van de Breevaart Bravenboer Jarno, In der Maur Caroline D, Bos P Koen, Feenstra Louw, Verhaar Jan A N, Weinans Harrie, van Osch Gerjo J V M
Erasmus Orthopaedic Research Laboratory, Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands.
Arthritis Res Ther. 2004;6(5):R469-76. doi: 10.1186/ar1216. Epub 2004 Aug 6.
The objective of the present study was to investigate whether treatment of articular cartilage with hyaluronidase and collagenase enhances histological and mechanical integration of a cartilage graft into a defect. Discs of 3 mm diameter were taken from 8-mm diameter bovine cartilage explants. Both discs and annulus were either treated for 24 hours with 0.1% hyaluronidase followed by 24 hours with 10 U/ml collagenase or left untreated (controls). Discs and annulus were reassembled and implanted subcutaneously in nude mice for 5 weeks. Integration of disc with surrounding cartilage was assessed histologically and tested biomechanically by performing a push-out test. After 5 weeks a significant increase in viable cell counts was seen in wound edges of the enzyme-treated group as compared with controls. Furthermore, matrix integration (expressed as a percentage of the total interface length that was connected; mean +/- standard error) was 83 +/- 15% in the treated samples versus 44 +/- 40% in the untreated controls. In the enzyme-treated group only, picro-Sirius Red staining revealed collagen crossing the interface perpendicular to the wound surface. Immunohistochemical analyses demonstrated that the interface tissue contained cartilage-specific collagen type II. Collagen type I was found only in a small region of fibrous tissue at the level of the superficial layer, and collagen type III was completely absent in both groups. A significant difference in interfacial strength was found using the push-out test: 1.32 +/- 0.15 MPa in the enzyme-treated group versus 0.84 +/- 0.14 MPa in the untreated controls. The study shows that enzyme treatment of cartilage wounds increases histological integration and improves biomechanical bonding strength. Enzymatic treatment may represent a promising addition to current techniques for articular cartilage repair.
本研究的目的是调查用透明质酸酶和胶原酶处理关节软骨是否能增强软骨移植物与缺损处的组织学和力学整合。从直径8毫米的牛软骨外植体中取出直径3毫米的圆盘。圆盘和环带要么先用0.1%透明质酸酶处理24小时,再用10 U/ml胶原酶处理24小时,要么不进行处理(作为对照)。将圆盘和环带重新组装后皮下植入裸鼠体内5周。通过组织学评估圆盘与周围软骨的整合情况,并通过推出试验进行生物力学测试。5周后,与对照组相比,酶处理组伤口边缘的活细胞计数显著增加。此外,处理过的样本中基质整合(以连接的总界面长度的百分比表示;平均值±标准误差)为83±15%,而未处理的对照组为44±40%。仅在酶处理组中,苦味酸天狼星红染色显示胶原垂直于伤口表面穿过界面。免疫组织化学分析表明,界面组织含有软骨特异性的II型胶原。I型胶原仅在表层水平的一小片纤维组织区域中发现,两组中均完全没有III型胶原。通过推出试验发现界面强度存在显著差异:酶处理组为1.32±0.15 MPa,未处理的对照组为0.84±0.14 MPa。该研究表明,对软骨伤口进行酶处理可增加组织学整合并提高生物力学结合强度。酶处理可能是目前关节软骨修复技术的一个有前景的补充。