纳米羟基磷灰石/胶原/聚乳酸复合物与骨髓间充质干细胞修复兔下颌骨缺损(英文)

Nano-hydroxyapatite/collagen/poly(L-lactic acid) co-cultured with bone marrow stromal cells for repair of rabbit mandibular defect

背景:为颌骨缺损患者选择适宜的骨移植材料替代自体骨是当前研究的热点。目的:观察纳米羟基磷灰石/胶原/聚乳酸与兔骨髓间充质干细胞复合物用于修复兔下颌骨缺损的能力,比较其与自体骨修复及单纯纳米羟基磷灰石/胶原/聚乳酸修复的差异。设计、时间及地点:随机对照动物实验,于2007-03/10在锦州市中心医院动物实验室完成。材料:40只新西兰兔随机分成纳米羟基磷灰石/胶原/聚乳酸复合骨髓基质干细胞填充组(简称复合组)、自体骨填充组、单纯支架材料填充组及空白对照组,每组10只。方法:在兔下颌骨体部制造大小为15mm×15mm的全厚骨缺损模型。复合组于缺损处植入骨髓基质干细胞与纳米羟基磷灰石/胶原/聚乳酸体外联合培养14d的复合物;自体骨填充组于缺损处植入自体髂骨;单纯支架材料充填组于缺损处植入纳米羟基磷灰石/胶原/聚乳酸;空白对照组不作任何植入。主要观察指标:分别于植入后1,3,6个月进行骨密度检测及组织学染色观察,根据检测结果评价骨修复效果。结果:复合组与自体骨填充组骨密度比较,差异无显著性(P>0.05),且均高于单纯支架材料充填组及空白对照组(P<0.01)。复合组和自体骨填充组材料植入后6个月时见,新生骨组织渐成熟,呈大块状,桥接缺损断端,支架材料已所剩无几。单纯支架材料充填组植入后6个月时见,植入区骨小梁增多,但仍见较多纤维组织嵌于其中,易见未降解完全的支架材料。结论:纳米羟基磷灰石/胶原/聚乳酸与骨髓间充质干细胞复合物修复下颌骨缺损效果与自体骨修复相似,均优于单纯支架材料修复。

BACKGROUND： Selection of proper bone transplantation materials to substitute autogenous bone for treatment of jaw bone defect in patients has become the focus of current researches. OBJECTIVE： To observe the ability of tissue engineered bone constructed with nano-hydroxyapatite/co!lagen/poly（L-lactic acid） （nHAC/PLA） co-cultured with bone marrow stromal cells （BMSCs） in treatment of rabbit mandibular defect, and to make a comparison with autogenous bone and simple nHAC/PLA. DESIGN, TIME AND SETTING： A randomized controlled animal experiment was performed at the Animal Laboratory of Jinzhou Central Hospital between March and October 2007. MATERIALS： A total of 40 New Zealand rabbits were randomized to 4 groups, with 10 rabbits per group： nHAC/PLA co-cultured with rabbit BMSCs （BMSCs/nHAC/PLA）, autogenous bone, nHAC/PLA, and control. METHODS： A 15 mm×15 mm full-thickness bone defect was created in rabbit mandible body. In the BMSCs/nHAC/PLA group, bone defect was repaired by nHAC/PLA co-cultured with BMSCs for 14 days in vitro; the bone defect in the autogenous bone and nHAC/PLA groups was treated by autogenous iliac bone and nHAC/PLA, respectively; while the control group received no any treatment. MAIN OUTCOME MEASURES： At 1, 3, and 6 months after surgery, bone mineral density （BMD） measurement and histological examination were performed to evaluate the repairing effects of bone defect. RESULTS： The BMSCs/nHAC/PLA group exhibited the BMD similar to the autogenous bone group （P 〉 0.05）, but it was significantly higher compared to the nHAC/PLA group and the blank control group （P 〈 0.01）. At 6 months after surgery, newly formed bone tissue grew towards large bulk and bridged defected stumps, and the scaffold materials were hardly seen in the BMSCs/nHAC/PLA and autogenous bone groups; simultaneously, the nHAC/PLA group exhibited increased trabecular bone with many fibrous tissues and incompletely degraded scaffold materials. CONCLUSION： BMSCs/nHAC/PLA scaffold exhibits the effects similar to autogenous bone, but superior to nHAC/PLA scaffold in the treatment of mandibular defects.