Samuel Shani, Ahmad Raja Elina, Ramasamy Thamil Selvee, Manan Faizal, Kamarul Tunku
Department of Physiology, Faculty of Medicine, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia; Tissue Engineering Group (TEG), National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, 50603 Lembah Pantai, Kuala Lumpur, Malaysia.
Department of Physiology, Faculty of Medicine, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia.
Injury. 2018 Apr;49(4):775-783. doi: 10.1016/j.injury.2018.02.020. Epub 2018 Feb 21.
It has been previously suggested that the use of regenerative promoters, which include bone marrow-derived mesenchymal stem cells (MSCs) or natural growth factors supplement such as platelet-rich concentrate (PRC) could promote cartilage regeneration. However, the notion that the concurrent use of both promoters may provide a synergistic effect that improves the repair outcome of focal cartilage injury has not been previously demonstrated. This study was thus conducted to determine whether the concomitant use of PRC could further enhance the reparative potential of MSCs encapsulated in alginate transplanted into focal cartilage injury in rabbits.
Artifically created full thickness cartilage defects were made on the weight-bearing region of medial femoral condyles in bilateral knees of New Zealand White rabbits (N = 30). After one month, the right knee was treated with either i) PRC (n = 10), ii) MSCs (n = 10), or, iii) a combination of PRC and MSCs (PRC + MSC) (n = 10), all encapsulated in alginate. The left knee remained untreated (control). Rabbits were sacrificed at 3 and 6 months after treatment. Cartilage tissue regeneration was accessed using ICRS morphologic scoring, histologic grading by O'Driscoll scoring, immunohistochemical staining and quantitative analysis of glycosaminoglycans (GAG) per total protein content.
At 3 months, transplantation using PRC alone was equally effective as MSCs in inducing the repair of cartilage defects. However, PRC + MSC resulted in significantly higher ICRS and O'Driscoll scores (p < 0.05) as compared to other groups. The regenerated tissues from the PRC + MSC group also had stronger staining for Safranin-O and collagen type II. By 6 months, in addition to superior ICRS and O'Driscoll scores as well as stronger staining, glycosaminoglycan per total protein content was also significantly higher (p < 0.05) in the PRC + MSC group (3.4 ± 0.3 μg/mg) as compared to the MSC (2.6 ± 0.2 μg/mg) or PRC (2.1 ± 0.2 μg/mg) groups.
PRC enhances the reparative effects of MSC in treating focal articular cartilage injuries.
此前有研究表明，使用再生促进剂，包括骨髓间充质干细胞（MSCs）或天然生长因子补充剂如富血小板浓缩液（PRC），可以促进软骨再生。然而，同时使用这两种促进剂可能会产生协同效应，从而改善局灶性软骨损伤修复效果的观点，此前尚未得到证实。因此，本研究旨在确定PRC的联合使用是否能进一步增强封装在藻酸盐中的MSCs对兔局灶性软骨损伤的修复潜力。
在新西兰白兔（N = 30）双侧膝关节内侧股骨髁的负重区域人为制造全层软骨缺损。1个月后，右膝分别接受以下治疗：i）PRC（n = 10），ii）MSCs（n = 10），或iii）PRC与MSCs的组合（PRC + MSC）（n = 10），所有均封装在藻酸盐中。左膝不进行治疗（作为对照）。在治疗后3个月和6个月处死兔子。使用国际软骨修复协会（ICRS）形态学评分、O'Driscoll评分进行组织学分级、免疫组织化学染色以及对每总蛋白含量的糖胺聚糖（GAG）进行定量分析来评估软骨组织再生情况。
在3个月时，单独使用PRC进行移植在诱导软骨缺损修复方面与MSCs同样有效。然而，与其他组相比，PRC + MSC组的ICRS和O'Driscoll评分显著更高（p < 0.05）。PRC + MSC组再生组织的番红O和II型胶原染色也更强。到6个月时，除了具有更高的ICRS和O'Driscoll评分以及更强的染色外，PRC + MSC组每总蛋白含量的糖胺聚糖也显著高于MSCs组（2.6±0.2μg/mg）或PRC组（2.1±0.2μg/mg）（3.4±0.3μg/mg）（p < 0.05）。
PRC可增强MSCs在治疗局灶性关节软骨损伤中的修复作用。
