Wang J S, Diaz J, Sabokbar A, Athanasou N, Kjellson F, Tanner K E, McCarthy I D, Lidgren L
Department of Orthopaedics, Lund University, Lund 22185, Sweden.
J R Soc Interface. 2005 Mar 22;2(2):71-8. doi: 10.1098/rsif.2004.0009.
Iodixanol (IDX) and iohexol (IHX) have been investigated as possible radiopacification agents for polymethylmethacrylate (PMMA) bone cement, to replace the currently used barium sulphate and zirconia. IDX and IHX are both water-soluble iodine-based contrast media and for the last 20 years have been used extensively in clinical diagnostic procedures such as contrast media enhanced computed tomography, angiography and urography. One of the major reasons to remove the current radiopacifying agents is their well-documented cytotoxicity and their potential to increase bone resorption. Using in vitro bone resorption assays, the effect of PMMA particles plus IDX or IHX to induce osteoclast formation and lacunar resorption on dentine slices has been investigated. These responses have been compared with the in vitro response to PMMA particles containing the conventional radiopacifying agents, that is, barium sulphate and zirconia. In parallel, the in vivo reaction, in terms of new bone formation, to particles of these materials has been tested using a bone harvest chamber in rabbit tibiae. In vitro cell culture showed that PMMA containing IHX resulted in significantly less bone resorption than PMMA containing the conventional opacifiers. In vivo testing, however, showed no significant differences between the amounts of new bone formed around cement samples containing the two iodine-based opacifying agents in particulate form, although both led to fewer inflammatory cells than particles of PMMA containing zirconia. Our results suggest that a non-ionic radiopacifier could be considered as an alternative to the conventional radiopacifying agents used in biomaterials in orthopaedic surgery.
碘克沙醇（IDX）和碘海醇（IHX）已被研究作为聚甲基丙烯酸甲酯（PMMA）骨水泥可能的造影剂，以取代目前使用的硫酸钡和氧化锆。IDX和IHX都是水溶性碘基造影剂，在过去20年中已广泛用于临床诊断程序，如造影剂增强计算机断层扫描、血管造影和尿路造影。去除当前造影剂的主要原因之一是其已被充分证明的细胞毒性及其增加骨吸收的潜力。使用体外骨吸收试验，研究了PMMA颗粒加IDX或IHX对牙本质切片上破骨细胞形成和陷窝吸收的诱导作用。这些反应已与对含有传统造影剂（即硫酸钡和氧化锆）的PMMA颗粒的体外反应进行了比较。同时，使用兔胫骨中的骨采集室测试了这些材料颗粒在新骨形成方面的体内反应。体外细胞培养表明，含IHX的PMMA导致的骨吸收明显少于含传统遮光剂的PMMA。然而，体内测试表明，含有两种颗粒状碘基遮光剂的水泥样品周围形成的新骨量之间没有显著差异，尽管两者导致的炎症细胞都比含氧化锆的PMMA颗粒少。我们的结果表明，非离子型造影剂可被视为整形外科生物材料中使用的传统造影剂的替代品。
