Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
J Tissue Eng. 2012;3(1):2041731412453577. doi: 10.1177/2041731412453577. Epub 2012 Jul 2.
Repairing tendon injuries with recombinant human platelet-derived growth factor-BB has potential for improving surgical outcomes. Augmentation of sutures, a critical component of surgical tendon repair, by coating with growth factors may provide a clinically useful therapeutic device for improving tendon repair. Therefore, the purpose of this study was to (a) coat Vicryl sutures with a defined dose of recombinant human platelet-derived growth factor-BB without additional coating excipients (e.g. gelatin), (b) quantify the recombinant human platelet-derived growth factor-BB released from the suture, and (c) use the recombinant human platelet-derived growth factor-BB-coated sutures to enhance tendon repair in a rat Achilles tendon transection model.
Vicryl sutures were coated with 0, 0.3, 1.0, and 10.0 mg/mL concentrations of recombinant human platelet-derived growth factor-BB using a dip-coating process. In vitro release was quantified by an enzyme-linked immunosorbent assay. Acutely transected rat Achilles tendons were repaired using one of the four suture groups (n = 12 per group). Four weeks following repair, the tensile biomechanical and histological (i.e. collagen organization and angiogenesis) properties were determined.
A dose-dependent bolus release of recombinant human platelet-derived growth factor-BB occurred within the first hour in vitro, followed by a gradual release over 48 h. There was a significant increase in ultimate tensile strength (p < 0.01) in the two highest recombinant human platelet-derived growth factor-BB dose groups (1.9 ± 0.5 and 2.1 ± 0.5 MPa) relative to controls (1.0 ± 0.2 MPa). The modulus significantly increased (p = 0.031) with the highest recombinant human platelet-derived growth factor-BB dose group (7.2 ± 3.8 MPa) relative to all other groups (control: 3.5 ± 0.9 MPa). No significant differences were identified for the maximum load or stiffness. The histological collagen and angiogenesis scores were comparable in all groups, although there was a trend for improved collagen organization in the recombinant human platelet-derived growth factor-BB-treated groups (p = 0.054).
The results of this study suggest that recombinant human platelet-derived growth factor-BB can be used to reproducibly coat Vicryl sutures and improve remodeling in a rat Achilles tendon transection model by significantly decreasing the resulting cross-sectional area, thus improving the material properties of the repaired tendon.
使用重组人血小板衍生生长因子 BB 修复肌腱损伤有可能改善手术效果。通过在缝线（外科肌腱修复的关键组成部分）上涂覆生长因子来增强缝线，可以为改善肌腱修复提供一种有临床应用价值的治疗设备。因此，本研究的目的是：(a)在不添加额外涂层赋形剂（如明胶）的情况下，用一定剂量的重组人血小板衍生生长因子 BB 涂覆 Vicryl 缝线；(b)定量分析从缝线中释放的重组人血小板衍生生长因子 BB；(c)使用涂覆重组人血小板衍生生长因子 BB 的缝线增强大鼠跟腱横断模型中的肌腱修复。
使用浸涂工艺，将 Vicryl 缝线用 0、0.3、1.0 和 10.0mg/ml 的重组人血小板衍生生长因子 BB 浓度进行涂层。通过酶联免疫吸附试验定量分析体外释放情况。采用急性横断大鼠跟腱，用 4 种缝线组中的一种（每组 12 只）进行修复。修复 4 周后，测定拉伸生物力学和组织学（即胶原组织和血管生成）特性。
在体外最初的 1 小时内，出现了剂量依赖性的重组人血小板衍生生长因子 BB 突释，随后在 48 小时内逐渐释放。与对照组（1.0±0.2 MPa）相比，两个最高剂量的重组人血小板衍生生长因子 BB 剂量组（1.9±0.5 和 2.1±0.5 MPa）的最终拉伸强度显著增加（p＜0.01）。与所有其他组（对照组：3.5±0.9 MPa）相比，最高重组人血小板衍生生长因子 BB 剂量组的模量显著增加（p=0.031）（7.2±3.8 MPa）。最大负荷或刚度没有显著差异。尽管在重组人血小板衍生生长因子 BB 治疗组中，胶原组织的排列有改善的趋势（p=0.054），但所有组的组织学胶原和血管生成评分均相似。
本研究结果表明，重组人血小板衍生生长因子 BB 可用于重复涂覆 Vicryl 缝线，并通过显著减小横截面积来改善大鼠跟腱横断模型中的重塑，从而改善修复肌腱的材料特性。
