WHBE兔膝骨关节炎模型的建立与PRFr的干预研究

Establishment of a WHBE rabbit knee osteoarthritis model and therapeutic effect of platelet-rich fibrin releasates

目的采用内侧副韧带和部分髌韧带切除术建立WHBE兔KOA模型并用富血小板纤维蛋白释放液(PRFr)干预,探讨WHBE兔KOA模型软骨损伤和炎症的机制以及PRFr干预疗效。方法取WHBE兔24只,随机分成3组,即对照(NC)组(n=6)、模型(KOA)组(n=12)和治疗(PRFr)组(n=6);其中KOA组和PRFr组分别于术后第7天和第14天时向两侧关节腔内注射生理盐水和PRFr 0.5 mL。造模4、8周时,各组动物进行行为学评分、X线影像学观察,并取血清进行ELISA检测IL-1β、TNF-α、MMP-13水平,4周时KOA组处理6只,8周时处理各组剩余动物,取兔双侧膝关节,进行大体评分,脱钙后行病理切片制作,然后进行HE染色、甲苯胺蓝染色和番红O固绿染色以及TGF-β、BMP3和NF-κB免疫组化表达检测。结果与NC组比,造模后WHBE兔Lequesne MG行为学评分,Mankin’s评分,Pelletier评分均显著升高(P<0.01),可见膝关节肿胀明显、关节疼痛刺激和活动受限明显,且X光显示软组织呈高密度阴影,关节积液较多,解剖观察显示关节面粗糙,病理观察显示软骨表面缺损,软骨细胞丢失或部分丢失,表明WHBE兔KOA模型成立。与KOA组比较,PRFr干预治疗后血清炎症水平(IL-1β、TNF-α、MMP-13)均显著降低(P<0.05,P<0.01),软骨表面粗糙程度低,大部分软骨细胞分布整齐;同时TGF-β、BMP3和NF-κB表达水平亦显著降低(P<0.01)。结论本研究成功建立了WHBE兔KOA模型,且PRFr可通过TGF-β/BMP和NF-κB途径改善WHBE兔KOA模型软骨损伤和炎症。

Objective To investigate the mechanism of cartilage injury and inflammation in the WHBE rabbit KOA model and the effect of platelet-rich fibrin releasates(PRFr)treatment on the KOA process,we established a WHBE rabbit KOA model by excision of medial collateral and partial patellar ligaments and administered a PRFr solution.Methods Twenty-four WHBE rabbits were randomly divided into three groups:normal control(NC)group(n=6),model(KOA)group(n=12),and cure(PRFr)group(n=6).KOA and PRFr groups were injected with 0.5 mL saline and PRFr into both joint cavities on 7 and 14 postoperative days,respectively.At 4 and 8 weeks of modeling,the knee joint grade scoring,X-ray imaging,and gross scoring were performed.Serum levels of IL-1β,TNF-α,and MMP-13 were measured by ELISA.At 4 weeks,6 animals in the KOA group were euthanized,and at 8 weeks,the remaining animals in each group were euthanized.Pathological sections were prepared after decalcification,and then HE,toluidine blue,and safranin O-fast green staining and immunohistochemical analysis of TGF-β,BMP3,and NF-κB were conducted.Results The Lequesne MG behavioral score,Mankin’s score,and Pelletier score of WHBE rabbits after the operation were significantly increased compared with the NC group(P<0.01).Pathological observations revealed surface defects of the cartilage and partial loss of chondrocytes.These result indicated that the KOA model was established successfully.In KOA rabbits,knee joint swelling,joint pain stimulation,and movement limitation were obvious.X-rays showed a high-density soft tissue shadow,indicating more joint effusion and a rough articular surface in general.After PRFr treatment,the serum levels of proinflammatory factors IL-1β,TNF-α,and MMP-13 in KOA model rabbits were significantly reversed(P<0.05,P<0.01).Additionally,the cartilage surface became smooth,and most chondrocytes were neatly distributed.Expression levels of TGF-β,BMP3,and NF-κB induced by KOA were also significantly decreased(P<0.01).Conclusions We successfully established a KOA model in WHBE rabbits,and PRFr improved the cartilage injury and inflammation of the WHBE rabbit KOA model through TGF-β/BMP and NF-κB pathways.