Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan.
J Cell Physiol. 2010 Nov;225(2):291-5. doi: 10.1002/jcp.22223.
Articular cartilage defects that do not repair spontaneously induce osteoarthritic changes in joints over a long period of observation. In this study, we examined the usefulness of transplanting culture-expanded bone marrow mesenchymal cells into osteochondral defects of joints with cartilage defects. First, we performed experiments on rabbits and up on obtaining good results proceeded to perform the experiments on humans. Macroscopic and histological repair with this method was good, and good clinical results were obtained although there was no significant difference with the control group. Recent reports have indicated that this procedure is comparable to autologous chondrocyte implantation, and concluded that it was a good procedure because it required one step less than that required by surgery, reduced costs for patients, and minimized donor site morbidity. Although some reports have previously shown that progenitor cells formed a tumor when implanted into immune-deficient mice after long term in vitro culture, the safety of the cell transplantation was confirmed by our clinical experience. Thus, this procedure is useful, effective, and safe, but the repaired tissues were not always hyaline cartilage. To obtain better repair with this procedure, treatment approaches using some growth factors during in vitro culture or gene transfection are being explored.
关节软骨缺损如果不能自发修复，在长时间的观察过程中会在关节中引起骨关节炎的变化。在这项研究中，我们研究了将培养扩增的骨髓间充质细胞移植到有软骨缺损的关节骨软骨缺损中的效果。首先，我们在兔子身上进行了实验，在获得良好的结果后，我们继续在人类身上进行实验。这种方法在宏观和组织学上的修复效果良好，虽然与对照组相比没有显著差异，但仍获得了良好的临床效果。最近的报告表明，该方法与自体软骨细胞移植相当，并且由于该方法比手术少一步，降低了患者的成本，最大限度地减少了供体部位的发病率，因此是一种很好的方法。尽管以前的一些报告显示，在体外长期培养后将祖细胞植入免疫缺陷小鼠时会形成肿瘤，但我们的临床经验证实了细胞移植的安全性。因此，该方法既有效又安全，但修复的组织并不总是透明软骨。为了获得更好的修复效果，正在探索在体外培养过程中使用一些生长因子或基因转染的治疗方法。
