复合骨髓间充质干细胞的生物型异种韧带移植修复损伤前交叉韧带

Biological xenogeneic ligament graft combined with bone marrow mesenchymal stem cells to repair anterior cruciate ligament injury

背景:异种韧带易于获得,具有韧带支架结构,有利于组织长入和爬行替代,经处理可完全消除抗原性,不引起免疫排斥反应,具有良好生长支架功能。目的:探索生物型异种韧带替代同种异体韧带移植重建山羊前交叉韧带损伤的可行性。方法:将24只健康山羊随机等分成A,B,C三组,取羊的左膝关节,制作成前交叉韧带断裂缺失模型,建立胫骨、股骨端骨隧道后,A,B,C组分别植入复合骨髓间充质干细胞的生物型异种韧带、生物型异种韧带和同种异体韧带。结果与结论:复合骨髓间充质干细胞的生物型异种韧带植入山羊体内后,无明显排斥反应,具有良好的组织相容性,植入韧带作为功能性支架重建前交叉韧带,在动物膝关节内环境的诱导下,使自体新生组织长入并替代支架,形成自体新生韧带,骨腱部愈合良好,但其与同种异体韧带重建前交叉韧带在组织学、免疫反应、生物力学方面差异无显著性意义,而植入复合骨髓间充质干细胞的生物型异种韧带山羊宿主自体组织可以长入并建立微循环。提示复合骨髓间充质干细胞的生物型异种韧带可加速微循环建立,促进韧带生长,尤其对韧带再血管化作用显著,但对韧带生物力学无明显影响。

BACKGROUND： Xenogeneic ligament is readily available, which has ligament scaffold structure and is conducive to tissue ingrowth and creeping substitution. After processing, the xenogeneic ligament, with the presence of good growth scaffold function, can be completely eliminated antigenicity that can cause immune rejection. OBJECTIVE： To study the feasibility of biological xenogeneic ligament graft instead of allogeneic ligament graft for reconstruction of goat anterior cruciate ligament. METHODS： Twenty-four healthy adult goats were randomly divided into A, B, C groups, and then, the left knee joints of goats were removed to establish animal models of anterior cruciate ligament injury in the three groups. After the establishment of the tibia and femoral bone tunnel, groups A, B, C were respectively transplanted with biological xenogeneic ligament graft combined with bone marrow mesenchymal stem cells, biological xenogeneic ligament graft alone, and allogenic ligament. RESULTS AND CONCLUSION： After implantation, no rejection but good biocompatibility was found in the group A, in which, the transplanted ligament as a functional scaffold for anterior cruciate ligament reconstruction, and new tissues in-grew and replaced the scaffold under intraarticular environment to form the new ligament withgood bone tendon healing. However, there were no differences in histology, immune response, biomechanical findings between groups A and C. Additionally, in the group A, the host tissues were found to grow into the scaffold and establish a micro-circulation. These findings indicate that xenogeneic ligament combined with bone marrow mesenchymal stem cells can accelerate the establishment of micro-circulation and promote the growth of ligaments, especially improve the ligament revascularization significantly, but has no influence on the biological characteristics of the ligament.