碱性成纤维细胞生长因子促进冻干肌腱移植重建前交叉韧带的早期血管生成: 组织学表现(英文)

Angiogenic effect of basic fibroblast growth factor on anterior cruciate ligament reconstruction with freeze-dried tendon implants at early stage: A histological observation

背景:以往实验已证实碱性成纤维细胞生长因子在体内外均有促新生血管形成的作用。冻干法可以减低移植物的抗原性,经冻干处理后的移植物保存时间长并且运输方便,更容易商品化。冻干肌腱补充活性细胞生长因子有望加速新血管的生成。目的:拟验证碱性成纤维细胞生长因子促进冻干肌腱移植重建前交叉韧带后早期血管的生成作用。设计、时间及地点:对照观察动物实验,于2006-06/2007-06 在解放军第四军医大学西京医院骨科研究所完成。材料:选用健康成年家犬 14 只。方法:取 2 只犬,无菌手术取其双下肢伸趾长肌腱 16 条,冻干处理后供实验用。将其余12 只犬左、右侧膝关节分别移植单纯冻干肌腱和复合 100 μg/L 碱性成纤维细胞生长因子后冻干肌腱重建前交叉韧带。主要观察指标:分别于移植后 1,2,3,4,5,6 周取材,每次取 2 只。进行苏木精-伊红染色,通过图像分析仪定性观察新生血管的生成情况。结果:复合碱性成纤维细胞生长因子冻干肌腱组移植后两三周出现新生血管,四五周达到高峰;单纯冻干肌腱组移植后四五周出现新生血管。复合碱性成纤维细胞生长因子冻干肌腱组新血管长入肌腱的时间先于对照组,深度深于对照组。结论:复合 100 μg/L 碱性成纤维细胞生长因子的冻干肌腱移植重建前交叉韧带后,在新血管形成的时间及长入肌腱的深度方面均优于单纯冻干肌腱。

BACKGROUND： Based on previous studies, the combination of basic fibroblast growth factor （bFGF） with graft may accelerate the procedure of vascular invasion of anterior cruciate ligament （ACL） graft. The antigenicity of graft could be inhibited by the destruction of major histolocompatibility complex （MHC） through the treatment of allogenous tendon by freeze. The freeze-dried tendon showed advantages including prolonged storage time, availability for transport and possibility of commercial application. There is no experimental and clinical study on the graft substance of bFGF combined tendon in ACL reconstruction in animal model so far. OBJECTIVE： To observe histologically the effect of exogenous application of bFGF combined to freeze-dried tendon on angiogenic enhancement in early ACL reconstruction. DESIGN, TIME AND SETTING： Controlled animal study, which was performed in the Department of Orthopeadics, Xijing Hospital, Fourth Military Medical University of Chinese PLA between June 2006 and June 2007. MATERIALS： Fourteen dogs were used in the experiment. METHODS： Extensor digitorum longus tendon was harvested from the rest 2 dogs and treated by freeze-dry as graft for other experimental dogs. bFGF （100μg/L） was combined to freeze-dried tendon and then transplanted into one side knee to substitute the original ACL, while only freeze-dried tendon was used in the transplantation at the other side as control. MAIN OUTCOME MEASURES： Twelve of them were randomly divided into 6 groups according to the 6 time points, i.e., 1, 2, 3, 4, 5, 6 weeks after surgery （2 dogs in each group）. The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. RESULTS： Neovascularization occurred at the 2nd to 3ra weeks and reached the peak at the 4^th to 5^th weeks postoperatively at the experimental sides. By contrast, the neovascularization occurred at the 4^th to 5^th weeks postoperatively at the control sides Neovascularization in the combined group was longer and deeper than that in the control group. CONCLUSION： The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze-dried tendon are superior to those in the control group.