Hankemeier Stefan, van Griensven Martijn, Ezechieli Marco, Barkhausen Tanja, Austin Matthew, Jagodzinski Michael, Meller Rupert, Bosch Ulrich, Krettek Christian, Zeichen Johannes
Trauma Department, Hanover Medical School (MHH), Carl-Neuberg-Str 1, 30625, Hanover, Germany.
Arch Orthop Trauma Surg. 2007 Nov;127(9):815-21. doi: 10.1007/s00402-007-0366-z. Epub 2007 Jun 14.
The original complex structure and mechanical properties are not fully restored after ligament and tendon injuries. Due to their high proliferation rate and differentiation potential, Bone Marrow Stromal Cells (BMSC) are considered to be an ideal cell source for tissue engineering to optimize the healing process. Ideal matrices for tissue engineering of ligaments and tendons should allow for homogenous cell seeding and offer sufficient stability.
A mixture of human BMSC and liquid fibrin glue was injected into a standardized full-thickness window defect of the patellar tendon of immunodeficient rats (BMSC group). The histology of the tissue was analysed 10 and 20 days postoperatively and compared to four control groups. These groups consisted of a cohort with a mixture of human fibroblasts and fibrin glue, fibrin glue without cells, a defect group without treatment, and a group with uninjured patellar tendon tissue.
Tendon defects in the BMSC group revealed dense collagen fibres and spindle-shaped cells, which were mainly orientated along the loading axis. Histologic sections of the control groups, especially of untreated defects and of defects filled with fibrin glue only, showed irregular patterns of cell distribution, irregular formed cell nucleoli and less tissue maturation. Compared to healthy tendon tissue, higher numbers of cells and less intense matrix staining was observed in the BMSC group. No ectopic bone or cartilage formation was observed in any specimen.
Injection of human BMSC in a fibrin glue matrix appears to lead to more mature tissue formation with more regular patterns of cell distribution. Advantages of this "in-vivo" tissue engineering approach are a homogenous cell-matrix mixture in a well-known and approved biological matrix, and simple, minimally-invasive application by injection.
韧带和肌腱损伤后，其原有的复杂结构和力学性能无法完全恢复。由于骨髓间充质干细胞（BMSC）具有较高的增殖率和分化潜能，被认为是组织工程中优化愈合过程的理想细胞来源。用于韧带和肌腱组织工程的理想基质应允许细胞均匀接种并提供足够的稳定性。
将人BMSC与液体纤维蛋白胶的混合物注入免疫缺陷大鼠髌腱的标准化全层窗口缺损处（BMSC组）。术后10天和20天对组织进行组织学分析，并与四个对照组进行比较。这些组包括一组人成纤维细胞与纤维蛋白胶的混合物、无细胞的纤维蛋白胶、未治疗的缺损组以及未受伤髌腱组织组。
BMSC组的肌腱缺损显示出密集的胶原纤维和纺锤形细胞，主要沿负荷轴排列。对照组的组织学切片，尤其是未治疗的缺损和仅填充纤维蛋白胶的缺损，显示细胞分布不规则、细胞核仁形态不规则且组织成熟度较低。与健康肌腱组织相比，BMSC组观察到更多的细胞和较弱的基质染色。在任何标本中均未观察到异位骨或软骨形成。
在纤维蛋白胶基质中注射人BMSC似乎能导致更成熟的组织形成，细胞分布模式更规则。这种“体内”组织工程方法的优点是在一种知名且已获批准的生物基质中形成均匀的细胞 - 基质混合物，并且通过注射进行简单、微创的应用。
