Shaw K Aaron, Johnson Peter C, Williams David, Zumbrun Steven D, Topolski Richard, Cameron Craig D
Department of Orthopaedic Surgery, Dwight D. Eisenhower Army Medical Center, 300 E Hospital Road, Fort Gordon, GA 30905.
Dwight D. Eisenhower Army Medical Center, 300 E Hospital Road, Fort Gordon, GA 30905.
Mil Med. 2017 Jul;182(7):e1941-e1947. doi: 10.7205/MILMED-D-16-00370.
The effects of blast exposure have gained increasing interest in the military medical community with their continued occurrence on the battlefield. The impact of the direct and indirect energy imparted from blasts to hollow viscera, as well as closed head injuries, have been well studied. However, the injury to articular cartilage has not been investigated, despite previous correlations regarding the development of osteoarthritis. The purpose of this study was to assess the degree of injury to articular chondrocytes after exposure to a simulated blast overpressure wave.
Fresh juvenile porcine stifle joints were subjected to a simulated blast overpressure wave utilizing a custom fabricated blast simulator with compressed gases, within the reported range of observed battlefield blasts. Chondrocyte viability was assessed with live/dead staining using ethidium homodimer-2 and calcien acetoxymethylester stain and confocal laser scanning microscopy, calculated as a ratio of dead chondrocytes to live chondrocytes. Testing was performed at time points of 2, 4, and 8 hours after blast exposure and was compared with unblasted control samples.
Chondrocyte viability decreased after exposure to a blast overpressure wave when compared with control samples. The amount of death was greater closer to the articular surface and dissipated with increasing tissue depth. Chondrocyte death increased with time after exposure.
Chondrocyte death is present after exposure to a simulated blast wave. There is an inverse relationship between chondrocyte viability and the depth from the articular surface. Additional studies are needed to further characterize dose and time effects of blast exposure.
随着战场上爆炸事件的持续发生,爆炸暴露的影响在军事医学界越来越受到关注。爆炸对中空脏器施加的直接和间接能量的影响,以及闭合性头部损伤,都已得到充分研究。然而,尽管先前有关于骨关节炎发展的相关性研究,但关节软骨损伤尚未得到调查。本研究的目的是评估暴露于模拟爆炸超压波后关节软骨细胞的损伤程度。
利用定制的压缩气体爆炸模拟器,在报告的战场爆炸观察范围内,对新鲜的幼年猪膝关节施加模拟爆炸超压波。使用乙锭同二聚体-2和钙黄绿素乙酰氧基甲酯染色以及共聚焦激光扫描显微镜,通过活/死染色评估软骨细胞活力,计算为死软骨细胞与活软骨细胞的比例。在爆炸暴露后2、4和8小时的时间点进行测试,并与未爆炸的对照样本进行比较。
与对照样本相比,暴露于爆炸超压波后软骨细胞活力下降。死亡数量在靠近关节表面处更大,并随着组织深度的增加而消散。暴露后软骨细胞死亡随时间增加。
暴露于模拟爆炸波后存在软骨细胞死亡。软骨细胞活力与距关节表面的深度呈反比关系。需要进一步的研究来进一步表征爆炸暴露的剂量和时间效应。