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自体软骨微移植用于软骨修复的理论依据和临床前证据。

Rationale and pre-clinical evidences for the use of autologous cartilage micrografts in cartilage repair.

作者信息

Viganò Marco, Tessaro Irene, Trovato Letizia, Colombini Alessandra, Scala Marco, Magi Alberto, Toto Andrea, Peretti Giuseppe, de Girolamo Laura

机构信息

IRCCS Istituto Ortopedico Galeazzi, via Riccardo Galeazzi 4, 20161, Milan, Italy.

Human Brain Wave, corso Galileo Ferraris 63, 10128, Turin, Italy.

出版信息

J Orthop Surg Res. 2018 Nov 6;13(1):279. doi: 10.1186/s13018-018-0983-y.

Abstract

BACKGROUND

The management of cartilage lesions is an open issue in clinical practice, and regenerative medicine represents a promising approach, including the use of autologous micrografts whose efficacy was already tested in different clinical settings. The aim of this study was to characterize in vitro the effect of autologous cartilage micrografts on chondrocyte viability and differentiation and perform an evaluation of their application in racehorses affected by joint diseases.

MATERIALS AND METHODS

Matched human chondrocytes and micrografts were obtained from articular cartilage using Rigenera® procedure. Chondrocytes were cultured in the presence or absence of micrografts and chondrogenic medium to assess cell viability and cell differentiation. For the pre-clinical evaluation, three racehorses affected by joint diseases were treated with a suspension of autologous micrografts and PRP in arthroscopy interventions. Clinical and radiographic follow-ups were performed up to 4 months after the procedure.

RESULTS

Autologous micrografts support the formation of chondrogenic micromasses thanks to their content of matrix and growth factors, such as transforming growth factor β (TGFβ) and insulin-like growth factor 1 (IGF-1). On the other hand, no significant differences were observed on the gene expression of type II collagen, aggrecan, and SOX9. Preliminary data in the treatment of racehorses are suggestive of a potential in vivo use of micrografts to treat cartilage lesions.

CONCLUSION

The results reported in this study showed the role of articular micrografts in the promoting chondrocyte differentiation suggesting their potential use in the clinical practice to treat articular lesions.

摘要

背景

软骨损伤的管理在临床实践中仍是一个未解决的问题,再生医学是一种有前景的方法,包括使用自体微移植,其疗效已在不同临床环境中得到验证。本研究的目的是在体外表征自体软骨微移植对软骨细胞活力和分化的影响,并评估其在受关节疾病影响的赛马中的应用。

材料与方法

使用Rigenera®程序从关节软骨中获取匹配的人软骨细胞和微移植。在有或无微移植及软骨形成培养基的情况下培养软骨细胞,以评估细胞活力和细胞分化。对于临床前评估,在关节镜干预中,用自体微移植和富血小板血浆(PRP)的悬浮液治疗3匹受关节疾病影响的赛马。术后进行长达4个月的临床和影像学随访。

结果

自体微移植由于其基质和生长因子(如转化生长因子β(TGFβ)和胰岛素样生长因子1(IGF-1))的含量,支持软骨形成微团的形成。另一方面,在II型胶原蛋白、聚集蛋白聚糖和SOX9的基因表达上未观察到显著差异。在赛马治疗中的初步数据表明微移植在体内治疗软骨损伤方面具有潜力。

结论

本研究报告的结果显示了关节微移植在促进软骨细胞分化中的作用,表明其在临床实践中治疗关节损伤的潜在用途。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a23/6218996/9eb8ba377d0e/13018_2018_983_Fig1_HTML.jpg

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