Albiñana-Cunningham Juan N, Ripalda-Cemboráin Purificación, Labiano Tania, Echeveste José I, Granero-Moltó Froilán, Alfonso-Olmos Matías
Orthopaedic Surgery and Traumatology Department, Clínica Universidad de Navarra, 36 Pio XII Avenue, 31008, Pamplona, Spain.
Orthopaedic Surgery and Traumatology Department, Complejo Hospitalario de Navarra, 3 Irunlarrea Street, 31008, Pamplona, Spain.
J Orthop Surg Res. 2018 Apr 5;13(1):72. doi: 10.1186/s13018-018-0781-6.
TGF-β has been described as a mediator of fibrosis and scarring. Several studies achieved reduction in experimental scarring through the inhibition of TGF-β. Fibroblasts have been defined as the cell population originating fibrosis, blocking fibroblast invasion may impair epidural fibrosis appearance. For this purpose, biocompatible materials used as mechanical barriers and a TGF-β inhibitor peptide were evaluated in the reduction of epidural fibrosis.
A L6 laminectomy was performed in 40 New Zealand white rabbits. Divided into four groups, each rabbit was assigned to receive either collagen sponge scaffold (CS group), gelatin-based gel (GCP group), P144® (iTGFβ group), or left untreated (control group). Four weeks after surgery, cell density, collagen content, and new bone formation of the scar area were determined by histomorphometry. Two experienced pathologists scored dura mater adhesion, scar density, and inflammatory infiltrate in a blinded manner.
In all groups, laminectomy site was filled with fibrous tissue and the dura mater presented adhesions. Only GCP group presented a significant reduction in collagen content and scar density.
GCP treatment reduces epidural fibrosis although did not prevent dura mater adhesion completely.
转化生长因子-β（TGF-β）已被描述为纤维化和瘢痕形成的介质。多项研究通过抑制TGF-β实现了实验性瘢痕形成的减少。成纤维细胞被定义为引发纤维化的细胞群体，阻断成纤维细胞的侵入可能会损害硬膜外纤维化的形成。为此，对用作机械屏障的生物相容性材料和一种TGF-β抑制肽在减少硬膜外纤维化方面进行了评估。
对40只新西兰白兔进行L6椎板切除术。将每只兔子分为四组，分别接受胶原海绵支架（CS组）、明胶基凝胶（GCP组）、P144®（iTGFβ组）或不进行治疗（对照组）。术后四周，通过组织形态计量学测定瘢痕区域的细胞密度、胶原含量和新骨形成。两名经验丰富的病理学家以盲法对硬脑膜粘连、瘢痕密度和炎症浸润进行评分。
所有组中，椎板切除部位均充满纤维组织，硬脑膜出现粘连。只有GCP组的胶原含量和瘢痕密度显著降低。
GCP治疗可减少硬膜外纤维化，尽管不能完全防止硬脑膜粘连。
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