脂肪来源间充质干细胞在半月板无血管区修复中的作用：兔的实验研究。

The effect of the addition of adipose-derived mesenchymal stem cells to a meniscal repair in the avascular zone: an experimental study in rabbits.

机构信息

Arthroscopic Surgery Unit, Department of Orthopedic Surgery, Hospital Ramón y Cajal, Madrid, Spain.

出版信息

Arthroscopy. 2011 Dec;27(12):1688-96. doi: 10.1016/j.arthro.2011.06.041. Epub 2011 Oct 15.

DOI:10.1016/j.arthro.2011.06.041

PMID:22001734

Abstract

PURPOSE

To determine whether adipose-derived mesenchymal stem cells (ASCs) affect the healing rate of meniscal lesions sutured in the avascular zone in rabbits.

METHODS

Four groups were used. In group A (n = 12) a short, 5-mm-long longitudinal lesion in the avascular zone of the anterior horn of the medial meniscus was created and immediately sutured. In group B (n = 8) the same short lesion was created but suture was delayed 3 weeks. In group C (n = 12) a larger, 15-mm-long lesion that spanned the whole meniscus was created and sutured immediately. In group D (n = 8) the same large lesion was sutured 3 weeks later. Both knees in each rabbit were used: 1 served as the control, and in the other, 1 × 10(5) allogeneic ASCs marked with bromodeoxyuridine were placed in the lesion immediately before suturing. The animals were killed at 12 weeks.

RESULTS

In group A (short lesion, acute repair) 6 of 12 ASC-treated menisci and 0 of 12 controls had some healing (P = .014). In group B (short lesion, delayed repair) 2 of 8 ASC-treated menisci and 1 of 8 controls had some healing (P = .5). In group C (long lesion, acute repair) 6 of 12 ASC-treated menisci and 0 of 12 controls had some healing (P = .014). In group D (long lesion, delayed repair) 4 of 8 ASC-treated menisci and 0 of 8 controls had some healing (P = .07). The addition of ASCs increased the healing rate (odds ratio, 32 [range, 3.69 to 277]; P = .002). The histologic analysis of the healed zones identified well-formed meniscal fibrocartilage with persistence of cells derived from the ASCs (immunolocated with anti-bromodeoxyuridine antibodies).

CONCLUSIONS

Adding ASCs to a repair in the avascular zone of rabbit menisci increases the chances of healing. Healing is improved in small and larger lesions. When suture is delayed, the effect is not as evident.

CLINICAL RELEVANCE

In the future, ASCs might help in meniscal repair in the avascular zone.

摘要

目的

确定脂肪间充质干细胞（ASCs）是否会影响兔半月板无血管区缝合后愈合率。

方法

使用四组动物。A 组（n = 12）中，在前内侧半月板前角无血管区创建一个 5mm 长的短纵向损伤，并立即进行缝合。B 组（n = 8）中，创建相同的短损伤，但缝合延迟 3 周。C 组（n = 12）中，创建一个跨越整个半月板的 15mm 长的大损伤，并立即进行缝合。D 组（n = 8）中，缝合相同的大损伤，但延迟 3 周。每只兔子的双膝均被使用：其中一只作为对照，另一只在缝合前立即将 1×10(5)个标记有溴脱氧尿苷的同种异体 ASCs 放置在损伤处。动物在 12 周时被处死。

结果

A 组（短损伤，急性修复）中，12 个 ASC 治疗的半月板中有 6 个和 12 个对照中有 0 个有一定程度的愈合（P =.014）。B 组（短损伤，延迟修复）中，8 个 ASC 治疗的半月板中有 2 个和 8 个对照中有 1 个有一定程度的愈合（P =.5）。C 组（长损伤，急性修复）中，12 个 ASC 治疗的半月板中有 6 个和 12 个对照中有 0 个有一定程度的愈合（P =.014）。D 组（长损伤，延迟修复）中，8 个 ASC 治疗的半月板中有 4 个和 8 个对照中有 0 个有一定程度的愈合（P =.07）。添加 ASCs 增加了愈合率（比值比，32[范围，3.69 至 277]；P =.002）。对愈合区的组织学分析发现，有形成分良好的半月板纤维软骨，并且存在来源于 ASCs 的细胞（用抗溴脱氧尿苷抗体免疫定位）。