标均无明显异常,最长随访达4年未发现病灶复发。结论由患者自体间充质干细胞构建的组织工程骨具有良好的生物安全性和成骨效能。

Objective To investigate the therapeutic effect and safety of the tissue-engineered bone which is constructed from the autogenous mesenehymal stem cells （MSCs） from bone marrow. Methods Totally 30 patients who suffered from long bone defect because of tumor or trauma were subjected in this study with informed consent. MSCs, isolated from every individual patient＇ s bone marrow, were cultured in vitro and induced to differentiate into osteoblasts, and finally mount to a self-made allogeneie decalcified bone matrix scaffold in order to construct tissue-engineered bone （TEB）. Then the engineered bone was transplanted into the defect. In this procedure, strict screening and detections were carried out on the target cells or tissues in different phases of the TEB construction. The efficacy and security of this approach were evaluated by radiologieal and serological assays and the outcomes of follow-up. Results All patients were followed up for over half a year and the longest was 4 years. The therapeutic effects of the TEB was similar to autologous bone treatment in bone formation rate and outcome. There was no any abnormality in hepatic/renal functions, ESR, immunoglobins during the follow-up. Conclusion The individualized tissue-engineered bone made of the patient＇ s autologous mesenehymal stem cells shows favourable biological safety and satisfactory osteogenie capability.