Kwon Soon-Yong, Chung Jin-Wha, Park Hee-Jung, Jiang Yuan-Yuan, Park Jung-Keug, Seo Young-Kwon
Department of Orthopaedic Surgery, St. Mary's Hospital, Seoul, Korea.
Proc Inst Mech Eng H. 2014 Apr;228(4):388-96. doi: 10.1177/0954411914528890. Epub 2014 Apr 4.
In this study, silk thread (Bombyx mori) was braided to a tube-like shape and sericin was removed from the silk tube. Thereafter, collagen/chondroitin-6-sulfate solution was poured into the silk tube, and the lyophilization process was performed. To assess the inflammatory response in vivo, raw silk and sericin-free silk tubes were implanted in the subcutaneous layer of mice. After 10 days of in vivo implantation, mild inflammatory responses were observed around the sericin-free silk tubes, and severe inflammation with the presence of neutrophils and macrophages was observed around the raw silk tubes. At 24 weeks post implantation, the regenerated tendon had a thick, cylindrical, grayish fibrous structure and a shiny white appearance, similar to that of the native tendon in the rabbit model of tendon defect. The average tensile strength of the native tendons was 220 ± 20 N, whereas the average tensile strength of the regenerated tendons was 167 ± 30 N and the diameter of the regenerated tendon (3 ± 0.2 mm) was similar to that of the native tendons (4 ± 0.3 mm). Histologically, the regenerated tendon resembled the native tendon, and all the regenerated tissues showed organized bundles of crimped fibers. Masson trichrome staining was performed for detecting collagen synthesis, and it showed that the artificial tendon was replaced by new collagen fibers and extracellular matrix. However, the regenerated tendon showed fibrosis to a certain degree. In conclusion, the artificial tendon, comprising a braided silk tube and lyophilized collagen sponge, was optimal for tendon reconstruction. Thus, this study showed an improved regeneration of neo-tendon tissues, which have the structure and tensile strength of the native tendon, with the use of the combination of collagen and silk scaffold.
在本研究中，将丝线（家蚕）编织成管状，并从丝管中去除丝胶蛋白。此后，将胶原蛋白/硫酸软骨素-6-溶液倒入丝管中，并进行冻干处理。为了评估体内的炎症反应，将生丝和无丝胶蛋白的丝管植入小鼠皮下层。体内植入10天后，在无丝胶蛋白的丝管周围观察到轻度炎症反应，而生丝管周围观察到伴有中性粒细胞和巨噬细胞的严重炎症。植入后24周，再生肌腱具有厚的、圆柱形的、灰白色纤维结构和闪亮的白色外观，类似于兔肌腱缺损模型中的天然肌腱。天然肌腱的平均抗张强度为220±20N，而再生肌腱的平均抗张强度为167±30N，再生肌腱的直径（3±0.2mm）与天然肌腱的直径（4±0.3mm）相似。组织学上，再生肌腱类似于天然肌腱，所有再生组织均显示有组织的卷曲纤维束。进行了Masson三色染色以检测胶原蛋白合成，结果表明人工肌腱被新的胶原纤维和细胞外基质所取代。然而，再生肌腱显示出一定程度的纤维化。总之，由编织丝管和冻干胶原海绵组成的人工肌腱最适合肌腱重建。因此，本研究表明，通过使用胶原蛋白和丝支架的组合，新肌腱组织的再生得到改善，其具有天然肌腱的结构和抗张强度。
