自体骨软骨移植联合富血小板血浆对兔膝关节骨软骨缺损的修复作用及机制

Effect and Mechanism of Autologous Osteochondral Transplantation combined with Platelet-rich Plasma on the Repair of Osteochondral Defect in Rabbits Knee Joint

目的:探讨自体骨软骨移植联合富血小板血浆(PRP)修复兔膝关节骨软骨缺损的效果及其机制。方法:40只SPF级新西兰大白兔随机分为对照组、模型组、移植组、PRP组和联合组,每组8只。对照组不进行任何干预,另外4组构建关节软骨缺损模型,分别为空白模型、自体骨软骨移植模型、PRP植入模型和自体骨软骨移植联合PRP植入模型。干预8周后,使用国际软骨修复学会(ICRS)组织学分级对软骨修复情况进行评价,并运用酶联免疫吸附法检测膝关节液中谷胱甘肽(GSH)、丙二醛(MDA)、超氧化物歧化酶(SOD)和8-羟基脱氧鸟苷(8-OHdG)表达水平。结果:ICRS组织学分级显示,移植组、PRP组和联合组的骨表面、软骨矿化、基质和细胞分布评分均高于模型组(P<0.05),且联合组的软骨矿化、基质和细胞分布评分亦均高于移植组和PRP组(P<0.05)。与对照组比,模型组关节液中GSH和SOD水平明显降低,而MDA和8-OHdG明显升高(P<0.05)。移植8周后,移植组上述指标均未见明显改善(P>0.05),而PRP组和联合组各指标均明显改善(P<0.05)。PRP组关节液中GSH和SOD水平明显高于移植组,而MDA和8-OHdG水平低于移植组(P<0.05)。联合组MDA水平明显低于PRP组(P<0.05)。结论:PRP能够明显改善关节氧化应激损伤,可有效促进关节软骨修复,有助于提高自体骨软骨移植的疗效。

Objective:To investigate the effect and mechanism of autologous osteochondral transplantation combined with platelet-rich plasma(PRP)in repairing osteochondral defects in rabbits’knee joints.Methods:40 SPF grade New Zealand white rabbits were randomly divided into control group,model group,transplantation group,PRP group and combination group,with 8 rabbits in each group.The control group did not conduct any intervention,and the other 4 groups constructed models of articular cartilage defects,including the blank model,autologous osteochondrocartilage transplantation model,PRP implantation model,and autologous osteochondrocartilage transplantation combined with PRP implantation model.8 weeks after the intervention,cartilage repair was evaluated by histological grading of the international society for cartilage repair(ICRS),and the expression levels of glutathione(GSH),malondialdehyde(MDA),superoxide dismutase(SOD)and 8-hydroxydeoxyguanosine(8-oHdG)in the knee joint fluid were detected by ELISA.Results:ICRS histological grading showed that bone surface mineralization,cartilage mineralization,matrix and cell distribution scores in transplantation group,PRP group and combination group were all higher than those in the model group(P<0.05),and cartilage mineralization,matrix and cell distribution in the combination group were all higher than those in the transplantation group and PRP group(P<0.05).Compared with the control group,the levels of GSH and SOD in the joint fluid of the model group were significantly reduced,while MDA and 8-oHdG were significantly increased(P<0.05).After 8 weeks of transplantation,none of the above indicators were significantly improved in the transplantation group(P>0.05),while all the indicators were significantly improved in the PRP group and the combination group(P<0.05).The levels of GSH and SOD in joint fluid in PRP group were significantly higher than those in the transplantation group,while MDA and 8-oHdG levels were lower than those in the transplantation group(P<0.05).MDA level in the combin ation group was significantly lower than that in the PRP group(P<0.05).Conclusion:PRP can significantly improve the oxidative stress injury of joints,effectively promote the repair of articular cartilage,and improve the effect of autologous osteochondral transplantation.