Suppr超能文献

重组人骨形态发生蛋白-2 对硬脑膜替代物置换硬脑膜后生长犬颅骨大缺损骨再生的影响。

Effect of recombinant human bone morphogenetic protein-2 on bone regeneration in large defects of the growing canine skull after dura mater replacement with a dura mater substitute.

机构信息

International Craniofacial Institute, Cleft Lip and Palate Treatment Center, Medical City Dallas, Dallas, Texas, USA.

出版信息

J Neurosurg. 2010 Feb;112(2):319-28. doi: 10.3171/2009.1.JNS08976.

Abstract

OBJECT

This study was designed to evaluate the bone regeneration potential of the dura mater and dura mater substitute (Durepair) in the presence of recombinant human bone morphogenetic protein-2 (rhBMP-2) delivered in a collagen sponge-collagen-ceramic matrix (CCM; MasterGraft Matrix) in a large skull defect in growing canines.

METHODS

Forty immature male beagles were used to create two 2.5 x 4-cm cranial defects on each side of the sagittal suture. The dura mater on the left side was cut to make a 1 x 3-cm defect and replaced with bovine skin collagen (Durepair). The dura mater on the right side remained intact. Different doses of rhBMP-2 (none [8 animals], 0.11 mg/ml [4 animals], 0.21 mg/ml [4 animals], and 0.43 mg/ml [8 animals]) were infused on 2 Type I bovine absorbable collagen sponge (ACS) strips. The strips were layered with the CCM (15% hydroxyapatite [HA]/85% tricalcium phosphate [TCP]) to reconstruct both cranial defects. In a fifth group (8 animals), 0.43 mg/ml rhBMP-2 was directly infused into the CCM. Demineralized canine cancellous freeze-dried demineralized bone matrix (DBM; 8 animals) was used as a control in a sixth group. All materials were fixed under 2 resorbable protective sheets (MacroPore). Skulls were resected 16 weeks after operation. Histological and histomorphometric analyses on the percentage of the defect spanned by bone, and the percentage of residual HA-TCP granules and collagen were analyzed.

RESULTS

Calcified seroma was the only complication observed and only occurred in the 0.43-mg/ml rhBMP-2 groups (Groups 4 and 5). Dura mater repair appeared complete at 4 months in all animals. New bone was formed sporadically throughout the skull defect in the ACS+CCM and DBM groups without rhBMP-2. In all rhBMP-2 groups, mature new bone (compact and trabecular) was uniformly formed across the defect on both the repaired and intact dura mater sides. There was significant new compact bone formation on top of the repaired dura mater, which did not appear in the ACS+CCM and DBM groups lacking rhBMP-2. Greater HA-TCP and collagen scaffold resorption was noted in rhBMP-2 groups compared with non-rhBMP-2 groups. Statistical analysis showed there was a significantly lower percentage of bone spanning the defect in the ACS+CCM group compared with groups with rhBMP-2, with more residual HA-TCP and collagen on the repaired dura mater side than the intact dura mater side (p < 0.05). In all rhBMP-2 groups, there were no significant differences in new bone formation between the repaired and intact dura mater sides (p > 0.05).

CONCLUSIONS

The ACS+CCM combination had an effect similar to demineralized bone-on-bone regeneration in craniofacial reconstruction. The addition of rhBMP-2 to CCM directly or with ACS induces mature new bone formation in large cranial defects both in the presence of intact dura mater and repaired dura mater.

摘要

目的

本研究旨在评估在含有重组人骨形态发生蛋白-2(rhBMP-2)的胶原海绵-胶原-陶瓷基质(CCM;MasterGraft Matrix)中,硬脑膜和硬脑膜替代物(Durepair)在生长犬颅骨大缺损中的骨再生潜力。

方法

40 只未成熟雄性比格犬被用于在矢状缝两侧各创建 2.5 x 4 厘米的颅骨缺损。左侧硬脑膜被切开以形成 1 x 3 厘米的缺损并用牛皮肤胶原(Durepair)替代。右侧硬脑膜保持完整。不同剂量的 rhBMP-2(无[8 只动物]、0.11 mg/ml[4 只动物]、0.21 mg/ml[4 只动物]和 0.43 mg/ml[8 只动物])被注入 2 个 I 型牛可吸收胶原海绵(ACS)条上。将 CCM(15%羟基磷灰石[HA]/85%磷酸三钙[TCP])分层以重建两个颅骨缺损。在第五组(8 只动物)中,0.43 mg/ml rhBMP-2 直接注入 CCM。犬脱矿冻干脱矿骨基质(DBM;8 只动物)被用作第六组的对照。所有材料均在 2 个可吸收保护片(MacroPore)下固定。术后 16 周切除颅骨。对骨缺损跨越百分比、残留 HA-TCP 颗粒和胶原的百分比进行组织学和组织形态计量学分析。

结果

仅在 0.43-mg/ml rhBMP-2 组(第 4 和第 5 组)中观察到钙化性血清肿这一唯一并发症。所有动物在 4 个月时硬脑膜修复均完全。在没有 rhBMP-2 的 ACS+CCM 和 DBM 组中,颅骨缺损的整个区域均有新骨形成。在所有 rhBMP-2 组中,在修复和未修复的硬脑膜两侧的整个缺损上均形成了成熟的新骨(致密和小梁)。在修复的硬脑膜上形成了明显的新致密骨,而在缺乏 rhBMP-2 的 ACS+CCM 和 DBM 组中则没有。与非 rhBMP-2 组相比,rhBMP-2 组的 HA-TCP 和胶原支架吸收更多。统计学分析显示,ACS+CCM 组骨跨越缺损的百分比明显低于 rhBMP-2 组,修复硬脑膜侧的残留 HA-TCP 和胶原明显多于未修复硬脑膜侧(p < 0.05)。在所有 rhBMP-2 组中,修复和未修复硬脑膜侧的新骨形成无显著差异(p > 0.05)。

结论

ACS+CCM 联合应用在颅面重建中具有类似于脱矿骨对骨再生的效果。在硬脑膜完整和修复的情况下,rhBMP-2 直接或与 ACS 联合添加到 CCM 中可诱导大颅骨缺损中成熟的新骨形成。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验