Vieira M H C, Oliveira R J, Eça L P M, Pereira I S O, Hermeto L C, Matuo R, Fernandes W S, Silva R A, Antoniolli A C M B
Centro de Estudos em Células-Tronco, Terapia Celular e Genética Toxicológica, Núcleo de Hospital Universitário, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil.
Instituto de Pesquisas de Células-Tronco, São Paulo, SP, Brasil.
Genet Mol Res. 2014 Dec 12;13(4):10434-49. doi: 10.4238/2014.December.12.5.
Rupture of the Achilles tendon diminishes quality of life. The gold-standard therapy is a surgical suture, but this presents complications, including wound formation and inflammation. These complications spurred evaluation of the therapeutic potential of mesenchymal stem cells (MSCs) from adipose tissue. New Zealand rabbits were divided into 6 groups (three treatments with two time points each) evaluated at either 14 or 28 days after surgery: cross section of the Achilles tendon (CSAT); CSAT + Suture; and CSAT + MSC. A comparison between all groups at both time points showed a statistically significant increase in capillaries and in the structural organization of collagen in the healed tendon in the CSAT + Suture and CSAT + MSC groups at the 14-day assessment. Comparison between the two time points within the same group showed a statistically significant decrease in the inflammatory process and an increase in the structural organization of collagen in the CSAT and CSAT + MSC groups. A study of the genomic integrity of the cells suggested a linear correlation between an increase of injuries and culture time. Thus, MSC transplantation is a good alternative for treatment of Achilles tendon ruptures because it may be conducted without surgery and tendon suture and, therefore, has no risk of adverse effects resulting from the surgical wound or inflammation caused by nonabsorbable sutures. Furthermore, this alternative treatment exhibits a better capacity for wound healing and maintaining the original tendon architecture, depending on the arrangement of the collagen fibers, and has important therapeutic potential.
跟腱断裂会降低生活质量。金标准疗法是手术缝合,但这会带来包括伤口形成和炎症在内的并发症。这些并发症促使人们评估脂肪组织间充质干细胞(MSCs)的治疗潜力。将新西兰兔分为6组(三种治疗方法,每个方法设两个时间点),在手术后14天或28天进行评估:跟腱横切面(CSAT)组;CSAT + 缝合组;以及CSAT + MSC组。在两个时间点对所有组进行比较,结果显示在14天评估时,CSAT + 缝合组和CSAT + MSC组愈合跟腱中的毛细血管数量及胶原蛋白的结构组织有统计学意义的增加。对同一组内两个时间点进行比较,结果显示CSAT组和CSAT + MSC组的炎症过程有统计学意义的减轻,胶原蛋白的结构组织有增加。对细胞基因组完整性的研究表明损伤增加与培养时间之间存在线性相关性。因此,MSC移植是治疗跟腱断裂的一个良好替代方案,因为它无需手术和肌腱缝合即可进行,因此没有手术伤口或不可吸收缝线引起的炎症所导致的不良反应风险。此外,这种替代治疗在伤口愈合和维持原始肌腱结构方面表现出更好的能力,这取决于胶原纤维的排列,并且具有重要的治疗潜力。