Bolt Patrick, Clerk Avnish Neil, Luu Hue H, Kang Quan, Kummer Jennifer L, Deng Zhong-Liang, Olson Kirstina, Primus Frank, Montag Anthony G, He Tong-Chuan, Haydon Rex C, Toolan Brian C
Section of Orthopaedic Surgery and Rehabilitation Medicine, Department of Surgery, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 3079, Chicago, IL 60637, USA.
J Bone Joint Surg Am. 2007 Jun;89(6):1315-20. doi: 10.2106/JBJS.F.00257.
Molecular and cellular-based enhancements of healing combined with conventional methods may yield better outcomes after the surgical management of tendon injury. We examined the histological and biomechanical effects of adenovirus-mediated transgene expression of bone morphogenetic protein-14 (BMP-14) on healing in a rat Achilles tendon laceration model. Specifically, we hypothesized that this delivery system for gene therapy would hasten the restoration of the normal histological appearance and tensile strength of a surgically repaired tendon.
The right Achilles tendon of ninety male Sprague-Dawley rats was transected, repaired, and immediately infected with adenovirus expressing either the gene for green fluorescent protein (AdGFP) or the gene for human BMP-14 and green fluorescent protein (AdBMP-14). A sham control group received no viral-mediated infection after repair. Animals from each of the three groups were killed at one, two, and three weeks after surgery. The retrieved tendons were inspected, examined under light and fluorescent microscopy, and tested to determine their tensile strength.
Tendons transduced with BMP-14 exhibited less visible gapping, a greater number of neotenocytes at the site of healing, and 70% greater tensile strength than did either those transduced with GFP or the sham controls at two weeks after repair. Histological examination revealed no inflammatory response to the adenovirus in tendons transduced with BMP-14 or GFP. No ectopic bone or cartilage formed in the tendons transduced with BMP-14.
Adenovirus-mediated gene therapy with BMP-14 expedites tendon-healing in this animal model. No adverse immunological response to the adenoviral vector was detected in the host tissue, and the local production of BMP-14 did not induce unwelcome bone or cartilage formation within the healing tendon.
The results of this animal study suggest that gene therapy with BMPs may improve the capacity of injured musculoskeletal tissue to heal.
基于分子和细胞的愈合增强技术与传统方法相结合,可能会在肌腱损伤的手术治疗后产生更好的效果。我们在大鼠跟腱撕裂模型中研究了腺病毒介导的骨形态发生蛋白-14(BMP-14)转基因表达对愈合的组织学和生物力学影响。具体而言,我们假设这种基因治疗的递送系统将加速手术修复肌腱的正常组织学外观和拉伸强度的恢复。
将90只雄性Sprague-Dawley大鼠的右跟腱切断、修复,并立即用表达绿色荧光蛋白基因(AdGFP)或人BMP-14和绿色荧光蛋白基因(AdBMP-14)的腺病毒感染。假手术对照组在修复后未接受病毒介导的感染。三组中的每组动物在手术后1周、2周和3周处死。取出的肌腱进行检查,在光镜和荧光显微镜下观察,并测试其拉伸强度。
与用GFP转导的肌腱或假手术对照组相比,用BMP-14转导的肌腱在修复后2周时可见的间隙更小,愈合部位的新生细胞数量更多,拉伸强度高70%。组织学检查显示,用BMP-14或GFP转导的肌腱对腺病毒无炎症反应。用BMP-14转导的肌腱中未形成异位骨或软骨。
在该动物模型中,腺病毒介导的BMP-14基因治疗可加速肌腱愈合。在宿主组织中未检测到对腺病毒载体的不良免疫反应,并且BMP-14的局部产生未在愈合的肌腱内诱导不希望的骨或软骨形成。
这项动物研究的结果表明,用BMPs进行基因治疗可能会提高受伤肌肉骨骼组织的愈合能力。