Sarıkaya Baran, Yumuşak Nihat, Yigin Akın, Sipahioğlu Serkan, Yavuz Ünal, Altay Mehmet Akif
Department of Orthopedics and Traumatology, Harran University School of Medicine, 63100 Sanliurfa, Turkey.
Eklem Hastalik Cerrahisi. 2017 Aug;28(2):92-9. doi: 10.5606/ehc.2017.55396.
This study aims to compare the histological healing process and gene expression profile in tendon after the administration of human recombinant epidermal growth factor (hrEGF) and platelet-rich plasma (PRP).
A total of 24 mature New Zealand white rabbits (6-month-old; weight 2.5-3.0 kg) were used in the study. Patellar tendons of rabbits were tenotomized and then repaired. Rabbits were separated into three groups and repair areas were injected with 1 mL hrEGF in group 1 (n=9) and 1 mL PRP in group 2 (n=9). No injection was performed in group 3 (controls, n=6). Tissue samples were obtained from the repaired patellar tendons of three rabbits each from groups 1 and 2 and of two rabbits from group 3 at the end of the first, second, and fourth weeks, and these tissues were histologically and genetically assessed. Expression levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-8, and chemokine receptors (CXCR1, CXCR2) were examined.
The frequency of neovascularization was detected to be higher in group 1 compared to group 3 at the end of the second and fourth weeks (p=0.018 and p=0.009, respectively). Group 1 was detected to show more increase in terms of the prevalence of tenocytes (p=0.014 and p=0.009, respectively) at the end of the second week, and in terms of collagen intensity at the end of the fourth week (p=0.0018 and p=0.034, respectively) compared to groups 2 and 3. Highest levels of TNF-α, IL-6, and IL-8 were detected in group 1, followed by groups 2 and 3 at all time points. Highest CXCR2 gene expression was detected in group 1.
Compared to PRP, hrEGF caused more increase in healing tissue at neovascularization, tenocyte, fibroblast, collagen, and tissue macrophage levels; and higher levels of TNF-α, IL-6, IL8, and CXCR2. Intralesional hrEGF administration can effectively accelerate tendon healing.
本研究旨在比较人重组表皮生长因子（hrEGF）和富血小板血浆（PRP）给药后肌腱的组织学愈合过程和基因表达谱。
本研究共使用24只成年新西兰白兔（6个月大；体重2.5 - 3.0千克）。将兔的髌腱切断后进行修复。将兔分为三组，第1组（n = 9）在修复部位注射1 mL hrEGF，第2组（n = 9）注射1 mL PRP。第3组（对照组，n = 6）不进行注射。在第1、2和4周结束时，从第1组和第2组各取3只兔以及第3组取2只兔的修复髌腱获取组织样本，并对这些组织进行组织学和遗传学评估。检测肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、IL-8和趋化因子受体（CXCR1、CXCR2）的表达水平。
在第2周和第4周结束时，检测到第1组的新生血管形成频率高于第3组（分别为p = 0.018和p = 0.009）。与第2组和第3组相比，在第2周结束时，第1组的腱细胞患病率增加更多（分别为p = 0.014和p = 0.009），在第4周结束时，胶原强度增加更多（分别为p = 0.0018和p = 0.034）。在所有时间点，第1组检测到的TNF-α、IL-6和IL-8水平最高，其次是第2组和第3组。第1组检测到的CXCR2基因表达最高。
与PRP相比，hrEGF在新生血管形成、腱细胞、成纤维细胞、胶原和组织巨噬细胞水平上使愈合组织增加更多；并且TNF-α、IL-6、IL-8和CXCR2水平更高。病灶内注射hrEGF可有效加速肌腱愈合。
