Voss Andreas, McCarthy Mary Beth, Hoberman Alexander, Cote Mark P, Imhoff Andreas B, Mazzocca Augustus D, Beitzel Knut
Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.; Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany.
Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.
Arthroscopy. 2016 Nov;32(11):2381-2392.e1. doi: 10.1016/j.arthro.2016.04.033. Epub 2016 Jun 25.
The purpose of this study was to quantitatively assess the ability of bone marrow-derived mesenchymal stem cells (bMSC) to differentiate toward bone, fat, cartilage, and tendon lineages when grown on commercially available scaffolds compared with control and native tendon tissue.
BMSCs were cultured and analyzed by fluorescent automated cells sorting for surface markers CD73, -90, and -105. BMSCs were grown on rotator cuff tendon (RCT), decellularized human dermis patch (DDP), bilayer collagen matrix, and fibrin matrix (FM) to test their differentiation potential using quantitative polymerase chain reaction and establish markers for osteogenic, adipogenic, chondrogenic, and tenogenic lineages. Immunocytochemical testing was used to determine the specific proteins present on the scaffolds.
Alkaline phosphatase and osteocalcin gene expression was significantly higher on RCT (P < .001) and collagen scaffold (CS) (P < .001) compared with DDP and FM scaffolds (P < .001, P < .001). When differentiated toward a cartilage lineage, bMSCs grown on CS had significantly more type II collagen and aggrecan compared with DDP (P < .001, P < .001), FM (P < .001, P < .001), and RCT (P < .001, P < .001). Differentiated bMSCs grown on the CS had a significant increase in PPARγ and FABP4 gene expression compared with bMSCs grown on all other scaffolds (all P < .001). The differentiation of bMSCs into tendon on CSs had significantly more tenacin C, decorin, and type III collagen gene expression when compared with RCT, DDP, and FM (all P < .001). Decorin gene expression in the control undifferentiated CS was also significantly increased, suggesting that the matrix alone may promote a tenogenic lineage (P = .637).
Differences in the extracellular matrix composition of scaffolds significantly impact their potential to promote differentiation of bMSCs. Comparing the native RCT to the tested scaffolds showed that a high content of type I and III collagen significantly increased the potential of bMSCs to differentiate toward bone, tendon, fat, and cartilage lineages.
This in vitro study shows the differences between commercially available scaffolds for rotator cuff repairs. Therefore, these results support clinical use depending on the surgical intention and the potential of bMSCs to differentiate into bone, tendon, cartilage, and fat tissue.
本研究的目的是定量评估与对照和天然肌腱组织相比,在市售支架上培养时骨髓间充质干细胞(bMSC)向骨、脂肪、软骨和肌腱谱系分化的能力。
通过荧光自动细胞分选对骨髓间充质干细胞进行培养和分析,检测其表面标志物CD73、-90和-105。将骨髓间充质干细胞培养在肩袖肌腱(RCT)、脱细胞人真皮贴片(DDP)、双层胶原基质和纤维蛋白基质(FM)上,使用定量聚合酶链反应测试其分化潜能,并确定成骨、成脂、成软骨和成腱谱系的标志物。采用免疫细胞化学检测确定支架上存在的特定蛋白质。
与DDP和FM支架相比,RCT(P <.001)和胶原支架(CS)(P <.001)上碱性磷酸酶和骨钙素基因表达显著更高(P <.001,P <.001)。当向软骨谱系分化时,与DDP(P <.001,P <.001)、FM(P <.001,P <.001)和RCT(P <.001,P <.001)相比,在CS上培养的骨髓间充质干细胞产生的II型胶原蛋白和聚集蛋白聚糖显著更多。与在所有其他支架上培养的骨髓间充质干细胞相比,在CS上培养的分化骨髓间充质干细胞PPARγ和FABP4基因表达显著增加(所有P <.001)。与RCT、DDP和FM相比,骨髓间充质干细胞在CS上分化为肌腱时,肌腱蛋白C、核心蛋白聚糖和III型胶原蛋白基因表达显著更多(所有P <.001)。对照未分化CS中的核心蛋白聚糖基因表达也显著增加,表明单独的基质可能促进成腱谱系(P =.637)。
支架细胞外基质组成的差异显著影响其促进骨髓间充质干细胞分化的潜能。将天然RCT与测试支架进行比较表明,I型和III型胶原蛋白的高含量显著增加了骨髓间充质干细胞向骨、肌腱、脂肪和软骨谱系分化的潜能。
这项体外研究显示了用于肩袖修复的市售支架之间的差异。因此,这些结果支持根据手术意图以及骨髓间充质干细胞分化为骨、肌腱、软骨和脂肪组织的潜能进行临床应用。