Abrahamsson S O
Department of Hand Surgery, Malmö General Hospital.
Scand J Plast Reconstr Surg Hand Surg Suppl. 1991;23:1-51.
I. The rabbit flexor tendon within the synovial sheath contains segments with fibrocartilage-like areas. These segments have a higher proteoglycan and a lower collagen and non-collagen protein synthesis compared to the segment with "true" tendon tissue. Cell proliferation is also lower within the proximal segment than in the intermediate and distal segments. These regional variations should be considered when interpreting experimental data. They may also be of importance for the variable healing capacity of different flexor tendon regions. II. Recombinant human insulin-like growth factor, insulin and fetal calf serum stimulate matrix synthesis and cell proliferation in a dose dependent manner in flexor tendon explants cultured for three days. rhIGF-I was more potent than insulin in stimulating cell proliferation and matrix synthesis. rhIGF-I also stimulated matrix synthesis to a higher degree than FCS. III. In long-term culture of flexor tendon explants, the addition of rhIGF-I to the culture medium stimulates matrix synthesis, but does not influence turn-over rates. The total hexosamine and collagen contents in tendons cultured in medium with rhIGF-I remain at the same level, while non-collagen protein content decreases. There are no major differences in matrix metabolism between tendons cultured in medium supplemented with FCS or with rhIGF-I only. rhIGF-I may therefore be used as a growth factor supplement in serum-free culture of tendon tissue. IV. Dehydration inhibits in vitro matrix synthesis and cell proliferation in tendon explants. These effects are counteracted by keeping the exposed tendon segments moist with physiological saline solution during preparation. The sensitivity of tendon tissue to dehydration should be considered during tendon surgery. V. Tendon explants, cultured in a diffusion chamber, survive and exhibit an intrinsic capacity for healing. In healing tendon segments incubated for three weeks, protein synthesis remains unchanged and collagen synthesis decreases, whereas the rate of cell proliferation increases as compared with native tendons. VI. Endotenon cells of the rabbit flexor tendon can restore the injured tendon surface and bridge the tendon gap. The rabbit flexor tendon is a morphologically and biochemically heterogeneous tissue with an intrinsic capability for healing. Tendon tissue is susceptible to dehydration and during exposure quickly looses its viability. The metabolic and proliferative capacity of the tendon is stimulated by growth factors and rhIGF-I may be of importance in tendon healing.
一、滑膜鞘内的兔屈肌腱含有具有纤维软骨样区域的节段。与具有“真正”肌腱组织的节段相比，这些节段的蛋白聚糖含量较高，胶原蛋白和非胶原蛋白的合成较低。近端节段内的细胞增殖也低于中间节段和远端节段。在解释实验数据时应考虑这些区域差异。它们对于不同屈肌腱区域可变的愈合能力也可能很重要。二、重组人胰岛素样生长因子、胰岛素和胎牛血清以剂量依赖性方式刺激培养三天的屈肌腱外植体中的基质合成和细胞增殖。rhIGF-I在刺激细胞增殖和基质合成方面比胰岛素更有效。rhIGF-I刺激基质合成的程度也高于胎牛血清。三、在屈肌腱外植体的长期培养中，向培养基中添加rhIGF-I可刺激基质合成，但不影响周转率。在含有rhIGF-I的培养基中培养的肌腱中的总己糖胺和胶原蛋白含量保持在同一水平，而非胶原蛋白含量降低。在仅添加胎牛血清或rhIGF-I的培养基中培养的肌腱之间，基质代谢没有重大差异。因此，rhIGF-I可作为肌腱组织无血清培养中的生长因子补充剂。四、脱水会抑制肌腱外植体的体外基质合成和细胞增殖。在制备过程中用生理盐水保持暴露的肌腱节段湿润可抵消这些影响。在肌腱手术期间应考虑肌腱组织对脱水的敏感性。五、在扩散室中培养肌腱外植体，其能够存活并展现出内在的愈合能力。在培养三周的愈合肌腱节段中，蛋白质合成保持不变，胶原蛋白合成减少，而与天然肌腱相比，细胞增殖速率增加。六、兔屈肌腱的腱内膜细胞可以修复受损的肌腱表面并桥接肌腱间隙。兔屈肌腱是一种形态和生化上异质的组织，具有内在的愈合能力。肌腱组织易受脱水影响，暴露后会迅速丧失活力。生长因子可刺激肌腱的代谢和增殖能力，rhIGF-I在肌腱愈合中可能很重要。
