骨不连断端及周围组织骨形态发生蛋白2与核心蛋白多糖的表达

Expression of bone morphogenetic protein-2 and decorin at the fracture ends and the surrounding tissues of bone nonunion

背景:骨形态发生蛋白2和核心蛋白多糖两种因子均具有促进成骨的活性,并有相关报道两者在促进成骨方面相互促进。目的:了解骨不连骨折区不同部位组织骨形态发生蛋白2、核心蛋白多糖的表达情况。方法:11例骨不连患者,骨折持续时间平均11个月。在手术中分类获取骨折端及其周围的组织,包括骨断端、髓腔内容物和贴骨瘢痕,采用免疫组化染色、Real-timePCR检测不同部位组织中骨形态发生蛋白2、核心蛋白多糖的表达。结果与结论:贴骨瘢痕组织骨形态发生蛋白2的表达最高,与骨断端和髓腔内容物组织比较,差异有显著性意义(P<0.05);骨断端组织核心蛋白多糖的表达最高,与髓腔内容物和贴骨瘢痕组织比较,差异有显著性意义(P<0.05)。结果可见骨不连接区组织的抗纤维化和成骨能力的低下,与骨形态发生蛋白2和核心蛋白多糖不能同时高表达有关,因此骨不连区联合注射促成骨因子骨形态发生蛋白2和核心蛋白多糖不但可以促进骨诱导能力的提高,还有可能增强陈旧瘢痕的转化,从而使骨不连的治疗效果更好。

BACKGROUND：Bone morphogenetic protein-2 and decorin have the potential to promote fracture healing,and many reports have proved that they can promote each other in promoting fracture healing.OBJECTIVE：To detect the expression of bone morphogenetic protein-2 and decorin at the fracture ends and the surrounding tissues of bone nonunion.METHODS：Eleven patients with a delayed union（eight patients） and a nonunion（fifteen patients） were included.The average duration of the delayed union or nonunion was 11 months.Sample tissues were obtained from the fracture end and its surrounding zone,including fracture ends,medullary cavity contents and the surface scar of bone.Immunohistochemical staining and real time PCR were used to detect the expression of bone morphogenetic protein-2 and decorin of these different tissues.RESULTS AND CONCLUSION：The expression of bone morphogenetic protein-2 of the surface scar tissues was higher than that of the fracture ends and medullary cavity contents,and the difference was significant（P 0.05）;the expression of decorin of the fracture ends was higher than that of the medullary cavity contents and surface scar tissues,and the difference was significant（P 0.05）.Visibly,tissues＇ lower capabilities of anti-fibrosis and osteogenesis of the nonunion district was related to the asynchronous highly expression of bone morphogenetic protein-2 and decorin.Therefore,the joint injection of bone morphogenetic protein,such as bone morphogenetic protein-2 and decorin into the bone nonunion district can not only promote bone induction capabilities,but also can enhance the conversion of obsolete scar,and make the treatment effect of nonunion be better.