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经皮注射骨水泥增强剂(rhPDGF-BB 和 β-磷酸三钙 [β-TCP]/牛 I 型胶原基质)可增加老年雌性狨猴的椎体骨密度。

Percutaneous injection of augment injectable bone graft (rhPDGF-BB and β-tricalcium phosphate [β-TCP]/bovine type I collagen matrix) increases vertebral bone mineral density in geriatric female baboons.

机构信息

BioMimetic Therapeutics, Inc., 389 Nichol Mill Lane, Franklin, TN 37067, USA.

出版信息

Spine J. 2013 May;13(5):580-6. doi: 10.1016/j.spinee.2013.02.029. Epub 2013 Mar 27.

Abstract

BACKGROUND CONTEXT

Recombinant human platelet-derived growth factor-BB (rhPDGF-BB) homodimer is a chemotactic, mitogenic, and angiogenic factor expressed by platelets. This biological triad is profoundly important in the bone regenerative cascade. Therefore, the expectation was that rhPDGF-BB locally administered to designated lumbar vertebrae in a soluble Type I bovine collagen/β-tricalcium phosphate (β-TCP) injectable paste would have an osteoanabolic effect.

PURPOSE

The study objective focused on safety and efficacy of the rhPDGF-BB and soluble Type I bovine collagen/β-TCP to increase bone density when injected directly into specific lumbar vertebral bodies in elderly (17- to 18-year-old) female baboons.

STUDY DESIGN/SETTING: The study was designed to determine whether vertebral bone mineral density (BMD) in aged female baboons could be increased by locally administering recombinant rhPDGF-BB combined in a soluble Type I bovine collagen/β-TCP paste formulation.

METHODS

A total of six baboons were divided equally into two groups. Group 1 received 1.0 mg/mL rhPDGF-BB in 20 mM sodium acetate plus soluble Type I bovine collagen/β-TCP. Group 2 was treated with 20 mM sodium acetate plus soluble Type I bovine collagen/β-TCP. Baboons in each group also received a sham surgery. Surgery was conducted using a percutaneous, fluoroscopically guided approach, and quantitative computed tomography (qCT) and radiographs were done at dedicated time periods. The qCT was used to determine volumetric BMD (vBMD). At euthanasia (36-week posttreatment), lumbar vertebrae were recovered and analyzed by qCT scans and histology. Funds were received to support this work from BioMimetic Therapeutics, Inc. The device that is the subject of this manuscript is not Food Drug Administration approved for this indication and is not commercially available in the United States.

RESULTS

The qCT and histopathological data suggested that vBMD and bone morphology increased significantly in the lumbar vertebrae treated with the rhPDGF-BB-containing composition.

CONCLUSIONS

Bone mineral density and bone morphology quality of lumbar vertebrae in aged female baboons were improved by direct injection of rhPDGF-BB in a soluble Type I bovine collagen/β-TCP paste. Throughout the course of the study, there were neither local nor systemic adverse effects.

摘要

背景

重组人血小板衍生生长因子-BB(rhPDGF-BB)同二聚体是一种由血小板表达的趋化因子、有丝分裂原和血管生成因子。这一生物三联体在骨再生级联反应中非常重要。因此,人们期望将 rhPDGF-BB 局部施用于可溶性 I 型牛胶原蛋白/β-磷酸三钙(β-TCP)可注射糊剂中指定的腰椎,以产生成骨作用。

目的

本研究的目的是研究 rhPDGF-BB 与可溶性 I 型牛胶原蛋白/β-TCP 联合使用是否能增加老年(17-18 岁)雌性狨猴特定腰椎的骨密度。

研究设计/地点:该研究旨在确定局部给予重组 rhPDGF-BB 联合可溶性 I 型牛胶原蛋白/β-TCP 糊剂是否能增加老年雌性狨猴的椎体骨密度(BMD)。

方法

共 6 只狨猴分为两组,每组 3 只。第 1 组接受 1.0mg/ml rhPDGF-BB 加 20mM 醋酸钠加可溶性 I 型牛胶原蛋白/β-TCP。第 2 组接受 20mM 醋酸钠加可溶性 I 型牛胶原蛋白/β-TCP。每组的狨猴还接受了假手术。手术采用经皮、荧光引导的方法进行,在特定时间点进行定量计算机断层扫描(qCT)和 X 光检查。qCT 用于测定体积骨密度(vBMD)。在安乐死(治疗后 36 周)时,回收腰椎进行 qCT 扫描和组织学分析。本研究工作得到了 Biomimetic Therapeutics,Inc 的资助。本文所述器械未经美国食品和药物管理局批准用于该适应证,也未在美国商业销售。

结果

qCT 和组织病理学数据表明,rhPDGF-BB 含组合物治疗的腰椎 vBMD 和骨形态明显增加。

结论

直接向可溶性 I 型牛胶原蛋白/β-TCP 糊剂中注射 rhPDGF-BB 可改善老年雌性狨猴腰椎的骨密度和骨形态质量。在整个研究过程中,既没有局部也没有全身不良反应。

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