Joo Min Wook, Chung Seung Jae, Shin Seung Han, Chung Yang-Guk
Department of Orthopedic Surgery, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Cells Tissues Organs. 2017;203(6):327-338. doi: 10.1159/000454915. Epub 2017 Jan 25.
To develop a clinically effective bone regeneration strategy, we compared bone regeneration using allogeneic cancellous bone granule scaffolds loaded with autologous bone marrow-derived mesenchymal stem cells (BM-MSC) with or without autologous platelet-rich plasma (PRP). Critical-sized segmental bone defects were made at the mid-shaft of both radiuses in 41 New Zealand White rabbits. Small-sized allogeneic cancellous bone granules (300-700 μm in diameter) loaded with BM-MSC were implanted on one side, and PRP was added. On the other side, autologous BM-MSC loaded onto allogeneic cancellous granules were grafted as a control. Bone regeneration was assessed by radiographic evaluation at 4, 8, and 16 weeks postimplantation and by micro-computed tomography (micro-CT) and histological evaluation of the retrieved specimens at 8 and 16 weeks. The experimental group did not show significantly higher bone quantity indices than the control group at any time point. Micro-CT analysis revealed that both groups had similar mean total volumes, surface areas, and other parameters at 8 and 16 weeks. Histological evaluation of 8- and 16-week specimens also showed a similar progression of new bone formation and maturation. In this experiment using a contralateral control group in the same individual, an initial single addition of PRP in allogeneic cancellous bone granules loaded with BM-MSC for critical-sized bone defects in the weight-bearing area did not induce a consequent difference in bone healing. Further research into the optimal preparation and application of PRP is necessary. Furthermore, studies involving a greater number of subjects and larger experimental animals could determine the clinical relevance of PRP treatment.
为制定一种临床有效的骨再生策略，我们比较了使用负载自体骨髓间充质干细胞（BM-MSC）的同种异体松质骨颗粒支架进行骨再生的情况，其中一组添加了自体富血小板血浆（PRP），另一组未添加。在41只新西兰白兔的双侧桡骨中段制造临界尺寸的节段性骨缺损。将负载BM-MSC的小尺寸同种异体松质骨颗粒（直径300-700μm）植入一侧，并添加PRP。另一侧，将负载自体BM-MSC的同种异体松质颗粒作为对照进行移植。在植入后4、8和16周通过影像学评估骨再生情况，并在8和16周通过微型计算机断层扫描（micro-CT）和对取出标本进行组织学评估。在任何时间点，实验组的骨量指标均未显著高于对照组。Micro-CT分析显示，两组在8周和16周时的平均总体积、表面积和其他参数相似。对8周和16周标本的组织学评估也显示出新骨形成和成熟的进展相似。在本实验中，在同一个体中使用对侧对照组，对于负重区域的临界尺寸骨缺损，在负载BM-MSC的同种异体松质骨颗粒中最初单次添加PRP并未导致骨愈合出现后续差异。有必要进一步研究PRP的最佳制备和应用。此外，涉及更多受试者和更大实验动物的研究可以确定PRP治疗的临床相关性。
