Fraitzl C R, Leunig M, Demhartner T J, Sckell A, Ganz R, Hofstetter W
Department of Orthopaedic Surgery, University of Bern, Switzerland.
Clin Orthop Relat Res. 2001 Jan(382):267-76.
Allogeneic bone from bone banks frequently is used when large skeletal defects have to be bridged in orthopaedic surgery. Beside immunologic rejection of the graft, the loss in osteogenic potential caused by bone banking procedures may be a major reason for limited clinical success. Similar problems as described for bone have occurred with cartilage and osteochondral transplants. Improving the properties of allogenic bone so that its biologic activity becomes comparable to autologous bone could be substantially beneficial for the outcome of allograft transplantation. To dissect the steps involved in the integration of a fetal osteochondral graft as it matures to bone, the current study compared the development and biologic function of metatarsals from 18-day-old fetal mice freshly transplanted in three different immunologic settings. Morphologic assessment of (1) isografts and (2) allografts in nonsensitized hosts 12 days after transplantation revealed that the grafts bear an intrinsic potential to develop after transplantation. In allografts in nonsensitized hosts, however, a slight alteration in biologic activity as compared with isografts could be detected already in this early phase after transplantation by in situ hybridization for messenger ribonucleic acids encoding extracellular matrix proteins. (3) In contrast to isografts and allografts in nonsensitized hosts, morphologic features and biologic function of allografts transplanted to presensitized hosts were altered severely.
当骨科手术中需要修复大的骨骼缺损时,骨库的异体骨经常被使用。除了移植物的免疫排斥反应外,骨库处理过程导致的成骨潜能丧失可能是临床成功率有限的主要原因。软骨和骨软骨移植也出现了与骨移植类似的问题。改善异体骨的特性,使其生物活性与自体骨相当,可能会显著有利于同种异体移植的结果。为了剖析胎儿骨软骨移植物成熟为骨的整合过程中的步骤,本研究比较了在三种不同免疫环境下新鲜移植的18日龄胎儿小鼠跖骨的发育和生物学功能。移植后12天对(1)同基因移植物和(2)非致敏宿主中的同种异体移植物进行形态学评估,结果显示移植物在移植后具有内在的发育潜能。然而,在非致敏宿主的同种异体移植物中,通过对编码细胞外基质蛋白的信使核糖核酸进行原位杂交,在移植后的这个早期阶段,就可以检测到与同基因移植物相比生物活性有轻微改变。(3)与非致敏宿主中的同基因移植物和同种异体移植物相比,移植到预先致敏宿主中的同种异体移植物的形态特征和生物学功能发生了严重改变。