Block Jon E
2210 Jackson Street, Suite 401, San Francisco, CA 94115, USA.
Med Hypotheses. 2005;65(4):740-7. doi: 10.1016/j.mehy.2005.04.026.
Autologous bone marrow serves as the richest and most readily available repository of progenitor cells capable of differentiating into mature bone forming cells. Numerous studies have demonstrated that bone marrow alone or cell suspensions of marrow usually diluted in culture medium affect de novo bone formation when implanted in soft tissue sites. Consequently, when bone marrow is used to enrich orthopaedic grafting matrices such as xenograft, demineralized bone matrix, or ceramic materials it almost invariably produces faster and more consistent defect healing compared to bone marrow or the carrier matrix alone and, in some cases, equivalent healing to autograft. This article evaluates the clinical effectiveness of these grafting materials for various orthopaedic applications such as healing long bone defects and enhancing spinal fusion procedures, and hypothesizes that enrichment with bone marrow is integral to timely and satisfactory graft incorporation. Methods such as centrifugation, culture expansion and selective cell retention that concentrate and deliver marrow-derived osteoprogenitor cells to the graft site as a means of mimicking more closely the consistent bone forming potential of autologous bone graft are also discussed.
自体骨髓是最丰富且最容易获取的祖细胞库，这些祖细胞能够分化为成熟的骨形成细胞。大量研究表明，单独的骨髓或通常在培养基中稀释的骨髓细胞悬液植入软组织部位时会影响新骨形成。因此，当骨髓用于富集骨科移植基质（如异种移植物、脱矿骨基质或陶瓷材料）时，与单独使用骨髓或载体基质相比，它几乎总是能产生更快、更一致的缺损愈合，并且在某些情况下，愈合效果等同于自体移植。本文评估了这些移植材料在各种骨科应用（如治疗长骨缺损和增强脊柱融合手术）中的临床效果，并假设用骨髓富集对于及时且满意的移植物整合至关重要。还讨论了诸如离心、培养扩增和选择性细胞保留等方法，这些方法将骨髓来源的骨祖细胞浓缩并输送到移植部位，以此更紧密地模拟自体骨移植持续的骨形成潜力。
