Lucarelli Enrico, Fini Milena, Beccheroni Amira, Giavaresi Gianluca, Di Bella Claudia, Aldini Nicolò Nicoli, Guzzardella Gaetano, Martini Lucia, Cenacchi Annarita, Di Maggio Nunzia, Sangiorgi Luca, Fornasari Pier Maria, Mercuri Mario, Giardino Roberto, Donati Davide
Regeneration and Tissue Engineering Laboratory, Istituti Ortopedici Rizzoli, via Pupilli I, 40136 Bologna, Italy.
Clin Orthop Relat Res. 2005 Jun(435):62-8. doi: 10.1097/01.blo.0000165736.87628.12.
Early vascular invasion is a key factor in bone allograft incorporation. It may reduce the complications related to slow and incomplete bone integration. Bone-marrow-derived stromal stem cells associated with platelet-rich plasma are potent angiogenic inducers proven to release vascular endothelial growth factor. Our goal was to test whether the combination of stromal stem cells and platelet-rich plasma is able to increase massive allograft integration in a large animal model with sacrifice at 4 months. A critical defect was made in the mid-diaphysis of the metatarsal bone of 10 sheep; the study group received an allograft plus stromal stem cells, platelet-rich plasma, and collagen (six animals) and the control group received only the allograft (four animals). Investigation was done with radiographs, mechanical tests and histomorphometric analysis, including new vascularization. Results showed substantial new bone formation in the allograft of the study group. Bone formation is correlated with better vascular invasion and remodeling of the graft in the study group. These results confirm the key role played by stromal stem cells and platelet-rich plasma in bone repair. Further studies are needed to better define the role stromal stem cells play when implanted alone.
早期血管侵入是同种异体骨移植融合的关键因素。它可能会减少与缓慢和不完全骨整合相关的并发症。与富含血小板血浆相关的骨髓源性基质干细胞是有效的血管生成诱导剂，已被证明能释放血管内皮生长因子。我们的目标是在一个4个月时实施安乐死的大型动物模型中，测试基质干细胞和富含血小板血浆的组合是否能够促进大块同种异体骨移植的融合。在10只绵羊的跖骨干中部制造一个关键缺损；研究组接受同种异体骨移植加基质干细胞、富含血小板血浆和胶原蛋白（6只动物），对照组仅接受同种异体骨移植（4只动物）。通过X线片、力学测试和组织形态计量分析（包括新血管形成）进行研究。结果显示研究组同种异体骨中有大量新骨形成。研究组的骨形成与移植物更好的血管侵入和重塑相关。这些结果证实了基质干细胞和富含血小板血浆在骨修复中所起的关键作用。需要进一步研究以更好地确定单独植入时基质干细胞所起的作用。
